ABSTRACT
OBJECTIVE: In Korea, approximately 600 thousand artificial abortions are done officially during the course of a year, and dilatation and curettage is commonly used as a method for selective abortion. In addition, because of the increasing use of hormone replacement therapy for treating postmenopausal syndrome and for the diagnostic purposes for postmenopausal bleeding, the importance of dilatation and curettage is emphasized more and more. Our objective was to verify the effects of delayed time between paracervical block and the procedure of dilatation and curettage on pain and patient satisfaction. METHODS: 92 women who underwent dilatation and curettage were picked and divided into 2 groups randomly. In group A there was no transit delay time between paracervical block and the procedure, and in group B, there was 5 minutes delay time. We used the VAS (Visual Analogue Scale) to measure numerical value of pain and patient satisfaction during uterine cervical dilatation, the actual procedure of curettage, and 30-45 minutes after the procedure. RESULTS: There was no statistically meaningful difference on the pain value and patient satisfaction between group A and group B measured during uterine cervix dilatation, curettage, and 30-45 minutes after the procedure. CONCLUSION: The transit delay time between paracervial anesthesia and dilatation and curettage had no specific effects on the pain or patient satisfaction of the procedure. Therefore, the main role of paracervical anesthesia is not to block the peripheral nerve, but instead to dilatate the tissue mechanically.
Subject(s)
Female , Humans , Pregnancy , Abortion, Eugenic , Anesthesia , Anesthesia, Obstetrical , Cervix Uteri , Curettage , Dilatation and Curettage , Dilatation , Hemorrhage , Hormone Replacement Therapy , Korea , Labor Stage, First , Patient Satisfaction , Peripheral NervesABSTRACT
Arteriovenous malformation of the pelvic organ is a very rare cause of massive uterine bleeding. But, it is important to consider in the assessment of a patient with abnormal uterine bleeding because accurate diagnosis can allow appropriate treatment to be planned and avoid hysterectomy in women who wish to retain their reproductive capacity. This malformation may be congenital or acquired. In the past, the diagnosis is usually made retrospecively after hysterectomy, however, recently it may be made before management by ultrasound, doppler ultrasound, pelvic angiography, magnetic resonance imaging, etc. We have experienced two cases of arteriovenous malformation of the uterus, which is presented with a brief review of the literatures.
Subject(s)
Female , Humans , Arteriovenous Malformations , Diagnosis , Hysterectomy , Magnetic Resonance Angiography , Ultrasonography , Uterine Hemorrhage , UterusABSTRACT
Mature cystic teratoma of the ovary is the most common ovarian germ cell tumor and almost benign, but malignant transformation occurs in less than 2% of benign mature teratoma. Of the malignancies arising in teratomas, squamous cell carcinoma is the most common (70-80%). The presentation in stage I disease dose not differ from that of benign cystic teratoma. In the early stage, the treatment is possible through surgical intervention alone. We experienced a case of squamous cell carcinoma of the ovary arising in mature cystic teratoma, which is presented with a brief review of literature.
Subject(s)
Female , Carcinoma, Squamous Cell , Neoplasms, Germ Cell and Embryonal , Ovary , TeratomaABSTRACT
OBJECTIVES: Arteriovenous fistula (AVF) is Achilles hill of patients receiving maintenance hemodialysis, but thrombosis of AVF is a frequently encountered problem in maintenance hemodialysis patients. AVF thrombosis or occlusion is known to be associated with old age, underlying diabetes mellitus, increased fibrinogen and factor VIII, short AVF maturation time, low dialyzer blood flow, etc. Recently, several reports suggested that high titer of IgG anticardiolipin antibody (IgG-ACA) is associated with single or repeated clotting of AVF and elevated Lp(a) level is associated with vascular access occlusion in patients under maintenance hemodialysis. This study is to investigate the relationship between AVF thrombosis and the presence of elevated titiers of LP(a) and IgG-ACA. METHODS: This study included 20 patients with end stage renal disease under hemodialysis via AVF. Ten subjects have had one or more episodes of AVF obstruction (group A). Another 10 subjects without episodes of AVF obstruction (group B) were selected matching with age, sex, underlying disease, duration of hemodialysis, blood glucose level and lipid profile of subjects in group A. The IgG, IgM anticardiolipin antibody titers with indirect ELISA method and LP(a) level with turbidimetric assay were measured and analysed. RESULTS: Four subjects in group A showed positive IgG-ACA titer what of all subjects in group B were negative titer (p=0.03). Only one subject in group A and two subjects in group B showed positive IgM-ACA titer (p>0.05). The median value of Lp(a) was 32.75 (mg/dl), 43.1 (mg/dl) in group A and group B respectively and was not significantly different each other (p>0.05). CONCLUSIONS: In end stage renal patients receiving hemodialysis, positive IgG-ACA titier seems to be an independent risk factor of AVF thrombosis.