The Effect of intraperitoneal instillation of Mistletoe extract during the diagnostic laparoscopy for pain of endometriosis / 대한산부인과학회지

OBJECTIVE: Immune alternation is related to the pathogenesis and progression of endometriosis. Helixor-A, mistletoe extract, has been known that it has immune modulation effect. Therefore the purpose of this study is to determine the effects of Helixor-A for pain of endometriosis by intraperitoneal instillation of mistletoe extract during the diagnostic laparoscopy. METHODS: Among the paitients who visited to outpatient clinic due to chronic pelvic pain, 30 patients who had laparoscopically-confirmed endometriosis were included in this study. Helixor-A 5 mg was instilled into the posterior cul-de-sac during the diagnostic laparoscopy. Before diagnostic laparoscopy and one month after laparoscopy, the patients recorded pain scores. RESULTS: In 11 of 30 patients (36.7%), pelvic pain of endometriosis improved after laparoscopy. In 2 of 30 patients, the side-effect of Helixor- A appeared and they were easily controlled by antihistamines. CONCLUSION: The instillation of Helixor-A during diagnostic laparoscopy, that is essential for confirmation of endometriosis, may be helpful as a supportive treatment for treatment of pelvic pain due to endometriosis with classical treatment such as GnRH agonist therapy.

Surgical treatment of ovarian dermoid cysts: a clinical evaluation between vaginal and laparoscopic removal / 대한산부인과학회지

OBJECTIVE: This study was conducted to compare the results between vaginal and laparoscopic removal for surgical treatment of ovarian dermoid cysts. METHODS: This retrospective study was performed in 228 patients, who underwent vaginal (Group A: 159) or laparoscopic (Group B: 69) removal of ovarian dermoid cysts between January 1998 and May 2004. The vaginal removal was performed after reduction of mass size by suction of its contents, and laparoscopic removals with Lapbag(R). RESULTS: The mean age was 37.7 +/- 9.7 years in Group A and 30.5 +/- 9.2 years in Group B. The number of patients had a previous abdominal open surgery was 30 (17.8%) in Group A and 15 (21.7%) in Group B. The mean diameter of the ovarian dermoid cysts was 6.1 +/- 2.1 cm in Group A and 5.7 +/- 2.0 cm in Group B. The differences between preoperative and postoperative hemoglobin was 1.8 +/- 1.4 g/dL in Group A and 1.5 +/- 0.8 g/dL in Group B (p<0.05). Operating time was 34 +/- 16 minutes in Group A and 82 +/- 36 minutes in Group B (p<0.01). The number of patients had febrile morbidity (greater than 38 degrees C 24h after surgery) was 3 (1.7%) in Group A and 2 (2.8%) in Group B. The feeling of satisfaction was very high in both groups. CONCLUSION: Both vaginal and laparoscopic removal of ovarian dermoid cysts are useful and effective treatment. However, the vaginal removal have cheap hospital expenses, shorter operating time, and no surgical trauma on abdominal wall. So, it have great advantages compare with laparoscopic removal. Vaginal removal can be considered a useful alternative procedure.

The Effect of subcutaneous injection of Mistletoe extract for the treatment of chronic pelvic pain / 대한산부인과학회지

OBJECTIVE: Chronic pelvic pain is pelvic pain which is not completely controlled by classical treatments. In many reports, immune alternation is related to original diseases that induce the chronic pelvic pain. Mistletoe extract has been known that it has immune modulation effect. Therefore the purpose of this study is to determine the pain-reducing effects of mistletoe extract for chronic pelvic pain that is not controlled by classical treatments. METHODS: The fitty-eight patients who visited to outpatient department of Department of Obstetrics and Gynecology, Chonnam National University Hospital due to chronic pelvic pain. Mistletoe extract (Helixor-A(R)) 5-10 mg was injected subcutaneously 3 times per week for 5 weeks, and the change of pain and short-term side-effects after injections were observed. In patients after 6 month of follow-up, the change of pain and long-term side-effects were also observed. RESULTS: In 2 of 58 patients (0.03%), treatments were discontinued doe to severe general side effect. In 48 of 56 patients (85.7%), chronic pelvic pains were improved. In 40 of 56 patients (69%), mild side effects as like mild itching were appeared and they were easily controlled by anti-histamines and conservative treatments. In 6 months after injection, general itching sensation and easily catched common cold were complaint in 4 of 10 patients. CONCLUSION: The subcutaneous injection of mistletoe extract may effective treatment method for the chronic pelvic pain that is not controlled by classical treatment. However more studies about log-term effect of mistletoe therapy are needed.

Primary Melanoma of the Anorectum Report of Three Cases

Primary melanoma of anorectum is a very rare, aggressive tumor with a reported 5-year survival rate of 6%. Over 90% of all anorectal melanomas arise at the dentate line, but primary lesions well above this line in the rectum or rectosigmoid have been reported. Surgical treatments of this virulent tumor have ranged from conservative approach, such as wide local excision to abdominoperineal resection (APR) with or without bilateral inguinal lymphadenectomy. When wide local excision was compared to APR in terms of survival, no significant difference was noted. However, five-year survivors had 2 mm thin lesion, and underwent radical surgery. We have experienced three cases of primary anorectal melanoma, two of which underwent radical surgery and survived 20 months and 6 months respectively. One patient had wide local excision, and survived 5 months. One of the three patient had von Recklinghausen disease with caf -au-lait spots and primary melanoma, which is probably one of the first reported case in the literature.

Topographic Measurements of the Optic Nerve Head with Confocal Scanning Laser Tomography in Normal Koreans

In glaucoma, we need an accurate, highly reproducible analysis method for the purpose of early detection of fine glaucomatous optic nerve head change. Nowadays many investigations using confocal laser tomographic scanner (Heidelberg Retinal Tomograph ; HRT) are actively undertaken. We analyzed the optic nerve head of 479 normal eyes(male:308, female:171) with HRT, and got the mean value of each parameter in HRT. We compared the difference between men and women. We also observed the distribution of the value of each parameter in normal adult. In addition, for the parameter of rim/disc area ratio, we got the mean value in 6 divisions of optic nerve head. The range of distribution of disc area was from 1.139 mm2 to 4.512 mm2, cup area ranged from 0.104 mm2 to 2.667 mm2, and rim area was from 0.760 mm2 to 2.925 mm2. The parameter which showed difference between men and women was height variation contour. For rim/disc area ratio, the mean value of each 6 divisions were as follows: nasal inferior, 0.909; nasal, 0.908; nasal superior, 0.860; temporal inferior, 0.763; temporal 0.519; temporal superior 0.738. We can make good use of the normal parameters of HRT in Koreans for diagnosis and treatment of glaucoma.