HIFU: Effects and Clinical Effectiveness of Non-surgical Therapy for Uterine Fibroids

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Erratum to: HIFU: Effects and Clinical Effectiveness of Non-surgical Therapy for Uterine Fibroids

Author's list and affiliation correction.

Clinical efficacy of laparoscopic myomectomy for 110 cases of various sized myomas / 대한산부인과학회지

OBJECTIVE: To assess the feasibility and clinical efficacy of laparoscopic myomectomy (LM). METHODS: We analyzed retrospectively the data for 110 LM preformed at Kangbuk Samsung Hospital between July 2003 and July 2006. We reviewed their clinical charts and the operative and anesthetic records, and analyzed data on the patients' age, parity, previous operative history, preoperative indication, the diameter of the largest myoma, operating time, number of the removed myoma, hospital stay, change of the hemoglobin concentration from preoperative to postoperative day 1, concomitant procedures, histopathological reports, and complications. RESULTS: The mean age of the patients was 35.7+/-5.8 years, the mean parity was 0.8+/-0.9, and 26 (23%) patients had a previous operative history. The most common operative indication was a palpable abdominal mass (46 patients, 41.9%), followed by chronic pelvic pain (32 patients, 29.0%), abnormal uterine bleeding (24 patients, 21.8%), urinary frequency (7 patients, 6.4%), and infertility (1 patient, 0.9%). The mean operating time was 82.9+/-30.8 minutes, and the mean diameter of the largest myoma was 7.1+/-2.3 cm. The heaviest of the removed myoma weighed 795 gm. The mean change of the hemoglobin concentration was 2.2+/-1.1 g/dL, and the mean hospital stay was 3.5+/-1.4 days. Postoperatively, transfusions were done 10% (11 cases) of patients, and 2 cases of paralytic ileus and a case of subcutaneous emphysema were noted. Conversion rate to laparotomy was 0.9% (1 case). CONCLUSION: LM for various sized myomas can be performed successfully and effectively by decreasing laparoconversion, if the surgical team and the laparoscopic surgeon are experienced and enhanced equipment is available.

Laparoscopic Myomectomy for Large Myomas

The aim of this study was to assess the feasibility and efficacy of laparoscopic myomectomy (LM) for large myomas. A subpopulation of 51 patients with myomas 8 cm or larger in diameter was selected from 155 patients who underwent LM at Kangbuk Samsung Hospital from July 2003 to November 2006. The mean age of the patients was 34.9+/-5.6 yr, mean parity was 0.6+/-0.9, and 8 patients had a previous operative history. The most common operative indication was a palpable abdominal mass (24 patients, 47%). The mean operating time was 85.6+/-38.9 min, and the mean diameter of the largest myoma was 9.3+/-1.8 cm. The mean change in hemoglobin concentration was 2.1+/-1.2 g/dL. Histopathological diagnosis included 49 patients of leiomyoma (96.1%) and 2 patients of leiomyoma with adenomyosis (3.9%). Postoperatively, a transfusion was done in 7 patients, and a case of subcutaneous emphysema was noted. None of the operations was switched to laparotomy. With the newly-developed screw and the port placement system that was modified from the Choi's 4-trocar method to obtain better surgical vision, LM of large myomas proved to be one of the efficient and feasible methods.

Human chorionic gonadotropin and invasion of trophoblast into the tubal wall in tubal pregnancy / 대한산부인과학회지

OBJECTIVE: To evaluate the relationship between gestational age, tubal ultrasonographic diameter, and serum beta-hCG levels and different stages of trophoblastic infiltration of the tubal wall in tubal pregnancy. METHODS: The 45 cases of fallopian tube containing tubal pregnancy were reviewed. Gestational age, diameter of the tubal mass, and beta-hCG level on the day of surgery were calculated by transvaginal sonography and immunoassay respectively. The tubal pregnancy was classified according to the depth of trophoblastic infiltration: trophoblast limited to the tubal mucosa (stage I), extension to the tubal muscularis (stage II), or complete tubal wall infiltration up to the serosa discontinued by trophoblastic cells (stage III). RESULTS: 14 patients (31.1%) had stage I tubal infiltration, 10 patients (22.2%) had stage II infiltration, 21 patients (46.7%) had stage III infiltration. There was no relationship between gestational age, tubal diameter and stage, but there was a predictable correlation between beta-hCG and the depth of trophoblastic invasion. The median beta-hCG level was 1,332.1 mIU/mL (range, 215-2,995 mIU/mL) for patients with stage I infiltration, 9,548.0 mIU/mL (range, 569-43,989 mIU/mL) for stage II infiltration, and 23,087.9 mIU/mL (range, 1,373-98,000 mIU/mL) for stage III infiltration. Cut off level of beta-hCG for each stage were 1,996.5 mIU/mL (stage I vs II, III) and 5,665 mIU/mL (stage I, II vs III) respectively. CONCLUSION: These findings may explain why beta-hCG is a important predicting factor for invasion of trophoblast in tubal pregnancy.

Identification of High Risk Group of HPV associated with Cervical Cancer in Korean Women / 대한산부인과학회잡지

OBJECTIVE: To identify genital HPV types and high risk group of HPV associated with cervical cancer in Korean women. METHODS: Both Pap test and HPV-DNA test using PCR assay were performed as screening test for cervical cancer in this clinic. When patients were positive in HPV-DNA test, HPV genotyping using sequencing method and cervical biopsy were performed. RESULTS: Frequent age group of HPV infection was 40 yrs (34.3%) and prevalence of HPV infection was 9.8%. Twenty-three types of HPV were detected. HPV 16 and 58 were detected in invasive cancer. HPV 16, 31, 33, 45, and 58 were detected in HSIL. HPV 6, 11, 18, 53, 59, and 66 were detected in LSIL. HPV 16 was most commonly detected in HSIL and invasive cancer. CONCLUSION: HPV 16, 31, 33, 45, and 58 are included in high risk group of HPV in Korean women. It may be very effective in early detection of cervical cancer to classify HPV types included in high risk group of cervical cancer in Korean women and to perform cervical biopsy in the patients who have high risk types of HPV infection.

Identification of High Risk Group of HPV associated with Cervical Cancer in Korean Women / 대한산부인과학회잡지

OBJECTIVE: To identify genital HPV types and high risk group of HPV associated with cervical cancer in Korean women. METHODS: Both Pap test and HPV-DNA test using PCR assay were performed as screening test for cervical cancer in this clinic. When patients were positive in HPV-DNA test, HPV genotyping using sequencing method and cervical biopsy were performed. RESULTS: Frequent age group of HPV infection was 40 yrs (34.3%) and prevalence of HPV infection was 9.8%. Twenty-three types of HPV were detected. HPV 16 and 58 were detected in invasive cancer. HPV 16, 31, 33, 45, and 58 were detected in HSIL. HPV 6, 11, 18, 53, 59, and 66 were detected in LSIL. HPV 16 was most commonly detected in HSIL and invasive cancer. CONCLUSION: HPV 16, 31, 33, 45, and 58 are included in high risk group of HPV in Korean women. It may be very effective in early detection of cervical cancer to classify HPV types included in high risk group of cervical cancer in Korean women and to perform cervical biopsy in the patients who have high risk types of HPV infection.