Influence of progestrone receptor and vascularity in leiomyoma to the growth and clinical symptoms / 대한산부인과학회지

OBJECTIVE: Myoma is the most frequent benign tumor in women's pelvic cavity. Myoma causes a lot of symptoms that degrade the life quality of the patients. If the patient with leiomyoma does not require the treatment, regular follow-up is recommended. However, there is no definite method to predict the clinical outcome of leiomyoma patients. So we evaluate if the hormone receptors and vascular viability can predict the clinical outcomes in leiomyoma patients. METHODS: We perform the leiomyoma biopsy and ultrasonogram in leiomyoma patients who are symptomatic, premenopaused, and unnecessary to receive treatment. The patients were grouped into two as the results of progesterone receptor status of leiomyoma ; strong positive (> or = 75% positive to progesterone receptor), trace and negative (<25% positive to progesterone receptor). Also, we evaluates the vascular state and the resistance index (RI) of feeding arteries of myoma with doppler ultrasonogram. The severities of clinical symptoms are interpreted by using Uterine fibroid symptom and health-related quality of life questionnaire (UFS-QOL). RESULTS: After 8 months, the strong positive group shows the greater increasement of myoma volume than the trace and negative group. Also, the patient's symptoms and scores of life-quality decrease in strong positive group. In contrast, the trace and negative group show the improvement in clinical symptoms and life-quality. CONCLUSION: As a result, we concluded the status of hormonal receptor and feeding arteries can predict the clinical change of leiomyoma.

Magnetic resonance imaging in the evaluation of uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis: a case report / 대한산부인과학회지

Uterus didelphys with unilateral obstructed hemivagina is indeed a very rare congenital anomaly. Uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis usually presents after menarche with progressive abdominal pain during menses secondary to hematocolpos. The method of choice for diagnosis is magnetic resonance imaging (MRI). MRI can do much for the early diagnosis and the prevention against further complications of this condition because it can demonstrate the mullerian duct anomaly complicated with obstructed hemivagina in detail and even ipsilateral renal agenesis. A greater awareness of the syndrome of uterus didelphys, obstructed hemivagina, and ipsilateral renal agenesis should lead to its prompt diagnosis, allowing for early and appropriate surgical intervention as well as decreased long-term morbidity. Early accurate diagnosis after menarche followed by excision and marsupialization of the blind hemivagina offers complete relief of symptoms and preserves reproductive potential. We report a case of uterine didelphys with obstructed hemivagina and ipsilateral renal agensis with a brief review of the literature.

Radiofrequency myolysis: New conservative management of myoma / 대한산부인과학회지

OBJECTIVE: To evaluate the clinical efficacy of radiofrequency myolysis which is new developed uterine preserving management of myoma. METHODS: 17 patinets (27 myomas) who done radiofrequency myolysis between Oct. 2004-Dec. 2004 were participated this study. Preoperatively, Hemoglobin and subjective symptoms were checked and size of myoma was checked using ultrasonogram or computed tomogram (CT). Radiofrequency was applied to myoma for 10 to 40 minutes per one. Follow up sonogram or CT were done 7 days, 1 month, 2 month and 3 month after myolysis. RESULTS: Average age of patients was 42.7+/-8.6 (yr) and average size of myoma was 4.9+/-2.3 cm. We followed 27 nodules. After 3 months, reduction of volume was observed 65%, from 30% to 94%. 3 nodule, which was followed only 2 months, reduced by 46%. About subjective symptoms, 80% reduction was reported after 3 months (50-100%). Menorrhagia reduced 91% in average and pressure symptoms reduced 71% in average. No severe complication like bowel injury, bladder injury, infection and pulomonary embolism was not observed. Serious vaginal bleeding was reported for 3 patients, and their hemoglobin decreased from 10.8 mg/dL preoperatively to 8.7 mg/dL postopertively. CONCLUSION: Radiofrequency myolysis decreased myoma 65% in average. No serious complication were reported.

Effect of weight loss on health related quality of life in obese patients

BACKGROUND: Weight loss in obese patients has been shown to decrease plasma lipid level and high blood pressure, to improved glycemic control in diabetic patients and to decrease cardiovascular risk in obese patients. But, study for association of weight loss and Health related Quality of Life is not well known yet worldwide. This study was to determine whether weight loss would associate with improvements on Health Related Quality of Life. METHODS: Participants was recruited in 48 obese patient visiting obesity clinic of Family Medicine of Sungkyunkwan University Hospital. 27 patients who answered mailed questionnaire was analyzed. Health Related quality of life was measured by Catholic Medical Center Health Survey(CMCHS) V 1.0. Questionnaire included not only Health Related Quality of Life but also alcohol habit, excercise, smoking, marital status, economic status, education. RESULTS: In multiple regression analysis, weight loss is statistically significant differences on satisfaction, vitality, physical function, social function, role limitation general health dimensions of CMCHS. CONCLUSION: The Results of this study demonstrate that weight loss on obese patients may be associated with an improvement in Health Related Quality of Life.