Effects of the GnRH agonist therapy before laparoscopic myomectomy / 대한산부인과학회지

OBJECTIVE: The aim of this study was to evaluate the effectiveness of GnRH agonist therapy prior to the planned myomectomy for the women who want to preserve their fertility. METHODS: We reviewed 20 patients who had GnRH agonist therapy prior to the planned myomectomy from October 2003 to September 2004. RESULTS: Mean age of the patients was 37.8+/-4.5 y and nulliparous women were 7 (35%) among 20. Average 3.05 (range 1-4) times of GnRH agonist injection was done prior to a surgery. Indications of myomectomy were menorrhagia (13/20, 65%), dysmenorrhea (7/20, 35%), and palpable pelvic mass (6/20, 30%). Average of the longest diameter of the largest myoma was 79.8 mm at first visit ultrasonography, and reduced to 60.8 mm after the completion of GnRH agonist treatment. This means that average 55.8% of volume reduction was achieved by GnRH agonist. Among 20 patients, 18 (90%) had laparoscopic myomectomy and 2 (10%) had laparotomy. Of the 2 patients who had laparotomy, one had severe adhesion caused by prior pelvic surgery and another had very large myoma which was refractory to the GnRH agonist therapy. The global mean operative time was 125+/-51 min. Average hemoglobin drop after operation was 1.6 g/dL and no patient had transfusion. Total hospital stay was 3.9+/-1.1 days for patients who had laparoscopic myomectomy and 8.5+/-2.1 days for patients who had laparotomy. CONCLUSION: The use of GnRH agonist prior to the planned myomectomy was effective in reducing myoma volume and it enables surgeons to choose less invasive surgical approach.

A Case of Ethmoid Mucocele

Mucocele is a chronic, expansile, cyst-like lesion of the paranasaI sinuses. They contain sterile mucoid material and are lined by mucosa of the affected cavity. Mucocele develops when drainage of normal sinus secretion is obstructed usually by scarring, inflammation, trauma, and tumor. Most of the mucocele are found in the frontal sinus and anterior ethmoid sinus. They may present ophthalmic manifestations such as exophthalmos, displacement of the eye, and limitation of eyeball movement. We experienced a case of left ethmoid mucocele in a 48-year old man. Histologic examination confirmed the mass to be mucocele of the ethmoid Sinus.

The Significance of Clinical Symptoms in Dry Eye Patients and Statistical Analysis of the Patiants

From April 1 to July 30, 1989, we studied 188 subjects(male 25, female 163) with suspected dry eye based on their clinical symptoms and their response to conventional treatment with artificial tear. Schirmer Test and Tear break-up time measurement(B.U.T.) were performed on each patient. There have been many reports that Schirmer test and B.U.T. measurement can be influenced by many enviromental factors and testing methods so the question of their relative value has not yet been sloved. the purpose of this study was to evaluate the importance of clinical symptoms and signs in diagnosing dry eye. Demographic aspect of dry eye patients in Korea was also analysed. The results were as follows: 1. The sex distribution was 163 females(87%) and 25 males(13%). There were absolutely more females than males. 2. The ages ranged from 15 to 83 years old. The peak age was from 41 to 50 years(29%). 3. Among 163 female patients, the majority 103(63%) were menopausal and postmenopausal females. 4. Among major chief clinical complaints, foreign body sensation showed the highest frequency with 67 patients(35%). 5. Major aggravating factor of the disese was prolonged use of eye which showed highest frequency with 122 patients(65%). 6. There were no statistically significant differences in the mean value of BU.T. and Schirmer test between right left eye(p<0.05). 7. In the majority of the cases 153(82%) the B.U.T. and Schirmer test value were 8 sec and 8mm or below respectively.