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Sample records for benign gynecological diseases

  1. Serum vascular endothelial growth factor and adiponectin levels in patients with benign and malignant gynecological diseases.

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    Lasalandra, Carla; Coviello, Maria; Falco, Gaetano; Divella, Rosa; Trojano, Giuseppe; Laterza, Anna Maria; Quero, Carmela; Pepe, Vito; Zito, Francesco Alfredo; Quaranta, Michele

    2010-05-01

    One of the most specific and critical regulators of angiogenesis is vascular endothelial growth factor (VEGF), which regulates endothelial proliferation, permeability, and survival. Vascular endothelial growth factor is an angiogenic mediator in tumors and has been implicated in the pathogenesis and progression of cancer. Adipose tissue is a major endocrine and it secretes hormones termed adipokines. These factors are derived from adipocytes and include proteins and metabolites such as adiponectin. Recently, adiponectin was also shown to modulate angiogenesis. This study was designed to determine the serum VEGF and adiponectin levels in patients with benign and malignant gynecological diseases and if there was a correlation between serum VEGF and adiponectin. Serum samples, collected fasting before surgery or intervention, were available for total of 114 female patients recorded between October 2006 and December 2008. Diagnosis of benign and malignant gynaecological diseases was established by biopsy. Serum levels VEGF and adiponectin were using commercially available enzyme linked immunosorbent assay (R&D Systems Inc, Minneapolis, MN), respectively. Statistical analysis was performed by using the SPSS 9.0 software package (SPSS, Inc, Chicago, IL). The correlation between serum VEGF and serum Adiponectin was calculated using the Pearson correlation coefficient. P values of benign and malignant gynecological diseases of the patient. Only for serum VEGF levels was a significant difference observed (P = 0.004) between patients with benign and malignant gynecological diseases. A significantly inverse correlation between serum VEGF and adiponectin levels among patients with benign and malignant gynecological diseases was found. Adiponectin level is not correlated with body mass index. This is one of the first report on adiponectin in benign and malignant gynecological diseases. Future studies are needed to address the clinical potential role of adiponectin in cancer.

  2. Subsequent Oophorectomy and Ovarian Cancer after Hysterectomy for Benign Gynecologic Conditions at Chiang Mai University Hospital.

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    Jitkunnatumkul, Aurapin; Tantipalakorn, Charuwan; Charoenkwan, Kittipat; Srisomboon, Jatupol

    2016-01-01

    This study was undertaken to determine the incidence of subsequent oophorectomy due to ovarian pathology or ovarian cancer in women with prior hysterectomy for benign gynecologic conditions at Chiang Mai University Hospital. Medical records of women who underwent hysterectomy for benign gynecologic diseases and pre-cancerous lesions between January 1, 2004 and December 31, 2013 at Chiang Mai University Hospital were retrospectively reviewed. The incidence and indications of oophorectomy following hysterectomy were analyzed. During the study period, 1,035 women had hysterectomy for benign gynecologic conditions. Of these, 590 women underwent hysterectomy with bilateral salpingo-oophorectomy and 445 hysterectomy with bilateral ovarian preservation or unilateral salpingo-oophorectomy. The median age was 47 years (range, 11-75 years). Ten women (2.45 %) had subsequent oophorectomy for benign ovarian cysts. No case of ovarian cancer was found. The mean time interval between hysterectomy and subsequent oophorectomy was 43.1 months (range, 2-97 months) and the mean follow-up time for this patient cohort was 51 months (range, 1.3-124.9 months). According to our hospital-based data, the incidence of subsequent oophorectomy in women with prior hysterectomy for benign gynecologic conditions is low and all present with benign conditions.

  3. Solo surgeon single-port laparoscopic surgery with a homemade laparoscope-anchored instrument system in benign gynecologic diseases.

    Science.gov (United States)

    Yang, Yun Seok; Kim, Seung Hyun; Jin, Chan Hee; Oh, Kwoan Young; Hur, Myung Haeng; Kim, Soo Young; Yim, Hyun Soon

    2014-01-01

    The objective of this study was to present the initial operative experience of solo surgeon single-port laparoscopic surgery (SPLS) in the laparoscopic treatment of benign gynecologic diseases and to investigate its feasibility and surgical outcomes. Using a novel homemade laparoscope-anchored instrument system that consisted of a laparoscopic instrument attached to a laparoscope and a glove-wound retractor umbilical port, we performed solo surgeon SPLS in 13 patients between March 2011 and June 2012. Intraoperative complications and postoperative surgical outcomes were determined. The primary operative procedures performed were unilateral salpingo-oophorectomy (n = 5), unilateral salpingectomy (n = 2), adhesiolysis (n = 1), and laparoscopically assisted vaginal hysterectomy (n = 5). Additional surgical procedures included additional adhesiolysis (n = 4) and ovarian drilling (n = 1).The primary indications for surgery were benign ovarian tumors (n = 5), ectopic pregnancy (n = 2), pelvic adhesion (infertility) (n = 1), and benign uterine tumors (n = 5). Solo surgeon SPLS was successfully accomplished in all procedures without a laparoscopic assistant. There were no intraoperative or postoperative complications. Our laparoscope-anchored instrument system obviates the need for an additional laparoscopic assistant and enables SPLS to be performed by a solo surgeon. The findings show that with our system, solo surgeon SPLS is a feasible and safe alternative technique for the treatment of benign gynecologic diseases in properly selected patients. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

  4. Readmission After Gynecologic Surgery: A Comparison of Procedures for Benign and Malignant Indications.

    Science.gov (United States)

    Cory, Lori; Latif, Nawar; Brensinger, Colleen; Zhang, Xiaochen; Giuntoli, Robert L; Burger, Robert A; Morgan, Mark; Ko, Emily

    2017-08-01

    To compare 30-day postsurgical readmission rates and associated risk factors for readmission among women undergoing gynecologic surgery for benign and malignant conditions. In a retrospective cohort study, we identified patients after surgery for benign and malignant gynecologic conditions in the National Surgical Quality Improvement Program database between January 1, 2011, and December 31, 2012. Data collected included surgical factors, perioperative characteristics, surgical complications, and 30-day readmissions. The primary study outcome was readmission rates after gynecologic surgery for benign and oncologic conditions. Secondary study outcomes were risk factors associated with readmission among gynecologic surgeries performed for benign and oncologic conditions. Approximately 3% (1,444/46,718) compared with 8.2% (623/7,641) of patients who underwent gynecologic surgery for benign and malignant indications, respectively, were readmitted (P<.01). Compared with patients with benign surgical indications, those with uterine cancer (readmission rate 6.6%; odds ratio [OR] 2.21, 95% CI 1.95-2.51), ovarian cancer (readmission rate 10.9%; OR 3.82, 95% CI 3.29-4.45), and cervical cancer (readmission rate 10.1%; OR 3.51, 95% CI 2.71-4.53) were more likely to be readmitted. In multivariable models, independent risk factors for readmission for gynecologic cancer surgery included worse preoperative conditions (OR 1.49, 95% CI 1.17-1.90) and major complications (OR 17.84, 95% CI 14.19-22.43). In comparison, independent risk factors for readmission after surgery for benign indications included comorbid conditions (OR 1.36, 95% CI 1.18-1.57), operative time (15-59 minutes: referent; 60 minutes or greater: 1.37, 95% CI 1.14-1.63) and major complications (OR 53.91, 95% CI 46.98-61.85). Among gynecologic surgeries, those performed for oncologic indications were associated with readmission rates 2.8 times that of surgeries performed for benign indications. In adjusted models

  5. Advantages of robotics in benign gynecologic surgery.

    Science.gov (United States)

    Truong, Mireille; Kim, Jin Hee; Scheib, Stacey; Patzkowsky, Kristin

    2016-08-01

    The purpose of this article is to review the literature and discuss the advantages of robotics in benign gynecologic surgery. Minimally invasive surgery has become the preferred route over abdominal surgery. The laparoscopic or robotic approach is recommended when vaginal surgery is not feasible. Thus far, robotic gynecologic surgery data have demonstrated feasibility, safety, and equivalent clinical outcomes in comparison with laparoscopy and better clinical outcomes compared with laparotomy. Robotics was developed to overcome challenges of laparoscopy and has led to technological advantages such as improved ergonomics, visualization with three-dimensional capabilities, dexterity and range of motion with instrument articulation, and tremor filtration. To date, applications of robotics in benign gynecology include hysterectomy, myomectomy, endometriosis surgery, sacrocolpopexy, adnexal surgery, tubal reanastomosis, and cerclage. Though further data are needed, robotics may provide additional benefits over other approaches in the obese patient population and in higher complexity cases. Challenges that arose in the earlier adoption stage such as the steep learning curve, costs, and operative times are becoming more optimized with greater experience, with implementation of robotics in high-volume centers and with improved training of surgeons and robotic teams. Robotic laparoendoscopic single-site surgery, albeit still in its infancy where technical advantages compared with laparoscopic single-site surgery are still unclear, may provide a cost-reducing option compared with multiport robotics. The cost may even approach that of laparoscopy while still conferring similar perioperative outcomes. Advances in robotic technology such as the single-site platform and telesurgery, have the potential to revolutionize the field of minimally invasive gynecologic surgery. Higher quality evidence is needed to determine the advantages and disadvantages of robotic surgery in benign

  6. Association of nursing-documented ambulation with length of stay following total laparoscopic hysterectomy for benign gynecologic disease

    OpenAIRE

    Kim, Kidong; Yoo, Sooyoung; Yang, Eun Joo; No, Jae Hong; Hwang, Hee; Kim, Yong-Beom

    2013-01-01

    Objective The objective was to examine the association of postoperative physical activity with length of stay in patients who received total laparoscopic hysterectomy for benign gynecologic disease. Methods The case group was composed of 70 patients who entered a critical pathway for elective total laparoscopic hysterectomy from 2009 to 2012 and were discharged behind schedule. The control group was selected from patients who were discharged on schedule, and matched to cases using 1:3 ratio p...

  7. Opportunistic bilateral salpingectomy during benign gynecological surgery for ovarian cancer prevention: a survey of Gynecologic Oncology Committee of Japan Society of Obstetrics and Gynecology.

    Science.gov (United States)

    Mikami, Mikio; Nagase, Satoru; Yamagami, Wataru; Ushijma, Kimio; Tashiro, Hironori; Katabuchi, Hidetaka

    2017-07-01

    Recent evidence has supported the concept that epithelial ovarian cancer (EOC) arises from the cells of the fallopian tube or endometrium. This study investigated current practice in Japan with respect to performing opportunistic bilateral salpingectomy (OBS) during gynecological surgery for benign disease for Ovarian Cancer Prevention. We mailed a questionnaire to 767 hospitals and clinics, comprising 628 accredited training institutions of the Japan Society of Obstetrics and Gynecology (JSOG), Japan Society of Gynecologic Oncology (JSGO), or Japan Society of Gynecologic and Obstetric Endoscopy and Minimally Invasive Therapy (JSGOE) and 139 private institutions with at least one JSGOE-certified licensed gynecologic laparoscopist. Among the 767 institutions, 444 (57.9%) provided responses, including 91 (20.6%) that were both JSGOE and JSGO accredited, 71 (16.0%) that were only JSGO accredited, 88 (19.8%) that were only JSGOE accredited, and 194 (43.7%) that were unaccredited. It was found that awareness and performance of OBS largely depended on the JSGO and/or JSGOE accreditation status. OBS was only performed at 54.0% of responding institutions and just 6.8% of the institutions were willing to participate in randomized controlled trials to validate this method for reducing the incidence of ovarian cancer. The JSOG Gynecologic Tumor Committee will announce its opinion on salpingectomy for ovarian cancer prevention to all JSOG members and will develop a system for monitoring the number of OBS procedures in Japan. Copyright © 2017. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology

  8. Bemiparin for thromboprophylaxis after benign gynecologic surgery: a randomized clinical trial.

    Science.gov (United States)

    Alalaf, S K; Jawad, A K; Jawad, R K; Ali, M S; Al Tawil, N G

    2015-12-01

    Venous thromboembolism (VTE) is the leading cause of mortality and morbidity in women following gynecologic surgery. To determine the efficacy of a second-generation low molecular weight heparin (bemiparin) for thromboprophylaxis after benign gynecologic surgery. We performed a single-blind randomized controlled trial including women in the moderate-risk, high-risk and highest-risk groups for developing VTE after benign gynecologic surgery. Participants were randomized at a 1 : 1 ratio into parallel groups to receive either seven daily doses of 3500 IU of subcutaneous bemiparin or to a non-intervention group receiving standard rehydration and advice on ambulation. Participants were followed up for 7 days and 30 days postoperatively for symptomatic VTE, which was confirmed by compression Doppler ultrasound, magnetic resonance imaging, or computed tomographic pulmonary angiography, according to the type of VTE. In total, 387 participants were randomized to the bemiparin group and 387 to the non-intervention group. The incidence of symptomatic VTE (deep vein thrombosis and pulmonary embolism) events was lower (0/377) in participants who received bemiparin than in those who received no pharmacologic intervention (12/380, 3.2%; 95% confidence interval [CI] 0.002-0.6). Logistic regression analysis showed significant associations between VTE and immobility (odds ratio [OR] 7.1; 95% CI 1.3-36.2), varicose veins (OR 16.8; 95% CI 3.1-76.2), and thrombophilia (OR 39.3; 95% CI 1.5-1006.7). There were no major bleeding events or side effects related to the use of bemiparin. Bemiparin was an effective thromboprophylactic agent for preventing venous thrombosis after benign gynecologic surgery. © 2015 International Society on Thrombosis and Haemostasis.

  9. Differential Diagnosis of Gynecologic Organ-Related Diseases in Women Presenting with Ascites

    Directory of Open Access Journals (Sweden)

    Ming-Huei Cheng

    2008-12-01

    Full Text Available Ascites is a pathologic accumulation of fluid within the peritoneal cavity, and usually develops as a result of liver disease, congestive heart failure or nephrotic syndrome. Ascites is also a common manifestation of some gynecologic diseases. It is important that health care workers consider gynecologic problems among the potential differential diagnoses in patients presenting with ascites. Various kinds of ovarian diseases, such as epithelial ovarian cancer, benign ovarian fibroma, stromal hyperplasia, ovarian hyperstimulation syndrome, primary peritoneal serous carcinoma, endometriosis and peritoneal tuberculosis, should be kept in mind when women are found to have ascites.

  10. Urinary Tract Injury in Gynecologic Laparoscopy for Benign Indication: A Systematic Review.

    Science.gov (United States)

    Wong, Jacqueline M K; Bortoletto, Pietro; Tolentino, Jocelyn; Jung, Michael J; Milad, Magdy P

    2018-01-01

    To perform a comprehensive literature review of the incidence, location, etiology, timing, management, and long-term sequelae of urinary tract injury in gynecologic laparoscopy for benign indication. A systematic review of PubMed, EMBASE, Cochrane Library, and ClinicalTrials.gov was conducted. Four hundred thirty-three studies were screened for inclusion with 136 full-text articles reviewed. Ninety studies published between 1975 and 2015 met inclusion criteria, representing 140,444 surgeries. Articles reporting the incidence of urinary tract injury in gynecologic laparoscopy for benign indication were included. Exclusion criteria comprised malignancy, surgery by urogynecologists, research not in English, and insufficient data. A total of 458 lower urinary tract injuries were reported with an incidence of 0.33% (95% CI 0.30-0.36). Bladder injury (0.24%, 95% CI 0.22-0.27) was overall three times more frequent than ureteral injury (0.08%, 95% CI 0.07-0.10). Laparoscopic hysterectomy not otherwise specified (1.8%, 95% CI 1.2-2.6) and laparoscopically assisted vaginal hysterectomy (1.0%, 95% CI 0.9-1.2) had the highest rates of injury. Most ureteral injuries resulted from electrosurgery (33.3%, 95% CI 24.3-45.8), whereas most bladder injuries resulted from lysis of adhesions (23.3%, 95% CI 18.7-29.0). Ureteral injuries were most often recognized postoperatively (60%, 95% CI 47-76) and were repaired by open ureteral anastomosis (47.4%, 95% CI 36.3-61.9). In contrast, bladder injuries were most often recognized intraoperatively (85%, 95% CI 75-95) and were repaired by laparoscopic suturing (34.9%, 95% CI 29.2-41.7). The incidence of lower urinary tract injury in gynecologic laparoscopy for benign indication remains low at 0.33%. Bladder injury was three times more common than ureteral injury, although ureteral injuries were more often unrecognized intraoperatively and underwent open surgical repair. These risk estimates can assist gynecologic surgeons in effectively

  11. The place of robotics in gynecologic surgery.

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    Quemener, J; Boulanger, L; Rubod, C; Cosson, M; Vinatier, D; Collinet, P

    2012-10-01

    Robot-assisted laparoscopic gynecologic surgery has undergone widespread development in recent years. The surgical literature on this subject continues to grow. The goal of this article is to summarize the principal indications for robotic assistance in gynecologic surgery and to offer a general overview of the principal articles dealing with robotic surgery for both benign and malignant disease. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  12. Clinical performance of LOCI™-based tumor marker assays for tumor markers CA 15-3, CA 125, CEA, CA 19-9 and AFP in gynecological cancers.

    Science.gov (United States)

    Dolscheid-Pommerich, Ramona C; Keyver-Paik, Mignon; Hecking, Thomas; Kuhn, Walther; Hartmann, Gunther; Stoffel-Wagner, Birgit; Holdenrieder, Stefan

    2017-10-01

    Evidence is sparse regarding the clinical performance of luminescent oxygen channeling immunoassays-based tumor marker assays in gynecological cancer. Analyzing serum samples of 336 patients with Dimension™Vista1500, we investigated the diagnostic power of carbohydrate antigen 15-3, carbohydrate antigen 125, carcinoembryonic antigen, carbohydrate antigen 19-9, and alpha-fetoprotein in patients suffering from different types of gynecological cancer and precancerous gynecological diseases and compared findings to appropriate control groups. The cohort comprised 177 female patients with gynecological cancers (73 breast, 22 cervical, 16 endometrial, 17 vulva, and 49 ovarian cancers), 26 patients with precancerous gynecological diseases (11 vulva, 4 cervical, and 10 breast), 109 patients with benign gynecological diseases, and 24 healthy controls. Discriminative power was assessed by areas under the curve in receiver operating characteristic curves, and sensitivities were determined at a fixed specificity of 95%. Levels of biomarkers in healthy controls were in the expected ranges and a discriminative power between gynecological cancers and healthy controls was observed for several tumor markers. Established tumor type-associated markers were elevated in specific gynecological cancers and benign controls as well as within precancerous gynecological diseases and healthy control group. In ovarian cancer, carbohydrate antigen 125 and carbohydrate antigen 15-3 were significantly elevated compared to the respective benign diseases. Carbohydrate antigen 125 was the most conclusive marker (area under the curve = 0.86% and 77.6% sensitivity at 95% specificity). In breast cancer, carcinoembryonic antigen and carbohydrate antigen 15-3 were significantly higher than in the respective benign diseases. Carcinoembryonic antigen achieved the most conclusive area under the curve (0.65) with 31.5% sensitivity at 95% specificity. None of the investigated markers was found to be of

  13. Economic and Survival Implications of Use of Electric Power Morcellation for Hysterectomy for Presumed Benign Gynecologic Disease.

    Science.gov (United States)

    Wright, Jason D; Cui, Rosa R; Wang, Anqi; Chen, Ling; Tergas, Ana I; Burke, William M; Ananth, Cande V; Hou, June Y; Neugut, Alfred I; Temkin, Sarah M; Wang, Y Claire; Hershman, Dawn L

    2015-11-01

    Electric power morcellation during laparoscopic hysterectomy allows some women to undergo minimally invasive surgery but may disrupt underlying occult malignancies and increase the risk of tumor dissemination. We developed a state transition Markov cohort simulation model of the risks and benefits of hysterectomy (abdominal, laparoscopic, and laparoscopic with electric power morcellation) for women with presumed benign gynecologic disease. The model considered perioperative morbidity, mortality, risk of cancer and dissemination, and outcomes in women with an underlying malignancy. We explored the effectiveness from a societal perspective stratified by age (women. Per 10 000 women younger than age 40 years, laparoscopic hysterectomy with morcellation was associated with 1.57 more cases of disseminated cancer and 0.97 fewer deaths than abdominal hysterectomy. The excess cases of disseminated cancer per 10 000 women with morcellation compared with abdominal hysterectomy increased with age to 47.54 per 10 000 in women age 60 years and older. Compared with abdominal hysterectomy, this resulted in 0.30 (age 40-49 years), 5.07 (age 50-59 years), and 18.14 (age 60 years and older) excess deaths per 10 000 women in the respective age groups. Laparoscopic hysterectomy without morcellation is the most beneficial approach of the three methods of hysterectomy studied. In older women, the risks of electric power morcellation may outweigh the benefits of minimally invasive hysterectomy. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  14. Robotic surgery in complicated gynecologic diseases: experience of Tri-Service General Hospital in Taiwan.

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    Tan, Shun-Jen; Lin, Chi-Kung; Fu, Pei-Te; Liu, Yung-Liang; Sun, Cheng-Chian; Chang, Cheng-Chang; Yu, Mu-Hsien; Lai, Hung-Cheng

    2012-03-01

    Minimally invasive surgery has been the trend in various specialties and continues to evolve as new technology develops. The development of robotic surgery in gynecology remains in its infancy. The present study reports the first descriptive series of robotic surgery in complicated gynecologic diseases in Taiwan. From March 2009 to February 2011, the records of patients undergoing robotic surgery using the da Vinci Surgical System were reviewed for patient demographics, indications, operative time, hospital stay, conversion to laparotomy, and complications. Sixty cases were reviewed in the present study. Forty-nine patients had benign gynecologic diseases, and 11 patients had malignancies. These robot-assisted laparoscopic procedures include nine hysterectomy, 15 subtotal hysterectomy, 13 myomectomy, eight staging operation, two radical hysterectomy, five ovarian cystectomy, one bilateral salpingo-oophorectomy and myomectomy, two resections of deep pelvic endometriosis, one pelvic adhesiolysis, three sacrocolpopexy and one tuboplasty. Thirty-three patients had prior pelvic surgery, and one had a history of pelvic radiotherapy. Adhesiolysis was necessary in 38 patients to complete the whole operation. Robotic myomectomy was easily accomplished in patients with huge uterus or multiple myomas. The suturing of myometrium or cervical stump after ligation of the uterine arteries minimized the blood loss. In addition, it was much easier to dissect severe pelvic adhesions. The dissection of para-aortic lymph nodes can be easily accomplished. All these surgeries were performed smoothly without ureteral, bladder or bowel injury. The present analyses include various complicated gynecologic conditions, which make the estimation of the effectiveness of robotic surgery in each situation individually not appropriate. However, our experiences do show that robotic surgery is feasible and safe for patients with complicated gynecologic diseases. Copyright © 2012. Published by

  15. Laparoendoscopic Single-Site Surgery for the Treatment of Benign Adnexal Disease: A Prospective Trial

    Directory of Open Access Journals (Sweden)

    Anna Fagotti

    2010-01-01

    Full Text Available Background. To validate feasibility, efficacy, and safeness of laparoscopic treatment of benign adnexal diseases through a single transumbilical access (LESS in a prospective series of patients. Methods. A prospective clinical trial including 30 women has been conducted at the Division of Gynecology of Catholic University of Sacred Hearth of Rome. Patients underwent different laparoscopic procedures by LESS utilizing a multiport trocar and conventional straight laparoscopic instrumentation. Intra and perioperative outcome has been reported. Results. Ten mono/bilateral adnexectomies and 20 cystectomies have been performed by LESS approach. Laparoscopic procedures were completed through a single access in 28 cases (93.4%. No major intra- or postoperative complications were observed. Mean hospital stay was 1.3 days. Conclusions. LESS approach is feasible to treat benign adnexal disease with a very low conversion rate and no early or late complications. More clinical data are needed to confirm these advantages compared to standard laparoscopic technique.

  16. Radical pancreaticoduodenectomy for benign disease.

    LENUS (Irish Health Repository)

    Kavanagh, D O

    2008-01-01

    Whipple\\'s procedure is the treatment of choice for pancreatic and periampullary malignancies. Preoperative histological confirmation of malignancy is frequently unavailable and some patients will subsequently be found to have benign disease. Here, we review our experience with Whipple\\'s procedure for patients ultimately proven to have benign disease. The medical records of all patients who underwent Whipple\\'s procedure during a 15-year period (1987-2002) were reviewed; 112 patients underwent the procedure for suspected malignancy. In eight cases, the final histology was benign (7.1%). One additional patient was known to have benign disease at resection. The mean age was 50 years (range: 30-75). The major presenting features included jaundice (five), pain (two), gastric outlet obstruction (one), and recurrent gastrointestinal haemorrhage (one). Investigations included ultrasound (eight), computerised tomography (eight), endoscopic retrograde cholangiopancreatography (seven; of these, four patients had a stent inserted and three patients had sampling for cytology), and endoscopic ultrasound (two). The pathological diagnosis included benign biliary stricture (two), chronic pancreatitis (two), choledochal cyst (one), inflammatory pseudotumour (one), cystic duodenal wall dysplasia (one), duodenal angiodysplasia (one), and granular cell neoplasm (one). There was no operative mortality. Morbidity included intra-abdominal collection (one), anastomotic leak (one), liver abscess (one), and myocardial infarction (one). All patients remain alive and well at mean follow-up of 41 months. Despite recent advances in diagnostic imaging, 8% of the patients undergoing Whipple\\'s procedure had benign disease. A range of unusual pathological entities can mimic malignancy. Accurate preoperative histological diagnosis may have allowed a less radical operation to be performed. Endoscopic ultrasound-guided fine needle aspirate (EUS-FNA) may reduce the need for Whipple\\'s operation

  17. Radical Pancreaticoduodenectomy for Benign Disease

    Directory of Open Access Journals (Sweden)

    D. O. Kavanagh

    2008-01-01

    Full Text Available Whipple's procedure is the treatment of choice for pancreatic and periampullary malignancies. Preoperative histological confirmation of malignancy is frequently unavailable and some patients will subsequently be found to have benign disease. Here, we review our experience with Whipple's procedure for patients ultimately proven to have benign disease. The medical records of all patients who underwent Whipple's procedure during a 15-year period (1987–2002 were reviewed; 112 patients underwent the procedure for suspected malignancy. In eight cases, the final histology was benign (7.1%. One additional patient was known to have benign disease at resection. The mean age was 50 years (range: 30–75. The major presenting features included jaundice (five, pain (two, gastric outlet obstruction (one, and recurrent gastrointestinal haemorrhage (one. Investigations included ultrasound (eight, computerised tomography (eight, endoscopic retrograde cholangiopancreatography (seven; of these, four patients had a stent inserted and three patients had sampling for cytology, and endoscopic ultrasound (two. The pathological diagnosis included benign biliary stricture (two, chronic pancreatitis (two, choledochal cyst (one, inflammatory pseudotumour (one, cystic duodenal wall dysplasia (one, duodenal angiodysplasia (one, and granular cell neoplasm (one. There was no operative mortality. Morbidity included intra-abdominal collection (one, anastomotic leak (one, liver abscess (one, and myocardial infarction (one. All patients remain alive and well at mean follow-up of 41 months. Despite recent advances in diagnostic imaging, 8% of the patients undergoing Whipple'’s procedure had benign disease. A range of unusual pathological entities can mimic malignancy. Accurate preoperative histological diagnosis may have allowed a less radical operation to be performed. Endoscopic ultrasound–guided fine needle aspirate (EUS-FNA may reduce the need for Whipple's operation in

  18. The ABC of benign breast disease

    African Journals Online (AJOL)

    Benign breast disease is common, although the incidence is sparsely documented in ... The clinical presentation of benign breast diseases includes one or more of the ... problem, with various terms such as mastodynia, mastitis and fibrocystic ...

  19. Spectrum of benign breast diseases

    International Nuclear Information System (INIS)

    Khanzada, T.W.; Samad, A.; Sushel, C.

    2009-01-01

    Objective: To determine the frequencies of various benign breast diseases (BBD) in female patients in three private hospitals of Hyderabad. Methodology: This is a prospective cohort study of all female patients visiting the surgical clinic with breast problems. This study was conducted at Isra University Hospital Hyderabad and two other private hospitals of Hyderabad over a period of about three years starting from March 2004 to February 2007. All female patients visiting the surgical clinic with breast problems were included in the study. Patients with obvious clinical features of malignancy or those who on work up were diagnosed as carcinoma were excluded from the study. Results: A total of 275 patients were included in the study. About 44% (120/275) patients belonged to third decade of life (age between: 21-30 years) followed by 33% from forth decade (age between: 31- 40 years). Fibroadenoma was the most common benign breast disease, seen in 27% (75/275) of patients, followed by fibrocystic disease seen in about 21% (57/275) patients. Conclusion: Benign Breast Diseases (BBD) are common problems in females of reproductive age. Fibroadenoma is the commonest of all benign breast disease in our set up mostly seen in second and third decade of life. Fibrocystic disease of the breast is the next common BBD whose incidence increases with increasing age. (author)

  20. Gynecologic ultrasonography: recent advances and research in various technical modalities

    Directory of Open Access Journals (Sweden)

    Juraj Drobný

    2010-10-01

    Full Text Available Juraj DrobnýFirst Department of Obstetrics and Gynaecology, St. Cyril and Method University Hospital, Bratislava, Slovak RepublicAbstract: This paper reviews clinical research in gynecologic sonography, focussing on uterine cavity lesions, endometrial abnormalities and adnexal masses (including endometriosis, and ectopic pregnancy. For each topic, detection of sonographic pathologic features and sonographic mode are discussed, as well as the latest applications of sonodiagnostic methods, and relevant topics in clinical research. A new approach to evaluation of sonographic structures can be seen, including for borderline mucinous and serous ovarian tumors, in mean gray value, evaluation of grade of tissue echogenicity, evaluation of intact endometrial midline echo in ectopic pregnancy, and application of gel instillation sonography. Novel sonographic three-dimensional modalities, such as virtual navigation through three orthogonal planes, multislice tomosonography, volumetry by a virtual organ computer-aided analysis system, three-dimensional power Doppler, and space reconstruction of structures enable gynecologic diagnoses to be made more exactly. Clinical research investigates different sonographic features in benign and malignant gynecologic pathology. For studies of typical signs of benign uterine fibroids, endometrial volume, and vascularization of malignant endometrial tumors, as well as typical benign adnexal structures, the ovarian crescent sign were performed. At this time, no exact sonographic features for distinguishing between benign and malignant gynecologic tumors are available.Keywords: sonography, uterine cavity lesions, endometrial abnormalities, adnexal masses

  1. Radiation treatment of benign diseases

    International Nuclear Information System (INIS)

    Reitan, J.B.; Flatby, J.; Backe, S.; Lundgren, L.

    1984-01-01

    The report deals with an estimation of the volume of radiation treatment of benign diseases in Norway and gives a survey of the subjective opinion of patients regarding the result of the treatment. Reported subjective recovery after radiation treatment seems to be at the same level as recovery without treatment. For an indication of the objective effect of radiation treatment of benign diseases, the subjective effect of this treatment has to be compared with objective findings

  2. Modern role and issues of radiation therapy for benign diseases

    International Nuclear Information System (INIS)

    Miyashita, Tsuguhiro; Tateno, Atsushi; Kumazaki, Tatsuo

    1999-01-01

    Cases of radiation therapy for benign diseases have diminished in number because of recent alternative methods and knowledge about radiation carcinogenesis. In contrast to this tendency, our cases of benign diseases have recently increased. The facts made us reconsider today's radiation therapy of benign diseases. We reviewed 349 patients who were diagnosed as having benign tumors or non-neoplastic conditions and treated by radiation therapy in the past sixteen years. Analyzed items were the annual transition of treatment number, sorts of diseases, patients' age and sex, and the goal of therapy. Of all radiation therapy patients, benign diseases account for 9.26%. The annual percentages were 0.5%, 6.0%, 11.2% and 13.7% at intervals of five years since 1982. The majority was 246 post-operative irradiation for keloids (71%) and 41 pituitary adenomas (12%). Compared with malignant tumors, benign disease patients were statistically younger and female-dominant. Applications of radiation therapy in keloids and pituitary adenomas had definite goals, but were unclear in other rare diseases. Benign diseases should be treated by radiation therapy as the second or third option, provided the patients have serious symptoms and their diseases do not respond to other modalities. It seems to be widely accepted that favorite cases such as keloids and pituitary adenomas are treated by radiation therapy. But, optimal radiation therapies for other rare benign diseases have not been established. Therefore, the building of databases on radiation therapy on benign diseases should be pursued. Since benign disease patients were young and female-dominant and had many remaining years, their carcinogenicity potential should be considered. (author)

  3. THE EFFECTIVENESS OF THE IMPLEMENTATION OF TECHNOLOGY SUBSTITUTING INPATIENT TREATMENT DURING THE MEDICAL CARE PROVISION TO WOMEN WITH BENIGN GYNECOLOGICAL NEOPLASMS

    Directory of Open Access Journals (Sweden)

    A. A. Lobganidze

    2017-01-01

    Full Text Available Relevance. Over the last decades, such technology substituting inpatient treatment as outpatient treatment has been actively discussed and used in practice. Despite this fact, many problems of outpatient treatment have not been solved in full, no effective leverages contributing to creating economic incentives for increasing the volume and range of medical services in day hospitals have been found in the mandatory medical insurance system.Objective. Based on an in-depth analysis of medical care provision to women with benign gynaecological neoplasms, to offer measures for improvement of medical care in outpatient facilities, particularly by using technologies substituting inpatient treatment, and to evaluate their effectiveness.Materials and methods. A comprehensive retrospective evaluation of outpatient and inpatient medical care was conducted in St. Petersburg over the period from 2008 to 2015. The information contained in the database of billed and paid invoices of the obligatory medical insurance system of St. Petersburg was studied. For the total period of eight years, the data on medical care provision to 81 622 women suffering from benign tumors of the female reproductive organs, particularly in day hospitals, were obtained. In the period 2015–2016, medical care provision to patients with benign neoplasms of the gynecological sphere was thoroughly analyzed. In 18 women’s health departments and 19 in-patient facilities in all districts of the city, all cases of treatment of patients in the basic women’s health departments and in-patient facilities were analyzed by experts. By Taking into account the obtained results, an organizational experiment on introducing substituting technologies followed by evaluating the effectiveness of their use was developed and implemented on the basis of the medical institutions in one of the districts of St. Petersburg.Results. The activeness of outpatient facilities for treatment of women with benign

  4. Sclerotherapy for Benign Cystic Diseases in the Neck

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ji Hoon; Sohn, Chul Ho; Choi, Seung Hong; Yun, Tae Jin [Dept. of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2012-08-15

    Surgery has been the classic treatment of choice for benign cystic diseases, including lymphatic malformation, ranula, branchial cleft cyst, thyroglossal duct cyst, thyroid cyst, parathyroid cyst, and lymphocele. However, surgery is associated with a tendency toward recurrence and may be accompanied by various complications, such as nerve injuries, vascular injuries, and scar formation. Therefore, sclerotherapy using various agents has been applied successfully to treatment of benign cystic diseases in the neck. This editorial reviews the use of various sclerotic agents and application of sclerotherapy to benign cystic diseases in the neck.

  5. Sclerotherapy for Benign Cystic Diseases in the Neck

    International Nuclear Information System (INIS)

    Kim, Ji Hoon; Sohn, Chul Ho; Choi, Seung Hong; Yun, Tae Jin

    2012-01-01

    Surgery has been the classic treatment of choice for benign cystic diseases, including lymphatic malformation, ranula, branchial cleft cyst, thyroglossal duct cyst, thyroid cyst, parathyroid cyst, and lymphocele. However, surgery is associated with a tendency toward recurrence and may be accompanied by various complications, such as nerve injuries, vascular injuries, and scar formation. Therefore, sclerotherapy using various agents has been applied successfully to treatment of benign cystic diseases in the neck. This editorial reviews the use of various sclerotic agents and application of sclerotherapy to benign cystic diseases in the neck.

  6. CT and MR imaging of gynecological emergency disease

    International Nuclear Information System (INIS)

    Fujii, Shinya; Kinoshita, Toshibumi; Tahara, Takatoshi; Matsusue, Eiji; Ogawa, Toshihide

    2004-01-01

    We describe the CT and MRI findings of gynecologic emergency diseases: pelvic inflammatory disease, ectopic pregnancy, ovarian hemorrhage, ovarian torsion, rupture of ovarian tumor, eclampsia, and HELLP (hemolysis, elevated liver enzymes, and low platelet count) syndrome. Diagnostic keys to these diseases are presented in this review. CT and MRI play a complementary role to sonography in accurately diagnosing these diseases. In situations that require an exact, immediate diagnosis, radiologists should be familiar with the key imaging findings. (author)

  7. Radiotherapy of benign diseases

    International Nuclear Information System (INIS)

    Haase, W.

    1982-01-01

    Still today radiotherapy is of decisive relevance for several benign diseases. The following ones are briefly described in this introductory article: 1. Certain inflammatory and degenerative diseases as furuncles in the face, acute thrombophlebitis, recurrent sudoriparous abscesses, degenerative skeletal diseases, cervical syndrome and others; 2. rheumatic joint diseases; 3. Bechterew's disease; 4. primary presenile osteoporosis; 5. synringomyelia; 6. endocrine ophthalmopathy; 7. hypertrophic processes of the connective tissue; 8. hemangiomas. A detailed discussion and a profit-risk analysis is provided in the individual chapters of the magazine. (MG) [de

  8. Imaging malignant and apparent malignant transformation of benign gynaecological disease

    Energy Technology Data Exchange (ETDEWEB)

    Lee, A.Y.; Poder, L.; Qayyum, A.; Wang, Z.J.; Yeh, B.M. [Department of Radiology, University of California San Francisco, San Francisco, CA (United States); Coakley, F.V., E-mail: Fergus.Coakley@radiology.ucsf.ed [Department of Radiology, University of California San Francisco, San Francisco, CA (United States)

    2010-12-15

    Common benign gynaecological diseases, such as leiomyoma, adenomyosis, endometriosis, and mature teratoma, rarely undergo malignant transformation. Benign transformations that may mimic malignancy include benign metastasizing leiomyoma, massive ovarian oedema, decidualization of endometrioma, and rupture of mature teratoma. The aim of this review is to provide a contemporary overview of imaging findings in malignant and apparent malignant transformation of benign gynaecological disease.

  9. Benign paroxysmal positional vertigo in Parkinson's disease

    NARCIS (Netherlands)

    Wensen, E. van; Leeuwen, R.B. van; Zaag-Loonen, H.J. van der; Masius-Olthof, S.; Bloem, B.R.

    2013-01-01

    BACKGROUND: Dizziness is a frequent complaint of patients with Parkinson's disease (PD), and orthostatic hypotension (OH) is often thought to be the cause. We studied whether benign paroxysmal positional vertigo (BPPV) could also be an explanation. AIM: To assess the prevalence of benign paroxysmal

  10. Cost and robotic surgery in gynecology.

    Science.gov (United States)

    Knight, Jason; Escobar, Pedro F

    2014-01-01

    Since the introduction of robotic technology, there have been significant changes to the field of gynecology. The number of minimally invasive procedures has drastically increased, with robotic procedures rising remarkably. To date several authors have published cost analyses demonstrating that robotic hysterectomy for benign and oncologic indications is more costly compared to the laparoscopic approach. Despite being more expensive than laparoscopy, other studies have found robotics to be less expensive and more effective than laparotomy. In this review, controversies surrounding cost-effectiveness studies are explored. © 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.

  11. The effect of peritoneal gas drain on postoperative pain in benign gynecologic laparoscopic surgery: a double-blinded randomized controlled trial controlled trial

    Directory of Open Access Journals (Sweden)

    Tharanon C

    2016-08-01

    Full Text Available Chantip Tharanon, Kovit Khampitak Department of Obstetrics and Gynecology, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand Objectives: To compare the effect of peritoneal gas drain on postoperative pain in benign gynecologic laparoscopic surgery and the amount of postoperative analgesic dosage.Methods: The trial included 45 females who had undergone operations during the period December 2014 to October 2015. The patients were block randomized based on operating time (<2 and ≥2 hours. The intervention group (n=23 was treated with postoperative intraperitoneal gas drain and the control group (n=22 was not. The mean difference in scores for shoulder, epigastric, suprapubic, and overall pain at 6, 24, 48 hours postoperatively were statistically evaluated using mixed-effect restricted maximum likelihood regression. The differences in the analgesic drug usage between the groups were also analyzed using a Student’s t-test. The data were divided and analyzed to two subgroups based on operating time (<2 hours, n=20; and ≥2 hours, n=25.Results: The intervention had significantly lower overall pain than the control group, with a mean difference and 95% confidence interval at 6, 24, and 48 hours of 2.59 (1.49–3.69, 2.23 (1.13–3.34, and 1.48 (0.3–2.58, respectively. Correspondingly, analgesic drug dosage was significantly lower in the intervention group (3.52±1.47 mg vs 5.72±2.43 mg, P<0.001. The three largest mean differences in patients with operating times of ≥2 hours were in overall pain, suprapubic pain at 6 hours, and shoulder pain at 24 hours at 3.27 (1.14–5.39, 3.20 (1.11–5.26, and 3.13 (1.00–5.24, respectively. These were greater than the three largest mean differences in the group with operating times of <2 hours, which were 2.81 (1.31–4.29, 2.63 (0.51–4.73, and 2.02 (0.68–3.36. The greatest analgesic drug requirement was in the control group with a longer operative time.Conclusion: The use of

  12. Clinical application of pelvic MR angiography for gynecologic diseases

    Energy Technology Data Exchange (ETDEWEB)

    Ohnishi, Takeshi [Saint Marianna Univ., Kawasaki, Kanagawa (Japan). School of Medicine

    1996-08-01

    Magnetic resonance (MR) imaging is the second most important method next to the ultrasound for the diagnosis of gynecological disorders. MR angiography provides a new noninvasive method for evaluating vascular occlusive disease of the lower extremities and the branches of abdominal aorta. To our knowledge, no determinant of efficacy of MR angiography and images of gynecological diseases have yet been made. Maximum intensity projection image was obtained from the data set by the three dimensional contrast enhanced MR angiography (3D-CE MRA) with newly designed fat suppression method. MR angiogram reveals well visualization of lower abdominal aorta and its branches. Furthermore, uterine arteries were identified in 49.3% of the cases, branching from the internal iliac artery. Leiomyoma of the uterus showed an enhanced uterus in 53.7% of the eases. All cases of endometriosis demonstrated a homogeneous, high signal intensity being a specific finding. In conclusion, maximum intensity projection image of pelvis showed a good visualization of the lower abdominal aorta and its branches. Uterine artery and, in a few cases, ovarian artery can be demonstrated on MR angiography. All cases of endometriosis showed a significant, high signal intensity. This technique is noninvasive and be a supplementary method for diagnosis and follow up of vasculature of gynecological disorders. (author)

  13. Clinical application of pelvic MR angiography for gynecologic diseases

    International Nuclear Information System (INIS)

    Ohnishi, Takeshi

    1996-01-01

    Magnetic resonance (MR) imaging is the second most important method next to the ultrasound for the diagnosis of gynecological disorders. MR angiography provides a new noninvasive method for evaluating vascular occlusive disease of the lower extremities and the branches of abdominal aorta. To our knowledge, no determinant of efficacy of MR angiography and images of gynecological diseases have yet been made. Maximum intensity projection image was obtained from the data set by the three dimensional contrast enhanced MR angiography (3D-CE MRA) with newly designed fat suppression method. MR angiogram reveals well visualization of lower abdominal aorta and its branches. Furthermore, uterine arteries were identified in 49.3% of the cases, branching from the internal iliac artery. Leiomyoma of the uterus showed an enhanced uterus in 53.7% of the eases. All cases of endometriosis demonstrated a homogeneous, high signal intensity being a specific finding. In conclusion, maximum intensity projection image of pelvis showed a good visualization of the lower abdominal aorta and its branches. Uterine artery and, in a few cases, ovarian artery can be demonstrated on MR angiography. All cases of endometriosis showed a significant, high signal intensity. This technique is noninvasive and be a supplementary method for diagnosis and follow up of vasculature of gynecological disorders. (author)

  14. Benign breast disease and risk of thyroid cancer.

    Science.gov (United States)

    Luo, Juhua; Hendryx, Michael; Nassir, Rami; Cheng, Ting-Yuan David; Lane, Dorothy; Margolis, Karen L

    2017-09-01

    It has been suggested that breast and thyroid diseases may be linked. The aim of this study was to investigate the association between benign breast disease and subsequent risk of thyroid cancer. Postmenopausal women (n = 133,875) aged 50-79 years were followed up for a mean of 14 years. Benign breast disease was defined by history of biopsy. Incident thyroid cancer cases were confirmed by medical record review. Multivariable Cox proportional hazard modeling was used to estimate hazard ratios. There were 370 incident thyroid cancer cases during the follow-up period. Compared to women without BBD, women with BBD had a significant increased risk of thyroid cancer after adjusting for potential confounders (HR 1.38 95% CI 1.10-1.73), especially for women with more than two biopsies (HR 1.59 95% CI 1.10-2.26). There were no significant differences in thyroid tumor size, stage or histologic types between women with and without BBD. Our large prospective study observed that postmenopausal women with BBD had an increased risk for thyroid cancer compared with women without BBD. A more detailed investigation of thyroid cancer risk according to different subtypes of benign breast disease is needed to better understand the association observed between thyroid and benign breast diseases.

  15. The ABC of benign breast disease | Ndhluni | Continuing Medical ...

    African Journals Online (AJOL)

    Benign breast disease is common, although the incidence is sparsely documented in the literature and is probably quite underestimated. The main reason is that it is regarded as unimportant, with far more attention being focused on breast cancer. However, benign breast disease is far more common than breast cancer.

  16. Robotic surgery in complicated gynecologic diseases: Experience of Tri-Service General Hospital in Taiwan

    Directory of Open Access Journals (Sweden)

    Shun-Jen Tan

    2012-03-01

    Conclusion: The present analyses include various complicated gynecologic conditions, which make the estimation of the effectiveness of robotic surgery in each situation individually not appropriate. However, our experiences do show that robotic surgery is feasible and safe for patients with complicated gynecologic diseases.

  17. Methodological principles of radiation influence upon specific function of female organism and gynecological diseases

    International Nuclear Information System (INIS)

    Tsvelev, Yu.V.; Kira, E.F.

    1994-01-01

    1025 women permanently residing at the territory subjected to radioactive contamination due to the Chernobyl NPP accident underwent dispensary examination in 1991-1992. Study of ionizing radiation influence on specific functions (menstrual, reproductive, secretory and gynecological) of female organism is carried out. It is found that the highest percentage in the structure of gynecological diseases is accounted for inflammatory diseases of uterine appendages and neck of the uterus. 1 tab

  18. Nerve Invasion by Epithelial Cells in Benign Breast Diseases

    Directory of Open Access Journals (Sweden)

    Yu-Jan Chan

    2009-03-01

    Full Text Available Nerve invasion by glandular epithelial cells in a lesion is usually regarded as invasive carcinoma. However, some benign conditions in the pancreas, prostate, breast and other organs may show involvement of nerve bundles by benign epithelial cells. We report an 18-year-old female with nerve invasion in benign breast disease. The lesion in her right breast revealed fibrocystic changes with ductal hyperplasia and stromal sclerosis. Perineural and intraneural involvement by bland-looking small ducts lined by 2 layers of cells including an outer layer of myoepithelial cells were found, suggestive of benign nerve invasion. There was no evidence of malignant cells in any of the sections. The patient remains well after 31 months of follow-up. About 44 cases of nerve invasion in benign breast diseases have been reported in the literature. It is necessary to carefully evaluate nerve involvement in breast lesions to avoid over-diagnosis and inappropriate operation.

  19. The decline of hysterectomy for benign disease.

    LENUS (Irish Health Repository)

    Horgan, R P

    2012-01-31

    Hysterectomy is one of the most common gynaecological surgical procedures performed but there appears to be a decline in the performance of this procedure in Ireland in recent times. We set out to establish the extent of the decline of hysterectomy and to explore possible explanations. Data for hysterectomy for benign disease from Ireland was obtained from the Hospital In-Patient Enquiry Scheme (HIPE) section of the Economic and Social Research Institute for the years 1999 to 2006. The total number of hysterectomies performed for benign disease showed a consistent decline during this time. There was a 36% reduction in the number of abdominal hysterectomy procedures performed.

  20. Variation of autosomes and X chromosome STR in breast cancer and gynecological cancer tissues

    Directory of Open Access Journals (Sweden)

    Hou Youxiang

    2017-04-01

    Full Text Available This study analyses 1000 cases of patients with breast cancer and 2000 cases of patients with gynecological cancer (1000 cases of malignant tumor, 1000 cases of benign tumors, where breast cancer and malignant tumor patients comprise the observation group, while patients with benign tumors comprise the control group. Through DNA extraction, STR genotyping and variation verification, microdissection, individual STR mutation rate and loci STR mutation rate of the two groups of patients were calculated. Results show that there are no significant (P > 0.05 differences in the STR variation of autosomes and X chromosome between patients in the observation group and those in the reference group. However, significant (P < 0.05 intergroup differences were found for STR variation typing between patients with malignant and benign tumors. Using STR genotyping for autosomes and X chromosomes, gynecological cancer patients were found to be more likely to mutate, with a clear relationship between STR variation and tumor differentiation degrees. The study on the variation analysis of autosomes and X chromosome STR in breast and gynecological cancer tissues is expected to have a high application value when applied to medical research and identification processes.

  1. CT findings of pleural lesions: differential diagnosis between malignant benign diseases

    Energy Technology Data Exchange (ETDEWEB)

    Baek, Seung Yon; Lim, Tae Hwan; Kim, Woo Sun; Park, Kwang Gil [Asan Medical Center, University of Ulsan, College of Medicine, Seoul (Korea, Republic of)

    1991-05-15

    A number of benign and malignant diseases may cause pleural abnormalities. Since the resolution of computed tomography (CT) has been improved, the detailed anatomy of pleura can now be well delineated in various pleural diseases. We reviewed retrospectively the CT findings of 60 patients with pathologically proved pleural diseases in order to find out the differential points between benign and malignant diseases. Thirty-six patients had malignant diseases (20 adenocarcinoma, 8 squamous cell carcinoma, 4 small cell carcinoma, 2 lung metastasis, 1 large cell carcinoma, 1 small and large cell carcinoma), and 24 patients had benign diseases (16 tuberculosis including empyema, 3 bacterial empyema, 3 pneumonia, 1 lung abscess, 1 lung contusion). The CT features that suggested malignant pleural diseases were high-grade mediastinal involvement (57.9%, {rho} < 0.1), thick and irregular thickening with nodularity and mass formations (38.5%, {rho} < 0.1), Circumferential pleural thickening 132.1%, {rho} < 0.01), and aggressive pleural effusion 122.2%, {rho} < 0.05). Benign pleural lesions were typically represented by pleural calcification (50%) and extrapleural fat accumulation (45.8%)

  2. Gallium scanning in differentiating malignant from benign asbestos-related pleural disease

    International Nuclear Information System (INIS)

    Teirstein, A.S.; Chahinian, P.; Goldsmith, S.J.; Sorek, M.

    1986-01-01

    In order to assess the utility of 67gallium citrate in delineating malignant pleural mesothelioma from benign asbestos-related pleural disease, 49 patients with malignant mesothelioma and 16 with benign asbestos-related pleural disease were studied. Seven patients with malignant mesothelioma had no history of asbestos exposure, while the remaining 58 patients were exposed. Forty-three of the 49 patients (88%) with malignant mesothelioma had a positive 67gallium scan including 36 of the 42 (86%) patients with asbestos exposure and all 7 patients without a history of asbestos exposure. Three of 16 patients (19%) with benign asbestos-related pleural disease had a positive scan. 67Gallium radionuclide imaging is nonspecific but may be valuable in noninvasive monitoring of asbestos-exposed populations, which have a high risk for the late development of benign and/or malignant pleural disease

  3. Venous thromboembolic complications to hysterectomy for benign disease

    DEFF Research Database (Denmark)

    Kahr, Henriette Strøm; Thorlacius-Ussing, Ole; Christiansen, Ole Bjarne

    2018-01-01

    women undergoing hysterectomy for benign conditions from 1996 to 2015. PATIENTS: Women aged 18 years and older who underwent hysterectomy for benign disease were stratified into 3 groups according to the hysterectomy approach: abdominal, laparoscopic, or vaginal. INTERVENTIONS: Hysterectomy...... were the approach to hysterectomy and a history of thromboembolic disease. In the multivariable analysis, the risk of VTE was significantly reduced with laparoscopic hysterectomy (hazard ratio [HR] = 0.51; 95% confidence interval [CI], 0.28-0.92; p = .03) and vaginal hysterectomy (HR = 0.39; 95% CI, 0...

  4. A Clinico-Pathological Study on Benign Breast Diseases

    Science.gov (United States)

    Sangma, Mima B. Maychet; Panda, Kishori; Dasiah, Simon

    2013-01-01

    Background: To study the patterns of clinically benign breast disease in females and to co-relate them with the pathological findings. Methods: One hundred females who attended the Surgery Outpatients Department in Indira Gandhi Medical College and Research Institute, Pondicherry, with various forms of benign breast diseases during the period from October 2011 to September 2012, were studied. Early diagnoses by doing a triple assessment like a clinical examination, FNAC or a core needle biopsy and imaging methods like ultrasonography or mammography, were made within 72 hrs from the first consultation. The clinical diagnoses were compared with the cytological or histological findings wherever possible and their accuracies were evaluated. Results: Out of the 100 female patients who were studied, 87 patients who presented with breast lumps and fibroadenoma, accounted for 48% of the cases, which was the highest number of patients. Fibrocystic changes and breast abscesses came next with 18% and 12% cases respectively. We detected 3 cases of proliferative disease with atypia and one case with florid hyperplasia, which had high and low risk factors respectively, for developing invasive carcinoma. The oldest lady of the group who was clinically diagnosed to have benign disease, was detected to have invasive ductal carcinoma. They were treated in our hospital and were advised follow up. Conclusion: Benign breast diseases are common in female patients and fibroadenoma is the commonest of them all. Triple assessment provided a quick diagnosis and it alleviated unnecessary anxiety from the patients about breast cancer. The clinical diagnosis of a breast lump, as confirmed by cytology and histology, was accurate in 91.95 % of the cases. PMID:23634406

  5. Intra-corporeal anastomosis in laparoscopic surgery for benign colorectal disease

    DEFF Research Database (Denmark)

    Antonsen, Jacob; Balachandran, Rogini; Holm, Finn Stigsen

    2017-01-01

    INTRODUCTION: Recent studies have described the benefits of performing bowel resections for benign and malignant diseases as a total laparoscopic procedure with intra-corporeal anastomosis. We describe our preliminary experience with total laparoscopic surgery for benign lower gastrointestinal...

  6. No gynecologist in town: the gynecological care of women in rural Taiwan

    Directory of Open Access Journals (Sweden)

    Lai LJ

    2015-07-01

    likely to consult for gynecological diseases (23.8% versus 35.4%; P<0.001 and visit gynecologists (18.7% versus 30.4%; P<0.001 than women in towns with a gynecologist. The disparity existed in each age group. Among 5,189 adult women living in towns without a gynecologist and having gynecological diseases, 78.5% (number [n]=4,074 visited gynecologists out of town, especially for infertility, benign disorders of the uterus and ovaries, gynecological examinations, and contraceptive problems, and by contrast 23.3% (n=1,209 visited nongynecologists in town, most commonly for menopausal disorders, endometriosis and pelvic pain, menstrual disorders and hormonal dysfunction, and genital dysplasia.Conclusion: Gynecological care of rural women was adversely affected by the shortage of gynecologists. The consequences of accessibility in underserved areas deserve further investigation. Keywords: gynecological care, urban–rural health service, women’s health

  7. Identifying Two Common Types of Breast Benign Diseases Based on Multiphoton Microscopy

    Directory of Open Access Journals (Sweden)

    Yan Wu

    2018-01-01

    Full Text Available Multiphoton microscopy has attracted increasing attention and investigations in the field of breast cancer, based on two-photon excited fluorescence (TPEF and second-harmonic generation (SHG. However, the incidence of breast benign diseases is about 5 to 10 times higher than breast cancer; up to 30% of women suffer from breast benign diseases and require treatment at some time in their lives. Thus, in this study, MPM was applied to image fibroadenoma and fibrocystic lesion, which are two of the most common breast benign diseases. The results show that MPM has the capability to identify the microstructure of lobule and stroma in normal breast tissue, the interaction of compressed ducts with surrounding collagen fiber in fibroadenoma, and the architecture of cysts filled with cystic fluid in fibrocystic disease. These findings indicate that, with integration of MPM into currently accepted clinical imaging system, it has the potential to make a real-time diagnosis of breast benign diseases in vivo, as well as breast cancer.

  8. Doppler ultrasound in obstetrics and gynecology. 2. rev. and enl. ed.

    International Nuclear Information System (INIS)

    Maulik, D.

    2005-01-01

    The second edition of Doppler Ultrasound in Obstetrics and Gynecology has been expanded and comprehensively updated to present the current standards of practice in Doppler ultrasound and the most recent developments in the technology. Doppler Ultrasound in Obstetrics and Gynecology encompasses the full spectrum of clinical applications of Doppler ultrasound for the practicing obstetrician-gynecologist, including the latest advances in 3D and color Doppler and the newest techniques in 4D fetal echocardiography. Written by preeminent experts in the field, the book covers the basic and physical principles of Doppler ultrasound; the use of Doppler for fetal examination, including fetal cerebral circulation; Doppler echocardiography of the fetal heart; and the use of Doppler for postdated pregnancy and in cases of multiple gestation. Chapters on the use of Doppler for gynecologic investigation include ultrasound in ectopic pregnancy, for infertility, for benign disorders and for gynecologic malignancies. (orig.)

  9. Doppler ultrasound in obstetrics and gynecology. 2. rev. and enl. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Maulik, D. [Winthrop Univ. Hospital, Mineola, NY (United States). Dept. of Obstetrics and Gynecology; Zalud, I. (eds.) [Kapiolani Medical Center for Women and Children, Honolulu, HI (United States)

    2005-07-01

    The second edition of Doppler Ultrasound in Obstetrics and Gynecology has been expanded and comprehensively updated to present the current standards of practice in Doppler ultrasound and the most recent developments in the technology. Doppler Ultrasound in Obstetrics and Gynecology encompasses the full spectrum of clinical applications of Doppler ultrasound for the practicing obstetrician-gynecologist, including the latest advances in 3D and color Doppler and the newest techniques in 4D fetal echocardiography. Written by preeminent experts in the field, the book covers the basic and physical principles of Doppler ultrasound; the use of Doppler for fetal examination, including fetal cerebral circulation; Doppler echocardiography of the fetal heart; and the use of Doppler for postdated pregnancy and in cases of multiple gestation. Chapters on the use of Doppler for gynecologic investigation include ultrasound in ectopic pregnancy, for infertility, for benign disorders and for gynecologic malignancies. (orig.)

  10. Surgery versus pharmacotherapy of benign thyroid diseases

    International Nuclear Information System (INIS)

    Younes, Nidal A.; Albousal, Abla M.

    2003-01-01

    Surgical management of thyroid diseases (BTDs) has been a topic of interest and confusion for many years. Almost 80% of thyroidectomies at an average endocrine surgical unit are carried out for BTDs.Resistance to surgical intervention in BTDs has been based on the belief that increased complication rate is inherent in its use, this is despite thepotential advatages in terms of confirming the benign nature of the lesion, controlling the disease, and relieving of local symptoms of large neck mass. Benign thyroid diseases are more likely to occur in middle-aged woman living in iodine deficient areas, or have a family history of goiter, or in patients taking iodine-containig drugs, like amoidarone, or in patients with previous history of x-ray exposure. However, the physician must be carefull in making the diagnosis of BTDsin patients of extremes of age or in presence of positive history of radiation, or in patients with family history of thyroid or colon cancer . In this atricle we will review the etiology,epidemiology , diagonastic methodologiesand the recent trends in the sugical and medical mangement of BTDs. (author)

  11. Efficacy of Single-dose and 2-dose Intravenous Administration of Ramosetron in Preventing Postoperative Nausea and Vomiting After Laparoscopic Gynecologic Operation: A Randomized, Double-blind, Placebo-controlled, Phase 2 Trial.

    Science.gov (United States)

    Lee, Banghyun; Kim, Kidong; Suh, Dong Hoon; Shin, Hyun-Jung; No, Jae Hong; Lee, Jung Ryeol; Jee, Byung Chul; Hwang, Jung Won; Do, Sang Hwan; Kim, Yong Beom

    2017-06-01

    This randomized trial investigated whether a 2-dose administration of intravenous ramosetron (5-hydroxytryptamine type 3 receptor antagonist) is more effective than a single-dose administration in preventing postoperative nausea and vomiting (PONV) in 89 patients who were scheduled to undergo laparoscopic operation for benign gynecologic diseases and to receive intravenous patient-controlled analgesia for relief of postoperative pain. After assignment at a ratio of 1:1, intravenous ramosetron (0.3 mg) was initially administered at the end of skin closure in all patients. Thereafter, ramosetron (0.3 mg) and placebo were administered to the study and control groups, respectively, at 4 hours after the operation. The baseline and operative characteristics were similar between the groups. The incidence of PONV during the 24-hour period after operation which was assessed as the primary endpoint did not differ between the groups. No serious adverse events occurred in either group. A 2-dose administration of intravenous ramosetron may not be superior to a single-dose administration in preventing PONV in patients undergoing laparoscopic operation for benign gynecologic diseases.

  12. Four Cases of Postoperative Pneumothorax Among 2814 Consecutive Laparoscopic Gynecologic Surgeries: A Possible Correlation Between Postoperative Pneumothorax and Endometriosis.

    Science.gov (United States)

    Hirata, Tetsuya; Nakazawa, Akari; Fukuda, Shinya; Hirota, Yasushi; Izumi, Gentaro; Takamura, Masashi; Harada, Miyuki; Koga, Kaori; Wada-Hiraike, Osamu; Fujii, Tomoyuki; Osuga, Yutaka

    2015-01-01

    To evaluate the frequency of pneumothorax after laparoscopic surgery and to identify possible correlations to endometriosis. Retrospective review. Tokyo University Hospital between 2006 and 2013. Four patients among a total of 2814 patients with a postoperative pneumothorax. Laparoscopic surgery for gynecologic benign disease. The main outcome was the clinical frequency and characteristics of the patients with postoperative pneumothorax. We observed 4 (0.14%) cases of postoperative pneumothorax after laparoscopic surgery, all of whom were diagnosed with endometriomas and developed a right-sided pneumothorax. The incidence of postoperative pneumothorax in 1097 patients with endometriomas was 0.36%, which was significantly higher than those without endometriomas. The presence of endometrioma should be considered a risk factor for postoperative pneumothorax in gynecologic laparoscopic surgery. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

  13. Obstetric and gynecological diseases and complications resulting from vaginal dysbacteriosis.

    Science.gov (United States)

    Kovachev, Stefan Miladinov

    2014-08-01

    Accurate knowledge of the composition and ecology of vaginal microbial environment of a healthy woman is necessary for the understanding of normal flora and how to reduce the risk for diseases. Vagina and its microflora form a balanced ecosystem in which dominated bacteria are vaginal lactobacilli. There are dynamic changes in this ecosystem having structure and composition depending on many factors. The term dysbacteriosis defines any movement outside the normal range for the given biotope of obligate and/or facultative microflora. Such a change in the quantity and quality of the respective microbial balance is fraught with danger and requires correction and recovery. The purpose of this overview is to examine obstetric and gynecological diseases that can cause vaginal impaired microbial balance. Vaginal dysbacteriosis is a cause, predecessor, and often also consequence of vaginal infections. In essence, any vaginal infection can be seen as dysbacteriosis, developed to the most severe extent. Here, there is a dominant microorganism other than lactic acid bacteria in the vagina (clinically manifested or not, respectively), depletion of defense mechanisms of the vagina associated with the shift of lactobacilli from their dominant role in the vaginal balance, decrease in their number and species diversity, and a resulting change in the healthy status of the vagina. Vaginal dysbacteriosis can be found in pathogenetic mechanism, whereby many obstetric and gynecological diseases develop. Most of these diseases lead directly to increased maternal and infant morbidity and mortality, so it is important to understand the reasons for them and the arrangements for their prevention.

  14. The preponderance and dye-tissue receptive variability analyses of malignant and benign lesions of the female genitalia

    Directory of Open Access Journals (Sweden)

    F.M. Onyije

    2017-04-01

    Conclusion: Our study reported the preponderance of benign lesions than malignant lesions in the sample population. Comparatively, MT exhibited the best dye-tissue receptivity in both benign and malignant lesions than the baseline dye (H&E and remains a valuable tool for the diagnosis of gynecological lesions.

  15. Benign breast disease, mammographic breast density, and the risk of breast cancer.

    Science.gov (United States)

    Tice, Jeffrey A; O'Meara, Ellen S; Weaver, Donald L; Vachon, Celine; Ballard-Barbash, Rachel; Kerlikowske, Karla

    2013-07-17

    Benign breast disease and high breast density are prevalent, strong risk factors for breast cancer. Women with both risk factors may be at very high risk. We included 42818 women participating in the Breast Cancer Surveillance Consortium who had no prior diagnosis of breast cancer and had undergone at least one benign breast biopsy and mammogram; 1359 women developed incident breast cancer in 6.1 years of follow-up (78.1% invasive, 21.9% ductal carcinoma in situ). We calculated hazard ratios (HRs) using Cox regression analysis. The referent group was women with nonproliferative changes and average density. All P values are two-sided. Benign breast disease and breast density were independently associated with breast cancer. The combination of atypical hyperplasia and very high density was uncommon (0.6% of biopsies) but was associated with the highest risk for breast cancer (HR = 5.34; 95% confidence interval [CI] = 3.52 to 8.09, P < .001). Proliferative disease without atypia (25.6% of biopsies) was associated with elevated risk that varied little across levels of density: average (HR = 1.37; 95% CI = 1.11 to 1.69, P = .003), high (HR = 2.02; 95% CI = 1.68 to 2.44, P < .001), or very high (HR = 2.05; 95% CI = 1.54 to 2.72, P < .001). Low breast density (4.5% of biopsies) was associated with low risk (HRs <1) for all benign pathology diagnoses. Women with high breast density and proliferative benign breast disease are at very high risk for future breast cancer. Women with low breast density are at low risk, regardless of their benign pathologic diagnosis.

  16. Safety of endoscopic removal of self-expandable stents after treatment of benign esophageal diseases

    NARCIS (Netherlands)

    van Halsema, Emo E.; Wong Kee Song, Louis M.; Baron, Todd H.; Siersema, Peter D.; Vleggaar, Frank P.; Ginsberg, Gregory G.; Shah, Pari M.; Fleischer, David E.; Ratuapli, Shiva K.; Fockens, Paul; Dijkgraaf, Marcel G. W.; Rando, Giacomo; Repici, Alessandro; van Hooft, Jeanin E.

    2013-01-01

    Temporary placement of self-expandable stents has been increasingly used for the management of benign esophageal diseases. To evaluate the safety of endoscopic removal of esophageal self-expandable stents placed for the treatment of benign esophageal diseases. Multicenter retrospective study. Six

  17. Comparison of Na+/I- symporter expression rate in malignant and benign thyroid diseases: immunohistochemical study

    International Nuclear Information System (INIS)

    Kang, Do Young; Jeong, Young Jin; Lee, Kyung Eun; Park, Heon Soo; Yoo, Young Hyun; Roh, Mee Sook

    2006-01-01

    Previous studies have not showed consistent results for the level of expression of sodium/iodide symporter (NIS) in thyroid diseases, especially malignant tumor. We undertook this study to evaluate the distribution of NIS expression in malignant thyroid diseases and compare with that in benign thyoid disease. Total patients were 119 cases (Men 15, 48±13 yrs). Total number of samples were 205 pieces. In malignant thyroid disease, there were 153 samples: 90 in papillary carcinoma, 4 in follicular carcinoma, 2 in medullary carcinoma and 57 in metastatic lymph node. In benign thyroid disease, there were 52 samples: 36 in goiter/cyst, 11 in thyroiditis and 5 in follicular adenoma. Using immunohistochemical methods, we probed 205 samples with monoclonal anti-NIS Ab. Grading of staining was scored as 0 (negative or absent), 1 (weakly positive), 2 (moderately positive) or 3 (strongly positive). Expression rate (ER) of NIS positivity in individual disease entity was expressed as percentage of total number divided by number in 2 plus 3 grade. ERs of malignant thyroid diseases were 63% in papillary carcinoma, 81% in metastatic lymph node, 71% in follicular carcinoma and 100% in medullary carcinoma. ERs of benign thyroid disease were 53% in goiter/cyst, 64% in thyroiditis and 40% in follicular adenoma. ER of benign thyroid deceases was higher than benign thyroid diseases (71% vs 54%). Grading of NIS expression in papillary carcinoma or goiter/cyst was heterogeneously distributed in considerable cases. Normal tissue also showed heterogeneous distribution or NIS expression, which was not correlated with that of primary lesion. In papillary thyroid carcinoma, distribution of NIS expression was heterogeneous and increased, and not different compared with that of benign thyroid disease

  18. Impact of radiation therapy for benign diseases

    International Nuclear Information System (INIS)

    Kantor, G.; Van Houtte, P.; Beauvois, S.; Roelandts, M.

    1997-01-01

    Radiation therapy of benign diseases represent a wide panel of indications. Some indications are clearly identified as treatment of arteriovenous malformations (AVM), hyperthyroid ophthalmopathy, postoperative heterotopic bone formations or keloid scars. Some indications are under evaluation as complications induced by neo-vessels of age-related macular degeneration or coronary restenosis after angioplasty. Some indications remain controversial with poor evidence of efficiency as treatment of bursitis, tendinitis or Dupuytren's disease. Some indications are now obsolete such as warts, or contra-indicated as treatment of infant and children. (authors)

  19. Early Experience of Robotic Hysterectomy for Treatment of Benign Uterine Disease.

    Science.gov (United States)

    Gutierrez, Ana Luiza; Binda, Márcia Luisa Montalvão Appel; Ramos, José Geraldo Lopes

    2016-09-01

    Objectives  To demonstrate the initial experience of robotic hysterectomy to treat benign uterine disease at a university hospital in Brazil. Methods  A cross-sectional study was conducted to review data from the first twenty patients undergoing robotic hysterectomy at our hospital. The surgeries were performed from November 2013 to August 2014, all of them by the same surgeon. The patients were reviewed for preoperative characteristics, including age, body mass index (BMI), indications for the hysterectomy and previous surgeries. Data of operative times, complications, postoperative pain and length of hospital stay were also collected. Results  The total operating room time was 252.9 minutes, while the operative time was 180.7 minutes and the console time was 136.6 minutes. Docking time was 4.2 minutes, and the average undocking time was 1.9 minutes. There was a strong correlation between the operative time and the patient's BMI ( r  = 0.670; p  = 0.001). The console time had significant correlation with the uterine weight and the patient's BMI ( r  = 0.468; p  = 0.037). A learning curve was observed during docking and undocking times. Conclusion  Despite its high cost, the robotic surgery is gaining more space in gynecological surgery. By the results obtained in our hospital, this surgical proposal proved to be feasible and safe. Our initial experience demonstrated a learning curve in some ways. Thieme Publicações Ltda Rio de Janeiro, Brazil.

  20. MR imaging in gynecology and obstetrics

    International Nuclear Information System (INIS)

    Bauer, M.; Tontsch, P.; Schulz-Wendtland, R.

    2000-01-01

    The toolbook covers the full range of indications for MRI in obstetrics and gynecology. It is the joint work of radiologists and obstetrician-gynecologists and supplies state-of-the-art information needed by doctors in the private practice or a hospital department. Examples from the Table of Contents: Physical principles of MRI, applications and performance aspects. Systematic presentation of diagnostic findings for comparative analysis and assessment. Biological effects and risks. Benign and malignant neoplasms of the mammary glands and the female genital organs. MRI for prenatal care and diagnostic evaluation. New method: MR spectroscopy. (orig./CB) [de

  1. The radiation therapy of benign diseases

    International Nuclear Information System (INIS)

    Hess, F.

    1980-01-01

    X-ray should only be applied when other forms of treatment of good-natured diseases do not provide equally good results. One should note that somatic lesion should be completely avoided and genetic lesion avoided to the greatest probability. One can distinguish according to ones aims between inflammation irradiation, pain irradiation, stimulation therapy and functional therapy. An indication for inflammation irradiation can be post-operative parotitis, furuncle in the face, mastitis puerperalis, panaritium ossale, recurrent sudoriparouns abscesses and repelling reactions after transplanting organs. Pain irradiation is indicated with degenerative diseases of the skeleton system. A further possible application is radiotherapy of hypotrophic processes and benign tumours. Functional radiotherapy is indicated with hyperendocrinism, neurovegetative disorders and allergies. (MG) [de

  2. Benign breast diseases: experience at isra university hospital, hyderabad, pakistan

    International Nuclear Information System (INIS)

    Memon, W.; Mannan, A.; Gilani, R.

    2017-01-01

    To determine the frequency of Benign Breast Disease (BBD) in Isra University Hospital Hyderabad. Methodology: This prospective, descriptive study was carried out at Isra University Hospital Hyderabad, Pakistan from January 2014 and January 2016. Data including age, presenting complaints, clinical examination, histopathological examination and treatment given were all collected from patients presenting in surgery department with breast complaints and recorded. All patients with breast malignancy and trauma of breast were excluded from the study. Data were analyzed using SPSS v. 17. Results: A total of 105 patients with benign breast disease admitted during the study period. Mean age of patients was 30 years (range 13-65). Fibroadenoma was the most common diagnosis in 45(42%), followed by fibrocystic disease 25(23%), breast abscesses 15(14%), sebaceous cyst 10(9.5%), duct ectasia 4(3.8%) and Phylloides 2(1.9%) cases. Conclusion: Fibroadenoma was the most common BBD followed by fibrocystic disease with presentation of either discrete mass or mastalgia. (author)

  3. Emotional state and coping style among gynecologic patients undergoing surgery.

    Science.gov (United States)

    Matsushita, Toshiko; Murata, Hinako; Matsushima, Eisuke; Sakata, Yu; Miyasaka, Naoyuki; Aso, Takeshi

    2007-02-01

    The aim of the present study was to investigate changes in emotional state and the relationship between emotional state and demographic/clinical factors and coping style among gynecologic patients undergoing surgery. Using the Japanese version of the Profile of Mood States (POMS), 90 patients (benign disease: 32, malignancy: 58) were examined on three occasions: before surgery, before discharge, and 3 months after discharge. They were also examined using the Coping Inventory for Stressful Situations (CISS) on one occasion before discharge. The scores for the subscales depression, anger, and confusion were the highest after discharge while those for anxiety were the highest before surgery. The average scores of the POMS subscales for all subjects were within the normal range. With regard to the relationship between these emotional states and other factors, multiple regressions showed that the principal determinants of anxiety before surgery were religious belief, psychological symptoms during hospitalization and emotion-oriented (E) coping style; further, it was found that depression after discharge could be explained by chemotherapy, duration of hospitalization, and E coping style. The principal determinants of anger after discharge and vigor before surgery were length of education and E coping style, and severity of disease, chemotherapy, E coping style and task-oriented coping style, respectively. Those of post-discharge fatigue and confusion were length of education, psychological symptoms, and E coping style. In summary it is suggested that the following should be taken into account in patients undergoing gynecologic surgery: anxiety before surgery, depression, anger, and confusion after surgery, including coping styles.

  4. Radiation for not-so-benign coronary artery disease

    International Nuclear Information System (INIS)

    Massullo, Vincent

    1996-01-01

    The role of radiation therapy in the treatment of malignant disease has long been accepted. More limited application of radiation in the treatment of benign conditions has been proven but generally not pursued. On the centennial anniversary of radiation therapy, a promising, but as yet unproved, application of radiation for treatment of benign vascular disease has become an exciting field of research, speculation, and controversy. This panel presentation will discuss the rationales and dilemmas of applying radiation in the prevention of arterial restenosis after therapeutic intervention. Coronary artery bypass grafting and more recently coronary angioplasty have become accepted, effective therapies to reverse significant coronary stenosis, and thereby benefit the majority of patients with coronary artery disease. However, a large proportion of patients will suffer restenosis in spite of optimal conventional therapy. The search for a means to prevent such restenosis has been partially successful by therapies, and even engineering intravascular devices. In spite of these efforts, a significant number of patients will fail today's conventional therapy and suffer arterial restenosis. Fibroblast myointimal proliferation is felt to be a major element in this restenosis process. Clinical experience shows that radiation inhibits other similar benign fibroblast proliferative processes such as keloid scar formation and heterotopic ossification. Radiation is now being considered as a means to inhibit myointimal fibroblast proliferation and hopefully prevent attendant arterial restenosis as well. This has catalyzed various animal model investigations that have shown significant arteries. Promising results in the animal model and in very early human institutional trials. These trials are designed to determine if radiation is truly effective and can be safely delivered to prevent restenosis in diseased human arteries. This panel discussion will provide a firm basic science and

  5. 99Tcm-MIBI imaging in diagnosing benign/malign pulmonary disease and analysis of lung cancer DNA content

    International Nuclear Information System (INIS)

    Feng Yanlin; Tan Jiaju; Yang Jie; Zhu Zheng; Yu Fengwen; He Xiaohong; Huang Kemin; Yuan Baihong; Su Shaodi

    2002-01-01

    Objective: To evaluate the value of 99 Tc m -methoxyisobutylisonitrile (MIBI) lung imaging in diagnosing benign/malign pulmonary disease and the relation of 99 Tc m -MIBI uptake ratio (UR) with lung cancer DNA content. Methods: Early and delay imaging were performed on 27 cases of benign lung disease and 46 cases of malign lung disease. Visual analysis of the images and T/N uptake ratio measurement were performed on every case. Cancer cell DNA content and DNA index (DI) were measured in 24 cases of malign pulmonary disease. Results: The delay phase UR was 1.13 ± 0.19 in benign disease group, and the delay phase UR was 1.45 ± 0.21 in malign disease group (t6.51, P 99 Tc m -MIBI is not an ideal imaging agent for differentiating pulmonary benign/malign disease. Lung cancer DNA content may be reflected by delay phase UR

  6. Clinical treatment planning in gynecologic cancer

    International Nuclear Information System (INIS)

    Brady, L.W.; Markoe, A.M.; Micaily, B.; Damsker, J.I.; Karlsson, U.L.; Amendola, B.E.

    1987-01-01

    Treatment planning in gynecologic cancer is a complicated and difficult procedure. It requires an adequate preoperative assessment of the true extent of the patient's disease process and oftentimes this can be achieved not only by conventional studies but must employ surgical exploratory techniques in order to truly define the extent of the disease. However, with contemporary sophisticated treatment planning techniques that are now available in most contemporary departments of radiation oncology, radiation therapy is reemerging as an important and major treatment technique in the management of patients with gynecologic cancer

  7. Differentiation of malignant and degenerative benign bone disease using 99mTc-citrate scintigraphy

    International Nuclear Information System (INIS)

    Guo Rui; Jin Jianhua; Li Sijin; Li Xianfeng; Zhang Xiaojuan; Ren Yuan

    2008-01-01

    Objective: To differentiate malignant and degenerative benign bone disease using 99m Tc- citrate scintigraphy. Methods: Thirty-nine patients (92 lesions) with confirmed malignant bone disease or degenerative benign bone disease were studied, for which the results of 99m Te-methylene diphosphonate( 99m Tc- MDP) scintigraphy were positive. 99m Tc-citrate scintigraphy was performed within a time interval of 2-7 days after 99m Tc-MDP scintigraphy. Visual analysis and semiquantitative analysis were applied. Each lesion was scored as malignant or benign, which was independently verified, using conventional techniques (histopathology, X-ray, CT, MRI and clinical follow up). Results: In visual analysis of 99m Tc-citrate imaging, most malignant lesions (35/48, 72.92%) clearly showed high radioactivity accumulation, while most benign lesions (39/44, 88.64%) had not obviously visible uptake of 99m Tc-citrate. In semiquantitative analysis of 99m Tc- citrate image, malignant lesions demonstrated a higher lesion-to-background radioisotope uptake ratio (RUR) than that of benign degenerative lesions (1.47 ± 0.42 vs. 1.09 ± 0.38, t=2.887, P 99m Tc-MDP in the two groups is of the same (1.96 ± 0.25 vs. 1.87 ± 0.21, t=1.178, P>0.20). Conclusion: 99m Tc- citrate scintigraphy is a promising method to differentiate malignant from benign degenerative lesions seen as areas of increased activity on 99m Tc-MDP bone scintigraphy. (authors)

  8. Comparison of Na{sup +}/I{sup -} symporter expression rate in malignant and benign thyroid diseases: immunohistochemical study

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Do Young; Jeong, Young Jin; Lee, Kyung Eun; Park, Heon Soo; Yoo, Young Hyun; Roh, Mee Sook [Donga University College of Medicine, Busan (Korea, Republic of)

    2006-02-15

    Previous studies have not showed consistent results for the level of expression of sodium/iodide symporter (NIS) in thyroid diseases, especially malignant tumor. We undertook this study to evaluate the distribution of NIS expression in malignant thyroid diseases and compare with that in benign thyoid disease. Total patients were 119 cases (Men 15, 48{+-}13 yrs). Total number of samples were 205 pieces. In malignant thyroid disease, there were 153 samples: 90 in papillary carcinoma, 4 in follicular carcinoma, 2 in medullary carcinoma and 57 in metastatic lymph node. In benign thyroid disease, there were 52 samples: 36 in goiter/cyst, 11 in thyroiditis and 5 in follicular adenoma. Using immunohistochemical methods, we probed 205 samples with monoclonal anti-NIS Ab. Grading of staining was scored as 0 (negative or absent), 1 (weakly positive), 2 (moderately positive) or 3 (strongly positive). Expression rate (ER) of NIS positivity in individual disease entity was expressed as percentage of total number divided by number in 2 plus 3 grade. ERs of malignant thyroid diseases were 63% in papillary carcinoma, 81% in metastatic lymph node, 71% in follicular carcinoma and 100% in medullary carcinoma. ERs of benign thyroid disease were 53% in goiter/cyst, 64% in thyroiditis and 40% in follicular adenoma. ER of benign thyroid deceases was higher than benign thyroid diseases (71% vs 54%). Grading of NIS expression in papillary carcinoma or goiter/cyst was heterogeneously distributed in considerable cases. Normal tissue also showed heterogeneous distribution or NIS expression, which was not correlated with that of primary lesion. In papillary thyroid carcinoma, distribution of NIS expression was heterogeneous and increased, and not different compared with that of benign thyroid disease.

  9. Impact of radiation therapy for benign diseases; Role de la radiotherapie dans les affections benignes

    Energy Technology Data Exchange (ETDEWEB)

    Kantor, G. [Institut National de la Sante et de la Recherche Medicale (INSERM), Fondation Bergonie, 33 - Bordeaux (France); Van Houtte, P.; Beauvois, S.; Roelandts, M. [Institut Bordet, Brussels (Belgium)

    1997-12-31

    Radiation therapy of benign diseases represent a wide panel of indications. Some indications are clearly identified as treatment of arteriovenous malformations (AVM), hyperthyroid ophthalmopathy, postoperative heterotopic bone formations or keloid scars. Some indications are under evaluation as complications induced by neo-vessels of age-related macular degeneration or coronary restenosis after angioplasty. Some indications remain controversial with poor evidence of efficiency as treatment of bursitis, tendinitis or Dupuytren`s disease. Some indications are now obsolete such as warts, or contra-indicated as treatment of infant and children. (authors)

  10. Perspectives of radiation therapy in benign diseases

    International Nuclear Information System (INIS)

    Schultze, J.; Eilf, K.

    2006-01-01

    Purpose: the numbers of patients with nonmalignant diseases referred for radiation therapy had to be evaluated for the last 4 years. Patients and methods: in the years 2002, 2004, and 2005 radiation therapy was performed in 61, 40, and 26 patients, respectively. Regularly, more women than men were treated, median age annually was 57, 54, and 55 years, respectively (table 1). The radiotherapy scheme was not modified within the evaluated period. Results: the proportion of nonmalignant diseases among all patients treated decreased from 4.7% in 2002 to 3.3% in 2004 and 2.2% in 2005, respectively. A shift was noticed toward the treatment of four main diseases (endocrine orbitopathy, prevention of heterotopic ossification, meningeoma, tendinitis, table 2). The number of referring physicians decreased from 19 to six. Conclusion: due to administrative restrictions for treatment in hospitals, budget restrictions in private practices and lasting, insufficient revenues for radiotherapy in nonmalignant diseases, radiation therapy for the entire group of benign diseases is endangered. (orig.)

  11. Immunohistochemical localization of HE4 in benign, borderline, and malignant lesions of the ovary.

    Science.gov (United States)

    Georgakopoulos, Penelope; Mehmood, Saira; Akalin, Ali; Shroyer, Kenneth R

    2012-11-01

    Despite advances in the development of novel methods to improve treatment, ovarian carcinoma is still the leading cause of gynecologic cancer death in the United States and other industrialized nations. Improvements in the clinical outcome of ovarian cancer will be achieved if methods can be developed to enable the detection of these tumors at the earliest possible stage. Thus, it is critically important to identify and validate new biomarkers of ovarian cancer. HE4 expression was defined by immunohistochemical analysis of a wide range of benign, borderline, and malignant ovarian lesions, including serous, endometrioid, mucinous, and clear cell lesions of the ovary and in primary tubal carcinomas and the normal fallopian tube. At the cellular level, HE4 was highly expressed in malignant ovarian tumors and in a wide range of benign and borderline ovarian lesions. In addition, HE4 was highly expressed in primary fallopian tube carcinomas and benign fallopian tubal epithelial cells. These results support the conclusion that HE4 is widely expressed in most benign, borderline, and malignant lesions of the ovary and the fallopian tube. The detection of HE4 expression at high levels in some benign lesions and normal tissues suggests that HE4 could have limited specificity as a marker of ovarian or tubal carcinoma. Furthermore, the relatively weak expression that was observed in many ovarian carcinomas indicates that HE4 could fail to detect some cases of primary or recurrent disease.

  12. Lack of HPV in Benign and Malignant Epithelial Ovarian Tumors in Iran

    Science.gov (United States)

    Farzaneh, Farah; Nadji, Seyed Alireza; Khosravi, Donya; Hosseini, Maryam Sadat; Hashemi Bahremani, Mohammad; Chehrazi, Mohammad; Bagheri, Ghazal; Sigaroodi, Afsaneh; Haghighatian, Zahra

    2017-05-01

    Background: Ovarian epithelial tumors one of the most common gynecological neoplasms; we here evaluated the presence of HPV in benign and malignant examples. Methods: In this cross-sectional study the records of 105 patients with epithelial ovarian tumors (benign and malignant) referred to Imam Hossein University Hospital from 2012 to 2015 were evaluated along with assessment of the presence of the HPV infection using PCR. Results: Among 105 patients, comprising 26 (24.8%) with malignant and 79 (75.2%) with benign lesions, the factors found to impact on malignancy were age at diagnosis, age at first pregnancy, number of pregnancies and hormonal status. However, malignancies was not related to abortion, late menopause, and early menarche. In none of the ovarian tissues (benign and malignant) was HPV DNA found. Conclusion: In this study HPV DNA could not be found in any epithelial ovarian tumors (benign and malignant) removed from 105 women; more studies with larger sample size are needed for a definite conclusion. Creative Commons Attribution License

  13. MICROBIOLOGICAL ANALYSIS OF BILE IN PATIENTS WITH BENIGN AND MALIGNANT BILIOPANCREATIC DISEASES AND ITS CONSEQUENCES.

    Science.gov (United States)

    Alves, José Roberto; Silva, Rodrigo do Carmo; Guerra, Sâmea Costa Pinheiro; Freitas, Tiago Tavares de; Souza, Dyego Leandro Bezerra de; Amico, Enio Campos

    2016-01-01

    Bactibilia has several consequences to human health. Assessing the bile microbiology of patients with biliopancreatic diseases in order to identify bacteria and their possible infectious complications. Retrospective study of 30 bile culture samples from patients with benign and malignant biliopancreatic diseases. The samples were assessed to set the bile microbiological flora and to search for its possible link with comorbidity, carcinogenesis and postoperative infectious complications. Thirty bile samples from patients at mean age ≈57.7 years, mostly female (n=18), were assessed. Bactibilia was found in 12 cases, mostly in patients with benign diseases (n=8), older than 50 years (n=23) and female (n=10). Adenocarcinoma of the duodenal papilla (n=9) and cholelithiasis (n=8) were the most common diseases. Escherichia coli (n=5) and Klebsiella sp (n=3) were predominantly found in patients with benign diseases; and Klebsiella sp (n=2) and Streptococcus sp (n=2) were prevalent in cancer patients. There were postoperative infectious complications in seven cases, five of them in bactibilia-associated patients (P=0.084). Bactibilia was found in 12 samples and Escherichia coli and Klebsiella sp were most often identified in patients with benign diseases, as well as Streptococcus sp and Klebsiella sp in cancer patients. There was a trend of higher postoperative infectious complication incidence in patients with bactibilia.

  14. Epidemiology of gynecologic cancers in China.

    Science.gov (United States)

    Jiang, Xiyi; Tang, Huijuan; Chen, Tianhui

    2018-01-01

    Cancer has become a major disease burden across the globe. It was estimated that 4.29 million new incident cases and 2.81 million death cases of cancer would occur in 2015 in China, with the age-standardized incidence rate (ASIR) of 201.1 per 100,000 and age-standardized mortality rate (ASMR) of 126.9 per 100,000, respectively. For females, 2 of the top 10 most common types of cancer would be gynecologic cancers, with breast cancer being the most prevalent (268.6 thousand new incident cases) and cervical cancer being the 7th most common cancer (98.9 thousand new incident cases). The incidence and mortality of gynecologic cancers have been constantly increasing in China over last 2 decades, which become a major health concern for women. Survival rates of gynecologic cancers are generally not satisfactory and decrease along with advancing stage, though national data on survival are still not available. It is of great importance to overview on the epidemiology of gynecologic cancers, which may provide scientific clues for strategy-making of prevention and control, and eventually lowering the incidence and mortality rate as well as improving the survival rate in the future. Copyright © 2018. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.

  15. Familial benign chronic neutropenia associated with periodontal disease. A case report.

    Science.gov (United States)

    Deasy, M J; Vogel, R I; Macedo-Sobrinho, B; Gertzman, G; Simon, B

    1980-04-01

    A rare case report of periodontal disease associated with familial benign chronic neutropenia is presented. The medical, dental and family histories as well as clinical and histologic observations are described and discussed.

  16. Diagnosis of gynecologic pelvic masses by CT scans

    International Nuclear Information System (INIS)

    Ito, Hisao; Kubo, Atsushi; Takagi, Yaeko; Kinoshita, Fumio; Maekawa, Akira.

    1981-01-01

    Two hundred eighty four patients with gynecologic pelvic masses were evaluated with CT scans. Of the patients, 196 had subsequent surgical determination of abnormalities and pathological proof of diagnosis was obtained. Only these 196 patients were included in this study. The CT scans could provide correct diagnosis in 113 of 114 (99%) patients with benign uterine tumor and in all (100%) patients with either serous cystadenoma or dermoid cyst. However, evaluation of mucinous cystadenoma (44%) and endometriosis cyst (37%) by CT scan has some limitations. It was difficult to differentiate mucinous cystadenoma from ovarian carcinoma, because both lesions had partial multiloculation and solid-like areas in the cyst. The CT findings of endometriosis cyst had similarity with serous cystadenoma, and 5 of 8 patients with this disease were diagnosed as serous cystadenoma. Ovarian fibroma and endometrial cancer were also not determined by CT scans. CT identified 87% of patients with ovarian cancer, while false positive rate of this disease was 38% (8/21). In 6 of 13 patients with both of leiomyoma and ovarian cyst, CT was able to demonstrate ovarian lesions that were overlooked by bimanual examinations. The role of CT scanning in our clinical practice is discussed. (author)

  17. Management of gynecologic oncology emergencies

    International Nuclear Information System (INIS)

    Harwood-Nuss, A.L.; Benrubi, G.I.; Nuss, R.C.

    1987-01-01

    Gynecologic malignancies are the third most common cancer among women in the United States. Because of often subtle early findings, the diagnosis may not be made before the widespread dissemination of the disease. The Emergency Department physician will commonly encounter a woman with vaginal bleeding, pelvic pain, or a symptomatic abdominal mass. In this article, we have described the epidemiology, recognized patterns of spread, and associated findings of gynecologic tumors. The proper Emergency Department evaluation and management of these problems is emphasized with guidelines for the timing of referrals and consultation with the gynecologic oncologist. The treatment of gynecologic malignancies is often complicated and responsible for Emergency Department visits. The various modalities are addressed according to the organ systems affected and include sections on postoperative problems, gastrointestinal complaints, urologic complications of therapy, radiation therapy and its complications, with an emphasis on the most serious complications necessitating either careful outpatient management or hospital admission. As cost-containment pressure grows, we have included sections on chemotherapy and total parenteral nutrition, both of which are becoming common outpatient events for the cancer patient. 28 references

  18. Radiotherapy of benign diseases in Berlin (West)

    International Nuclear Information System (INIS)

    Saller, A.

    1979-01-01

    1. In Berlin (West), X-ray therapy was applied during the year 1973 in 18 hospitals and by 33 practicing physicians. The 3rd quarter of the year 1973 was taken as basis for the frequency of therapeutic X-ray application. From a total of 15912 patients, 9432 were X-rayed on account of malignant diseases, 6480 because of benigne diseases. This number definitely surpasses the number of cases treated in Munich by X-ray therapy. In Berlin, this might be connected to the age structure. 2. Utilizing the quotations and calculations put down in the report about the effect of atomic radiation by the Scientific Committee of the United Nations, and the values quoted for gonadal doses in the literature, a total-GSD-value of 0.82 +- 0.2 mrem/a was calculated for hospitals and practicing physicians in Berlin. In spite of higher frequencies, this value is approximately of the same order of magnitude as the values calculated for Munich for the year 1971 by I. and H.P. Schmelz. 3. The total-GSD-value for the population of the Federal Republic of Germany resulting from artificial radiation exposure during 1976 is reported to be approximately 60 mrem. Thus, the GSD-value for the X-ray therapy of benign diseases lies approximately at 1.3% and should be of minor significance for radiation-hygienic reflections. 4. Of primary concern is still the radiation exposure to individual patients. Because of possible secondary effects, X-ray therapy for keloids and hemangiomas in infancy and youth are of particular significance. For this reason, its proportion to GSD is also in Berlin relatively large. (orig.) [de

  19. Serum galectin-9 as a noninvasive biomarker for the detection of endometriosis and pelvic pain or infertility-related gynecologic disorders.

    Science.gov (United States)

    Brubel, Reka; Bokor, Attila; Pohl, Akos; Schilli, Gabriella Krisztina; Szereday, Laszlo; Bacher-Szamuel, Reka; Rigo, Janos; Polgar, Beata

    2017-12-01

    To investigate the usefulness of soluble galectin-9 (Gal-9) in the noninvasive laboratory diagnosis of endometriosis and various gynecologic disorders. Prospective case-control study. University medical centers. A total of 135 women of reproductive age were involved in the study, 77 endometriosis patients, 28 gynecologic controls, and 30 healthy women. Diagnostic laparoscopy and collection of tissue biopsies, peritoneal cells, and native peripheral blood from different case groups of gynecology patients and healthy women. The expression of mRNA and serum concentration of Gal-9. Semiquantitative reverse transcription-polymerase chain reaction analysis and serum soluble Gal-9 ELISA were performed on three different cohorts of patients: those with endometriosis, those with benign gynecologic disorders, and healthy controls. Differences in the Gal-9 concentrations between the investigated groups and the stability of Gal-9 in the serum and diagnostic characteristics of Gal-9 ELISA were determined by statistical evaluation and receiver operating characteristic (ROC) curve analysis. Significantly elevated Gal-9 levels were found in both minimal-mild (I-II) and moderate-severe (III-IV) stages of endometriosis in comparison with healthy controls. At a cutoff of 132 pg/mL, ROC analysis revealed an excellent diagnostic value of Gal-9 ELISA in endometriosis (area under the curve = 0.973) with a sensitivity of 94% and specificity of 93.75%, indicating better diagnostic potential than that of other endometriosis biomarkers. Furthermore, various pelvic pain or infertility-associated benign gynecologic conditions were also associated with increased serum Gal-9 levels. Our results suggest that Gal-9 could be a promising noninvasive biomarker of endometriosis and a predictor of various infertility or pelvic pain-related gynecologic disorders. Copyright © 2017 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  20. Influencing factors on the serum carcinoembryonic antigen (CEA) in benign liver diseases

    International Nuclear Information System (INIS)

    Pompecki, R.; Mehl, H.; Fehr, R.; Braun, H. von

    1982-01-01

    Carcinoembryonic antigen (CEA) was determined in the sera of 452 patients with benign liver diseases by radioimmunoassay (CEA-RIA Kit, Abbott). The CEA-level exceeded 2.5 ng/ml in 39 percent and 5.0 ng/ml in 9 percent of the cases. Independent influences of age, nicotin, and alcohol consumption and connective tissue proliferation of the liver on the CEA level were demonstrated and quantified by two- and higher-dimensional contingency table analysis. Toxic liver diseases were combined with elevated serum CEA values more often than inflammatory diseases. This aspect could not be investigated independently since there were only a few cases of toxic liver diseases without alcohol consumption. Sex and relative body weight do not seem to affect the CEA level. Additional diseases of the gastrointestinal tract or the cardiovascular system did not influence the serum CEA level in liver diseases. Therefore, in patients with benign liver diseases, an elevated serum CEA level indicates increased proliferation of the connective tissue. Age, nicotin, and alcohol consumption have to be considered independently in the clinical judgement of elevated serum CEA levels, irrespective of the underlying disease. (orig.) [de

  1. Pelvic artery embolization in gynecological bleeding

    International Nuclear Information System (INIS)

    Hausegger, K.A.; Schreyer, H.; Bodhal, H.

    2002-01-01

    The most common reasons for gynecological bleeding are pregnancy-related disorders, fibroids of the uterus, and gynecological malignances. Transarterial embolization is an effective treatment modality for gynecological bleeding regardless of its etiology. Depending on the underlying disease, a different technique of embolization is applied. In postpartal bleeding a temporary effect of embolization is desired, therefore gelatine sponge is used as embolizing agent. In fibroids and malignant tumors the effect should permanent, therefore PVA particles are used. Regardless the etiology, the technical and clinical success of transarterial embolization is at least 90%. In nearly every patient a post-embolization syndrome can be observed, represented by local pain and fever. This post-embolization syndrome usually does not last longer than 3 days. If embolization is performed with meticulous attention to angiographic technique and handling of embolic material, ischemic damage of adjacent organs is rarely observed. Transarterial embolization should be an integrative modality in the treatment of gynecological bleeding. (orig.) [de

  2. Guideline for radioiodine therapy for benign thyroid diseases (version 4)

    International Nuclear Information System (INIS)

    Dietlein, M.; Schicha, H.; Moser, E.; Reiners, C.; Schneider, P.; Schober, O.

    2007-01-01

    Version 4 of the guideline for radioiodine therapy for benign thyroid diseases includes an interdisciplinary consensus ondecision making for antithyroid drugs, surgical treatment and radioiodine therapy. The quantitative description of a specific goiter volume for radioiodine therapy or operation was cancelled. For patients with nodular goiter with or without autonomy, manifold circumstances are in favor of surgery (suspicion on malignancy, large cystic nodules, mediastinal goiter, severe compression of the trachea) or in favor of radioiodine therapy (treatment of autonomy, age of patient, co-morbidity, history of prior subtotal thyroidectomy, profession like teacher, speaker or singer). For patients with Graves' disease, radioiodine therapy or surgery are recommended in the constellation of high risk of relapse (first-line therapy), persistence of hyperthyroidism or relapse of hyperthyroidism. After counseling, the patient gives informed consent to the preferred therapy. The period after radioiodine therapy of benign disorders until conception of at least four months was adapted to the European recommendation. (orig.)

  3. Self-perception of swallowing by patients with benign nonsurgical thyroid disease.

    Science.gov (United States)

    Pernambuco, Leandro; Silva, Marlisson Pinheiro da; Almeida, Marluce Nascimento de; Costa, Erika Beatriz de Morais; Souza, Lourdes Bernadete Rocha de

    2017-02-23

    To verify the frequency of swallowing complaints in patients with benign nonsurgical thyroid disease and compare the self-perception of swallowing disorder intensity between different types of thyroid disease. The study sample comprised 39 women aged 19-58 years (38.54 ± 10.74) with hypothyroidism (n=22; 56.4%) or thyroid nodules (n=17; 43.6%). Presence and type of swallowing complaint and self-perception of swallowing disorder intensity were investigated by means of self-ratings recorded on a 100-millimeter visual analog scale. The data were analyzed by descriptive measures and the Mann-Whitney nonparametric test was used to compare the self-perception of swallowing disorder intensity between both clinical diagnoses of thyroid disease. The level of 5% was adopted for statistical significance. Twenty-six (66.7%) individuals reported the following swallowing complaints: pharyngolaryngeal stasis sensation (37.15%), chocking (34.29%), and odynophagia (28.57%). The mean value of self-perception of swallowing disorder intensity by the visual analog scale was 59.35 (± 27.38) millimeters. No difference in self-perception was reported between the clinical diagnoses of thyroid disease. In this sample, swallowing complaint was frequently observed in patients with benign nonsurgical thyroid disease. Moderate self-perception of swallowing disorder intensity was reported regardless of the clinical diagnosis of thyroid disease.

  4. Imaging of gynecologic emergencies

    International Nuclear Information System (INIS)

    Wagner, Matthias W.; Huisman, Thierry A.G.M.; John Hopkins Bayview Medical Center, Baltimore, MD; Kubik, Rahel A.

    2016-01-01

    Acute abdominal pain related to the female genital organs is frequently encountered in the emergency department. Gynecological emergencies are diseases of the female reproductive system that are potentially life-threatening and peril the sexual function and fertility. In the diagnostic work-up of acute abdominal pain, a wide variety of differential diagnoses needs to be considered depending on the age of the patient and a concomitant pregnancy. There is significant clinical overlap with gastrointestinal emergencies. Therefore, imaging plays a key role in diagnosing the cause of the pain and the planning of the therapy. The aim of this review is to illustrate the significant role of imaging in frequently encountered gynecologic emergencies.

  5. Oxidative stress induced damage in benign and malignant breast diseases: histopathological and biochemical aspects

    Directory of Open Access Journals (Sweden)

    Seema Khanna

    2012-04-01

    Full Text Available Increasing evidences indicate involvement of free radicals in the pathogenesis of benign and malignant breast diseases. Free radicals are highly reactive molecules and react with non–radicals in chain reaction leading to formation of new free radicals. If the defense mechanism of body fails to combat them, these free radicals pose a threat of injuring tissues by reacting with cell lipids. Lipids in the cell membrane undergo degradation to form hydroperoxides, which decompose to form a variety of products including malondialdehyde (MDA. MDA therefore was used as a marker to assess oxidative damage of cells and tissues. The aim of the present study was to assess the status of oxidative stress in the patients of benign and malignant breast diseases. Study has been made on the blood samples of 25 cases of benign breast disease and on an equal number of breast carcinoma patients. 20 healthy subjects were taken as the control cases.Mean MDA levels were significantly raised with depletion of antioxidant activity in all the patients in comparison to their control group suggesting the role of oxidative damage in the aetiopathogenesis of disease.

  6. Pancreaticojejunostomy, hepaticojejunostomy and double Roux-en-Y digestive tract reconstruction for benign pancreatic diseases.

    Science.gov (United States)

    Jia, Chang-Ku; Lu, Xue-Fei; Yang, Qing-Zhuang; Weng, Jie; Chen, You-Ke; Fu, Yu

    2014-09-28

    Surgery such as digestive tract reconstruction is usually required for pancreatic trauma and severe pancreatitis as well as malignant pancreatic lesions. The most common digestive tract reconstruction techniques (e.g., Child's type reconstruction) for neoplastic diseases of the pancreatic head often encompass pancreaticojejunostomy, choledochojejunostomy and then gastrojejunostomy with pancreaticoduodenectomy, whereas these techniques may not be applicable in benign pancreatic diseases due to an integrated stomach and duodenum in these patients. In benign pancreatic diseases, the aforementioned reconstruction will not only increase the distance between the pancreaticojejunostomy and choledochojejunostomy, but also the risks of traction, twisting and angularity of the jejunal loop. In addition, postoperative complications such as mixed fistula are refractory and life-threatening after common reconstruction procedures. We here introduce a novel pancreaticojejunostomy, hepaticojejunostomy and double Roux-en-Y digestive tract reconstruction in two cases of benign pancreatic disease, thus decreasing not only the distance between the pancreaticojejunostomy and choledochojejunostomy, but also the possibility of postoperative complications compared to common reconstruction methods. Postoperatively, the recovery of these patients was uneventful and complications such as bile leakage, pancreatic leakage and digestive tract obstruction were not observed during the follow-up period.

  7. The clinical significance of perioperative serum IL-10 level changes in patients with benign and malignant pulmonary diseases

    International Nuclear Information System (INIS)

    Qi Falian; Xu Jun; Du Xiumin; Lu Zhaotong; Fu Qiang

    2003-01-01

    Objective: To study the clinical significance of perioperative changes of serum IL-10 level in patients with benign and malignant pulmonary diseases. Methods: Serum IL-10 levels in patients with benign (n=17) and malignant (n=25) pulmonary diseases were measured before and 1, 3, 7, 14 days after operation with RIA. Values in 82 controls were also taken. Results: The preoperative levels of serum IL-10 in patients with lung cancer were significantly higher than those in other groups (p 0.05); The levels of serum IL-10 in 36.4% of all the patients with lung cancer on day 14 were higher than the upper limit of the normal value. In patients with benign lung diseases, perioperative changes were slight and non-significant. Conclusion: Serum IL-10 level is a reliable parameter for distinguishing benign lung disease from malignant ones. Defining preoperative and postoperative changes of serum IL-10 levels might be of prognostic value in patients with lung cancer

  8. A classification tree for the prediction of benign versus malignant disease in patients with small renal masses.

    Science.gov (United States)

    Rendon, Ricardo A; Mason, Ross J; Kirkland, Susan; Lawen, Joseph G; Abdolell, Mohamed

    2014-08-01

    To develop a classification tree for the preoperative prediction of benign versus malignant disease in patients with small renal masses. This is a retrospective study including 395 consecutive patients who underwent surgical treatment for a renal mass classification tree to predict the risk of having a benign renal mass preoperatively was developed using recursive partitioning analysis for repeated measures outcomes. Age, sex, volume on preoperative imaging, tumor location (central/peripheral), degree of endophytic component (1%-100%), and tumor axis position were used as potential predictors to develop the model. Forty-five patients (11.4%) were found to have a benign mass postoperatively. A classification tree has been developed which can predict the risk of benign disease with an accuracy of 88.9% (95% CI: 85.3 to 91.8). The significant prognostic factors in the classification tree are tumor volume, degree of endophytic component and symptoms at diagnosis. As an example of its utilization, a renal mass with a volume of classification tree to predict the risk of benign disease in small renal masses has been developed to aid the clinician when deciding on treatment strategies for small renal masses.

  9. Galactographic differentiation between malignant and benign disease in patients with pathologic nipple discharge

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Nariya; Cho, Hyun Yee [Gil Medical Center, Incheon (Korea, Republic of); Oh, Ki Keun [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2003-06-01

    To compare the galactographic findings of malignant and benign disease in patients with pathologic nipple discharge and to analyze the features suggesting malignancy. In 24 patients in whom pathologic nipple discharge had occurred, the findings of preoperative galactography were correlated with those of pathology. Nine of the 24 cases were malignant and the other 15 were benign. Intraductal calcification occurred in five malignant cases (56%) and two (13%) which were benign. Seven malignant cases (78%) involved the segmental ducts, and in eight (89%), the peripheral ducts below the subsegmental duct were involved. Five benign cases (33%) involved the lactiferous sinus, seven (47%) the segmental duct, and two (13%) the subsegmental duct. Distal duct dilatation occurred in four benign cases (27%), while ductal stenosis was noted in six cases (67%) and ductal distortion in seven (78%). A malignant tumor appeared as a multiple (n=5, 56%) or irregular (n=5, 56%) filling defect, and a benign tumor as a single (n=12, 80%), oval (n=6, 40%) or lobular (n=4, 27%) filling defect. At galactography, a malignant tumor frequently appeared as an irregular multiple intraductal filling defect in a peripheral duct. A benign tumor, on the other hand, appeared as an oval or lobular single lesion. The presence of ductal stenosis, distortion and intraductal microcalcifications not opacified by contrast material suggest possible malignancy.

  10. Incidence and clinical findings of benign, inflammatory disease in patients resected for presumed pancreatic head cancer

    NARCIS (Netherlands)

    van Gulik, T. M.; Reeders, J. W.; Bosma, A.; Moojen, T. M.; Smits, N. J.; Allema, J. H.; Rauws, E. A.; Offerhaus, G. J.; Obertop, H.; Gouma, D. J.

    1997-01-01

    BACKGROUND: The differentiation between cancer and benign disease in the pancreatic head is difficult. The aim of this study was to examine common features in a group of patients that had undergone pancreatoduodenectomy for a benign, inflammatory lesion misdiagnosed as pancreatic head cancer.

  11. Global epidemiology of hysterectomy: possible impact on gynecological cancer rates

    DEFF Research Database (Denmark)

    Hammer, Anne; Rositch, Anne; Kahlert, Johnny Abildgaard

    2015-01-01

    Despite the fact that hysterectomy is the most common surgical procedure worldwide in gynecology, national reporting of the incidence rate of gynecological cancers rarely removes the proportion no longer at risk of the disease from the population-at-risk-denominator (ie. women who have had a hyst...

  12. [Benign cutaneous lymphadenosis (Bäfverstedt's disease) of the nipple (author's transl)].

    Science.gov (United States)

    Kindermann, G; Sebicke, E

    1977-12-01

    Benign circumscribed cutaneous lymphadenosis of the areola of the nipple (Bäfverstedt's disease) occurs in children and adults. We observed 11 cases: 3 men, 3 children and 6 women. The areola undergoes rapid swelling and becomes red. At times the nipple itself is included. Unilateral enlargment and distortion of the nipple area becomes apparent. Sometimes this is associated with a tumor-like infiltration of the retro-mammillary tissue. In Contradistinction to Pagets disease of the nipple and to a mammillary adenoma there is no eczema and no ulceration. The clinical features and the typical pruritic course establish the diagnosis. Healing is spontaneous, but protracted. The aetiology is probably of an inflammatory nature. Treatment with short courses of antibiotics and anti-inflammatory agents resulted in a faster reduction of the cutaneous signs and corroborated the clinical diagnosis. We consider surgical treatment as unnecessary because circumscript benign lymphadenosis of the nipple area has a harmless course.

  13. Berek & Novak's gynecology

    National Research Council Canada - National Science Library

    Berek, Jonathan S; Novak, Emil

    2012-01-01

    .... The third section is on preventive and primary care for women, and the remaining five sections are directed at methods of diagnosis and management in general gynecology, operative general gynecology, urogynecology and pelvic reconstructive surgery, reproductive endocrinology, and gynecologic oncology"--Provided by publisher.

  14. Safety of endoscopic removal of self-expandable stents after treatment of benign esophageal diseases.

    Science.gov (United States)

    van Halsema, Emo E; Wong Kee Song, Louis M; Baron, Todd H; Siersema, Peter D; Vleggaar, Frank P; Ginsberg, Gregory G; Shah, Pari M; Fleischer, David E; Ratuapli, Shiva K; Fockens, Paul; Dijkgraaf, Marcel G W; Rando, Giacomo; Repici, Alessandro; van Hooft, Jeanin E

    2013-01-01

    Temporary placement of self-expandable stents has been increasingly used for the management of benign esophageal diseases. To evaluate the safety of endoscopic removal of esophageal self-expandable stents placed for the treatment of benign esophageal diseases. Multicenter retrospective study. Six tertiary care centers in the United States and Europe. A total of 214 patients with benign esophageal diseases undergoing endoscopic stent removal. Endoscopic stent removal. Endoscopic techniques for stent removal, time to stent removal, and adverse events related to stent removal. A total of 214 patients underwent a total of 329 stent extractions. Stents were mainly placed for refractory strictures (49.2%) and fistulae (49.8%). Of the removed stents, 52% were fully covered self-expandable metal stents (FCSEMSs), 28.6% were partially covered self-expandable metal stents (PCSEMSs), and 19.5% were self-expandable plastic stents. A total of 35 (10.6%) procedure-related adverse events were reported, including 7 (2.1%) major adverse events. Multivariate analysis revealed that use of PCSEMSs (P stent removal. Favorable factors for successful stent removal were FCSEMSs (P ≤ .012) and stent migration (P = .010). No significant associations were found for stent indwelling time (P = .145) and stent embedding (P = .194). Retrospective analysis, only tertiary care centers. With an acceptable major adverse event rate of 2.1%, esophageal stent removal in the setting of benign disease was found to be a safe and feasible procedure. FCSEMSs were more successfully removed than self-expandable plastic stents and PCSEMSs. Adverse events caused by stent removal were not time dependent. Copyright © 2013 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  15. What do women with gynecologic cancer know about HPV and their individual disease? A pilot study.

    Science.gov (United States)

    Pils, Sophie; Joura, Elmar A; Winter, Max-Paul; Shrestha, Anup; Jaeger-Lansky, Agnes; Ott, Johannes

    2014-05-30

    The vaccinations against human papilloma virus (HPV) are highly effective in preventing persistent infection. The level of knowledge about HPV and the consequences of an infection with this virus are low in the general population and in patients who suffer from HPV-associated diseases. We aimed to compare the level of knowledge about HPV and about the women's individual malignant disease between women with and without HPV-associated gynecologic cancer as well as the knowledge about individual malignant diseases. In a pilot study, 51 women with HPV-related cancer (cervical cancer: n=30; vulvar or vaginal cancer: n=21) and 60 women with non-HPV associated gynecologic malignancies (ovarian cancer: n=30; endometrial cancer, n=30) were included. They answered a questionnaire including questions about personal medical history, risk factors for cancer development, and HPV. The general level of knowledge of the term "HPV" was low (29.7%, 33/111) and it was similar in patients with HPV-related and non-HPV-associated cancer (18/60, 30.0% vs. 15/51, 29.4%, respectively; p=1.000). When asked about their disease, 80% (24/30) of women with ovarian cancer correctly named their diagnosis, followed by women with cervical cancer (73.3%, 22/30), endometrial cancer (70%, 21/30) and vaginal or vulvar cancer (42.9%, 9/21; p=0.008). The level of knowledge about HPV and the malignant diseases the patient suffered from was low. This applied even to patients with HPV associated malignancies.

  16. Acute urinary retention due to benign inflammatory nervous diseases.

    Science.gov (United States)

    Sakakibara, Ryuji; Yamanishi, Tomonori; Uchiyama, Tomoyuki; Hattori, Takamichi

    2006-08-01

    Both neurologists and urologists might encounter patients with acute urinary retention due to benign inflammatory nervous diseases. Based on the mechanism of urinary retention, these disorders can be divided into two subgroups: disorders of the peripheral nervous system (e.g., sacral herpes) or the central nervous system (e.g., meningitis-retention syndrome [MRS]). Laboratory abnormalities include increased herpes virus titers in sacral herpes, and increased myelin basic protein in the cerebrospinal fluid (CSF) in some cases with MRS. Urodynamic abnormality in both conditions is detrusor areflexia; the putative mechanism of it is direct involvement of the pelvic nerves in sacral herpes; and acute spinal shock in MRS. There are few cases with CSF abnormality alone. Although these cases have a benign course, management of the acute urinary retention is necessary to avoid bladder injury due to overdistension. Clinical features of sacral herpes or MRS differ markedly from those of the original "Elsberg syndrome" cases.

  17. Gynecologic cancer treatment: risk factors for therapeutically induced neoplasia

    International Nuclear Information System (INIS)

    Messerschmidt, G.L.; Hoover, R.; Young, R.C.

    1980-01-01

    Therapeutic intervention in a course of illness, while producing the desired result, also may have some adverse long-term effects on the patient. Second malignancies are one of the known complications of therapy. The treatments of gynecologic cancers by surgery, irradiation and chemotherapy have been associated with subsequent neoplasms. The use of normal skin from the thigh to fabricate an artificial vagina has resulted in more squamous cell carcinomas than expected. Alkylating agents used in the treatment of ovarian cancer and other diseases have been shown to lead to an increased risk of leukemia. The incidence of lymphoma and uterine, urinary bladder and colon carcinomas has been associated with prior irradiation for gynecologic disease. The literature regarding the therapeutically induced risk factors in gynecologic therapy is reviewed and areas of our knowledge that require more investigation are identified

  18. Helicobacter species are associated with possible increase in risk of biliary lithiasis and benign biliary diseases

    Directory of Open Access Journals (Sweden)

    Pandey Manoj

    2007-08-01

    Full Text Available Abstract Background Hepato-biliary tract lithiasis is common and present either as pain or as asymptomatic on abdominal ultrasonography for other causes. Although the DNA of Helicobacter species are identified in the gallbladder bile, tissue or stones analyzed from these cases, still a causal relationship could not be established due to different results from different geographical parts. Methods A detailed search of pubmed and pubmedcentral was carried out with key words Helicobacter and gallbladder, gallstones, hepaticolithiasis, cholelithiasis and choledocholithiasis, benign biliary diseases, liver diseases. The data was entered in a data base and meta analysis was carried out. The analysis was carried out using odds ratio and a fixed effect model, 95% confidence intervals for odds ratio was calculated. Chi square test for heterogeneity was employed. The overall effect was calculated using Z test. Results A total of 12 articles were identified. One study used IgG for diagnosis while others used the PCR for Ure A gene, 16 S RNA or Cag A genes. A couple of studies used culture or histopathology besides the PCR. The cumulative results show a higher association of Helicobacter with chronic liver diseases (30.48%, and stone diseases (42.96%(OR 1.77 95% CI 1.2–2.58; Z = 2.94, p = 0.003, the effect of each could not be identified as it was difficult to isolate the effect of helicobacter due to mixing of cases in each study. Conclusion The results of present meta analysis shows that there is a slight higher risk of cholelithiasis and benign liver disease (OR 1.77, however due to inherent inability to isolate the effect of stone disease from that of other benign lesions it is not possible to say for sure that Helicobacter has a casual relationship with benign biliary disease or stone disease or both.

  19. Anti-hemorrhagic effect of prophylactic tranexamic acid in benign hysterectomy-a double-blinded randomized placebo-controlled trial

    DEFF Research Database (Denmark)

    Topsoee, Märta Fink; Bergholt, Thomas; Ravn, Pernille

    2016-01-01

    and in 2004, 8% of all women in Denmark undergoing benign hysterectomy experienced a bleeding complication. Tranexamic acid is an antifibrinolytic agent that has shown to effectively reduce bleeding complications within other surgical and medical areas. However, knowledge about the drug's effect in relation...... to benign hysterectomy is still missing. OBJECTIVE: To investigate the antihemorrhagic effect of prophylactic tranexamic acid in elective benign hysterectomy. STUDY DESIGN: A double-blinded randomized placebo-controlled trial was conducted at 4 gynecological departments in Denmark from April 2013 to October...... 2014. A total of 332 women undergoing benign abdominal, laparoscopic, or vaginal hysterectomy were included in the trial, randomized to either 1 g of intravenous tranexamic acid or placebo at start of surgery. Chi-square test and Student t test statistical analyses were applied. RESULTS: The primary...

  20. Radiation therapy for benign diseases: patterns of care study in Germany

    International Nuclear Information System (INIS)

    Seegenschmiedt, M. Heinrich; Katalinic, Alexander; Makoski, Hans-Bruno; Haase, Wulf; Gademann, Guenther; Hassenstein, Eckhard

    2000-01-01

    Background: Radiotherapy of benign diseases is controversial and rarely applied in Anglo-American countries, whereas in other parts of the world it is commonly practiced for several benign disorders. Similar to a European survey, a pattern of care study was conducted in Germany. Method: Using a mailed questionnaire, radiation equipment, treatment indication, number of patients, and treatment concepts were assessed in 1994, 1995, and 1996 in 134 of 152 German institutions (88%): 22 in East and 112 in West Germany; 30 in university hospitals and 104 in community hospitals. Average numbers of each institution and of all institutions were analyzed for frequencies and ratios between regions and among institutions. Radiation treatment concepts were analyzed. Results: A mean of 2 (range 1-7) megavoltage and 1.4 (range 0-4) orthovoltage units were available per institution; 32 institutions (24%) had no orthovoltage equipment. A mean of 20,082 patients were treated annually: 456 (2%) for inflammatory diseases (221 hidradenitis, 78 local infection, 23 parotitis; 134 not specified) 12,600 (63%) for degenerative diseases (2711 peritendinitis humeroscapularis, 1555 epicondylitis humeri; 1382 plantar/dorsal heel spur; 2434 degenerative osteoarthritis; 4518 not specified); 927 (5%) for hyperproliferative diseases (146 Dupuytren's contracture, 382 keloids; 155 Peyronie's disease; 244 not specified); 1210 (6%) for functional disorders (853 Graves' orbitopathy; 357 not specified); and 4889 (24%) for other disorders (e.g., 3680 heterotopic ossification prophylaxis). In univariate analysis, there were geographic (West vs. East Germany) differences in using radiation therapy (RT) for inflammatory and degenerative disorders, and institutional differences (university versus community hospitals) in using RT for hyperproliferative and functional disorders (p < 0.05). The prescribed dose concepts were mostly in the low dose range, <10 Gy but varied widely and inconsistently within

  1. The manifestation of 18F-FDG imaging of coincidence SPECT in benign pulmonary diseases

    International Nuclear Information System (INIS)

    Miao Jisheng; Liu Jinjun; Wu Jiyong; Pan Huizhong; Wang Huoqiang; Shen Yi; Shi Degang

    2001-01-01

    Objective: To study the uptake of the 18 F-FDG in the benign pulmonary diseases with dual head SPECT coincidence detection system. Methods: Scanning were performed with dual head SPECT coincidence detection system for patients with pulmonary diseases,the uptake and the imaging characteristic of the diseases were analysed. Results: 1) In 28 tuberculosis (TB) patients, 19 cases with a negative imaging (68%, 19/28), whereas 9 cases with a positive result (32%, 9/28). The T/N value of the TB is 1.7 +- 1.2, but the T/N of the lung cancer is 4.1 +- 2.4, significantly different from them. In the skin PPD test, 9 cases with positive scans showed a 16.2 (12 - 22) mm diameter red spot, but 7 cases of negative scans with a 8.6 (0 - 15) mm diameter, both also have a significant difference. 2) Out of the 8 patients suffered from sarcoidosis, among them 5 active stage with positive scans, whereas another 3 remission cases with negative results. 3) In 18 inflammation cases, positive imagings were showed in 6 patients with cryptococcosis, mycoplasma pneumonia, mycosis, organized pneumonia, lung abscess and bacteria pneumonia. Conclusions: In some benign pulmonary diseases, 18 F-FDG imaging can be positive also. Analysing the characteristic of the imaging could rise specificity in lung cancer and also give some new clues to treatment of these benign pulmonary diseases

  2. Nuclear medicine for diagnosis in benign diseases of the skeleton

    International Nuclear Information System (INIS)

    Feine, U.

    1992-01-01

    In summary, the lecture presents today's state of nuclear medical diganostics in benign bone disease, the radiopharmaceuticals, and the methods used. Besides the 99 m-Tc-labeled diphosphonates a couple of additional radioactive labeled substances play an important part in bone scintigraphic imaging especially in scanning inflammatory bone disease and the bone marrow. There are several substances available to label leucocytes and human immunoglobulins. Concerning the methods the performance of the 3-phase bone scanning and the application of SPECT becomes increasingly important. In detail discussed are among other methods the inflammation-scanning in osteomyelitis, the scintigraphic imaging in benign bone tumors and tumor like lesions, in circulation disorders of the bone with necroses and hyperperfusion (reflex sympathetic dystrophy, transient hip osteoporosis), and in bone lesions following trauma or stress, for example also in battered child syndrome. The indication to the different imaging procedures as X-ray, computed tomography, nuclear magnetic resonance, and scintigraphic imaging are discussed, whereby the scintiscanning urges its place, mainly due to good specifity, in documenting the different functional states of the bone such as inflammation, perfusion, necrosis, tumor and/or bone marrow infiltration. (orig.) [de

  3. Global N-acetylaspartate concentration in benign and non-benign multiple sclerosis patients of long disease duration

    International Nuclear Information System (INIS)

    Achtnichts, Lutz; Gonen, Oded; Rigotti, Daniel J.; Babb, James S.; Naegelin, Yvonne; Penner, Iris-Katharina; Bendfeldt, Kerstin; Hirsch, Jochen; Amann, Michael; Kappos, Ludwig; Gass, Achim

    2013-01-01

    Background and objective: To examine whether clinically benign multiple sclerosis patients (BMS) show similar losses of their global N-acetylaspartate (NAA) neuronal marker relative to more clinically disabled patients of similar disease duration. Methods: The whole-brain NAA concentration (WBNAA) was acquired with whole-head non-localizing proton MR spectroscopy. Fractional brain parenchymal volume (fBPV), T 2 and T 1 lesion loads, were obtained from the MRI in: (i) 24 BMS patients: 23.1 ± 7.2 years disease duration, median Expanded Disability Status Scale (EDSS) score of 2.0 (range: 0–3); (ii) 26 non-benign MS patients (non-BMS), 24.5 ± 7.4 years disease duration, median EDSS of 4.0 (range: 3.5–6.5); (iii) 15 healthy controls. Results: Controls’ 12.4 ± 2.3 mM WBNAA was significantly higher than the BMS's and non-BMS's 10.5 ± 2.4 and 9.9 ± 2.1 mM (both p < 0.02), but the difference between the patients’ groups was not (p > 0.4). Likewise, the controls’ 81.2 ± 4.5% fBPV exceeded the BMS and non-BMS's 77.0 ± 5.8% and 76.3 ± 8.6% (p < 0.03), which were also not different from one another (p > 0.7). BMS patients’ T 1 -hypointense lesion load, 2.1 ± 2.2 cm 3 , was not significantly different than the non-BMS's 4.1 ± 5.4 cm 3 (p > 0.08) and T 2 -hyperintense loads: 6.0 ± 5.7 cm 3 and 8.7 ± 7.8 cm 3 , were also not different (p > 0.1). Conclusions: WBNAA differentiates normal controls from MS patients but does not distinguish BMS from more disabled MS patients of similar disease duration. Nevertheless, all MS patients who remain RR for 15+ years suffered WBNAA loss similar to the average RR MS population at fourfold shorter disease duration suggesting relative global neuronal sparing or leveling-off of the neurodegeneration rate

  4. Gynecologic cancer treatment: risk factors for therapeutically induced neoplasia

    International Nuclear Information System (INIS)

    Messerschmidt, G.L.; Hoover, R.; Young, R.C.

    1981-01-01

    Therapeutic intervention in a course of illness, while producing the desired result, also may have some adverse long-term effects on the patient. Second malignancies are one of the known complications of therapy. The treatments of gynecologic cancers by surgery, irradiation and chemotherapy have been associated with subsequent neoplasms. Care must be exercised in associating previous therapy and a subsequent malignancy. Naturally occurring second cancers must be separated from those which are iatrogenic. Associations in the literature have been made involving malignancies as a sequelae of prior gynecologic therapy. The use of normal skin from the thigh to fabricate an artificial vagina has resulted in more squamous cell carcinomas than expected. Alkylating agents used in the treatment of ovarian cancer and other diseases have been shown to lead to an increased risk of leukemia. Irradiation therapy, however, has not yet been shown to be related to leukemia in cervical cancer patients. The incidence of lymphoma and uterine, urinary bladder and colon carcinomas has been associated with prior irradiation for gynecologic disease. The literature regarding the therapeutically induced risk factors in gynecologic therapy is reviewed and areas of our knowledge that require more investigation are identified

  5. Utility of PET in gynecological cancer

    International Nuclear Information System (INIS)

    Choi, Chang Woon

    2002-01-01

    Clinical application of positron emission tomography (PET) is rapidly increasing for the detection and staging of cancer at whole-body studies performed with 2-[fluorine-18] fluoro-2-deoxy-D-glucose (FDG). Although many cancers can be detected by FDG-PET, there has been limited clinical experience with FDG-PET for the detection of gynecological cancers including malignancies in uterus and ovary. FDG-PET can show foci of metastatic disease that may not be apparent at conventional anatomic imaging and can aid in the characterization of indeterminate soft-tissue masses. Most gynecological cancers need to surgical management. FDG-PET can improve the selection of patients for surgical treatment and thereby reduce the morbidity and mortality associated with inappropriate surgery. FDG-PET is also useful for the early detection of recurrence and the monitoring of therapeutic effect. In this review, I discuss the clinical feasibility and imitations of this imaging modality in patients with gynecological cancers

  6. Systematic review of robotic surgery in gynecology: robotic techniques compared with laparoscopy and laparotomy.

    Science.gov (United States)

    Gala, Rajiv B; Margulies, Rebecca; Steinberg, Adam; Murphy, Miles; Lukban, James; Jeppson, Peter; Aschkenazi, Sarit; Olivera, Cedric; South, Mary; Lowenstein, Lior; Schaffer, Joseph; Balk, Ethan M; Sung, Vivian

    2014-01-01

    The Society of Gynecologic Surgeons Systematic Review Group performed a systematic review of both randomized and observational studies to compare robotic vs nonrobotic surgical approaches (laparoscopic, abdominal, and vaginal) for treatment of both benign and malignant gynecologic indications to compare surgical and patient-centered outcomes, costs, and adverse events associated with the various surgical approaches. MEDLINE and the Cochrane Central Register of Controlled Trials were searched from inception to May 15, 2012, for English-language studies with terms related to robotic surgery and gynecology. Studies of any design that included at least 30 women who had undergone robotic-assisted laparoscopic gynecologic surgery were included for review. The literature yielded 1213 citations, of which 97 full-text articles were reviewed. Forty-four studies (30 comparative and 14 noncomparative) met eligibility criteria. Study data were extracted into structured electronic forms and reconciled by a second, independent reviewer. Our analysis revealed that, compared with open surgery, robotic surgery consistently confers shorter hospital stay. The proficiency plateau seems to be lower for robotic surgery than for conventional laparoscopy. Of the various gynecologic applications, there seems to be evidence that renders robotic techniques advantageous over traditional open surgery for management of endometrial cancer. However, insofar as superiority, conflicting data are obtained when comparing robotics vs laparoscopic techniques. Therefore, the specific method of minimally invasive surgery, whether conventional laparoscopy or robotic surgery, should be tailored to patient selection, surgeon ability, and equipment availability. Copyright © 2014 AAGL. Published by Elsevier Inc. All rights reserved.

  7. Breast cancer risk after diagnosis by screening mammography of nonproliferative or proliferative benign breast disease: a study from a population-based screening program.

    Science.gov (United States)

    Castells, Xavier; Domingo, Laia; Corominas, Josep María; Torá-Rocamora, Isabel; Quintana, María Jesús; Baré, Marisa; Vidal, Carmen; Natal, Carmen; Sánchez, Mar; Saladié, Francina; Ferrer, Joana; Vernet, Mar; Servitja, Sonia; Rodríguez-Arana, Ana; Roman, Marta; Espinàs, Josep Alfons; Sala, María

    2015-01-01

    Benign breast disease increases the risk of breast cancer. This association has scarcely been evaluated in the context of breast cancer screening programs although it is a prevalent finding in mammography screening. We assessed the association of distinct categories of benign breast disease and subsequent risk of breast cancer, as well as the influence of a family history of breast cancer. A retrospective cohort study was conducted in 545,171 women aged 50-69 years biennially screened for breast cancer in Spain. The median of follow-up was 6.1 years. The age-adjusted rate ratio (RR) of breast cancer for women with benign breast disease, histologically classified into nonproliferative and proliferative disease with and without atypia, compared with women without benign breast disease was estimated by Poisson regression analysis. A stratified analysis by family history of breast cancer was performed in a subsample. All tests were two-sided. The age-adjusted RR of breast cancer after diagnosis of benign breast disease was 2.51 (95 % CI: 2.14-2.93) compared with women without benign breast disease. The risk was higher in women with proliferative disease with atypia (RR = 4.56, 95 % CI: 2.06-10.07) followed by those with proliferative disease without atypia (RR = 3.58; 95 % CI = 2.61-4.91). Women with nonproliferative disease and without a family history of breast cancer remained also at increased risk of cancer (OR = 2.23, 95 % CI: 1.86-2.68). An increased risk of breast cancer was observed among screening participants with proliferative or nonproliferative benign breast disease, regardless of a family history of breast cancer. This information may be useful to explore risk-based screening strategies.

  8. Estimation of cancer risks from radiotherapy of benign diseases

    International Nuclear Information System (INIS)

    Trott, K.R.; Kamprad, F.

    2006-01-01

    Background: The effective-dose method which was proposed by the ICRP (International Commission of Radiation Protection) for the estimation of risk to the general population from occupational or environmental, low-dose radiation exposure is not adequate for estimating the risk of cancer induction by radiotherapy of malignant or nonmalignant diseases. Methods:The risk of cancer induction by radiotherapy of benign diseases should be based on epidemiologic data directly derived from follow-up studies of patients who had been given radiotherapy for nonmalignant diseases in the past. Results: Risk factors were derived from epidemiologic studies of patients treated with irradiation for nonmalignant diseases to be used for selecting treatment options and optimizing treatment procedures. Conclusion: In most cases, cancer risks estimated by the effective-dose method may overestimate the true risks by one order of magnitude, yet in other cases even may underestimate it. The proposed method using organ-specific risk factors may be more suitable for treatment planning. (orig.)

  9. Quantitative Determination of Telomerase Activity in Breast Cancer and Benign Breast Diseases

    Czech Academy of Sciences Publication Activity Database

    Šimíčková, M.; Nekulová, M.; Pecen, Ladislav; Černoch, M.; Vagundová, M.; Pačovský, Z.

    2001-01-01

    Roč. 48, č. 4 (2001), s. 267-273 ISSN 0028-2685 R&D Projects: GA MZd NM17 Institutional research plan: AV0Z1030915 Keywords : telomerase activity * quantitative analysis * breast cancer * benign breast diseases * prognisis Subject RIV: BA - General Mathematics Impact factor: 0.637, year: 2001

  10. Gynecologic cancer

    International Nuclear Information System (INIS)

    Uehara, Takashi; Katsumata, Noriyuki

    2008-01-01

    Surgery and radiation therapy have been the main types of treatment for gynecologic cancer. However, chemotherapy in gynecologic oncology has recently made dramatic progress and presently is becoming the most widespread treatment. After the discovery of cisplatin in the field of chemotherapy for epithelial ovarian cancer, it has now become the leading treatment modality. According to the result of several important phase III randomized control trials (RCTs), the platinum-taxane combined therapy has now become the standard treatment regimen. Regarding endometrial cancer, Cisplatin-Adriamycin-Cyclophosphamide (CAP) therapy has been used as an effective adjuvant chemotherapy in Japan. The adjuvant chemotherapy (Adriamycin-Cisplatin therapy) for the endometrial cancer has now been recognized worldwide as the standard therapy based on the findings of a phase III RCT. Concurrent chemoradiotherapy for cervical cancer has also been recommended as the standard therapy in Japan since 1999 based on the successful results of numerous RCTs which proved its efficacy. The chemotherapy for gynecologic cancers has been investigated and standardized based on the results of numerous clinical trials. These trials have been conducted by many clinical trial groups, such as the Gynecologic Oncology Group (GOG), Southwest Oncology Group (SWOG), and the European Organization for Research and Treatment of Cancer (EORTC) throughout the world, in addition to the Japan Clinical Oncology Group (JCOG) and the Japanese Gynecologic Oncology Group (JGOG) in Japan. The valuable contributions of these clinical trials are helping in the development of new drug therapies, thus leading to such treatment regimens playing increasingly important and wider roles in the field of gynecologic oncology treatment in the future. (author)

  11. HE4 Tissue Expression and Serum HE4 Levels in Healthy Individuals and Patients with Benign or Malignant Tumors

    DEFF Research Database (Denmark)

    Karlsen, Nikoline S; Karlsen, Mona A; Høgdall, Claus K

    2014-01-01

    , this review aims to systematically outline published results of HE4 tissue expression and serum HE4 levels in healthy individuals and patients with benign or malignant tumors. Our findings suggest scientific basis for a potential diagnostic ability of HE4 in gynecologic cancer and lung cancer, and further...

  12. Global N-acetylaspartate concentration in benign and non-benign multiple sclerosis patients of long disease duration

    Energy Technology Data Exchange (ETDEWEB)

    Achtnichts, Lutz [Departments of Neurology and Neuroradiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel (Switzerland); Gonen, Oded, E-mail: oded.gonen@nyumc.org [Department of Radiology, New York University School of Medicine, 660 First Avenue, 4th Floor, New York, NY 10016 (United States); Rigotti, Daniel J.; Babb, James S. [Department of Radiology, New York University School of Medicine, 660 First Avenue, 4th Floor, New York, NY 10016 (United States); Naegelin, Yvonne [Departments of Neurology and Neuroradiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel (Switzerland); Penner, Iris-Katharina; Bendfeldt, Kerstin [Department of Cognitive Psychology and Methodology, University of Basel, Missionsstrasse 60/62, 4055 Basel (Switzerland); Hirsch, Jochen; Amann, Michael; Kappos, Ludwig [Departments of Neurology and Neuroradiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel (Switzerland); Gass, Achim [Departments of Neurology and Neuroradiology, University Hospital Basel, Petersgraben 4, CH-4031 Basel (Switzerland); Dept. of Neurology, Universitaetsmedizin Mannheim, University of Heidelberg (Germany)

    2013-12-01

    Background and objective: To examine whether clinically benign multiple sclerosis patients (BMS) show similar losses of their global N-acetylaspartate (NAA) neuronal marker relative to more clinically disabled patients of similar disease duration. Methods: The whole-brain NAA concentration (WBNAA) was acquired with whole-head non-localizing proton MR spectroscopy. Fractional brain parenchymal volume (fBPV), T{sub 2} and T{sub 1} lesion loads, were obtained from the MRI in: (i) 24 BMS patients: 23.1 ± 7.2 years disease duration, median Expanded Disability Status Scale (EDSS) score of 2.0 (range: 0–3); (ii) 26 non-benign MS patients (non-BMS), 24.5 ± 7.4 years disease duration, median EDSS of 4.0 (range: 3.5–6.5); (iii) 15 healthy controls. Results: Controls’ 12.4 ± 2.3 mM WBNAA was significantly higher than the BMS's and non-BMS's 10.5 ± 2.4 and 9.9 ± 2.1 mM (both p < 0.02), but the difference between the patients’ groups was not (p > 0.4). Likewise, the controls’ 81.2 ± 4.5% fBPV exceeded the BMS and non-BMS's 77.0 ± 5.8% and 76.3 ± 8.6% (p < 0.03), which were also not different from one another (p > 0.7). BMS patients’ T{sub 1}-hypointense lesion load, 2.1 ± 2.2 cm{sup 3}, was not significantly different than the non-BMS's 4.1 ± 5.4 cm{sup 3} (p > 0.08) and T{sub 2}-hyperintense loads: 6.0 ± 5.7 cm{sup 3} and 8.7 ± 7.8 cm{sup 3}, were also not different (p > 0.1). Conclusions: WBNAA differentiates normal controls from MS patients but does not distinguish BMS from more disabled MS patients of similar disease duration. Nevertheless, all MS patients who remain RR for 15+ years suffered WBNAA loss similar to the average RR MS population at fourfold shorter disease duration suggesting relative global neuronal sparing or leveling-off of the neurodegeneration rate.

  13. Benign gastric filling defect

    Energy Technology Data Exchange (ETDEWEB)

    Oh, K K; Lee, Y H; Cho, O K; Park, C Y [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1979-06-15

    The gastric lesion is a common source of complaints to Orientals, however, evaluation of gastric symptoms and laboratory examination offer little specific aid in the diagnosis of gastric diseases. Thus roentgenography of gastrointestinal tract is one of the most reliable method for detail diagnosis. On double contract study of stomach, gastric filling defect is mostly caused by malignant gastric cancer, however, other benign lesions can cause similar pictures which can be successfully treated by surgery. 66 cases of benign causes of gastric filling defect were analyzed at this point of view, which was verified pathologically by endoscope or surgery during recent 7 years in Yensei University College of Medicine, Severance Hospital. The characteristic radiological picture of each disease was discussed for precise radiologic diagnosis. 1. Of total 66 cases, there were 52 cases of benign gastric tumor 10 cases of gastric varices, 5 cases of gastric bezoar, 5 cases of corrosive gastritis, 3 cases of granulomatous disease and one case of gastric hematoma. 2. The most frequent causes of benign tumors were adenomatous polyp (35/42) and the next was leiomyoma (4/42). Others were one of case of carcinoid, neurofibroma and cyst. 3. Characteristic of benign adenomatous polyp were relatively small in size, smooth surface and were observed that large size, benign polyp was frequently type IV lesion with a stalk. 4. Submucosal tumors such as leiomyoma needed differential diagnosis with polypoid malignant cancer. However, the characteristic points of differentiation was well circumscribed smooth margined filling defect without definite mucosal destruction on surface. 5. Gastric varices showed multiple lobulated filling defected especially on gastric fundus that changed its size and shape by respiration and posture of patients. Same varices lesions on esophagus and history of liver disease were helpful for easier diagnosis. 6. Gastric bezoar showed well defined movable mass

  14. Benign gastric filling defect

    International Nuclear Information System (INIS)

    Oh, K. K.; Lee, Y. H.; Cho, O. K.; Park, C. Y.

    1979-01-01

    The gastric lesion is a common source of complaints to Orientals, however, evaluation of gastric symptoms and laboratory examination offer little specific aid in the diagnosis of gastric diseases. Thus roentgenography of gastrointestinal tract is one of the most reliable method for detail diagnosis. On double contract study of stomach, gastric filling defect is mostly caused by malignant gastric cancer, however, other benign lesions can cause similar pictures which can be successfully treated by surgery. 66 cases of benign causes of gastric filling defect were analyzed at this point of view, which was verified pathologically by endoscope or surgery during recent 7 years in Yensei University College of Medicine, Severance Hospital. The characteristic radiological picture of each disease was discussed for precise radiologic diagnosis. 1. Of total 66 cases, there were 52 cases of benign gastric tumor 10 cases of gastric varices, 5 cases of gastric bezoar, 5 cases of corrosive gastritis, 3 cases of granulomatous disease and one case of gastric hematoma. 2. The most frequent causes of benign tumors were adenomatous polyp (35/42) and the next was leiomyoma (4/42). Others were one of case of carcinoid, neurofibroma and cyst. 3. Characteristic of benign adenomatous polyp were relatively small in size, smooth surface and were observed that large size, benign polyp was frequently type IV lesion with a stalk. 4. Submucosal tumors such as leiomyoma needed differential diagnosis with polypoid malignant cancer. However, the characteristic points of differentiation was well circumscribed smooth margined filling defect without definite mucosal destruction on surface. 5. Gastric varices showed multiple lobulated filling defected especially on gastric fundus that changed its size and shape by respiration and posture of patients. Same varices lesions on esophagus and history of liver disease were helpful for easier diagnosis. 6. Gastric bezoar showed well defined movable mass

  15. Benign gastric filling defect

    Energy Technology Data Exchange (ETDEWEB)

    Oh, K. K.; Lee, Y. H.; Cho, O. K.; Park, C. Y. [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1979-06-15

    The gastric lesion is a common source of complaints to Orientals, however, evaluation of gastric symptoms and laboratory examination offer little specific aid in the diagnosis of gastric diseases. Thus roentgenography of gastrointestinal tract is one of the most reliable method for detail diagnosis. On double contract study of stomach, gastric filling defect is mostly caused by malignant gastric cancer, however, other benign lesions can cause similar pictures which can be successfully treated by surgery. 66 cases of benign causes of gastric filling defect were analyzed at this point of view, which was verified pathologically by endoscope or surgery during recent 7 years in Yensei University College of Medicine, Severance Hospital. The characteristic radiological picture of each disease was discussed for precise radiologic diagnosis. 1. Of total 66 cases, there were 52 cases of benign gastric tumor 10 cases of gastric varices, 5 cases of gastric bezoar, 5 cases of corrosive gastritis, 3 cases of granulomatous disease and one case of gastric hematoma. 2. The most frequent causes of benign tumors were adenomatous polyp (35/42) and the next was leiomyoma (4/42). Others were one of case of carcinoid, neurofibroma and cyst. 3. Characteristic of benign adenomatous polyp were relatively small in size, smooth surface and were observed that large size, benign polyp was frequently type IV lesion with a stalk. 4. Submucosal tumors such as leiomyoma needed differential diagnosis with polypoid malignant cancer. However, the characteristic points of differentiation was well circumscribed smooth margined filling defect without definite mucosal destruction on surface. 5. Gastric varices showed multiple lobulated filling defected especially on gastric fundus that changed its size and shape by respiration and posture of patients. Same varices lesions on esophagus and history of liver disease were helpful for easier diagnosis. 6. Gastric bezoar showed well defined movable mass

  16. PET/MR Imaging in Gynecologic Oncology.

    Science.gov (United States)

    Ohliger, Michael A; Hope, Thomas A; Chapman, Jocelyn S; Chen, Lee-May; Behr, Spencer C; Poder, Liina

    2017-08-01

    MR imaging and PET using 2-Deoxy-2-[ 18 F]fluoroglucose (FDG) are both useful in the evaluation of gynecologic malignancies. MR imaging is superior for local staging of disease whereas fludeoxyglucose FDG PET is superior for detecting distant metastases. Integrated PET/MR imaging scanners have great promise for gynecologic malignancies by combining the advantages of each modality into a single scan. This article reviews the technology behind PET/MR imaging acquisitions and technical challenges relevant to imaging the pelvis. A dedicated PET/MR imaging protocol; the roles of PET and MR imaging in cervical, endometrial, and ovarian cancers; and future directions for PET/MR imaging are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Immunoscintigraphy in gynecological oncology

    International Nuclear Information System (INIS)

    Pateisky, N.

    1987-01-01

    Immunologic and radionuclide methods are used increasingly in diagnostics and therapy. This applies especially to problems of malignant diseases. Tumor localization diagnosis has gained much from immunoscintigraphy, a non-invasive method combining immunologic and nuclear medicine techniques. Activated monoclonal antibodies against tumorous antigens make it possible to show malignant tumors scintigraphically. An introduction is given to the technique as well as first results of applying immunoscintigraphy to gynecological oncology. (author)

  18. Radiation therapy of benign diseases. What's new eight years after?; La radiotherapie des affections benignes: quelles indications huit ans plus tard?

    Energy Technology Data Exchange (ETDEWEB)

    Van Houtte, P.; Roelandts, M.; Devriendt, D. [Institut Jules-Bordet, Dept. de Radio-Oncologie, Bruxelles (Belgium); Minsat, M.; Laharie, H.; Kantor, G. [Bordeaux-2 Univ. Victor-Segalen, Dept. de Radiotherapie, Institut Bergonie, 33 - Bordeaux (France)

    2005-11-15

    The authors present an update version of the indications for radiotherapy in the management of benign diseases. This is based on available randomized trials and recent international meetings. Validated indications remain the prevention of resected heterotopic bone ossifications, keloids scars and pterygium and also treatment of arteriovenous malformations; the place of radiotherapy for malignant exophthalmia is more and more restricted. Randomized trials have demonstrated the efficacy of endo-brachytherapy in the prevention of restenosis after angioplasty but the use of embedded stent has replaced this indication. Macular degeneration is no more an indication of radiotherapy. Quality requirements for radiotherapy are identical for benign or malignant indications. (author)

  19. MR imaging in gynecology and obstetrics; MR-Tomographie in Gynaekologie und Geburtshilfe

    Energy Technology Data Exchange (ETDEWEB)

    Bauer, M.; Tontsch, P.; Schulz-Wendtland, R. (eds.)

    2000-07-01

    The toolbook covers the full range of indications for MRI in obstetrics and gynecology. It is the joint work of radiologists and obstetrician-gynecologists and supplies state-of-the-art information needed by doctors in the private practice or a hospital department. Examples from the Table of Contents: Physical principles of MRI, applications and performance aspects. Systematic presentation of diagnostic findings for comparative analysis and assessment. Biological effects and risks. Benign and malignant neoplasms of the mammary glands and the female genital organs. MRI for prenatal care and diagnostic evaluation. New method: MR spectroscopy. (orig./CB) [German] Das Lehrbuch deckt alle Indikationen der MRT in Gynaekologie und Geburtshilfe ab. Es wurde von Radiologen und Frauenaerzten gemeinsam verfasst und ist daher praxisgerecht. Aus dem Inhalt: Physikalische Grundlagen und Durchfuehrung der MRT und Systematik fuer die Beurteilung der MRT-Befunde. Biologische Wirkungen und Risiken, benigne und maligne Erkrankungen der Brustdruese und der weiblichen Genitalorgane. MRT in der Schwangerschaft. Neue Methode: MR-Spektroskopie. (orig./AJ)

  20. Smoking habit and benign breast disease

    International Nuclear Information System (INIS)

    Dziewulska-Bokiniec, A.

    1995-01-01

    The possible association between cigarette smoking and the risk of benign breast disease (BBD) was assessed in a case-control study conducted in Gdansk, Poland, between 1990 and 1994. The study compared 160 women with newly diagnosed BBD admitted to the Gdansk Cancer Outpatients Clinic and 160 controls, women from outpatients clinics at the Medical University of Gdansk. There was no convincing evidence of an association, either positive or negative, between various indicators of smoking habit (smoking status, number of cigarettes smoked per day, duration of smoking) and the risk of BBD. Slightly lower relative risk (RRs) of BBD in ex-smokers of 10 or more cigarettes per day (RR = 0.9; 95% confidence interval, CI: 0.4-2.2), and with duration of smoking >= (RR = 0.1-3.4), were also observed in current smokers (RR = 0.8; 95% CI: 0.4-1.5), and (RR = 0.8; 95% CI: 0.1-3.4), but these findings were not statistically significant. (author)

  1. Gestational Trophoblastic Disease -Choriocarcinoma

    International Nuclear Information System (INIS)

    Bozik, M.

    2011-01-01

    Gestational trophoblastic tumors are a group of a diseases from the benign hydatidiform mole, through the invasive mole to the highly malignant form of a choriocarcinoma. Choriocarcinoma is a rare tumor and it is the most malignant and aggressive neoplasm of all the gestational trophoblastic diseases. It grows rapidly and metastasizes to the lung, liver, and, less frequently, to the brain. The author presents the case of a 26-year-old woman who is indicated to the CT examination for suspected brain tumor based on the previous examinations. The patient was diagnosed with metastatic choriocarcinoma to the brain, kidney and adrenal gland on the basis of an anamnesis by her husband, a high value of beta-hCG and a gynecological examination. (author)

  2. Differentiation of malignant and degenerative benign bone disease using Tc-99m Citrate and Tc-99m MDP scintigraphy

    International Nuclear Information System (INIS)

    Jin, J.; Guo, R.; Li, S.-J.; Ren, Y.; Zhang, C.; Zhang, X.

    2007-01-01

    Full text: For the evaluation of bone metastases in patients (pts) with cancer, 99mTcMDP bone scintigraphy is an important tool, but some limitations exist. One of these is the differential diagnosis of malignant and degenerative benign bone disease. The aim of this study was to differentiate them using 99mTcCitrate and 99mTcMDP scintigraphy. Methods: 39 pts (92 lesions) with known malignant or degenerative benign bone disease were studied. 23 pts had malignant bone disease (48 lesions, group 1), the other 16 pts had degenerative benign bone disease (44 lesions, group2), for which the results of 99mTcMDP scintigraphy were positive. In both groups, 99mTcCitrate scintigraphy was performed within a time interval of 2-7 days after 99mTcMDP scintigraphy (555∼740MBq. static, 3hr, planar or SPECT i m a g e s w h e n r e q u i r e d ) . The 99mTccitrate/99mTcMDP lesion-to-background radioisotope uptake ratio (RUR) was calculated for each lesion. Conventional techniques (histopathology, X-ray, CT, MRI and clinical follow up) were considered to be proof of the presence of bone metastases and degenerative benign bone disease. Results: Uptake of 99mTcMDP in the two groups is the same (1.96±0.25 vs. 1.87±0.21; t=1.178, P>0.20), while in 99mTcCitrate image, malignant lesions demonstrated a higher uptake of lesion activity than that of benign degenerative lesions (1.47±0.42 vs. 1.09±0.38; t=2.887, P<0.01). The mean 99mTccitrate/99mTcMDP RUR in the malignant group was significantly higher than the mean in the benign group (0.78±0.21 vs. 0.54±0.19; t=3.646, P<0.001). Conclusions: The preliminary results of the study confirm the usefulness and feasibility of 99mTcCitrate scintigraphy for differentiating malignant from benign degenerative lesions seen as areas of increased activity on 99mTcMDP bone scintigraphy. (author)

  3. A STUDY OF SPECTRUM OF BENIGN BREAST DISEASE IN A TERTIARY CARE INSTITUTE OF CENTRAL INDIA

    Directory of Open Access Journals (Sweden)

    Abhishek Sharma

    2015-01-01

    Full Text Available AIMS AND OBJECTIVES: The presence of a lump in the breast is a great cause of anxiety and apprehension, to the female patients. This may be accrued to the increasing public awareness of breast cancer which is presently the most common female malignancy worldwide. The aim of th is study was to determine the frequency of benign breast diseases (BBD amongst patients in tertiary care institute of central India. MATERIAL AND METHOD: It was a cohort study. In this study all patients visiting the surgical OPD clinic with breast proble ms were included. This study was conducted at Chirayu Medical College and Hospital Bhopal over a period of four years starting from November 2010 to November 2014. All patients with definite symptoms and sign of malignancy or those who on evaluation were d iagnosed as carcinoma of breast were excluded from this study. RESULTS: A total of 112 patients were included in the study. About 54.4% (61/112 patients belonged to 3rd decade of life followed by 21.4% (24/112 from 4th decade (age between: 31 – 40 years . The most common benign breast disease, seen in 33.9% (38/112 of patients was fibro adenoma followed by fibrocystic disease seen in about 19.6% (22/112 patients. Breast abscess was seen in 20/112(17.8% and Mastalgia was present in 15/112 (13.3% patien ts. CONCLUSION: In females of reproductive age group Benign Breast Diseases (BBD are common problems. Fibro adenoma is the commonest of all benign breast disease mostly seen in 2nd and 3rd decade of life. Fibrocystic disease of the breast is the next comm on BBD whose incidence increases with increasing age. Routine mammographic screening of high risk groups aimed at early detection of these premalignant lesions is therefore indicated. A biopsy with histological diagnosis of all breast lumps is also recomme nded as this will aid in the detection of premalignant lesions particularly in low resource settings

  4. Early experience with the da Vinci® surgical system robot in gynecological surgery at King Abdulaziz University Hospital

    Directory of Open Access Journals (Sweden)

    Sait KH

    2011-07-01

    Full Text Available Khalid H SaitObstetrics and Gynecology Department, Faculty of Medicine, Gynecology Oncology Unit, King Abdulaziz University Hospital, Jeddah, Saudi ArabiaBackground: The purpose of this study was to review our experience and the challenges of using the da Vinci® surgical system robot during gynecological surgery at King Abdulaziz University Hospital.Methods: A retrospective study was conducted to review all cases of robot-assisted gynecologic surgery performed at our institution between January 2008 and December 2010. The patients were reviewed for indications, complications, length of hospital stay, and conversion rate, as well as console and docking times.Results: Over the three-year period, we operated on 35 patients with benign or malignant conditions using the robot for a total of 62 surgical procedures. The docking times averaged seven minutes. The mean console times for simple hysterectomy, bilateral salpingo-oophorectomy, and bilateral pelvic lymphadenectomy were 125, 47, and 62 minutes, respectively. In four patients, laparoscopic procedures were converted to open procedures, giving a conversion rate of 6.5%. All of the conversions were among the first 15 procedures performed. The average hospital stay was 3 days. Complications occurred in five patients (14%, and none were directly related to the robotic system.Conclusion: Our early experience with the robot show that with proper training of the robotic team, technical difficulty with the robotic system is limited. There is definitely a learning curve that requires performance of gynecological surgical procedures using the robot.Keywords: da Vinci robot, gynecological surgery, laparoscopy

  5. Pancreaticojejunostomy, hepaticojejunostomy and double Roux-en-Y digestive tract reconstruction for benign pancreatic diseases

    OpenAIRE

    Jia, Chang-Ku; Lu, Xue-Fei; Yang, Qing-Zhuang; Weng, Jie; Chen, You-Ke; Fu, Yu

    2014-01-01

    Surgery such as digestive tract reconstruction is usually required for pancreatic trauma and severe pancreatitis as well as malignant pancreatic lesions. The most common digestive tract reconstruction techniques (e.g., Child’s type reconstruction) for neoplastic diseases of the pancreatic head often encompass pancreaticojejunostomy, choledochojejunostomy and then gastrojejunostomy with pancreaticoduodenectomy, whereas these techniques may not be applicable in benign pancreatic diseases due to...

  6. Benign metastasizing leiomyoma presenting as multiple cystic pulmonary nodules: a case report.

    Science.gov (United States)

    Choe, Yeong Hun; Jeon, So Yeon; Lee, Yoon Chae; Chung, Myung Ja; Park, Seung Yong; Lee, Yong Chul; Kim, So Ri

    2017-09-12

    Benign metastatic leiomyoma (BML) is an extremely rare disease. Although uterine leiomyomas are benign histologically, they can metastasize to distant sites. While the incidence is very low, the lung is the organ most frequently affected by BML. Pulmonary BML usually presents as numerous well-defined nodules of various sizes, while the cavitary or cystic features in the nodules are rarely observed on radiologic images. A 52-year-old woman complained of cough and dyspnea for one month. She had been previously diagnosed with uterine leiomyoma and had undergone total hysterectomy about 14 years prior. High-resolution computed tomography (CT) images showed that there were multiple cystic nodules of various sizes in both lungs. Pathologic examination revealed that the pulmonary nodule had complex branching glandular structures lined by a single layer of simple cuboidal to columnar epithelium that was surrounded by abundant spindle cells. Additional immunohistochemistry data suggested that pulmonary nodule diagnosis was BML-associated uterine leiomyoma. In this report, we introduce an interesting case of pulmonary BML that presented as a combination of various kinds of nodules including simple round nodules, simple cysts, and cysts with a solid portion, which are very rare radiologic features of BML in lung. In addition, when the patient is a woman of reproductive age, physicians should meticulously review the gynecological history and suspect BML when there are various cystic pulmonary lesions.

  7. Intention to Seek Care for Symptoms Associated With Gynecologic Cancers, HealthStyles Survey, 2008

    OpenAIRE

    Trivers, Katrina F.; Rodriguez, Juan L.; Hawkins, Nikki A.; Polonec, Lindsey; Gelb, Cynthia A.; Purvis Cooper, Crystale

    2011-01-01

    Introduction Women with ovarian cancer typically experience symptoms before diagnosis; such symptoms for other gynecologic cancers have not been systematically studied. We investigated which symptoms of gynecologic cancers prompt intention to seek care among women and whether demographic differences in intention exist. This study was undertaken, in part, to inform development of the Centers for Disease Control and Prevention's campaign, Inside Knowledge: Get the Facts About Gynecologic Cancer...

  8. The results of the radioiodine-therapy of benign thyroid diseases respecting the applied radiation dose

    International Nuclear Information System (INIS)

    Maier, C.

    1994-09-01

    452 patients with benign thyroid diseases had been explored after 6 weeks, 6 months, 1 year, 5 years and 10 years after undergone radioiodine treatment retrospectively with regard to the applied radiation dose. A relevant relation between the radiation dose and the rate of hypothyroidism could only be proved as a tendency. Treating hyperthyroidism with radioiodine, the rates of hypothyroidism after therapy were not caused by significantly higher radiation doses. Therefore suggestions to change the used radiation-doses basically cannot be made. The applied doses of radiation are sufficient to achieve a rather satisfactory effect in healing hyperthyroidism. Cases of malignancy after radioiodine therapy could not be found in this population. The effective half-life determination before therapy can be neglected, because there was found a significant difference between the pre-therapeutically estimated half-life and the post-therapeutically measured effective half-life of radioiodine. Instead, fixed values of effective half-life should be used for each group of benign thyroid diseases. The radiation therapy still seems to be an efficient treatment to cure benign thyroid diseases with rare side effects. It also can be applied to patients below the age of 40. Generally it is an alternative to drug-therapy or surgery, always considering the individual relation between gain and risk. In this respect good results can be obtained and a relapse of hyperthyroidism is hardly to expect. (author)

  9. Pulmonary Benign Metastasizing Leiomyoma from the Uterine Leiomyoma: A Case Report

    International Nuclear Information System (INIS)

    Kołaczyk, Katarzyna; Chamier-Ciemińska, Katarzyna; Walecka, Anna; Chosia, Maria; Szydłowska, Iwona; Starczewski, Andrzej; Grodzki, Tomasz; Smereczyński, Andrzej; Sawicki, Marcin

    2015-01-01

    Benign metastasizing leiomyoma (BML) is a rare condition described as multiple well-differentiated leiomyomas at sites distant from the uterus. Apart from lungs it has also been reported in lymph nodes, heart, brain, bone, skin, eye and spinal cord. We present a case of pulmonary benign metastasizing leiomyoma in a female patient admitted to our hospital with suspicion of left adnexal tumor. A 45-year-old woman was referred to our hospital with suspicion of left adnexal tumor. The control transvaginal ultrasound examination performed at admission to the Gynecological Department excluded adnexal neoplasm. However, a large amount of fluid within the Douglas pouch raised the oncological concern. The patient underwent myomectomy in 2005. In the same year she was diagnosed with multiple lung nodules and underwent pulmonary wedge resection with the diagnosis of pulmonary benign metastasizing leiomyoma being stated. The decision of reevaluation of the specimen, control CT and puncture of the Douglas pouch fluid was made. Computed tomography performed at the Department of Diagnostic Imaging and Interventional Radiology of the Pomeranian Medical University Hospital revealed multiple, bilateral nodules. The microscopic examination of the samples confirmed the initial diagnosis of benign metastasizing leiomyoma with no evidence of neoplastic cells within the fluid. Pulmonary benign metastasizing leiomyoma is a rare entity. However, it should be always taken into consideration in women with a previous or coincident history of uterine leiomyoma, especially when no evidence of other malignancy is present

  10. NON-INFLAMMATORY BENIGN BREAST DISEASES (NIBBD: CONFUSING SURGICAL DISORDERS OF BREAST CANCER

    Directory of Open Access Journals (Sweden)

    Somashekhar V. Hiremath

    2016-08-01

    Full Text Available BACKGROUND Benign Breast diseases are of unknown aetiology, they could be inflammatory or non-inflammatory disorders of breast disease. Among these, NIBBD is a most confusing surgical disorder, diagnosis should be made at least after three assessments. AIM  To evaluate the prevalence of NIBBD.  Clinical analysis of NIBBD in women and reproductive age group between 20-40 years.  To prevent radical breast surgery in NIBBD.  To know about benign breast lesions in males excluding gynaecomastia. MATERIALS AND METHODS A clinicopathological study of NIBBD was taken in KIMS Hospital, Hubli, a tertiary care government hospital between June 2014 to June 2015. A total of 56 cases were selected of which 51 cases were submitted for clinicopathological study. RESULTS Increase incidents of fibroadenoma in females, in young age group, is noticed due to early menarche, early marriage, multiparity, fibrocystic diseases involvement at the age of 35 years, usually appear on either side of the breast. Moderate loss of glandular tissue is accelerated and replaced by connective tissue, hence fibrocystic diseases appear at late age group. Gynaecomastia is the only NIBBD, seen unilaterally in males. CONCLUSION NIBBD is more common in childbearing age group i.e. 15 to 45 years of age. Triple assessment is the choice of diagnosis, imaging modality being USG of the breast and mammography in suspected cases of malignancy. Most of the patients require surgical intervention and remodelling of the Breast, according to the volume loss of breast tissue.

  11. Benign breast diseases. Radiology, pathology, risk assessment. 2. ed.

    International Nuclear Information System (INIS)

    Chinyama, Catherine N.

    2014-01-01

    Radiological and pathological correlation of the full range of benign breast lesions, with emphasis on screen-detected lesions. Detailed discussion of risk assessment. Revised and updated edition, with a new chapter on gynaecomastia. Ideal aid to the management of patients with benign or indeterminate breast lesions in a multidisciplinary setting. The second edition of this book has been extensively revised and updated. There have been numerous scientific advances in the radiology, pathology and risk assessment of benign breast lesions since the publication of the first edition. The first edition concentrated on screen-detected lesions, which has since been rectified; new symptomatic and screen-detected lesions are discussed in the second edition and include: mastitis and breast abscesses, idiopathic granulomatous mastitis, diabetic mastopathy, phyllodes tumours, gynaecomastia and pseudoangiomatous stromal hyperplasia. The chapters on columnar cell lesions and mucocele-like lesions have been extensively updated. Where applicable, genetic analysis of the benign lesions, which is becoming part of personalised medicine in the field of breast cancer, has been included. The book also presents detailed analyses of the main models, such as the Gail Model, used to assess the subsequent risk of breast cancer in individuals. The current trend in the management of all cancers is preventative. Screening mammography detects early curable cancers as well as indeterminate lesions, the latter of which are invariably pathologically benign. The author has collated important benign lesions and, based on peer-reviewed publications, has documented the relative risk of subsequent cancer to allow the patient and the clinician to implement preventative measures where possible. This book will therefore serve as an essential component of multidisciplinary management of patients with symptomatic and screen-detected benign breast lesions.

  12. Benign breast diseases. Radiology, pathology, risk assessment. 2. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Chinyama, Catherine N. [Princess Elizabeth Hospital, Le Vauquiedor, St. Martin' s Guernsey, Channel Islands (United Kingdom); Brighton and Sussex Medical School, Brighton (United Kingdom)

    2014-04-01

    Radiological and pathological correlation of the full range of benign breast lesions, with emphasis on screen-detected lesions. Detailed discussion of risk assessment. Revised and updated edition, with a new chapter on gynaecomastia. Ideal aid to the management of patients with benign or indeterminate breast lesions in a multidisciplinary setting. The second edition of this book has been extensively revised and updated. There have been numerous scientific advances in the radiology, pathology and risk assessment of benign breast lesions since the publication of the first edition. The first edition concentrated on screen-detected lesions, which has since been rectified; new symptomatic and screen-detected lesions are discussed in the second edition and include: mastitis and breast abscesses, idiopathic granulomatous mastitis, diabetic mastopathy, phyllodes tumours, gynaecomastia and pseudoangiomatous stromal hyperplasia. The chapters on columnar cell lesions and mucocele-like lesions have been extensively updated. Where applicable, genetic analysis of the benign lesions, which is becoming part of personalised medicine in the field of breast cancer, has been included. The book also presents detailed analyses of the main models, such as the Gail Model, used to assess the subsequent risk of breast cancer in individuals. The current trend in the management of all cancers is preventative. Screening mammography detects early curable cancers as well as indeterminate lesions, the latter of which are invariably pathologically benign. The author has collated important benign lesions and, based on peer-reviewed publications, has documented the relative risk of subsequent cancer to allow the patient and the clinician to implement preventative measures where possible. This book will therefore serve as an essential component of multidisciplinary management of patients with symptomatic and screen-detected benign breast lesions.

  13. [3.0 T MRI with a high resolution protocol for the study of benign disease of the anus and rectum. Part one: High resolution protocol for 3.0 T MRI, anatomic review, benign tumors, and congenital or acquired alterations of the sphincter complex].

    Science.gov (United States)

    Herráiz Hidalgo, L; Cano Alonso, R; Carrascoso Arranz, J; Álvarez Moreno, E; Martínez de Vega Fernández, V

    2014-01-01

    Benign anorectal disease comprises a broad group of processes with very diverse origins; these processes may be congenital or acquired as well as inflammatory or tumor related. However, benign anorectal disease has received less attention in the scientific literature than malignant disease. We present an image-based review of the most common benign diseases of the anus and rectum. In this first part, we review the anatomy of the region and provide a brief description of the peculiarities of the high resolution protocol that we use with 3.0 T MRI. We go on to describe the most common benign anorectal tumors and developmental cystic lesions, together with their differential diagnoses, as well as congenital and acquired anomalies of the anorectal sphincter complex. Copyright © 2011 SERAM. Published by Elsevier Espana. All rights reserved.

  14. Performance of the IOTA ADNEX model in preoperative discrimination of adnexal masses in a gynecological oncology center.

    Science.gov (United States)

    Araujo, K G; Jales, R M; Pereira, P N; Yoshida, A; de Angelo Andrade, L; Sarian, L O; Derchain, S

    2017-06-01

    To evaluate the performance of the International Ovarian Tumor Analysis (IOTA) ADNEX model in the preoperative discrimination between benign ovarian (including tubal and para-ovarian) tumors, borderline ovarian tumors (BOT), Stage I ovarian cancer (OC), Stage II-IV OC and ovarian metastasis in a gynecological oncology center in Brazil. This was a diagnostic accuracy study including 131 women with an adnexal mass invited to participate between February 2014 and November 2015. Before surgery, pelvic ultrasound examination was performed and serum levels of tumor marker CA 125 were measured in all women. Adnexal masses were classified according to the IOTA ADNEX model. Histopathological diagnosis was the gold standard. Receiver-operating characteristics (ROC) curve analysis was used to determine the diagnostic accuracy of the model to classify tumors into different histological types. Of 131 women, 63 (48.1%) had a benign ovarian tumor, 16 (12.2%) had a BOT, 17 (13.0%) had Stage I OC, 24 (18.3%) had Stage II-IV OC and 11 (8.4%) had ovarian metastasis. The area under the ROC curve (AUC) was 0.92 (95% CI, 0.88-0.97) for the basic discrimination between benign vs malignant tumors using the IOTA ADNEX model. Performance was high for the discrimination between benign vs Stage II-IV OC, BOT vs Stage II-IV OC and Stage I OC vs Stage II-IV OC, with AUCs of 0.99, 0.97 and 0.94, respectively. Performance was poor for the differentiation between BOT vs Stage I OC and between Stage I OC vs ovarian metastasis with AUCs of 0.64. The majority of adnexal masses in our study were classified correctly using the IOTA ADNEX model. On the basis of our findings, we would expect the model to aid in the management of women with an adnexal mass presenting to a gynecological oncology center. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

  15. Diagnostic and interventional radiology in gynecologic neoplasms

    International Nuclear Information System (INIS)

    Thorvinger, B.

    1990-05-01

    The role and clinical value of the modern radiologic methods for evaluation of gynecologic tumors is not finally settled. The aims of our investigation were therefore to compare clinical examination with CT in patients with possible recurrence of cervical carcinoma; to evaluate the usefulness of CT in patients with fistulas following gynecologic tumors or their treatment; to evaluate the ability of transabdominal US and MR imaging in intrauterine staging including myometrial invasion on patients with endometrial carcinoma; to evaluate CT in the capacity of monitoring therapy response, probable recurrence or clinical remission in patients with ovarian carcinoma; and to evaluate the effect of intraarterial occlusion in facilitating surgery and in evaluating the role of the intraarterial infusion in gynecologic tumors otherwise refractory to all therapy given. CT was more accurate (91%) than clinical pelvic examination (78%) in revealing extensive disease after radiation and/ or surgical treatment. CT was also a most valuable tool in demonstrating genital fistulas following gynecologic malignancy or its treatment. Transabdominal US did not improve staging in early endometrila carcinoma while MR had potential for delineating intrauterine tumor growth (accuracy for myometrial invasion 95%). CT was most valuable in the evaluation of therapeutic response of ovarian malignancy. For possible recurrence or in clinical remission, only positive CT was of clinical significance. The potentials of transcatheter intraarterial management in order to facilitate operability are also discussed. (92 refs.)

  16. [Secondary osteoporosis in gynecology].

    Science.gov (United States)

    Taguchi, Y; Gorai, I

    1998-06-01

    Several diseases and medications are known to induce secondary osteoporosis. Among them, same situations are related to gynecological field. They include Turner's syndrome, anorexia nervosa, ovarian dysfunction, oophorectomy, GnRH agonist therapy, and osteoporosis associated with pregnancy. We briefly describe these secondary osteoporosis in this article as follows. Several studies have found osteoporosis to be a common complication of Turner's syndrome and hormone replacement therapy has been used as a possible management; in anorexic patient, low body weight, prolonged amenorrhea, early onset of anorexia nervosa, and hypercortisolism have been reported to be risks for bone demineralization; since oophorectomy which is a common intervention in gynecology leads osteoporosis, it is important to prevent osteoporosis caused by surgery as well as postmenopausal osteoporosis; GnRH agonist, which induces estrogen deficient state and affect bone mass, is commonly used as a management for endometriosis and leiomyoma of uterus; associated with pregnancy, post-pregnancy spinal osteoporosis and transient osteoporosis of the hip are clinically considered to be important and heparin therapy and magnesium sulfate therapy are commonly employed during pregnancy, affecting calcium homeostasis.

  17. Mesotherapy for benign symmetric lipomatosis.

    Science.gov (United States)

    Hasegawa, Toshio; Matsukura, Tomoyuki; Ikeda, Shigaku

    2010-04-01

    Benign symmetric lipomatosis, also known as Madelung disease, is a rare disorder characterized by fat distribution around the shoulders, arms, and neck in the context of chronic alcoholism. Complete excision of nonencapsulated lipomas is difficult. However, reports describing conservative therapeutic measures for lipomatosis are rare. The authors present the case of a 42-year-old man with a diagnosis of benign symmetric lipomatosis who had multiple, large, symmetrical masses in his neck. Multiple phosphatidylcholine injections in the neck were administered 4 weeks apart, a total of seven times to achieve lipolysis. The patient's lipomatosis improved in response to the injections, and he achieved good cosmetic results. Intralesional injection, termed mesotherapy, using phosphatidylcholine is a potentially effective therapy for benign symmetric lipomatosis that should be reconsidered as a therapeutic option for this disease.

  18. Can you ask? We just did! Assessing sexual function and concerns in patients presenting for initial gynecologic oncology consultation.

    Science.gov (United States)

    Kennedy, Vanessa; Abramsohn, Emily; Makelarski, Jennifer; Barber, Rachel; Wroblewski, Kristen; Tenney, Meaghan; Lee, Nita Karnik; Yamada, S Diane; Lindau, Stacy Tessler

    2015-04-01

    To describe patterns of response to, and assess sexual function and activity elicited by, a self-administered assessment incorporated into a new patient intake form for gynecologic oncology consultation. A cross-sectional study of patients presenting to a single urban academic medical center between January 2010 and September 2012. New patients completed a self-administered intake form, including six brief sexual activity and function items. These items, along with abstracted medical record data, were descriptively analyzed. Logistic regression was used to assess the association between sexual activity and function and disease status, adjusting for age. Median age was 50 years (range 18-91, N=499); more than half had a final diagnosis of cancer. Most patients completed all sex-related items on the intake form; 98% answered at least one. Among patients who were sexually active in the prior 12 months (57% with cancer, 64% with benign disease), 52% indicated on the intake form having, during that period, a sexual problem lasting several months or more. Of these, 15% had physician documentation of the sexual problem. Eighteen women were referred for care. Providers reported no patient complaints about the inclusion of sexual items on the intake form. Nearly all new patients presenting for gynecologic oncology consultation answered self-administered items to assess sexual activity and function. Further study is needed to determine the role of pre-treatment identification of sexual function concerns in improving sexual outcomes associated with cancer diagnosis and treatment. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Ultrasonographic Findings of the Prostatic Disease : Comparative Analysis of the Benign and Malignant Nodules

    International Nuclear Information System (INIS)

    Song, Yun Gyu; Kim, Ji Yang; Lee, Su Han; Kong, Su Jin; Sung, Young Soon; Kwon, Jae Soo

    1996-01-01

    We evaluated the characteristics of the benign and malignant nodules on transrectal ultrasound in diagnosis of prostatic disease. Histologic examination of the trans perineal prostatic biopsy of the total 47 cases resulted in 19 cases of BPH, 8 cases of prostatic cancer, and 20 cases of normal prostatic tissue group. The hypoechoic mass in peripheral zone on TRUS had high possibility of prostatic carcinoma and the isoechoic or mixed echogenic mass in central gland had high possibility of benign lesion. Hypoechoic haloes around nodules and cysts were noted in BPH and normal prostatic tissue group, that were compatible with benign lesion. The mean value of PSA was 12.0 ng/ ml in BPH, 8.5 ng / ml in normal prostatic tissue group, and 65.6 ng / ml in prostatic cancer, which was very high in prostatic cancer. Between BPH and normal prostatic tissue group, there was no demonstrable difference in location of nodule, pattern of calcification, and echogenicity of the nodules on TRUS. The size of prostatic gland was relatively smaller and mean value of PSA was lower in normal prostatic tissue group, compared with in BPH. In conclusion, the location of the nodules and PSA value are considered to be important in differentiation of the benign and malignant prostatic nodules

  20. Differential diagnosis of metastatic bone disease and benign bone disease on spine SPECT in patients with low back pain

    International Nuclear Information System (INIS)

    Lee, Seung Hun; Choi, Yun Young; Cho, Suk Shin

    2001-01-01

    One or more abnormal vertebrae detected on bone scintigraphy is a common finding in clinical practice, and it could pose a diagnostic dilemma especially in cancer patients, as either metastasis or benign disease may cause scintigraphic abnormality. The purpose of this study was to determine whether additional spine SPECT has a role in differentiating malignant from benign lesions in patients with back pain. We reviewed spine SPECT studies obtained over a three-year period in 108 patients. Among them, forty-five patients with abnormal SPECT and clinically followed records were evaluated (20 cancer patients were included). Uptake patterns were classified as follows: 1. Body: diffusely increased uptake, linear increased uptake of end plate, segmental increased uptake, and cold defect, 2 Posterior element; posterior to body (pedicle), posterior to intervertebral disc space (facet joint), and spinous process. Lesions were correlated with radiological findings and with final diagnosis. Sixty-nine bone lesions were detected on SPECT images, including 18 metastases, 28 degenerative diseases and 21 compression fractures. Cold defect (6) and segmental increased uptake (5) were dominant findings in metastasis: linear increased uptake (12), and facet joint uptake (15) were in degenerative change; and diffuse increased uptake (9), and linear increased uptake (9) were in compression fracture. Cold defect and segmental increased uptake of body were characteristic findings of metastasis, but care should be taken because compression fracture also shows segmental increased uptake in some cases. Degenerative disease was easily diagnosed because of the typical finding of linear increased uptake of end plate and facet joint. Therefore, additional bone SPECT after planar bone scan would be helpful for differentiating metastasis from benign condition in cancer patients

  1. Benign breast lesions in Eastern Nigeria

    International Nuclear Information System (INIS)

    Anyikam, A.; Nzegwn, Martin A.; Olusina, Daniel B.; Okoye, I.; Ozumba, Ben C.

    2008-01-01

    Objective was to characterize benign breast diseases in Eastern Nigeria and to highlight the age variations of these lesions as base line data. The Department of Morbid Anatomy, University of Nigeria Teaching Hospital, Enugu caters for over 30 million African blacks and receives 2000 surgical pathology specimens yearly. Seven hundred and twenty-two benign breast specimens were analyzed over 5 years from Ist January 2000 to 31 December 2004, out of 1050 breast samples received. Of 1050 breast specimens received, 722 (68.8%) were benign. Fibroadenoma was the most common lesion with 318 cases (44%), occurring at a mean age of 16-32 years. Next were fibrocystic changes with 165 cases (22.9%) at a mean age of 23-45 years. Normal breast in the axillary tail region was seen in 32 cases (4.4%), represented as no pathology, with a mean presentation age of 20-46 years. Low grade Phyllodes tumor had 28 cases (3.9%), presenting at an average mean age of 17-32 years. Lactating adenoma had 19 (2.6%) cases. Other lesions made up less than 3% each. Benign breast lesions peaked at the 20-24 age range and then declined. Most were females. Benign breast lesions occur more frequently than malignant breast lesions with a ratio of 2.3:1 and were presented 20 years earlier than their malignant counterparts. Fibroadenoma was the most common benign lesions followed by fibrocystic disease, similar to the findings in Western Nigeria. In Northern Nigeria, fibrocystic breast disease was more common. (author)

  2. Disparities in Gynecological Malignancies

    Directory of Open Access Journals (Sweden)

    Sudeshna eChatterjee

    2016-02-01

    Full Text Available Objectives: Health disparities and inequalities in access to care among different socioeconomic, ethnic, and racial groups have been well documented in the U.S. healthcare system. In this review, we aimed to provide an overview of barriers to care contributing to health disparities in gynecological oncology management and to describe site-specific disparities in gynecologic care for endometrial, ovarian, and cervical cancer. Methods: We performed a literature review of peer-reviewed academic and governmental publications focusing on disparities in gynecological care in the United States by searching PubMed and Google Scholar electronic databases. Results: There are multiple important underlying issues that may contribute to the disparities in gynecological oncology management in the United States, namely geographic access and hospital based-discrepancies, research-based discrepancies, influence of socioeconomic and health insurance status, and finally the influence of race and biological factors. Despite the reduction in overall cancer-related deaths since the 1990s, the 5-year survival for Black women is significantly lower than for White women for each gynecologic cancer type and each stage of diagnosis. For ovarian and endometrial cancer, black patients are less likely to receive treatment consistent with evidence-based guidelines and have worse survival outcomes even after accounting for stage and comorbidities. For cervical and endometrial cancer, the mortality rate for black women remains twice that of White women. Conclusions: Health care disparities in the incidence and outcome of gynecologic cancers are complex and involve biologic factors as well as racial, socioeconomic and geographic barriers that influence treatment and survival. These barriers must be addressed to provide optimal care to women in the U.S. with gynecologic cancer.

  3. Health care utilization one year following the diagnosis benign breast disease or breast cancer

    NARCIS (Netherlands)

    Keyzer-Dekker, Claudia M. G.; van Esch, Lotje; Schreurs, Wilhelmina H.; van Berlo, Charles L. H.; Roukema, Jan A.; de Vries, Jolanda; van der Steeg, Alida F. W.

    2012-01-01

    Purpose: We analyzed health care utilization (HCU) and its predictors in the first year after the diagnostic process for breast cancer (BC) or benign breast disease (BBD) using questionnaires. The impact of trait anxiety on HCU was examined. Results: In total 591 women were analyzed, 440 with BBD

  4. Technical Aspects of Laparoscopic Distal Pancreatectomy for Benign and Malignant Disease: Review of the Literature

    NARCIS (Netherlands)

    de Rooij, T.; Sitarz, R.; Busch, O. R.; Besselink, M. G.; Abu Hilal, M.

    2015-01-01

    Distal pancreatectomy is the standard curative treatment for symptomatic benign, premalignant, and malignant disease of the pancreatic body and tail. The most obvious benefits of a laparoscopic approach to distal pancreatectomy include earlier recovery and shorter hospital stay. Spleen-preserving

  5. Dose concepts and dosimetry for radioiodine therapy of benign thyroid diseases

    International Nuclear Information System (INIS)

    Bockisch, A.; Brandt-Mainz, K.; Goerges, R.

    1997-01-01

    Dose planning prior to radioiodine therapy of benign thyroidal disease is usually based on macrodosimetry. The paper shows that this assumption is acceptable. The common concepts for dose planning are given. The following target doses are nowadays widely accepted: 150 Gy for euthyroid goiter, 400 Gy for toxic adenoma, 150 Gy for disserminated autonomy, 200 Gy for hyperthyroid Grave's disease if posttherapeutic euthyroidism is intended, and 250 (to 300) Gy if the risk of recurrency is to be minimized ('ablative' concept). Finally, a surveyfis given concerning the precision in which the parameters relevant for the dose calcultion can be determined. For realistic favourable conditions, the dose can be determined with an accuracy of better than ±25%. (orig.) [de

  6. OCT in Gynecology

    Science.gov (United States)

    Kuznetsova, Irina A.; Gladkova, Natalia D.; Gelikonov, Valentin M.; Belinson, Jerome L.; Shakhova, Natalia M.; Feldchtein, Felix I.

    Timely and efficient diagnosis of diseases of the female reproductivesystem is very important from the social viewpoint [1, 2]. Diagnosticefficacy of the existing techniques still needs improvement sincemalignant neoplasms of the female reproductive system organs are stableleaders among causes of death (over 35.9 %) [3]. Each year, 851.9 thousand genital cancer cases are recorded worldwide [1, 2]. However, the diagnostic efficacy of the visual examination with biopsy is limited. Correct interpretation of colposcopic features requires high skills and long-term clinical experience, which makes colposcopy very subjective and limits interobserver agreement [8-10]. OCT is known to visualize in vivo and noninvasively tissue microstructure with spatial resolution approaching the histologic level and therefore can be expected to guide biopsies and to provide real-time tissue structure information when biopsies are contraindicated or impractical. Although thorough clinical studies are required to determine if OCT can be suitable for this purpose in gynecology in general and for cervical cancer in particular, the early results look encouraging. In this chapter, we present a wide spectrum of the OCT studies of different partsof the female reproductive system and demonstrate the potential of the clinical use of this new visualization method in gynecological practice.

  7. Value of the joint- and bone-scintigraphy in benign skeleton diseases

    International Nuclear Information System (INIS)

    Pfannenstiel, P.

    1976-01-01

    Although skeleton scintigraphy is a relatively 'young' method when compared with other scintigraphic techniques, it is of great value in the diagnosis of benign skeleton diseases. For a full exploitation of the diagnostic possibilities of nuclear medicine, however, close cooperation between clinical rheumatologists, orthopaedic surgeons, radiologists and experts in nuclear medicine. If the right method is used at the right time, the number of X-rays and thus the technical and financial expenditure may be reduced to a considerable degree. (GSE) [de

  8. Stereotactic body radiotherapy (SBRT): Technological innovation and application in gynecologic oncology.

    Science.gov (United States)

    Higginson, Daniel S; Morris, David E; Jones, Ellen L; Clarke-Pearson, Daniel; Varia, Mahesh A

    2011-03-01

    Stereotactic body radiotherapy (SBRT) is a novel form of noninvasive, highly conformal radiation treatment that delivers a high dose to tumor. The advantage of the technique resides in its ability to provide a high dose to tumor but spare normal tissues to an extent not previously possible. In this paper we will provide an introduction and review of this technology with regard to its use in gynecologic malignancies. Preliminary results from our experience are presented for the purpose of illustrating the range of SBRT applications in gynecologic oncology. A comprehensive literature review was conducted and our experience from the past three years was reviewed. Six case series are published that report results of SBRT for gynecologic malignancies. Sixteen gynecologic patients have been treated with SBRT at our institution. Treatment sites include pelvic and periaortic nodes (9 patients), oligometastatic disease (2), and cervical or endometrial primary tumors when other conventional external radiation or brachytherapy techniques were unsuitable (5). Preliminary follow-up at a median of 11 months (range, 0.3-33 months) demonstrates 79% locoregional control, 43% distant failure, and 50% overall survival. SBRT boosts to macroscopic periaortic node recurrences and other sites seem to provide local control and a possibility of long-term disease-free survival in carefully selected patients. Previously this had been difficult to achieve with conventional radiotherapy because of the proximity of periaortic nodes to small bowel. SBRT also offers a novel approach for minimally invasive treatment in the management of gynecological cancer where current surgical and radiotherapy techniques are unsuitable. Copyright © 2010 Elsevier Inc. All rights reserved.

  9. Intraoperative radiation therapy for locally advanced gynecological malignancies

    International Nuclear Information System (INIS)

    Haddock, M.G.; Petersen, I.A.; Webb, M.J.; Wilson, T.O.; Podratz, K.C.; Gunderson, L.L.

    1996-01-01

    Purpose: Evaluate disease control and survival in patients with locally advanced gynecological malignancies who received intraoperative radiation therapy with electrons (IOERT) as a component of treatment. Methods and Materials: Between March 1983 and June 1995, 63 patients (pts) with locally advanced primary (9 pts) or recurrent (54 pts) gynecological malignancies received IOERT as a component of attempted curative therapy. The site of origin was uterine cervix in 40 pts, uterine corpus in 16 pts, vagina in 5 pts, and ovary in 2 pts. Thirty-eight patients with recurrent disease had been previously irradiated (median prior RT dose 5040 cGy, range 900-8400). External beam radiotherapy (EBRT) was given to 43 of 63 pts either before or after IOERT (900-6570 cGy, median 4960 cGy). Chemotherapy was given to 21 pts prior to IOERT and following IOERT in 2 pts. IOERT doses ranged from 800 cGy to 2500 cGy with a median of 1750 cGy. The median IOERT dose was 2000 cGy in 20 patients with gross residual disease and 1500 cGy in 43 patients with microscopic residual disease. Endpoints included central control within the IOERT cone, local control, distant failure, disease free survival and overall survival. Variables evaluated for impact on disease outcome included tumor grade, primary site, prior RT, IOERT dose, EBRT dose, residual disease at time of IOERT, and use of chemotherapy. Results: Survival and disease control data are presented in the table below. There was no impact of any disease or treatment related variable on local or central failure. Pts with microscopic residual disease at the time of IOERT had significantly fewer distant metastases than pts with gross residual (5 yr 31% vs. 77%, p = 0.001) and improved survival (5 yr 37% vs. 10%, p = 0.02). Patients with recurrent disease after previous RT had survival and disease control rates which were similar to those seen in pts without priot RT. Toxicity ≥ grade 3 due to IOERT was observed in 11 pts (17%). Conclusion: A

  10. Evaluation of using 99Tcm-MDP SPECT/CT for differentiating malignancy from benignancy in femoral diseases

    International Nuclear Information System (INIS)

    Ou Xiaohong; Huang Rui; Su Minggang; Zhou Li'na; Fan Qiuping

    2010-01-01

    Objective: To evaluate the value of SPECT/CT in assessment of femoral foci of abnormal bone metabolism classified as intermediated on bone scanning using 99Tcm-methylene diphosphonate (MDP). Methods: There were 94 patients with solitary femoral abnormal uptake in bone scanning included. SPECT was accompanied by inline CT over the femoral region. All of the images were blindly interpreted independently by two experienced board-certified radiologists. The reference standard was follow-up over half a year of MRI, CT, SPECT, or pathology. Diagnosis which consist with reference were counted as accurate. Diagnosis which either not consist with reference or undetermined were counted as false. Results: Of the 94 patients, 78 patients (male 42 , female 36, mean age 62 yrs) have the definite diagnosis of their femoral foci. 19 were proved to be metastasis and the other 59 were benign diseases. The diagnostic accuracy by bone SPECT, bone CT and fusion imaging were 58.9%, 87.2%, 96.2% respectively. Conclusions: Most of the solitary femoral foci caused by benign diseases. SPECT/CT using 99 Tc m -MDP has additional valuable in differentiating malignancy from benignancy in femoral foci . (authors)

  11. Phase II clinical trial of robotic stereotactic body radiosurgery for metastatic gynecologic malignancies

    Directory of Open Access Journals (Sweden)

    Charles eKunos

    2012-12-01

    Full Text Available Background Recurrent gynecologic cancers are often difficult to manage without significant morbidity. We conducted a phase II study to assess the safety and the efficacy of ablative robotic stereotactic body radiosurgery (SBRT in women with metastatic gynecologic cancers. Methods A total of 50 patients with recurrent gynecologic cancer who had single or multiple (≤4 metastases underwent robotic-armed Cyberknife SBRT (24Gy/3 daily doses. Toxicities were graded prospectively by common toxicity criteria for adverse events (version 4.0. SBRT target responses were recorded following RECIST criteria (version 1.0. Rates of clinical benefit for SBRT and non-radiosurgical disease relapse were calculated. Disease-free and overall survivals were estimated by the Kaplan-Meier method and the Cox proportional hazards model was used to control for prognostic variables.Findings SBRT was safely delivered, with 49 (98% of 50 patients completing three prescribed fractions. The most frequent grade 2 or higher adverse events attributed to SBRT included fatigue (16%, nausea (8% and diarrhea (4%. One (2% grade 4 hyperbilirubinemia occurred. SBRT target response was 96% (48 of 50 patients. A 6-month clinical benefit was recorded in 34 (68% [95% CI, 53.2, 80.1] patients. No SBRT-targeted disease progressed. Non-radiosurgical disease relapse occurred in 31 (62% patients. Median disease-free survival was 7.8 months (95% CI, 4.0, 11.6. Median overall survival was 20.2 months (95% CI, 10.9, 29.5.Interpretation SBRT safely controlled metastatic gynecologic cancer targets. Given an observed high rate of non-radiosurgical disease relapse, a phase I trial assessing co-administration of SBRT and cytotoxic chemotherapy is underway.Funding Case Comprehensive Cancer Center

  12. Phase II Clinical Trial of Robotic Stereotactic Body Radiosurgery for Metastatic Gynecologic Malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Kunos, Charles A.; Brindle, James [Department of Radiation Oncology, University Hospitals Case Medical Center and Case Western Reserve University, School of Medicine, Cleveland, OH (United States); Waggoner, Steven; Zanotti, Kristine; Resnick, Kimberly; Fusco, Nancy; Adams, Ramon; Debernardo, Robert, E-mail: charles.kunos@uhhospitals.org [Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University Hospitals Case Medical Center and Case Western Reserve University, School of Medicine, Cleveland, OH (United States)

    2012-12-05

    Background: Recurrent gynecologic cancers are often difficult to manage without significant morbidity. We conducted a phase II study to assess the safety and the efficacy of ablative robotic stereotactic body radiosurgery (SBRT) in women with metastatic gynecologic cancers. Methods: A total of 50 patients with recurrent gynecologic cancer who had single or multiple (≤4) metastases underwent robotic-armed Cyberknife SBRT (24Gy/3 daily doses). Toxicities were graded prospectively by common toxicity criteria for adverse events (version 4.0). SBRT target responses were recorded following RECIST criteria (version 1.0). Rates of clinical benefit for SBRT and non-radiosurgical disease relapse were calculated. Disease-free and overall survivals were estimated by the Kaplan–Meier method and the Cox proportional hazards model was used to control for prognostic variables. Findings: SBRT was safely delivered, with 49 (98%) of 50 patients completing three prescribed fractions. The most frequent grade 2 or higher adverse events attributed to SBRT included fatigue (16%), nausea (8%), and diarrhea (4%). One (2%) grade four hyperbilirubinemia occurred. SBRT target response was 96% (48 of 50 patients). A 6-month clinical benefit was recorded in 34 [68% (95% CI, 53.2, 80.1)] patients. No SBRT targeted disease progressed. Non-radiosurgical disease relapse occurred in 31 (62%) patients. Median disease-free survival was 7.8 months (95% CI, 4.0, 11.6). Median overall survival was 20.2 months (95% CI, 10.9, 29.5). Interpretation: SBRT safely controlled metastatic gynecologic cancer targets. Given an observed high rate of non-radiosurgical disease relapse, a phase I trial assessing co-administration of SBRT and cytotoxic chemotherapy is underway. Funding: Case Comprehensive Cancer Center.

  13. Phase II Clinical Trial of Robotic Stereotactic Body Radiosurgery for Metastatic Gynecologic Malignancies

    International Nuclear Information System (INIS)

    Kunos, Charles A.; Brindle, James; Waggoner, Steven; Zanotti, Kristine; Resnick, Kimberly; Fusco, Nancy; Adams, Ramon; Debernardo, Robert

    2012-01-01

    Background: Recurrent gynecologic cancers are often difficult to manage without significant morbidity. We conducted a phase II study to assess the safety and the efficacy of ablative robotic stereotactic body radiosurgery (SBRT) in women with metastatic gynecologic cancers. Methods: A total of 50 patients with recurrent gynecologic cancer who had single or multiple (≤4) metastases underwent robotic-armed Cyberknife SBRT (24Gy/3 daily doses). Toxicities were graded prospectively by common toxicity criteria for adverse events (version 4.0). SBRT target responses were recorded following RECIST criteria (version 1.0). Rates of clinical benefit for SBRT and non-radiosurgical disease relapse were calculated. Disease-free and overall survivals were estimated by the Kaplan–Meier method and the Cox proportional hazards model was used to control for prognostic variables. Findings: SBRT was safely delivered, with 49 (98%) of 50 patients completing three prescribed fractions. The most frequent grade 2 or higher adverse events attributed to SBRT included fatigue (16%), nausea (8%), and diarrhea (4%). One (2%) grade four hyperbilirubinemia occurred. SBRT target response was 96% (48 of 50 patients). A 6-month clinical benefit was recorded in 34 [68% (95% CI, 53.2, 80.1)] patients. No SBRT targeted disease progressed. Non-radiosurgical disease relapse occurred in 31 (62%) patients. Median disease-free survival was 7.8 months (95% CI, 4.0, 11.6). Median overall survival was 20.2 months (95% CI, 10.9, 29.5). Interpretation: SBRT safely controlled metastatic gynecologic cancer targets. Given an observed high rate of non-radiosurgical disease relapse, a phase I trial assessing co-administration of SBRT and cytotoxic chemotherapy is underway. Funding: Case Comprehensive Cancer Center.

  14. Clinical outcomes research in gynecologic oncology.

    Science.gov (United States)

    Melamed, Alexander; Rauh-Hain, J Alejandro; Schorge, John O

    2017-09-01

    Clinical outcomes research seeks to understand the real-world manifestations of clinical care. In particular, outcomes research seeks to reveal the effects of pharmaceutical, procedural, and structural aspects of healthcare on patient outcomes, including mortality, disease control, toxicity, cost, and quality of life. Although outcomes research can utilize interventional study designs, insightful use of observational data is a defining feature of this field. Many questions in gynecologic oncology are not amenable to investigation in randomized clinical trials due to cost, feasibility, or ethical concerns. When a randomized trial is not practical or has not yet been conducted, well-designed observational studies have the potential to provide the best available evidence about the effects of clinical care. Such studies may use surveys, medical records, disease registries, and a variety of administrative data sources. Even when a randomized trial has been conducted, observational studies can be used to estimate the real-world effect of an intervention, which may differ from the results obtained in the controlled setting of a clinical trial. This article reviews the goals, methodologies, data sources, and limitations of clinical outcomes research, with a focus on gynecologic oncology. Copyright © 2017. Published by Elsevier Inc.

  15. Basics of Radiation Biology When Treating Hyperproliferative Benign Diseases

    Directory of Open Access Journals (Sweden)

    Franz Rödel

    2017-05-01

    Full Text Available For decades, low- and moderate-dose radiation therapy (RT has been shown to exert a beneficial therapeutic effect in a multitude of non-malignant conditions including painful degenerative muscoloskeletal and hyperproliferative disorders. Dupuytren and Ledderhose diseases are benign fibroproliferative diseases of the hand/foot with fibrotic nodules and fascial cords, which determine debilitating contractures and deformities of fingers/toes, while keloids are exuberant scar formations following burn damage, surgery, and trauma. Although RT has become an established and effective option in the management of these diseases, experimental studies to illustrate cellular composites and factors involved remain to be elucidated. More recent findings, however, indicate the involvement of radiation-sensitive targets like mitotic fibroblasts/myofibroblasts as well as inflammatory cells. Radiation-related molecular mechanisms affecting these target cells include the production of free radicals to hamper proliferative activity and interference with growth factors and cytokines. Moreover, an impairment of activated immune cells involved in both myofibroblast proliferative and inflammatory processes may further contribute to the clinical effects. We here aim at briefly describing mechanisms contributing to a modulation of proliferative and inflammatory processes and to summarize current concepts of treating hyperproliferative diseases by low and moderate doses of ionizing radiation.

  16. Imaging of gynecologic emergencies; Bildgebende Diagnostik gynaekologischer Notfaelle

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, Matthias W. [Universitaetsspital Zuerich (Switzerland). Inst. fuer Diagnostische und Interventionelle Radiologie; Huisman, Thierry A.G.M. [John Hopkins Bayview Medical Center, Baltimore, MD (United States). Dept. of Imaging and Imaging Science; John Hopkins Bayview Medical Center, Baltimore, MD (United States). Dept. of Pediatrc Radiology and Pediatric Neuroradiology; Kubik, Rahel A. [Kantonsspital Baden AG, Baden (Switzerland). Inst. fuer Radiologie

    2016-09-15

    Acute abdominal pain related to the female genital organs is frequently encountered in the emergency department. Gynecological emergencies are diseases of the female reproductive system that are potentially life-threatening and peril the sexual function and fertility. In the diagnostic work-up of acute abdominal pain, a wide variety of differential diagnoses needs to be considered depending on the age of the patient and a concomitant pregnancy. There is significant clinical overlap with gastrointestinal emergencies. Therefore, imaging plays a key role in diagnosing the cause of the pain and the planning of the therapy. The aim of this review is to illustrate the significant role of imaging in frequently encountered gynecologic emergencies.

  17. Port-site metastases following robot-assisted laparoscopic surgery for gynecological malignancies.

    Science.gov (United States)

    Lönnerfors, Celine; Bossmar, Thomas; Persson, Jan

    2013-12-01

    To evaluate the incidence and possible predictors associated with port-site metastases following robotic surgery. Prospective study. University Hospital. Women with gynecological cancer. The occurrence of port-site metastases in the first 475 women undergoing robotic surgery for gynecological cancer was reviewed. Rate of port-site metastases. A port-site metastasis was detected in nine of 475 women (1.9%). Eight women had either an unexpected locally advanced disease or lymph-node metastases at the time of surgery. All nine women received postoperative adjuvant therapy. Women with ≥ stage III endometrial cancer and women with node positive cervical cancer had a significantly higher risk of developing a port-site metastasis, as did women with high-risk histology endometrial cancer. Port-site metastases were four times more likely to occur in a specimen-retrieval port. One (0.2%) isolated port-site metastasis was detected. The median time to occurrence of a port-site metastasis was 6 months (range 2-19 months). Six of the nine women (67%) have died and their median time of survival from recurrence was 4 months (range 2-16 months). In women with gynecological cancer, the incidence of port-site metastases following robotic surgery was 1.9%. High-risk histology and/or advanced stage of disease at surgery seem to be contributing factors. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

  18. Radiation therapy of gynecological cancer

    International Nuclear Information System (INIS)

    Nori, D.; Hilaris, B.S.

    1987-01-01

    This book consists of three parts: General Principles; Clinical Applications; and Special Topics. Some of the papers are: Introduction to Basic Radiobiology; Staging and Work-up Procedures for Patients with Gynecological Cancers; Radiation Therapy in the Treatment of Cancer of the Cervix; Role of Interstitial Implantation in Gynecological Cancer; Role of Radiocolloids in Gynecological Cancer; Radiosensitizers and Protectors; and Management of Lymphoma Associated with Pregnancy

  19. Role of Nuclear Medicine in the Diagnosis of Benign Thyroid Diseases.

    Science.gov (United States)

    Garberoglio, Sara; Testori, Ornella

    2016-01-01

    A deep understanding of thyroid pathophysiology is the basis for diagnosing and treating benign thyroid diseases with radioactive materials, known as radiopharmaceuticals, which are introduced into the body by injection or orally. After the radiotracer administration, the patient becomes the emitting source, and several devices have been studied to detect and capture these emissions (gamma or beta-negative) and transform them into photons, parametric images, numbers and molecular information. Thyroid scintigraphy is the only technique that allows the assessment of thyroid regional function and, therefore, the detection of areas of autonomously functioning thyroid nodules. Scintigraphy visualizes the distribution of active thyroid tissue and displays the differential accumulation of radionuclides in the investigated cells, thus providing a functional map. Moreover, this technique is a fundamental tool in the clinical and surgical management of thyroid diseases, including: single thyroid nodules with a suppressed thyroid-stimulating hormone level, for which fine-needle aspiration biopsy (FNAB) is used to identify hot nodules; multinodular goiters, especially larger ones, to identify cold or indeterminate areas requiring FNAB and hot areas that do not need cytologic evaluation, and to evaluate mediastinal extension; the diagnosis of ectopic thyroid tissue; subclinical hyperthyroidism to identify occult hyperfunctioning tissue; follicular lesions to identify a functioning cellular adenoma that could be benign, although such nodules are mostly cold on scintigraphy; to distinguish low-uptake from high-uptake thyrotoxicosis, and to determine eligibility for radioiodine therapy. © 2016 S. Karger AG, Basel.

  20. Sexual self-schema and sexual morbidity among gynecologic cancer survivors.

    Science.gov (United States)

    Andersen, B L; Woods, X A; Copeland, L J

    1997-04-01

    Longitudinal research indicates that approximately 50% of women treated for gynecologic cancer have sexual dysfunctions as they recover and become cancer survivors. This outcome occurs in the context of satisfactory quality of life in other domains. This study, comparing gynecologic cancer survivors (n = 61) and gynecologically healthy women (n = 74), documents the reliability of the latter observations with measures of quality of life (general, depressive symptoms, social contacts, and stress), sexual functioning, and health. Of added importance are analyses focused on variables that may predict risk for sexual morbidity. Specifically, sexual self-schema is tested as an important, sexually relevant individual difference. In regression analyses that controlled for estimates of precancer sexual behavior (intercourse frequency), extent of disease-treatment, and menopausal symptoms, sexual self-schema accounted for significant variance in predicting current sexual behavior and responsiveness.

  1. An abnormal screening mammogram causes more anxiety than a palpable lump in benign breast disease

    NARCIS (Netherlands)

    Keyzer-Dekker, C. M. G.; van Esch, L.; de Vries, J.; Ernst, Marloes; Nieuwenhuijzen, G. A. P.; Roukema, J. A.; van der Steeg, A. F. W.

    Being recalled for further diagnostic procedures after an abnormal screening mammogram (ASM) can evoke a high state anxiety with lowered quality of life (QoL). We examined whether these adverse psychological consequences are found in all women with benign breast disease (BBD) or are particular to

  2. Celiac Disease Associated with a Benign Granulomatous Mass Demonstrating Self-Regression after Initiation of a Gluten-Free Diet.

    Science.gov (United States)

    Tiwari, Abhinav; Sharma, Himani; Qamar, Khola; Khan, Zubair; Darr, Umar; Renno, Anas; Nawras, Ali

    2017-01-01

    Celiac disease is a chronic immune-mediated enteropathy in which dietary gluten induces an inflammatory reaction predominantly in the duodenum. Celiac disease is known to be associated with benign small bowel thickening and reactive lymphadenopathy that often regresses after the institution of a gluten-free diet. A 66-year-old male patient with celiac disease presented with abdominal pain and diarrheal illness. Computerized tomography of the abdomen revealed a duodenal mass. Endoscopic ultrasound-guided fine needle aspiration of the mass revealed bizarre stromal cells which represent a nonspecific tissue reaction to inflammation. This inflammatory mass regressed after the institution of a gluten-free diet. This case report describes a unique presentation of celiac disease in the form of a granulomatous self-regressing mass. Also, this is the first reported case of bizarre stromal cells found in association with celiac disease. In addition to lymphoma and small bowel adenocarcinoma, celiac disease can present with a benign inflammatory mass, which should be serially monitored for resolution with a gluten-free diet.

  3. Celiac Disease Associated with a Benign Granulomatous Mass Demonstrating Self-Regression after Initiation of a Gluten-Free Diet

    Directory of Open Access Journals (Sweden)

    Abhinav Tiwari

    2017-08-01

    Full Text Available Celiac disease is a chronic immune-mediated enteropathy in which dietary gluten induces an inflammatory reaction predominantly in the duodenum. Celiac disease is known to be associated with benign small bowel thickening and reactive lymphadenopathy that often regresses after the institution of a gluten-free diet. A 66-year-old male patient with celiac disease presented with abdominal pain and diarrheal illness. Computerized tomography of the abdomen revealed a duodenal mass. Endoscopic ultrasound-guided fine needle aspiration of the mass revealed bizarre stromal cells which represent a nonspecific tissue reaction to inflammation. This inflammatory mass regressed after the institution of a gluten-free diet. This case report describes a unique presentation of celiac disease in the form of a granulomatous self-regressing mass. Also, this is the first reported case of bizarre stromal cells found in association with celiac disease. In addition to lymphoma and small bowel adenocarcinoma, celiac disease can present with a benign inflammatory mass, which should be serially monitored for resolution with a gluten-free diet.

  4. Guideline for radioiodine therapy for benign thyroid diseases (version 3)

    International Nuclear Information System (INIS)

    Dietlein, M.; Schicha, H.; Dressler, J.; Gruenwald, F.; Leisner, B.; Moser, E.; Reiners, C.; Schneider, P.; Schober, O.

    2004-01-01

    The version 3 of the guideline for radioiodine therapy for benign thyroid diseases presents first of all a revision of the version 2. The chapter indication for radioiodine therapy, surgical treatment or antithyroid drugs bases on an interdisciplinary consensus. The manifold criteria for decision making consider the entity of thyroid disease (autonomy, Graves' disease, goitre, goitre recurrence), the thyroid volume, suspicion of malignancy, cystic nodules, risk of surgery and co-morbidity, history of subtotal thyroidectomy, persistent or recurrent thyrotoxicosis caused by Graves' disease including known risk factors for relapse, compression of the trachea caused by goitre, requirement of direct therapeutic effect as well as the patient's preference. Because often some of these criteria are relevant, the guideline offers the necessary flexibility for individual decisions. Further topics are patients' preparation, counseling, dosage concepts, procedural details, results, side effects and follow-up care. The prophylactic use of glucocorticoids during radioiodine therapy in patients without preexisting ophthalmopathy as well as dosage and duration of glucocorticoid medication in patients with preexisting ophthalmopathy need to be clarified in further studies. The pragmatic recommendations for the combined use of radioiodine and glucocorticoids remained unchanged in the 3 rd version. (orig.) [de

  5. [Methylation of selected tumor-supressor genes in benign and malignant ovarian tumors].

    Science.gov (United States)

    Cul'bová, M; Lasabová, Z; Stanclová, A; Tilandyová, P; Zúbor, P; Fiolka, R; Danko, J; Visnovský, J

    2011-09-01

    To evaluate the usefullness of examination of methylation status of selected tumor-supressor genes in early diagnosis of ovarian cancer. Prospective clinical study. Department of Gynecology and Obstetrics, Department of Molecular Biology, Jessenius Medical Faculty, Commenius University, Martin, Slovak Republic. In this study we analyzed hypermethylation of 5 genes RASSF1A, GSTP, E-cadherin, p16 and APC in ovarian tumor samples from 34 patients - 13 patients with epithelial ovarian cancer, 2 patients with border-line ovarian tumors, 12 patients with benign lesions of ovaries and 7 patients with healthy ovarian tissue. The methylation status of promoter region of tumor-supressor genes was determined by Methylation Specific Polymerase Chain Reaction (MSP) using a nested two-step approach with bisulfite modified DNA template and specific primers. Gene methylation analysis revealed hypermethylation of gene RASSF1A (46%) and GSTP (8%) only in malignant ovarian tissue samples. Ecad, p16 and APC genes were methylated both in maignant and benign tissue samples. Methylation positivity in observed genes was present independently to all clinical stages of ovarian cancer and to tumor grades. However, there was observed a trend of increased number and selective involvement of methylated genes with increasing disease stages. Furthermore, there was no association between positive methylation status and histological subtypes of ovarian carcinomas. RASSF1A and GSTP promoter methylation positivity is associated with ovarian cancer. The revealed gene-selective methylation positivity and the increased number of methylated genes with advancing disease stages could be considered as a useful molecular marker for early detection of ovarian cancer. However, there is need to find diagnostic approach of specifically and frequently methylated genes to determining a methylation phenotype for early detection of ovarian malignancies.

  6. Acute gynecologic disorders in adolescents: CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Tong [Soonchunhyang Univ. Cheonan Hospital/Soonchunhyang Univ. College of Medicine, Cheonan (Korea, Republic of)

    2012-09-15

    Gynecologic disorders that cause pelvic pain in adolescents include hemorrhagic ovarian cysts, rupture or torsion of ovarian cyst or tumors, hematocolpos caused by vaginal obstruction, endometriosis, cystic uterine adenomyosis, pelvic inflammatory diseases, and pelvic inclusion cyst. The use of CT for the evaluation of pelvic pain is increasing, and CT is useful if ultrasound findings are not decisive and the lesion is extensive.

  7. Present state and perspectives of RIA in obstetrics and gynecology

    Energy Technology Data Exchange (ETDEWEB)

    Talas, M; Fingerova, H [Palackeho Univ., Olomouc (Czechoslovakia). Lekarska Fakulta

    1979-01-01

    A survey is presented of RIA methods introduced by the authors in their laboratory in the course of the last eight years. The results obtained by these methods in various physiological and pathological states are evaluated. The authors point to the possibilities of effective use of RIA for diagnostic purposes in obstetrics and gynecology taking into account also economic and organizational aspects. The most important trends of the use of RIA are accentuated not only in gynecological endocrinology and obstetrics but also in some other related fields, especially in the diagnosis and treatment of malignant diseases.

  8. Present state and perspectives of RIA in obstetrics and gynecology

    International Nuclear Information System (INIS)

    Talas, M.; Fingerova, H.

    1979-01-01

    A survey is presented of RIA methods introduced by the authors in their laboratory in the course of the last eight years. The results obtained by these methods in various physiological and pathological states are evaluated. The authors point to the possibilities of effective use of RIA for diagnostic purposes in obstetrics and gynecology taking into account also economic and organizational aspects. The most important trends of the use of RIA are accentuated not only in gynecological endocrinology and obstetrics but also in some other related fields, especially in the diagnosis and treatment of malignant diseases. (author)

  9. Promoting gynecologic cancer awareness at a critical juncture--where women and providers meet.

    Science.gov (United States)

    Cooper, Crystale Purvis; Gelb, Cynthia A; Rodriguez, Juan; Hawkins, Nikki A

    2014-06-01

    Given the absence of effective population-based screening tests for ovarian, uterine, vaginal, and vulvar cancers, early detection can depend on women and health care providers recognizing the potential significance of symptoms. In 2008, the Centers for Disease Control and Prevention's (CDC) Inside Knowledge campaign began distributing consumer education materials promoting awareness of gynecologic cancer symptoms. We investigated providers' in-office use of CDC gynecologic cancer materials and their recognition of the symptoms highlighted in the materials. We analyzed data from a national 2012 survey of US primary care physicians, nurse practitioners, and gynecologists (N = 1,380). Less than a quarter of providers (19.4%) reported using CDC gynecologic cancer education materials in their offices. The provider characteristics associated with the use of CDC materials were not consistent across specialties. However, recognition of symptoms associated with gynecologic cancers was consistently higher among providers who reported using CDC materials. The possibility that providers were educated about gynecologic cancer symptoms through the dissemination of materials intended for their patients is intriguing and warrants further investigation. Distributing consumer education materials in health care provider offices remains a priority for the Inside Knowledge campaign, as the setting where women and health care providers interact is one of the most crucial venues to promote awareness of gynecologic cancer symptoms.

  10. The Heart as a Site of Metastasis of Benign Metastasizing Leiomyoma: Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Mariam Meddeb

    2018-01-01

    Full Text Available Uterine leiomyomas are the most common gynecological tumors in premenopausal women. While the lung is the most common extrauterine organ afflicted, benign metastasizing leiomyomas (BML of the heart are rarities. We report an incidental finding of a cardiac mass in a 36-year-old woman who presented to the Emergency Department after a motor vehicle accident. CT scan of the chest revealed 2 well-circumscribed pulmonary nodules and a filling defect in the right ventricle. Echocardiogram showed a 4 cm mass attached to the right ventricular (RV septum. The cardiac tumor was resected and showed benign histologic features. Immunohistochemical staining was positive for smooth muscle α-actin and desmin, as well as estrogen and progesterone receptors, consistent with the diagnosis of uterine leiomyoma.

  11. Dosimetry in radioiodine therapy of benign thyroid diseases. Background and practice; Dosimetrie bei Radioiodtherapie benigner Schilddruesenerkrankungen. Hintergrund und Durchfuehrung

    Energy Technology Data Exchange (ETDEWEB)

    Bockisch, A.; Sonnenschein, W.; Jentzen, W.; Hartung, V.; Goerges, R. [Universitaetsklinikum Essen (Germany). Klinik fuer Nuklearmedizin

    2008-09-15

    Radioiodine therapy of benign thyroid diseases (focal = [toxic adenoma], multifocal, disseminated autonomy, Grave's disease or clinical relevant goitre) needs to be and can be performed individually for each patient. Most frequently a radioiodine test is performed applying a small activity of iodine-131 ({sup 131}I). The paper discusses some protocols for pre- or posttherapeutic dosimetry and discusses their advantages and disadvantages. All are based on the volumetry of the target tissue as well as the radioiodine kinetics in the target volume what may be represented by maximum uptake and half life of iodine retention in the thyroid. Possible disturbances and measuring uncertainties of these parameters are presented and discussed. In spite of the discussed uncertainties in dosimetry, due to its high therapeutic width radioiodine therapy is a very successful procedure to cure hyperthyroidism or to reduce goitre volume with only little side effects. (orig.)

  12. Benign breast lesions in Kano | Ochicha | Nigerian Journal of ...

    African Journals Online (AJOL)

    Results: Benign breast lesions accounted for 160 (73%) of all breast biopsies seen, and 71.9% of breast diseases in women with a benign to malignant ratio of 2.6 to 1. The mean age at presentation was 26 years. Fibrocystic disease was the commonest histological lesion comprising 55 (34.3%) of all cases, with a mean ...

  13. A novel serum microRNA panel to discriminate benign from malignant ovarian disease.

    LENUS (Irish Health Repository)

    Langhe, Ream

    2015-01-28

    Ovarian cancer is the seventh most common cancer in women and the most frequent cause of gynaecological malignancy-related mortality in women. Currently, no standardized reliable screening test exists. MicroRNA profiling has allowed the identification of signatures associated with diagnosis, prognosis and response to treatment of human tumours. The aim of this study was to determine if a microRNA signature could distinguish between malignant and benign ovarian disease. A training set of 5 serous ovarian carcinomas and 5 benign serous cystadenomas were selected for the initial experiments. The validation set included 20 serous ovarian carcinomas and 20 benign serous cystadenomas. The serum\\/plasma focus microRNA Exiqon panel was used for the training set. For the validation set a pick and mix Exiqon panel, which focuses on microRNAs of interest was used. A panel of 4 microRNAs (let-7i-5p, miR-122, miR-152-5p and miR-25-3p) was significantly down regulated in cancer patients. These microRNAs target WNT signalling, AKT\\/mTOR and TLR-4\\/MyD88, which have previously been found to play a role in ovarian carcinogenesis and chemoresistance. let-7i-5p, miR-122, miR-152-5p and miR-25-3p could act as diagnostic biomarkers in ovarian cancer.

  14. Interventional bronchoscopy for treatment of tracheal obstruction secondary to benign or malignant thyroid disease.

    Science.gov (United States)

    Noppen, Marc; Poppe, Kris; D'Haese, Jan; Meysman, Marc; Velkeniers, Brigitte; Vincken, Walter

    2004-02-01

    Surgery is the treatment of choice for symptomatic tracheal obstruction due to benign or malignant thyroid disease. In case of inoperability, or when surgery is refused, few therapeutic alternatives are available. Interventional bronchoscopic procedures have only been reported anecdotally. The objective of this study is to evaluate the results of interventional bronchoscopic procedures in the treatment of severe tracheal obstruction due to thyroid disease. Retrospective cohort analysis. University hospital, tertiary referral center. Thirty consecutive patients referred for bronchoscopic treatment of benign (n = 17) or malignant (n = 13) thyroid-related upper airway obstruction due to tracheomalacia, extrinsic compression, and/or tracheal ingrowth. Indications for bronchoscopic treatment were medical or surgical inoperability, prevention or treatment of tracheomalacia, and refusal of surgery. There were no procedure-related complications. Rigid bronchoscopy with dilatation, stenting and/or Nd-YAG laser treatment, and clinical follow-up. Subjective improvement, pulmonary function tests, early and late complications, and survival. In the benign group, immediate (100% relief of dyspnea) and long-term (88% relief of dyspnea) results were excellent after airway stenting (21 stents used in 17 patients). There was one unrelated death 1 week after stenting in a 98-year-old patient. There were 6% and 30% short-term and long-term complications, respectively, that could be managed endoscopically. In the malignant group, Nd-YAG laser treatment (n = 3) and stenting (n = 13) yielded immediate and long-term success in 92% of patients. There were 15% short-term and 8% long-term complications. Median survival time was 540 days. Interventional bronchoscopic procedures including Nd-YAG laser treatment and stenting are valuable alternatives to surgery in inoperable thyroid-induced tracheal obstruction, or when surgery is refused.

  15. On use of ultrasonography in obstetrics and gynecology

    International Nuclear Information System (INIS)

    Woo, Kwang Suk; Lee, Yong Woo

    1984-01-01

    Ultrasonography is playing an very important in diagnosis of normal pregnancy and the other diseases in the fields of obstetrics and gynecology. It is mainly used B-mode and Real time linear scan for pregnancy such as fetal movement during its early stage, fetal position, placenta location and biparietal diameter during its middle stage, and amniotic fluid and placenta previa during its late stage, as well as tumor accompanying pregnancy. Ultrasonography has been extensively used in the fields of obstetrics and gynecology for obtaining detailed images of soft tissues without hazard to the fetus and pregnant woman. In view of the need for its professionalism of high degree of skill, this treatise will introduce clinical instances and images obtained in the sonography room of the Seoul National University Hospital

  16. Side effects and risks of radioiodine treatment of benign thyroid diseases

    International Nuclear Information System (INIS)

    Becker, W.; Hohenberger, W.; Wolf, F.; Erlangen-Nuernberg Univ., Erlangen

    1990-01-01

    Radioiodine treatment is considered to be the treatment of choice in benign thyroid diseases because of its very low side effects. Real and hypothetic risks and side effects have to be differentiated. Both may occur early and late after the treatment. Radioiodinethyroiditis in small volumes at high doses is very rare. Exacerbation of a thyroid storm (0.34%) as well as local compressions accompanied with reactive edema of the thyroid are early real side effects of radioiodine treatment. Late real side effects are failure of treatment (7-30% of thyrotoxicosis) and induction of hypothyroidism (4-20% of functional autonomy and increasing frequency in Graves' diseases with time). Late hypothetic risks are somatic (1-9/10000 bis 1-9/100000) or genetic (1-9/100000). An early risk might be the misdiagnosis of an additional thyroid carcinoma. (orig.) [de

  17. Usefulness of serum CA-15.3 in the management of benign breast lesion.

    Science.gov (United States)

    Mondal, Hari Pada; Roy, Himanshu; Mondal, Palash; Saha, Mita; Basu, Nandita

    2012-04-01

    Benign breast lesion is an important risk factor for breast cancer and elevated CA-15.3 in serum is a well established marker of breast cancer. Core-needle biopsy is now the method of choice to sample non-palpable mammographic abnormality and as well as clinically palpable lesion. To asses relationship of serum CA-15.3 with different histologic entities of benign breast lesion and usefulness of this marker in predicting breast cancer in this high risk group, a study was conducted among 140 patients who had a diagnosis of benign breast lesion and malignancy following fine needle aspiration cytology (FNAC) at department of surgery, Medical College, Kolkata between 2007 and 2009. We prospectively estimated serum CA-15.3 level in all patients. Different histologic entities of benign breast lesion, who showed serum CA-15.3 level >30U/ml underwent tru-cut biopsy to detect malignancy. Of 140 patients studied, 50 were stamped as malignancy and 90 as benign after FNAC of which 20 patients had fibroadenoma, 25 had fibro-adenoma with fibrocystic disease, 20 had fibrocystic disease with epitheliosis and 25 had fibrocystic disease with atypia. All breast cancer patients and 10 each from fibro-adenoma with fibrocystic disease, fibrocystic disease with epitheliosis and fibrocystic disease with atypia had serum CA -15.3 level>30U/ml. Thirty patients with benign breast lesion who had raised CA-15.3 underwent core-needle biopsy. Fifteen patients were detected to have intraductal carcinoma, mostly with fibrocystic disease with atypia. Clinical applicability of serum CA-15.3 to detect breast cancer should be strongly considered in management of patients with benign breast lesion and tru-cut biopsy than FNAC be done before benign breast lesion being stamped as benign. Biopsy results that are not concordant with the targeted lesion require surgical biopsy.

  18. Transfusion rate and prevalence of unexpected red blood cell alloantibodies in women undergoing hysterectomy for benign disease

    DEFF Research Database (Denmark)

    Thoestesen, Lisbeth M; Rasmussen, Kjeld L; Lauszus, Finn F

    2011-01-01

    To determine transfusion rates, risk factors for transfusion and the prevalence of unexpected red blood cell alloantibodies in women undergoing hysterectomy for benign disease. In addition, we aimed to evaluate the necessity of the pretransfusion testing for red blood cell alloantibodies....

  19. Obstetric and gynecologic imaging

    International Nuclear Information System (INIS)

    Wicks, J.D.

    1987-01-01

    Obstetric and gynecologic imaging has undergone marked changes in the past 10 years, primarily because of the influence of new imaging modalities. The single modality that has most significantly changed the diagnostic approach to obstetric and gynecologic problems is diagnostic ultrasound. The remarkable ability of this technique to display the anatomy of the gravid and nongravid female pelvis without the use of ionizing radiation motivated the development of techniques and instrumentation that have supplanted but not totally replaced many x-ray based examinations. The use of diagnostic ultrasound for the evaluation of obstetric and gynecologic problems is the dominant theme of this chapter. Areas of patient diagnosis and management in which additional imaging techniques, x-rays, or magnetic resonance are used are presented where appropriate

  20. Gynecological cancer alarm symptoms:

    DEFF Research Database (Denmark)

    Balasubramaniam, Kirubakaran; Ravn, Pernille; dePont Christensen, René

    2016-01-01

    INTRODUCTION: To determine the proportion of patients who were referred to specialist care after reporting gynecological cancer alarm symptoms to their general practitioner. To investigate whether contact with specialist care was associated with lifestyle factors or socioeconomic status. MATERIAL...... and odds ratios (ORs) for associations between specialist care contact, lifestyle factors and socioeconomic status. RESULTS: The study included 25 866 non-pregnant women; 2957 reported the onset of at least one gynecological cancer alarm symptom, and 683 of these (23.1%) reported symptoms to their general......: Educational level influence contact with specialist care among patients with gynecological cancer alarm symptoms. Future studies should investigate inequalities in access to the secondary healthcare system. This article is protected by copyright. All rights reserved....

  1. Diagnostic and therapeutic pitfalls in benign vocal fold diseases

    Science.gov (United States)

    Bohlender, Jörg

    2013-01-01

    More than half of patients presenting with hoarseness show benign vocal fold changes. The clinician should be familiar with the anatomy, physiology and functional aspects of voice disorders and also the modern diagnostic and therapeutic possibilities in order to ensure an optimal and patient specific management. This review article focuses on the diagnostic and therapeutic limitations and difficulties of treatment of benign vocal fold tumors, the management and prevention of scarred vocal folds and the issue of unilateral vocal fold paresis. PMID:24403969

  2. Drug utilization study of gynecology OPD: In a tertiary care hospital.

    Directory of Open Access Journals (Sweden)

    Baig MS, Bagle TR,Gadappa SN, Deshpande Sonali, Doifode SM

    2013-04-01

    Full Text Available Background: The treatment of diseases by use of essential medicines, prescribed by generic names, has been emphasized by WHO and National Health Policy of India. Drugs used in gynaecology are one of the top selling drugs in India; however they are least studied with respect to drug utilization. Thus present study was undertaken to analyze drug utilization pattern of gynecology OPD in a tertiary care hospital. Materials and Methods: A retrospective, cross sectional, observational study of prescriptions in Gynecology OPD. Data was obtained from an electronic medical record database of patients that attended Gynecology OPD during the study period. Prescription records of patients were screened as per inclusion and exclusion criteria and 300 prescriptions were randomly selected by Openepi software. Patient related and drug related information was collected on a customized data collection sheet. Results: The mean age of patients was 30.19+9.83 years and common age of presentation was >18-30 years. In infective cases, vaginal discharge (10.33% was common, and in non-infective cases, menstrual disorders (24% were common. The average number of drugs per prescription was 3.47+1.53. In drug category, minerals (30.94% were most commonly prescribed, followed by antimicrobials (24.98%, and NSAIDs (13.37%. Polypharmacy was observed in 96.33% of the prescriptions. Conclusion: It is only by drug utilization studies that burden of diseases and corresponding utilization of drugs in gynecology can be measured. In our study majority of the drugs prescribed were generic which were from the essential medical list NLEM and WHO.

  3. Benign focal liver lesions: discrimination from malignant mimickers.

    Science.gov (United States)

    Alobaidi, Mohammad; Shirkhoda, Ali

    2004-01-01

    Focal lesions of the liver often have various imaging characteristics which may be interpreted as either benign or malignant. Understanding the underlying pathophysiology of these liver lesions may lead to characteristic imaging manifestations, which direct the radiologist to the diagnosis. Benign lesions include congenital hepatic cyst, autosomal dominant polycystic disease, hemangioma, focal nodular hyperplasia (FNH), hepatic adenoma, inflammatory pseudotumor, peliosis hepatis, focal fatty infiltration, hamartoma, and infectious processes such as hepatic abscess, echinococcal cyst, and candidiasis. Characteristic imaging features, clinical symptoms, and treatment/prognosis will be discussed. Emphasis will be placed on key reliable features of each disease to develop a method of discriminating these lesions from other benign and malignant disorders.

  4. Promoting Gynecologic Cancer Awareness at a Critical Juncture—Where Women and Providers Meet

    Science.gov (United States)

    Cooper, Crystale Purvis; Rodriguez, Juan; Hawkins, Nikki A

    2015-01-01

    Given the absence of effective population-based screening tests for ovarian, uterine, vaginal, and vulvar cancers, early detection can depend on women and health care providers recognizing the potential significance of symptoms. In 2008, the Centers for Disease Control and Prevention’s (CDC) Inside Knowledge campaign began distributing consumer education materials promoting awareness of gynecologic cancer symptoms. We investigated providers’ in-office use of CDC gynecologic cancer materials and their recognition of the symptoms highlighted in the materials. We analyzed data from a national 2012 survey of US primary care physicians, nurse practitioners, and gynecologists (N = 1,380). Less than a quarter of providers (19.4 %) reported using CDC gynecologic cancer education materials in their offices. The provider characteristics associated with the use of CDC materials were not consistent across specialties. However, recognition of symptoms associated with gynecologic cancers was consistently higher among providers who reported using CDC materials. The possibility that providers were educated about gynecologic cancer symptoms through the dissemination of materials intended for their patients is intriguing and warrants further investigation. Distributing consumer education materials in health care provider offices remains a priority for the Inside Knowledge campaign, as the setting where women and health care providers interact is one of the most crucial venues to promote awareness of gynecologic cancer symptoms. PMID:24214840

  5. Coloanal anastomosis in the management of benign and malignant rectal disease

    Energy Technology Data Exchange (ETDEWEB)

    Drake, D.B.; Pemberton, J.H.; Beart, R.W. Jr.; Dozois, R.R.; Wolff, B.G.

    1987-11-01

    The aim was to determine the efficacy, safety, and long-term clinical and functional results of coloanal anastomosis in patients with complicated benign and malignant rectal disease. Twenty-nine patients underwent coloanal or colopouch-anal anastomosis for either carcinoma of the rectum not technically amenable to conventional low anterior resection, severe radiation injury, large benign lower third tumors, or complications of previous operations. The mean age of the patients was 61 years and 82% were men. A diverting colostomy was constructed in 55% of the patients. The mean (+/- SEM) length of follow-up was 20 +/- 3 months. There was no operative mortality. Transient urinary retention, however, occurred in 40%, anastomotic stricture in 28%, and anastomotic leakage in 3.4%. Four patients (14%) could not have intestinal continuity restored and therefore were considered failures. The stool frequency for all remaining patients (N = 25) was 3 +/- 1 per day (mean +/- SEM) and did not vary with age, sex, or indication for operation. Complete continence was achieved by 84% of patients, but no patient was incapacitated by poor bowel function. In patients in whom a conventional colorectostomy is impractical or unwise, coloanal anastomosis is a safe and efficacious alternative operation that preserves anal continence.

  6. Coloanal anastomosis in the management of benign and malignant rectal disease

    International Nuclear Information System (INIS)

    Drake, D.B.; Pemberton, J.H.; Beart, R.W. Jr.; Dozois, R.R.; Wolff, B.G.

    1987-01-01

    The aim was to determine the efficacy, safety, and long-term clinical and functional results of coloanal anastomosis in patients with complicated benign and malignant rectal disease. Twenty-nine patients underwent coloanal or colopouch-anal anastomosis for either carcinoma of the rectum not technically amenable to conventional low anterior resection, severe radiation injury, large benign lower third tumors, or complications of previous operations. The mean age of the patients was 61 years and 82% were men. A diverting colostomy was constructed in 55% of the patients. The mean (+/- SEM) length of follow-up was 20 +/- 3 months. There was no operative mortality. Transient urinary retention, however, occurred in 40%, anastomotic stricture in 28%, and anastomotic leakage in 3.4%. Four patients (14%) could not have intestinal continuity restored and therefore were considered failures. The stool frequency for all remaining patients (N = 25) was 3 +/- 1 per day (mean +/- SEM) and did not vary with age, sex, or indication for operation. Complete continence was achieved by 84% of patients, but no patient was incapacitated by poor bowel function. In patients in whom a conventional colorectostomy is impractical or unwise, coloanal anastomosis is a safe and efficacious alternative operation that preserves anal continence

  7. Patient management in radioiodine therapy of benign thyroid disease

    International Nuclear Information System (INIS)

    Dressler, J.

    1997-01-01

    Benign thyroid disease ranks by far as the most frequent therapy in nuclear medicine. In Germany approximately 25 000 cases of hyperthyreosis are being treated in association with autonomy or Graves' disease, but also for the reduction of goiters or the correction of latent functional disturbances. In such indications radiotherapy is virtually free of risk as opposed to surgery and ranks more favorable in regard to costs and curative effects versus pharmacological long term treatment. Still regional varying therapeutical concepts and intentions are being pursued and trials of improvements described. There is consent in therapy that quality of treatment is closely linked to a specialized out-door platient preparation, individual hospital activity dosage and lifelong follow up including continued evaluation of therapeutical results. In this paper minimal requirements of outpatient measures before and after therapy are summarized which in Germany is only permitted on an inhospital patient basis. Considering basics of radioactive preventive law, scientific evidence of available results of therapeutical studies and a survey of German therapeutic centers, suggestions for a quality maintaining management in view of the most effective utilization for the limited available number of beds is presented for discussion. (orig.) [de

  8. Danish Gynecological Cancer Database

    DEFF Research Database (Denmark)

    Sørensen, Sarah Mejer; Bjørn, Signe Frahm; Jochumsen, Kirsten Marie

    2016-01-01

    AIM OF DATABASE: The Danish Gynecological Cancer Database (DGCD) is a nationwide clinical cancer database and its aim is to monitor the treatment quality of Danish gynecological cancer patients, and to generate data for scientific purposes. DGCD also records detailed data on the diagnostic measures...... data forms as follows: clinical data, surgery, pathology, pre- and postoperative care, complications, follow-up visits, and final quality check. DGCD is linked with additional data from the Danish "Pathology Registry", the "National Patient Registry", and the "Cause of Death Registry" using the unique...... Danish personal identification number (CPR number). DESCRIPTIVE DATA: Data from DGCD and registers are available online in the Statistical Analysis Software portal. The DGCD forms cover almost all possible clinical variables used to describe gynecological cancer courses. The only limitation...

  9. 21 CFR 884.4550 - Gynecologic surgical laser.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gynecologic surgical laser. 884.4550 Section 884....4550 Gynecologic surgical laser. (a) Identification. A gynecologic surgical laser is a continuous wave carbon dioxide laser designed to destroy tissue thermally or to remove tissue by radiant light energy...

  10. 42 CFR 493.945 - Cytology; gynecologic examinations.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Cytology; gynecologic examinations. 493.945 Section... Nonwaived Testing Proficiency Testing Programs by Specialty and Subspecialty § 493.945 Cytology; gynecologic... gynecologic examinations (Pap smears) in cytology, a program must provide test sets composed of 10- and 20...

  11. Adverse reactions analysis and prevention of antiseptic drug in the obstetrics and gynecology nursing.

    Science.gov (United States)

    Wang, Yongli; Bo, Qing; Zhang, Ying; He, Jing

    2018-05-01

    Antimicrobial agents are widely used in gynecologic inflammation and surgical period, so as to cure some infectious diseases, reduce the chance of surgical incision infection, but at the same time, there are many adverse reactions. The use of nursing interventions in obstetrics and gynecology can significantly reduce the adverse drug reactions in the treatment. The results showed that the incidence of adverse reactions in the observation group was 8.8%, while that in the control group was 15.6%. The incidence of adverse reactions in the observation group was significantly lower than that in the control group (P<0.05). The results showed that the nursing intervention in obstetrics and gynecology could reduce the adverse drug reactions. In a word, the nursing intervention of obstetrics and gynecology can greatly reduce the adverse reaction of antibiotics and has certain application value. It is worth popularizing in clinical practice.

  12. Intraoperative radiation therapy in gynecologic cancer: update of the experience at a single institution

    International Nuclear Information System (INIS)

    Garton, Graciela R.; Gunderson, Leonard L.; Webb, Maurice J.; Wilson, Timothy O.; Cha, Stephen S.; Podratz, Karl C.

    1997-01-01

    Purpose: To update the Mayo Clinic experience with intraoperative radiation therapy (IORT) in patients with gynecologic cancer. Methods and Materials: Between January 1983 and June 1991, 39 patients with recurrent or locally advanced gynecologic malignancies received intraoperative radiation therapy with electrons. The anatomical area treated was pelvis (side walls or presacrum) or periaortic nodes or a combination of both. In addition to intraoperative radiation therapy, 28 patients received external beam irradiation (median dose, 45 Gy; range, 0.9 to 65.7 Gy), and 13 received chemotherapy preoperatively. At the time of intraoperative radiation therapy and after maximum debulking operation, 23 patients had microscopic residual disease and 16 had gross residual disease up to 5 cm in thickness. Median follow-up for surviving patients was 43.4 months (range, 27.1 to 125.4 months). Results: The 5-year actuarial local control with or without central control was 67.4%, and the control within the IORT field (central control) was 81%. The risk of distant metastases at 5 years was 52% (82% in patients with gross residual disease and 33% in patients with only microscopic disease postoperatively). Actuarial 5-year overall survival and disease-free survival was 31.5 and 40.5%, respectively. Patients with microscopic disease had 5-year disease-free and overall survival of 55 and 50%, respectively. Grade 3 toxicity was directly associated with IORT in six patients (15%). Conclusion: Patients with local, regionally recurrent gynecologic cancer may benefit from maximal surgical debulking and IORT with or without external beam irradiation, especially those with microscopic residual disease

  13. Clinical application of shear wave elastography (SWE) in the diagnosis of benign and malignant breast diseases.

    Science.gov (United States)

    Chang, Jung Min; Moon, Woo Kyung; Cho, Nariya; Yi, Ann; Koo, Hye Ryoung; Han, Wonsik; Noh, Dong-Young; Moon, Hyeong-Gon; Kim, Seung Ja

    2011-08-01

    Shear wave elastography (SWE) is an emerging technique which can obtain quantitative elasticity values in breast disease. We therefore evaluated the diagnostic performance of SWE for the differentiation of breast masses compared with conventional ultrasound (US). Conventional US and SWE were performed by three experienced radiologists for 158 consecutive women who had been scheduled for US-guided core biopsy or surgical excision in 182 breast masses (89 malignancies and 93 benign; mean size, 1.76 cm). For each lesion, quantitative elasticity was measured in terms of the Young's modulus (in kilopascals, kPa) with SWE, and BI-RADS final categories were assessed with conventional US. The mean elasticity values were significantly higher in malignant masses (153.3 kPa ± 58.1) than in benign masses (46.1 kPa ± 42.9), (P masses as well as invasive and intraductal cancers with SWE. Our results suggest that SWE has the potential to aid in the differentiation of benign and malignant breast lesions.

  14. Benign bone tumors

    International Nuclear Information System (INIS)

    Gilday, D.L.; Ash, J.M.

    1976-01-01

    There is little information in the literature concerning the role of bone scanning in benign bone neoplasms except for sporadic reports. Since the advent of /sup 99m/Tc-polyphosphate, bone imaging has proven feasible and useful in locating the cause of bone pain, such as in osteoid osteomas, which are not always radiologically apparent, and in evaluating whether or not a radiologic lesion is indeed benign and solitary. Blood-pool images are particularly important in neoplastic disease, since the absence of hyperemia in the immediate postinjection period favors the diagnosis of a benign neoplasm, as does low-grade uptake on the delayed study. The scan, including pinhole magnification images, is especially valuable in diagnosing lesions in the spine and pelvis, which are poorly seen radiologically. We have studied various types of benign bone tumors, including simple and aneurysmal bone cysts, fibrous cortical defects, and nonossifying fibromas, all of which had minimal or no increased uptake of the radiopharmaceutical, unless traumatized. Although osteochondromas and enchondromas showed varied accumulation of activity, the scan was useful in differentiating these from sarcomatous lesions. All osteoid osteomas demonstrated marked activity, and could be accurately located preoperatively, as could the extent of fibrous dysplasia. The bone scan in the reticuloses also showed abnormal accumulation of activity, and aided in arriving at the prognosis and treatment of histiocytic bone lesions

  15. Radiotherapy for gynecologic cancer in nonagenarian patients: a framework for new paradigms.

    Science.gov (United States)

    Méry, Benoîte; Ndong, Sylvie Mengue; Guy, Jean-Baptiste; Assouline, Avi; Falk, Alexander T; Valeille, Anaïs; Trone, Jane-Chloé; Rivoirard, Romain; Auberdiac, Pierre; Vallard, Alexis; Espenel, Sophie; Moriceau, Guillaume; Collard, Olivier; Bosacki, Claire; Jacquin, Jean-Philippe; de Laroche, Guy; Fournel, Pierre; Chargari, Cyrus; Magné, Nicolas

    2016-05-09

    No consensus exists regarding the role of radiotherapy in the management of gynecologic cancer in nonagenarian patients. We retrospectively reviewed the outcomes of 19 consecutive nonagenarian patients with gynecologic cancer (6 endometrial cancers, 6 cervical cancers, 4 vulvar cancers, and 3 vaginal cancers) who were treated with radiotherapy. Radiotherapy was performed mainly in a palliative setting (n = 12; 63.2%), with a median dose of 45 Gy (range, 6-76 Gy). Infrequent major acute or late toxicities were reported. Among 19 patients, 9 (47.4%) experienced tumor progression, 5 (26.3%) experienced complete response, 2 (10.5%) experienced stable disease and/or partial response. At last follow-up, 12 patients (63.2%) had died; most deaths (n = 9) occurred because of the cancer. These results suggest that radiotherapy is feasible in the treatment of nonagenarian patients with gynecologic cancer.

  16. Gynecologic Malignancies Post-LeFort Colpocleisis

    Directory of Open Access Journals (Sweden)

    Rayan Elkattah

    2014-01-01

    Full Text Available Introduction. LeFort colpocleisis (LFC is a safe and effective obliterative surgical option for older women with advanced pelvic organ prolapse who no longer desire coital activity. A major disadvantage is the limited ability to evaluate for post-LFC gynecologic malignancies. Methods. We present the first case of endometrioid ovarian cancer diagnosed after LFC and review all reported gynecologic malignancies post-LFC in the English medical literature. Results. This is the second reported ovarian cancer post-LFC and the first of the endometrioid subtype. A total of nine other gynecologic malignancies post-LFC have been reported in the English medical literature. Conclusions. Gynecologic malignancies post-LFC are rare. We propose a simple 3-step strategy in evaluating post-LFC malignancies.

  17. Three-dimensional ultrasonography and power Doppler for discrimination between benign and malignant endometrium in premenopausal women with abnormal uterine bleeding.

    Science.gov (United States)

    El-Sharkawy, Mohamed; El-Mazny, Akmal; Ramadan, Wafaa; Hatem, Dina; Abdel-Hafiz, Aly; Hammam, Mohamed; Nada, Adel

    2016-03-16

    Ultrasonography has been extensively used in women suspected of having a gynecological malignancy. The aim of this study is to evaluate the efficacy of 3D ultrasonography and power Doppler for discrimination between benign and malignant endometrium in premenopausal women with abnormal uterine bleeding. This cross-sectional study included 78 premenopausal women with abnormal uterine bleeding scheduled for hysteroscopy and endometrial curettage. The endometrial thickness (ET), uterine artery pulsatility index (PI) and resistance index (RI), and endometrial volume (EV) and 3D power Doppler vascularization index (VI), flow index (FI), and vascularization flow index (VFI) were measured and compared with hysteroscopic and histopathologic findings. The ET (P benign and malignant endometrium was the VI with an area under the ROC curve of 0.88 at a cutoff value of 0.81%. 3D ultrasonography and power Doppler, especially endometrial VI, may be useful for discrimination between benign and malignant endometrium in premenopausal women with abnormal uterine bleeding.

  18. Benign Lesions of The Vocal Fold

    Directory of Open Access Journals (Sweden)

    Ozgur Surmelioglu

    2013-02-01

    Full Text Available Benign lesions of vocal folds are common disorders. Fifty percent of patients who have sound complaints are found to have these lesions after endoscopic and stroboscopic examinations. Benign vocal fold diseases are primarily caused by vibratory trauma. However they may also occur as a result of viral infections and congenital causes. These lesions are often presented with the complaints of dysphonia. [Archives Medical Review Journal 2013; 22(1.000: 86-95

  19. Impact of a Pediatric and Adolescent Gynecology Curriculum on an Obstetrics and Gynecology Residency.

    Science.gov (United States)

    Palaszewski, Dawn M; Miladinovic, Branko; Caselnova, Petra M; Holmström, Shelly W

    2016-12-01

    To determine the effectiveness of a new pediatric and adolescent gynecology (PAG) curriculum for improving obstetrics/gynecology resident physician knowledge and comfort level in patient management and to describe the current deficiencies in resident physician knowledge and comfort level in PAG. A PAG curriculum was implemented for the obstetrics/gynecology resident physicians (n = 20) at the University of South Florida in July 2013. Before and after the curriculum was introduced, resident physicians and recent graduates of the residency program completed a survey to assess their comfort level and a knowledge assessment consisting of 20 case-based questions. University-based residency program. Resident physicians and recent resident physician graduates in the Department of Obstetrics and Gynecology. Introduction of a PAG curriculum during the 2013-2014 academic year. Improvement in resident physicians' comfort level and knowledge in PAG. After the curriculum was introduced, comfort increased in examining the genitals of a pediatric gynecology patient (median difference = 1.5; P = .003) and history-taking, physical examination skills, and management (median difference = 1; P = .002) compared with before the curriculum. There was no significant difference in overall quiz score (15.5 ± 1.87 vs 15.8 ± 1.3; P = .78). A curriculum in PAG did improve resident comfort level in managing PAG patients, but did not significantly improve knowledge of this topic. Copyright © 2016.

  20. The spectrum of benign esophageal lesions: imaging findings

    International Nuclear Information System (INIS)

    Jang, Kyung Mi; Lee, Kyung Soo; Lee, Soon Jin; Kim, Eun A; Kim, Tae Sung; Han, Dae Hee; Shim, Young Mog

    2002-01-01

    Benign esophageal lesions occur in various diseases. Barium studies are useful for the evaluation of mucosal surface lesions but provide little information about the extramucosal extent of disease. Computed tomography and magnetic resonance imaging, on the other hand, permit the assessment of wall thickness, mediastinal involvement, adjacent lymphadenopathy, and distant spread. In diseases such as fibrovascular polyps, duplication cysts, scleroderma, trauma, caustic esophagitis, hiatal hernia, esophageal diverticulum, achalasia, and paraesophageal varices, the findings of imaging studies are specific, obviating the need for further invasive diagnostic work-up. The advent of helical computed tomography and its volume data set allows the acquisition of multiplanar images, and magnetic resonance imaging is useful both for this and for tissue characterization. Thus, multiplanar cross-sectional imaging further extends the role of imaging modalities to the evaluation of benign esophageal lesions. Through an awareness of the multiplanar cross-sectional appearances of various benign esophageal lesions, the radiologist can play an important role in the detection, diagnosis, further diagnostic planning, and treatment of the diseases in which they occur

  1. The spectrum of benign esophageal lesions: imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Kyung Mi; Lee, Kyung Soo; Lee, Soon Jin; Kim, Eun A; Kim, Tae Sung; Han, Dae Hee; Shim, Young Mog [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2002-09-01

    Benign esophageal lesions occur in various diseases. Barium studies are useful for the evaluation of mucosal surface lesions but provide little information about the extramucosal extent of disease. Computed tomography and magnetic resonance imaging, on the other hand, permit the assessment of wall thickness, mediastinal involvement, adjacent lymphadenopathy, and distant spread. In diseases such as fibrovascular polyps, duplication cysts, scleroderma, trauma, caustic esophagitis, hiatal hernia, esophageal diverticulum, achalasia, and paraesophageal varices, the findings of imaging studies are specific, obviating the need for further invasive diagnostic work-up. The advent of helical computed tomography and its volume data set allows the acquisition of multiplanar images, and magnetic resonance imaging is useful both for this and for tissue characterization. Thus, multiplanar cross-sectional imaging further extends the role of imaging modalities to the evaluation of benign esophageal lesions. Through an awareness of the multiplanar cross-sectional appearances of various benign esophageal lesions, the radiologist can play an important role in the detection, diagnosis, further diagnostic planning, and treatment of the diseases in which they occur.

  2. Technical Aspects of Laparoscopic Distal Pancreatectomy for Benign and Malignant Disease: Review of the Literature

    Science.gov (United States)

    de Rooij, T.; Sitarz, R.; Busch, O. R.; Besselink, M. G.; Abu Hilal, M.

    2015-01-01

    Distal pancreatectomy is the standard curative treatment for symptomatic benign, premalignant, and malignant disease of the pancreatic body and tail. The most obvious benefits of a laparoscopic approach to distal pancreatectomy include earlier recovery and shorter hospital stay. Spleen-preserving distal pancreatectomy should be attempted in case of benign disease. Spleen preservation can be achieved preferably by preserving the splenic vessels (Kimura technique), but also by resecting the splenic vessels and maintaining vascularity through the short gastric vessels and left gastroepiploic artery (Warshaw technique). Several studies have suggested a higher rate of spleen preservation with laparoscopy. The radical antegrade modular pancreatosplenectomy has become mainstay for treating pancreatic cancer and can be performed laparoscopically as well. Evidence on the feasibility and safety of laparoscopic distal pancreatectomy for cancer is scarce. Despite the obvious advantages of laparoscopic surgery, postoperative morbidity remains relatively high, mainly because of the high incidence of pancreatic fistula. For decades, surgeons have tried to prevent these fistulas but to date no strategy has been confirmed to be effective in 2 consecutive randomized studies. Pragmatic multicenter studies focusing on technical aspects of laparoscopic distal pancreatectomy are lacking and should be encouraged. PMID:26240565

  3. Technical Aspects of Laparoscopic Distal Pancreatectomy for Benign and Malignant Disease: Review of the Literature

    Directory of Open Access Journals (Sweden)

    T. de Rooij

    2015-01-01

    Full Text Available Distal pancreatectomy is the standard curative treatment for symptomatic benign, premalignant, and malignant disease of the pancreatic body and tail. The most obvious benefits of a laparoscopic approach to distal pancreatectomy include earlier recovery and shorter hospital stay. Spleen-preserving distal pancreatectomy should be attempted in case of benign disease. Spleen preservation can be achieved preferably by preserving the splenic vessels (Kimura technique, but also by resecting the splenic vessels and maintaining vascularity through the short gastric vessels and left gastroepiploic artery (Warshaw technique. Several studies have suggested a higher rate of spleen preservation with laparoscopy. The radical antegrade modular pancreatosplenectomy has become mainstay for treating pancreatic cancer and can be performed laparoscopically as well. Evidence on the feasibility and safety of laparoscopic distal pancreatectomy for cancer is scarce. Despite the obvious advantages of laparoscopic surgery, postoperative morbidity remains relatively high, mainly because of the high incidence of pancreatic fistula. For decades, surgeons have tried to prevent these fistulas but to date no strategy has been confirmed to be effective in 2 consecutive randomized studies. Pragmatic multicenter studies focusing on technical aspects of laparoscopic distal pancreatectomy are lacking and should be encouraged.

  4. Small cell carcinoma of the gynecologic tract: a multifaceted spectrum of lesions.

    Science.gov (United States)

    Atienza-Amores, Maria; Guerini-Rocco, Elena; Soslow, Robert A; Park, Kay J; Weigelt, Britta

    2014-08-01

    Small cell carcinoma (SmCC) of the female genital tract constitutes a diagnostic and clinical challenge given its rarity and the lack of standardized therapeutic approaches. Here we review the morphological, clinical and molecular features of gynecologic SmCCs and discuss potential areas for future research. Data for this review article were identified by searches of PubMed, EMBASE and the Internet using the search terms "small cell carcinoma" or "neuroendocrine carcinoma" and "gynecologic", "uterine cervix", "cervix", "uterus", "endometrium", "ovary", "vagina", "fallopian tube" or "vulva", and research articles published in English between 1972 and February 2014 were included. SmCCs arising from different organs within the gynecologic tract share the same histopathologic characteristics, which closely resemble those of small cell lung carcinoma. The expression of at least one immunohistochemical neuroendocrine marker is a common finding. The uterine cervix is the most frequent site of SmCC in the female genital tract. HPV infection seems to play a role in the development of cervical SmCC but not in cancers of other gynecologic sites. FIGO stage is an established prognostic factor, in particular in SCCs of the cervix. Irrespective of the site, SmCCs of the gynecologic tract display an aggressive clinical behavior with few reported long-term survivors. The therapeutic management includes surgery, radiotherapy and chemotherapy. Despite the potential differences in etiology and risk factors, SmCCs from different sites of the gynecologic tract have similar morphologic appearances and clinical behavior. Recent genomic analyses of small cell carcinoma of the lung have revealed potential driver genomic alterations. We posit that the comprehensive genomic characterization of gynecologic SmCCs may lead to the identification of markers that result in an improvement of diagnostic reproducibility of SmCCs of the gynecologic tract, and of molecular aberrations that may be

  5. Organization of health care for the patients with benign diseases: the problem of one-day hospitalization

    Directory of Open Access Journals (Sweden)

    L. V. Kochorova

    2013-01-01

    Full Text Available The article analises the volume of medical care to the citizens of St. Petersburg, suffering with benign diseases and hospitalized for one day. It is shown,that the level of one-day hospitalization is a marker of not approved hospitalization and unreasonable spending of funds in the state system of obligatory insurance.

  6. Results of radioiodine therapy of benign thyroid disease

    International Nuclear Information System (INIS)

    Pronath, A.

    1982-01-01

    The goal of this work is the quantification of therapy results of a radioiodine therapy with Iodine 131 on 367 patients with the following benign thyroid diseases: euthyroidal struma, hyperthyroidism, hyperthyroidal struma and autonomous adenoma. 1. Euthyroidal struma - subjective improvement and objective diminution of the struma by 63%, subjective or objective improvement by 21% of the patients. Including the probable successful therapies the success rate was all together 90.1%. 2. Hyperthyroidism - after one-time/more-time (18.6%) radioiodine therapy the success rate was 71.5/85.7% including latent (8.6/10.0%) and manifest (7.1/8.5%) hypothroidism. 3. Hyperthyroidal struma - after one-time/more-time (16.9%) radioiodine therapy the success rate was 74.7/90.1% including latent (-/5.7%) and manifest (1.4/2.8%) hypothyroidism. 4. Autonomous adenoma - after one-time/two-time (5.2%) radioiodine therapy the success rate was 80.5/84.6% including 15.5% latent hypothyroidism. The results will be discussed in comparison to published data and to operation and thyrostatic treatment. (TRV) [de

  7. Factors Affecting Gynecologic and Sexual Assessment in Older Women: A Lesson for Primary Care Providers

    Directory of Open Access Journals (Sweden)

    Ayasha Thomason

    2015-08-01

    Full Text Available Guidelines for screening of cervical cancer and pelvic exams for older women have recently changed. These changes may have unexpected sequelae in women over 65 years of age. This manuscript provides a review of gynecologic screening recommendations for older women in the U.S. and potential ramifications of these recent changes. Peer reviewed guidelines from the American College of Obstetrics and Gynecology, U.S. Preventative Task Force Services, the American Cancer Society, The Centers for Disease Control, and multiple original research articles and reviews were reviewed for this manuscript. Women over 65 are at greatest risk to develop late stage diagnoses of cancers, pelvic organ disease, incontinence, and infections. Clinicians will need to acutely consider this fact when communicating and screening this population. We conclude that practitioners should be aware of the new guidelines and should consider including gynecologic health history and symptom analysis as part of annual exams in women of all ages.

  8. Application of SPECT/CT imaging in the diagnosis of benign diseases

    International Nuclear Information System (INIS)

    Garcheva, M.; Demirev, A.

    2014-01-01

    The application of recently introduced hybrid nuclear medicine methods gains importance in a variety of clinical fields, mainly because of the unique combination between functional and anatomical data provided by those methods and their capability for a precise localization of pathological processes. Single photon emission computed tomography, combined with computed tomography (SPECT/CT) is one of those methods. Its role in nuclear cardiology is important, because it provides quick attenuation correction and calculates the calcium score. In nuclear endocrinology SPECT/CT participates in thyroid and parathyroid examinations, especially in cases, where there is a need for localization of ectopic parathyroid or thyroid tissue. In nuclear pulmonology, one of the best ways to attribute certain changes seen on the SPECT, to the zone of interest on the CT, is to study the fused images obtained from the SPECT/ CT scanner. In cases of suspected infection and inflammation, fused images are indispensable for accurate localization of the involved tissue (structure) and for discrimination between normal/abnormal uptake. Careful reading of the CT component (even low-dose) is related (in 10% of cases) to clinically important incidental findings: effusions, tumors, metastases or lymph node pathology. SPECT/CT increases the specificity of the examinations and improves significantly the localization of pathological processes. It provides additional information, shortens the diagnostic algorithm and influences the extent of surgical procedures. In many hybrid examinations the preferred CT component is a low-dose one, without considerable radiation exposure. The opportunity to combine nuclear medicine techniques and contrast CT images, aiming at better diagnosis needs further development. SPECT/CT provides important additional information and more accurate diagnostics in patients with benign diseases. (authors) Key words: SPECT/CT. BENIGN DISEASES

  9. Interphase ribosomal RNA cistron staining in thyroid epithelial cells in Grave's disease, Hashimoto's thyroiditis and benign and malignant tumours of the thyroid gland

    Science.gov (United States)

    Mamaev, N N; Grynyeva, E N; Blagosklonnaya, Y V

    1996-01-01

    Aim—To evaluate the expression of ribosomal cistrons in human thyroid epithelial cells (TECs) of patients with Grave's disease, Hashimoto's thyroiditis and benign and malignant tumours of the thyroid gland. Methods—TEC nucleoli were investigated in fine needle biopsy specimens from 10 controls, 39 patients with Grave's disease, 15 with Hashimoto's thyroiditis, 56 with benign, and 15 with malignant tumours of the thyroid. A one step silver staining method was applied. In most cases serum concentrations of thyroxine and triiodothyronine as well as goitre size were determined. In every case 100 TECs were evaluated for the mean numbers of nucleoli and for the average number of argyrophilic nucleolar organiser regions (AgNORs) per nucleus. Results—NORs were activated in all patients, but not in controls. The numbers of AgNORs in patients with Grave's disease were closely correlated with thyroxine or triiodothyronine, or both, concentrations and with the size of the thyroid. In patients with Hashimoto's thyroiditis about 30% of TECs nucleoli did not contain AgNORs, whereas others were heavily impregnated with silver. Compared with controls and benign tumours, the nucleoli of carcinomatous TECs were larger and irregular in shape. The mean number of AgNORs per nucleus in malignant cells was higher than that in their benign counterparts. Conclusions—The mechanism by which NORs are activated in TECs varies depending on the type of lesion. The higher AgNOR score in TECs from malignant tumours can be used to distinguish them from their benign counterparts. Images PMID:16696083

  10. Benign Cystic Mesothelioma Misdiagnosed as Peritoneal Carcinomatosis

    Directory of Open Access Journals (Sweden)

    Hyun Deok Shin

    2016-04-01

    Full Text Available Benign cystic mesothelioma (BCM is a rare benign disease that forms multicystic masses in the abdomen, pelvis, and retroperitoneum. It occurs predominantly in young to middle-aged women. The majority of cases were associated with a history of abdominal or pelvic operation, a history of endometriosis, and pelvic inflammatory disease. We present a unique case of BCM which is different to the previous cases. The patient was a 52-year-old man showing features of peritoneal carcinomatosis accompanied by ascites on abdominal computed tomography scans. We herein report a case of BCM misdiagnosed with peritoneal carcinomatosis.

  11. Musculoskeletal Pain in Gynecologic Surgeons

    Science.gov (United States)

    Adams, Sonia R.; Hacker, Michele R.; McKinney, Jessica L.; Elkadry, Eman A.; Rosenblatt, Peter L.

    2013-01-01

    Objective To describe the prevalence of musculoskeletal pain and symptoms in gynecologic surgeons. Design Prospective cross-sectional survey study (Canadian Task Force classification II-2). Setting Virtual. All study participants were contacted and participated via electronic means. Participants Gynecologic surgeons. Interventions An anonymous, web-based survey was distributed to gynecologic surgeons via electronic newsletters and direct E-mail. Measurements and Main Results There were 495 respondents with complete data. When respondents were queried about their musculoskeletal symptoms in the past 12 months, they reported a high prevalence of lower back (75.6%) and neck (72.9%) pain and a slightly lower prevalence of shoulder (66.6%), upper back (61.6%), and wrist/hand (60.9%) pain. Many respondents believed that performing surgery caused or worsened the pain, ranging from 76.3% to 82.7% in these five anatomic regions. Women are at an approximately twofold risk of pain, with adjusted odds ratios (OR) of 1.88 (95% confidence interval [CI], 1.1–3.2; p 5 .02) in the lower back region, OR 2.6 (95% CI, 1.4–4.8; p 5 .002) in the upper back, and OR 2.9 (95% CI, 1.8–4.6; p 5 .001) in the wrist/hand region. Conclusion Musculoskeletal symptoms are highly prevalent among gynecologic surgeons. Female sex is associated with approximately twofold risk of reported pain in commonly assessed anatomic regions. Journal of Minimally Invasive Gynecology (2013) 20, 656-660 PMID:23796512

  12. Complications of gynecologic and obstetric management

    International Nuclear Information System (INIS)

    Newton, M.; Newton, E.R.

    1987-01-01

    This book examines the incidence, diagnosis and management of complications associated with interventions used in gynecology and obstetrics. These are encountered in all phases of gynecologic and therapeutic procedures, radiation therapy, drug therapy and pre- and post-treatment care

  13. Optical coherence tomography in gynecology: a narrative review

    Science.gov (United States)

    Kirillin, Mikhail; Motovilova, Tatiana; Shakhova, Natalia

    2017-12-01

    Modern gynecologic practice requires noninvasive diagnostics techniques capable of detecting morphological and functional alterations in tissues of female reproductive organs. Optical coherence tomography (OCT) is a promising tool for providing imaging of biotissues with high resolution at depths up to 2 mm. Design of the customized probes provides wide opportunities for OCT use in gynecology. This paper contains a retrospective insight into the history of OCT employment in gynecology, an overview of the existing gynecologic OCT probes, including those for combination with other diagnostic modalities, and state-of-the-art application of OCT for diagnostics of tumor and nontumor pathologies of female genitalia. Perspectives of OCT both in diagnostics and treatment planning and monitoring in gynecology are overviewed.

  14. Epidemiology of gynecologic cancers in China

    OpenAIRE

    Jiang, Xiyi; Tang, Huijuan; Chen, Tianhui

    2017-01-01

    Cancer has become a major disease burden across the globe. It was estimated that 4.29 million new incident cases and 2.81 million death cases of cancer would occur in 2015 in China, with the age-standardized incidence rate (ASIR) of 201.1 per 100,000 and age-standardized mortality rate (ASMR) of 126.9 per 100,000, respectively. For females, 2 of the top 10 most common types of cancer would be gynecologic cancers, with breast cancer being the most prevalent (268.6 thousand new incident cases) ...

  15. 42 CFR 493.855 - Standard; Cytology: gynecologic examinations.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Standard; Cytology: gynecologic examinations. 493... Complexity, Or Any Combination of These Tests § 493.855 Standard; Cytology: gynecologic examinations. To participate successfully in a cytology proficiency testing program for gynecologic examinations (Pap smears...

  16. Microparticles and Exosomes in Gynecologic Neoplasias

    NARCIS (Netherlands)

    Nieuwland, Rienk; van der Post, Joris A. M.; Lok Gemma, Christianne A. R.; Kenter, G.; Sturk, Augueste

    2010-01-01

    This review presents an overview of the functions of microparticles and exosomes in gynecologic neoplasias. Growing evidence suggests that vesicles released from cancer cells in gynecologic malignancies contribute to the hypercoagulable state of these patients and contribute to tumor progression by

  17. Single benign metastasising leiomyoma of an inguinal lymph node.

    NARCIS (Netherlands)

    Laban, KG; Tobon-Morales, Roberto; Hodge, Janice; Schreuder, HWR

    2016-01-01

    Benign metastasising leiomyoma (BML) is a rare benign disease associated with uterine leiomyoma and history of uterine surgery. It most frequently occurs in premenopausal woman, with a pulmonary localisation, and consisting of multiple nodules. We present an uncommon case of a 69-year-old woman with

  18. 21 CFR 884.4120 - Gynecologic electrocautery and accessories.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Gynecologic electrocautery and accessories. 884... Surgical Devices § 884.4120 Gynecologic electrocautery and accessories. (a) Identification. A gynecologic electrocautery is a device designed to destroy tissue with high temperatures by tissue contact with an...

  19. Benign and Malignant Thyroid Gland Diseases in the Patients with Primary Hyperparathyroidism.

    Science.gov (United States)

    Celik, Mehmet; Guldiken, Sibel; Ayturk, Semra; Bulbul, Buket Yilmaz; Tastekin, Ebru; Can, Nuray; Sezer, Atakan; Ustun, Funda; Kucukarda, Ahmet

    2017-01-01

    This study aimed to evaluate concurrently detected thyroid pathologies in the patients who underwent surgery for primary hyperparathyroidism (PHPT). In this study, we retrospectively analyzed the files of the patients who underwent surgery for PHPT between 2012 and 2015. Pre- and post-operative laboratory examination results and preoperative radiological and nuclear medicine findings of the patients were retrospectively recorded. A total number of 41 patients with PHPT were divided into two groups as the Group 1 with PHPT and benign thyroid pathology (21 patients) and the Group 2 with PHPT and malignant thyroid pathology (20 patients). In Group 1, 18 and 3 of 21 patients were females and males, respectively. Group 2 included 15 male and 5 female patients. The mean age of the patients was found to be 55.6 and 53.9 years in Group 1 and Group 2, respectively. Both groups were matched for age and gender. In terms of thyroid pathology, 20 of 41 patients (48.7%) who underwent total thyroidectomy for PHPT were found to have thyroid papillary carcinoma while benign pathologic conditions were detected in 21 (51.3%) individuals. Cooccurrence of thyroid diseases and PHPT is common. Therefore, all the patients should preoperatively be evaluated for the presence of thyroid pathology to determine the technique of parathyroid surgery.

  20. Hypocalcaemia after total thyroidectomy for Graves' disease and for benign atoxic multinodular goitre.

    Science.gov (United States)

    Hallgrimsson, Páll; Nordenström, E; Bergenfelz, A; Almquist, M

    2012-10-01

    Postoperative hypocalcaemia has been reported to be more common after total thyroidectomy (TT) for Graves' disease than after TT for benign atoxic multinodular goitre (MNG). The reasons for this potential association are not clear. In the present study, the frequency and risk factors of hypocalcaemia after TT for Graves' vs MNG were compared. Between January 1999 and October 2009, patients with first-time surgery for Graves' disease or MNG treated with a TT were included in the study. Postoperative hypocalcaemia was defined by symptoms, calcium levels and treatment with calcium and/or vitamin D analogues during postoperative hospital stay, at discharge, and at the 6-week and 6-month follow-ups. Outcomes were compared with Mann-Whitney, chi(2) and Fishers' exact test where appropriate and by multivariable logistic regression analysis. There were 128 patients with Graves' disease and 81 patients with MNG. Patients with Graves' disease were younger than patients with MNG (median age, 35 vs 51 years, p Graves' disease (p Graves' disease, there was no difference in the overall frequency of biochemical hypocalcaemia, low levels of PTH and/or treatment with calcium and vitamin D.

  1. Prospective study of catheter-related central vein thrombosis in home parenteral nutrition patients with benign disease using serial venous Doppler ultrasound.

    Science.gov (United States)

    Cuerda, Cristina; Joly, Francisca; Corcos, Olivier; Concejo, Javier; Puiggrós, Carolina; Gil, Carmen; Pironi, Loris

    2016-02-01

    Catheter-related central vein thrombosis (CRVT) is a severe complication of home parenteral nutrition (HPN) that may be clinically manifest or subclinical. The aims of the study were to prospectively investigate the incidence of CRVT in patients on HPN with benign disease and determine the influence of different variables on this complication. A prospective, multicentre, observational study in the Home Artificial Nutrition-Chronic Intestinal Failure ESPEN group was performed. Patients with benign disease starting HPN or already on HPN after the insertion of a new catheter, were recruited and followed up with Color Doppler Duplex Sonography (CDDS) evaluations at baseline, 1 week, 3, 6 and 12 months after catheter insertion. Fisher's exact test was used to calculate the association of different variables (related to the patient, type of catheter, vascular access, insertion method, catheter care and anticoagulant treatment) with CRVT events. Sixty-two patients (31 males, 31 females) aged 50 ± 19 (19-83) years were included and followed for a median 363 days, with an Inter Quartile Range of 180-365 days, and a total of 16,186 catheter-days. Six patients had previous CRVT and 16 had history of thromboembolic disease (pulmonary and mesenteric). Forty one patients were receiving anticoagulant treatment. Fifty two patients had tunneled catheters and 10 implanted ports. Two patients had symptomatic thrombosis at 3 and 12 months of follow-up (2 and 3 weeks after normal routine CDDS evaluation). The incidence of CRVT was 0.045/catheter/year. CRVT was not significantly associated with any of the variables analyzed. The incidence of CRVT in patients on HPN for benign disease followed by CDDS is low in the first year of catheterization. We did not observe any case of asymptomatic CRVT. Based on our data, CDDS seems to have low effectiveness as a screening tool for CRVT in asymptomatic patients on HPN with benign disease. Copyright © 2015 Elsevier Ltd and European Society for

  2. Evaluation of Helicobacter pylori infection and other risk factors in patients with benign peptic ulcer disease

    Directory of Open Access Journals (Sweden)

    Depender Kumar Timshina

    2011-03-01

    Full Text Available Objective: To assess and compare the risk factors in patients with benign gastric and duodenal ulcers and to correlate the prevalence of Helicobacter pylori (H. pylori infection in benign peptic ulcer disease. Methods: A total of 30 consecutive patients with peptic ulcer disease were included in this study after upper gastrointestinal endoscopy. Their clinical profile and endoscopic findings were noted. Antral biopsies were subjected to histopathological examination and urease test for detection of H. pylori. Results were correlated. The study was cleared by the Institute Research Council and the Ethics committee. Results: The male: female ratio was 11:4. Overall, H. pylori infection was prevalent in 93.3% of the patients. Patients who took spicy food had a significantly higher rate of H. pylori positivity (P=0.04. Smoking, alcohol intake and NSAIDs did not affect H. pylori status in patients. There was no significant association between the site of the ulcer and H. pylori infection. Conclusions: Based on our observations we conclude that prevalence of H. pylori infection is similar in duodenal and gastric ulcers and intake of spicy food is a significant risk factor.

  3. Clinicopathological pattern of benign breast diseases among female ...

    African Journals Online (AJOL)

    This study describes our experience in the management of benign ... assessment consisting of clinical evaluation, breast imaging and fine needle aspiration cytology. (FNAC) has been recommended as a diagnostic tool for evaluation of patients with .... week for breast pain, breast lump and nipple discharge, respectively.

  4. The Rorschach in gynecological suffering: representations and complexes of the VI table

    Directory of Open Access Journals (Sweden)

    Salvatore Settineri

    2015-09-01

    Full Text Available Background. The literature shows that women with gynecological problems have psychosomatic alteration in the body image perception and sexual distress. To our knowledge, these issues have so far been analyzed separately and rarely through a projective methods. Aim. The aim of this study is to analyze the role of body image and its relative weakness in gynecological pathology, through the Rorschach projective method. Method. The observation group consists of 66 women with an average age of 49 ± 17 year, belonging to the clinic of the University Hospital Vulvologia and Colpocitologia "Gaetano Martino" of Messina. For the evalutation was used Rorschach, according to the clinical method, in order to explore the representations of the subject's inner world. Results. The responses to the Rorschach cards show a prevalence of anatomical and sexual content, devitalized animals and object, in particular to the table VI. We observed in women a complex regarding generativity that reveals a fragmentation of body image representation and of the sexual imaginative function of the inner world. Conclusions. The sexual suffering in gynecology is a dimension that influences the symptomathology in the extent to which the psychological aspects profoundly affect bodily perceptions, weakening the self-image and altering the course of the disease.   Keywords: body image, sexuality, Rorschach, psychosomatic gynecology.

  5. Retinoids, carotenoids, and tocopherols in breast adipose tissue and serum of benign breast disease and breast cancer patients

    Science.gov (United States)

    Various retinoic acid (RA) isomers (all-trans, 13-cis, 11-cis, and 9-cis) as well as retinol, carotenoids, and tocopherol concentrations were determined in both serum and breast adipose tissue of 22 benign breast disease patients and 52 breast cancer patients categorized into 4 stages by malignancy....

  6. Benign multiple sclerosis: a need for a consensus.

    Science.gov (United States)

    Glad, S B; Aarseth, J H; Nyland, H; Riise, T; Myhr, K-M

    2010-01-01

    To investigate the impact of different definitions on the frequency of benign multiple sclerosis (MS) in patients with a long follow-up, and to study the presence of non-motor symptoms and employment across the definitions. All patients alive (n = 188) with disease onset during 1976-1986 in Hordaland County, Norway, were clinically examined including the Expanded Disability Status Scale (EDSS) in 2003. Non-motor symptoms which included depression, cognitive impairment, fatigue and pain, and employment status were also registered. Three definitions of benign MS were used based on the following EDSS cut-off values: 2.0, 3.0 and 4.0. Two additional definitions were added using an EDSS part-time employment status. The frequency of benign MS increased from 14.5% for EDSS disease duration seems to be the most appropriate criterion in identifying patients with benign MS.

  7. Laparoscopic pancreatic surgery for benign and malignant disease

    NARCIS (Netherlands)

    de Rooij, Thijs; Klompmaker, Sjors; Abu Hilal, Mohammad; Kendrick, Michael L.; Busch, Olivier R.; Besselink, Marc G.

    2016-01-01

    Laparoscopic surgery for benign and malignant pancreatic lesions has slowly been gaining acceptance over the past decade and is being introduced in many centres. Some studies suggest that this approach is equivalent to or better than open surgery, but randomized data are needed to assess outcomes.

  8. Contemporary Management of Benign and Malignant Parotid Tumors.

    Science.gov (United States)

    Thielker, Jovanna; Grosheva, Maria; Ihrler, Stephan; Wittig, Andrea; Guntinas-Lichius, Orlando

    2018-01-01

    To report the standard of care, interesting new findings and controversies about the treatment of parotid tumors. Relevant and actual studies were searched in PubMed and reviewed for diagnostics, treatment and outcome of both benign and malignant tumors. Prospective trials are lacking due to rarity of the disease and high variety of tumor subtypes. The establishment of reliable non-invasive diagnostics tools for the differentiation between benign and malignant tumors is desirable. Prospective studies clarifying the association between different surgical techniques for benign parotid tumors and morbidity are needed. The role of adjuvant or definitive radiotherapy in securing loco-regional control and improving survival in malignant disease is established. Prospective clinical trials addressing the role of chemotherapy/molecular targeted therapy for parotid cancer are needed. An international consensus on the classification of parotid surgery techniques would facilitate the comparison of different trials. Such efforts should lead into a clinical guideline.

  9. Transarterial embolization for the treatment of massive bleeding in gynecologic and obstetric emergencies: a single center experience.

    Science.gov (United States)

    Hongsakul, Keerati; Songjamrat, Apiradee; Rookkapan, Sorracha

    2014-08-01

    Delayed treatment of the massive bleeding in gynecologic and obstetric conditions can cause high morbidity and mortality. The aim of this study is to assess the angiographic findings and outcomes of transarterial embolization in cases of massive hemorrhage from underlying gynecological and obstetrical conditions. This is a retrospective study of 18 consecutive patients who underwent transarterial embolization of uterine and/or hypogastric arteries due to massive bleeding from gynecological and obstetrical causes from January 2006 to December 2011. The underlying causes of bleeding, angiographic findings, technical success rates, clinical success rates, and complications were evaluated. Massive gynecological and obstetrical bleeding occurred in 12 cases and 6 cases, respectively. Gestational trophoblastic disease was the most common cause of gynecological bleeding. The most common cause of obstetrical hemorrhage was primary post-partum hemorrhage. Tumor stain was the most frequent angiographic finding (11 cases) in the gynecological bleeding group. The most common angiographic findings in obstetrical patients were extravasation (2 cases) and pseudoaneurysm (2 cases). Technical and final clinical success rates were found in all 18 cases and 16 cases. Collateral arterial supply, severe metritis, and unidentified cervical laceration were causes of uncontrolled bleeding. Only minor complications occurred, which included pelvic pain and groin hematoma. Percutaneous transarterial embolization is a highly effective and safe treatment to control massive bleeding in gynecologic and obstetric emergencies.

  10. Do expandable metallic airway stents have a role in the management of patients with benign tracheobronchial disease?

    Science.gov (United States)

    Madden, Brendan P; Loke, Tuck-Kay; Sheth, Abhijat C

    2006-07-01

    With increasing availability many centers are deploying expandable metallic stents to manage patients with diverse endobronchial disorders. Although these devices have an important role in malignant disease their usefulness in benign large airway disorders is less defined. Between 1997 and 2005, 31 patients aged 34 to 83 years with benign large airway compromise secondary to tracheomalacia (n = 7), posttracheostomy stricture (n = 8), posttracheostomy rupture (n = 2), postpneumonectomy bronchopleural fistula (n = 2), stricture after lung transplantation (n = 3), lobectomy, tuberculosis, traumatic injury to right main bronchus (n = 1 patient each), and external compression of the airway secondary to achalasia, multinodular goiter, aortic aneurysm, right brachiocephalic artery aneurysm, right interrupted aortic arch, and dissecting aneurysm (n = 1 patient each) who were medically unfit for formal surgical intervention were treated by Ultraflex stent deployment. The range of follow-up was 1 week to 96 months. Stents were deployed under anesthesia using rigid bronchoscopy. Complications included granulation tissue formation (n = 11) treated with Nd: YAG laser ablation, stent migration (n = 1; stent removed, another deployed), metal fatigue (n = 1), stent removal (n = 1), mucus plugging (n = 2), and halitosis (n = 6) difficult to treat despite antibiotics. Thirteen patients died of unrelated causes between 1 week and 15 months after stent deployment. Endobronchial metallic stents should be considered only for selected patients with large airway compromise secondary to benign airway diseases for whom other medical comorbidities contraindicate formal airway surgery. Once deployed, they are difficult to remove, are associated with significant complications, and require prospective bronchoscopic surveillance and often further therapeutic intervention.

  11. Benign hepatic portal venous gas following caustic ingestion

    International Nuclear Information System (INIS)

    Lewin, Maite; Tubiana, Jean-Michel; Pocard, Marc; Caplin, Scott; Parc, Rolland; Blain, Antoine

    2002-01-01

    Hepatic portal vein gas has been documented in numerous conditions and is traditionally regarded as a poor prognostic sign. There are, however, several reports of portal vein gas with a benign course. We report the first case of transient hepatic portal vein gas secondary to the ingestion of a caustic substance. The literature of hepatic portal vein gas in benign disease is reviewed. (orig.)

  12. Biomonitoring of organochlorines in women with benign and malignant breast disease

    International Nuclear Information System (INIS)

    Siddiqui, M.K.J.; Anand, M.; Mehrotra, P.K.; Sarangi, R.; Mathur, N.

    2005-01-01

    Established risk factors for breast cancer explain breast cancer risk only partially. Organochlorines are considered to be a possible cause for hormone-dependent cancers. A hospital-based case-control study, the first from India, was conducted among 50 women undergoing surgery for breast disease to examine the association between organochlorine exposure and breast cancer risk. Blood, tumor, and surrounding adipose tissue of the breast were collected from the subjects with benign (control) and malignant breast (study) lesions and analyzed to determine organochlorine insecticides using a gas-liquid chromatograph equipped with an electron capture detector. The α, β, γ, and δ isomers of hexachlorocyclohexane (HCH), p,p'-dichlorodiphenyltrichloroethane (DDT), o,p'-DDT, p,p-dichlorodiphenyldichloroethylene, and p,p'-dichlorodiphenyldichloroethane were frequently detected in three specimens. Total HCH and total DDT levels were higher in the blood of the study group (25 cases) than in those of the controls (25 cases) with only γ-HCH being significantly different (P0.05). However, both total HCH and total DDT were higher in the tumor tissues of the controls than in those of the study group; γ-HCH was significantly different (P0.05). The level of total HCH (α-HCH was significantly different, P0.05) was higher in the breast adipose tissue of the study group, whereas total DDT was higher in the breast adipose tissue of the control group. The distribution of known confounders of breast cancer including age, body mass index, age at menarche and menopause, duration of breast feeding, and family history related to breast disease did not differ significantly between benign and malignant groups. This pilot study with limited statistical power does not support a positive association between exposure to organochlorines and risk of breast cancer but paves the way for a larger Indian study with greater statistical power encompassing different regions of the country to enable

  13. Sexuality in Irish women with gynecologic cancer.

    Science.gov (United States)

    Cleary, Vicki; Hegarty, Josephine; McCarthy, Geraldine

    2011-03-01

    To investigate sexual self-concept, sexual relationships, and sexual functioning, and the relationship between these and certain demographic variables of Irish women, following a diagnosis of gynecologic cancer. Descriptive, correlational. Outpatient gynecologic oncology clinic in a large university hospital in Southern Ireland. 106 women with a diagnosis of and treatment for various gynecologic cancers (cervical, ovarian, endometrial, and vulvar). The Body Image Scale, Sexual Esteem Scale, and Sexual Self-Schema Scale were administered to women a minimum of six weeks postdiagnosis of any form of gynecologic cancer to measure sexual self-concept; the Intimate Relationships Scale to measure sexual relationships; and the Arizona Sexual Experiences Scale to measure sexual functioning. Sexual self-concept, body image, sexual esteem, sexual self-schema, sexual relationships, and sexual functioning. Participants reported negative changes in relation to their sexual self-concept, sexual relationships, and sexual functioning. Participants reported negative changes in relation to all stages of the sexual response cycle. Gynecologic cancer has the potential to negatively affect a woman's sexual self-concept, sexual relationships, and sexual functioning. Sexuality is a multidimensional construct and must be measured in this way. Healthcare professionals must use a holistic approach when providing information and support to patients with gynecologic cancer. Information must be provided to women on how cancer and its treatment has the potential to affect their sexual self-concept, sexual relationships, and sexual functioning, including information on how to overcome these alterations.

  14. Comprehensive MR imaging of acute gynecologic diseases.

    Science.gov (United States)

    Dohke, M; Watanabe, Y; Okumura, A; Amoh, Y; Hayashi, T; Yoshizako, T; Yasui, M; Nakashita, S; Nakanishi, J; Dodo, Y

    2000-01-01

    Rapid advances in techniques of magnetic resonance (MR) imaging have enabled diagnosis of acute gynecologic conditions, which are characterized by sudden onset of lower abdominal pain, fever, genital bleeding, intraperitoneal bleeding, or symptoms of shock. The chemical-selective fat-suppression technique not only helps establish the characteristics of lesions that contain fat components but also increases the conspicuity of inflammatory lesions. When a T2-weighted image is obtained with a very long effective echo time (>250 msec), even a small amount of ascites can be easily identified and the contrast between urine and complex fluid becomes more conspicuous. T2*-weighted images are useful for identification of hemorrhagic lesions by demonstrating deoxyhemoglobin and hemosiderin. Contrast material-enhanced dynamic subtraction MR imaging performed with a three-dimensional fast field-echo sequence and a rapid bolus injection of gadopentetate dimeglumine allows evaluation of lesion vascularity and the anatomic relationship between pelvic vessels and a lesion and allows identification of the bleeding point by demonstrating extravasation of contrast material. To optimize the MR imaging examination, attention should be given to the parameters of each pulse sequence and proper combination of the sequences.

  15. Exposure of Surgeons to Magnetic Fields during Laparoscopic and Robotic Gynecologic Surgeries.

    Science.gov (United States)

    Park, Jee Soo; Chung, Jai Won; Choi, Soo Beom; Kim, Deok Won; Kim, Young Tae; Kim, Sang Wun; Nam, Eun Ji; Cho, Hee Young

    2015-01-01

    To measure and compare levels of extremely-low-frequency magnetic field (ELF-MF) exposure to surgeons during laparoscopic and robotic gynecologic surgeries. Prospective case-control study. Canadian Task Force I. Gynecologic surgeries at the Yonsei University Health System in Seoul, Korea from July to October in 2014. Ten laparoscopic gynecologic surgeries and 10 robotic gynecologic surgeries. The intensity of ELF-MF exposure to surgeons was measured every 4 seconds during 10 laparoscopic gynecologic surgeries and 10 robotic gynecologic surgeries using portable ELF-MF measuring devices with logging capability. The mean ELF-MF exposures were .1 ± .1 mG for laparoscopic gynecologic surgeries and .3 ± .1 mG for robotic gynecologic surgeries. ELF-MF exposure levels to surgeons during robotic gynecologic surgery were significantly higher than those during laparoscopic gynecologic surgery (p gynecologic surgery and conventional laparoscopic surgery, hoping to alleviate concerns regarding the hazards of MF exposure posed to surgeons and hospital staff. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

  16. Benign Metastatic Leiomyoma Presenting as a Hemothorax

    Directory of Open Access Journals (Sweden)

    Anna M. Ponea

    2013-01-01

    Full Text Available Uterine leiomyomas have been reported to metastasize to various organs including the lungs, skeletal muscles, bone marrow, peritoneum, and heart. They may present with symptoms related to the metastases several years after hysterectomy. These tumors regress after menopause, and it is rare to detect active tumors in postmenopausal women. Despite their ability to metastasize, they are considered to be benign due to the lack of anaplasia. Pulmonary benign metastasizing leiomyoma is usually detected in the form of pulmonary nodules incidentally on imaging. Tissue biopsy of these nodules is required to identify them as benign metastasizing leiomyomas. Immunohistochemical analysis and molecular profiling may further help detect any malignant transformation in it. Untreated pulmonary benign metastasizing leiomyoma may result in the formation of cystic structures, destruction of lung parenchyma, and hemothorax and may cause respiratory failure. Surgical resection and hormonal therapy help prevent progression of this disease and provide an avenue for a cure.

  17. Measurement properties of ThyPRO short-form (ThyPRO-39) for use in Chinese patients with benign thyroid diseases.

    Science.gov (United States)

    Wong, Carlos K H; Choi, Edmond P H; Woo, Y C; Lang, Brian H H

    2018-04-18

    To evaluate the validity and reliability of a newly-translated Thyroid-specific Patient-Reported Outcome short-form (ThyPRO-39) instrument for ethnic-Chinese patients suffering from benign thyroid diseases. The translation and cross-cultural adaptation of the English ThyPRO-39 were performed using the double forward translation, reconciliation, single backward translation, and cognitive debriefing, followed by a panel review. Cross-sectional data of 308 patients with benign thyroid diseases were utilized for this psychometric evaluation of ThyPRO-39 instrument. Convergent validity between similar construct in the ThyPRO-39, SF-6D, and SF-12v2 was assessed using Spearman correlations. The internal construct validity was assessed by corrected item-total correlations. Sensitivity of the ThyPRO-39 domain scores was determined by performing known group comparisons by independent t test. The internal consistency reliability was assessed by Cronbach's alpha coefficient. Significant floor effects were observed in 9 out of 13 domains of the ThyPRO-39. The hypothesized correlations between similar constructs in the ThyPRO-39 and the SF-12v2 and SF-6D were generally observed, supporting convergent validity. The internal construct validity was supported in most items, except eight items in six scales. Scale score of hyperthyroid symptoms of the ThyPRO-39 was significantly higher in the group with Graves' disease or hyperthyroid disease than the group without Graves' disease nor hyperthyroid disease. Scale scores of eye symptoms and impaired daily life were significantly higher in the incidental group than the non-incidental group. For six domains (hyperthyroid symptoms, hypothyroid symptoms, eye symptoms, tiredness, depressivity, and emotional susceptibility), Cronbach's alpha did not reach the recommended standard of 0.7. This was the first psychometric study to translate and adapt the ThyPRO-39 instrument for non-Caucasian patients, and report its validity and reliability

  18. Guideline for radioiodine therapy for benign thyroid diseases (version 4); Leitlinie zur Radioiodtherapie (RIT) bei benignen Schilddruesenerkrankungen (Version 4)

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Schicha, H. [Koeln Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Dressler, J. [Nuklearmedizinische Klinik der Henriettenstiftung, Hannover (Germany). Abteilung fuer Nuklearmedizin; Gruenwald, F. [Frankfurt Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Leisner, B. [Nuklearmedizinische Klinik der Henriettenstiftung des allgemeinen Krankenhauses St. Georg, Hamburg (Germany); Moser, E. [Nuklearmedizinische Klinik der Henriettenstiftung der Radiologischen Universitaetsklinik Freiburg (Germany); Reiners, C.; Schneider, P. [Wuerzburg Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin; Schober, O. [Muenster Univ. (Germany). Klinik und Poliklinik fuer Nuklearmedizin

    2007-07-01

    Version 4 of the guideline for radioiodine therapy for benign thyroid diseases includes an interdisciplinary consensus ondecision making for antithyroid drugs, surgical treatment and radioiodine therapy. The quantitative description of a specific goiter volume for radioiodine therapy or operation was cancelled. For patients with nodular goiter with or without autonomy, manifold circumstances are in favor of surgery (suspicion on malignancy, large cystic nodules, mediastinal goiter, severe compression of the trachea) or in favor of radioiodine therapy (treatment of autonomy, age of patient, co-morbidity, history of prior subtotal thyroidectomy, profession like teacher, speaker or singer). For patients with Graves' disease, radioiodine therapy or surgery are recommended in the constellation of high risk of relapse (first-line therapy), persistence of hyperthyroidism or relapse of hyperthyroidism. After counseling, the patient gives informed consent to the preferred therapy. The period after radioiodine therapy of benign disorders until conception of at least four months was adapted to the European recommendation. (orig.)

  19. An analysis of the impact of pathology review in gynecological cancer

    International Nuclear Information System (INIS)

    Chafe, S.; Honore, L.; Pearcey, R.; Capstick, V.

    1996-01-01

    Objective: To analyze the impact of pathology review in gynecological malignancies. Materials and Methods: A retrospective chart review of all new gynecological patients seen between Dec. 2, 1993 and Jan. 4, 1996 was conducted to determine if a pathological review by the Institute's consultant pathologist altered the diagnosis, and if so whether the alteration changed patient management. A total of 528 patients were seen of which 124 had cervix cancer, 235 had endometrial cancer, 122 had a primary ovarian or peritoneal malignancy, 9 had a vaginal malignancy, 28 had vulvar cancer and 10 had a miscellaneous gynecological malignancy. Results: On pathology review the initial diagnosis was changed in 199 patients. This altered management of 63 patients. For patients with cervical cancer, the grade of tumor was the main alteration in pathological diagnosis, with occasional change in the presence of lymph vascular invasion. These did not translate into patient management changes. The occasional change in depth of invasion altered management in one patient. For endometrial primaries the changes in pathological diagnosis included grade, depth of invasion, and the presence of cervical involvement. This did change management in some cases. For the ovarian malignancies the main changes were grade, extent of disease or variation in histology, some of which resulted in changes in management. One patient with a vaginal lesion had the diagnosis changed which did change management. Of the patients diagnosed with vulvar cancer the pathological diagnosis changed in 8 patients. This included changes in grade and depth of invasion. This altered patient management in 2 patients. The remaining miscellaneous gynecological malignancies had only two diagnosis alterations which did alter management. Conclusion: Pathological reviews of gynecological malignancies are justified as it can alter patient management. In addition, the process facilitates the cooperation of the multidisciplinary team

  20. CT findings of benign omental lesions following abdominal cancer surgery

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sang Yun; Kim, Dong Won; Cho, Jin Han; Kwon, Hee Jin; Ha, Dong Ho; Oh, Jong Young [Diagnostic Radiology, Dong-A University College of Medicine, Busan (Korea, Republic of)

    2016-07-15

    The greater omentum is the largest peritoneal fold and can be the origin of primary pathologic conditions, as well as a boundary and conduit for disease processes. Most diseases involving the omentum manifest with nonspecific and overlapping features on computed tomography (CT). In particular, varying benign disease processes of traumatic, inflammatory, vascular, or systemic origin can occur in the omentum during the follow-up period after surgery for intra-abdominal malignancy. It can be challenging for radiologists due to various spectrum of CT findings. Thus, we reviewed the CT findings of various benign omental lesions after surgery for intra-abdominal malignancy.

  1. Malignant and benign diseases of the breast in 41 male patients: mammography, sonography and pathological correlations; Maligne und benigne Erkrankungen der Brust bei 41 maennlichen Patienten: Mammographie und Sonographie mit histopathologischer Korrelation

    Energy Technology Data Exchange (ETDEWEB)

    Partik, B.; Mallek, R.; Pokieser, P.; Wunderbaldinger, P.; Helbich, T.H. [Vienna Univ. (Austria). Klinik fuer Radiodiagnostik; Rudas, M. [Vienna Univ. (Austria). Inst. fuer Klinische Pathologie

    2001-11-01

    Aim: The goal of our study was to evaluate findings in mammography and sonography in male patients with pathohistologically proven diseases of the breast. Material and Methods: Mammographies and sonographies, which were obtained in 41 male patients in a 6-year period, were retrospectively evaluated in accordance with the BI-RADS trademark classification. Results: Histologically 13 carcinomas, 21 gynecomastias, 3 pseudogynecomastias, 2 epithelial inclusion cysts and 2 other benign lesions were diagnosed. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of mammography in differentiation of benign versus malignant disease were 92%, 89%, 80%, 96% and 90%, respectively. Additional sonography did not change these results. However, sonography increased diagnostic confidence in 18.2% (2/11) of suspicious lesions. Conclusion: In our study the invasive ductal carcinoma of male patients was a predominantly lobulated, ill-defined lesion in mammography and sonography. The differentiation of carcinoma to pseudogynecomastia and diffuse or dendritic gynecomastia was securely feasible. However, we could not reliably distinguish between carcinoma and some benign mass lesions. In cases of mammographically diagnosed masses or unclear mammography, additional sonography should be performed to increase the diagnostic confidence. (orig.) [German] Ziel: Die Befunde von Mammographie und Sonographie bei histologisch gesicherten malignen und benignen Mammaerkrankungen maennlicher Patienten zu evaluieren. Material und Methode: Retrospektiv wurden die in einem Zeitraum von 6 Jahren durchgefuehrten Mammographien und Sonographien bei 41 maennlichen Patienten in Anlehnung an die BI-RADS trademark Klassifikation ausgewertet. Resultate: Es wurden 13 Karzinome, 21 Gynaekomastien, 3 Pseudogynaekomastien, 2 Atherome und 2 weitere benigne Laesionen histologisch diagnostiziert. Die Mammographie zeigte in der Differenzierung maligne versus benigne Laesion

  2. NON–DESCENT VAGINAL HYSTERECTOMY FOR BENIGN GYNAECOLOGICAL DISEASE – A PROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Thulasi

    2016-04-01

    Full Text Available OBJECTIVE To assess safety and feasibility of non-descent vaginal hysterectomy for benign gynaecological disease. METHODS A prospective study was conducted at the Department of Obstetrics and Gynaecology of P K Das Institute of Medical Sciences from January 2013 to December 2013. An effort was made to perform hysterectomies vaginally in women with benign or premalignant conditions in the absence of prolapse. A suspected adnexal pathology, endometriosis, immobility of uterus, uterus size more than 16 weeks was excluded from the study. Vaginal hysterectomy was done in usual manner. In bigger size uterus, morcellation techniques like bisection, debulking, coring, myomectomy, or combination of these were used to remove the uterus. Data regarding age, parity, uterine size, estimated blood loss, length of operation, intraoperative and postoperative complications and hospital stay were recorded. RESULTS A total of 100 cases were selected for non-descent vaginal hysterectomy. Among them, 97 cases successfully underwent nondescent vaginal hysterectomy. Majority of the patients (55% were in age group 40-45 yrs. Four patients were nulligravida and eight patients had previous LSCS. Uterine size was ≤ 12 weeks in 84 cases and > 12-16 weeks in 16 cases. Commonest indication was leiomyoma of uterus (43%. Mean duration of surgery was 70±20.5 minutes. Mean blood loss was 150±65 mL. Reasons for failure to perform NDVH was difficulty in opening pouch of Douglas in two cases because of adhesions and in one case there was difficulty in reaching the fundal myoma which prevented the uterine descent. Intra–operatively, one case had bladder injury (1% that had previous 2 LSCS. Postoperatively, complications were minimal which included postoperative fever (11%, UTI (8% and vaginal cuff infection was (4%. Mean hospital stay was 3.5 days. CONCLUSION Vaginal hysterectomy is safe, feasible in most of the women requiring hysterectomy for benign conditions with less

  3. Clustered microcalcifications without mass on mammography : benignancy vs. malignancy

    Energy Technology Data Exchange (ETDEWEB)

    Han, Yoon Hee; Do, Young Soo; Oh, Hoon Il; Kim, Ki Hwan; Chin, Soo Yil [Korean Cancer Center Hostpital, Seoul (Korea, Republic of); Cho, Byung Jae [Chung Dam Radiologic Clinics, Seoul (Korea, Republic of); Han, Heon [Chungang Gil Hospital, Seoul (Korea, Republic of); Choi, Yeun Hyeun; Han, Boo Kyung [Sam Sung Medical Center, Seoul (Korea, Republic of); Park, Jung Mi [Asan Medical Center, Seoul (Korea, Republic of)

    1996-11-01

    The purpose of this study is to evaluate the accuracy of differentiation between benign and malignant clustered microcalcifications without mass on mammogram. Fourty six mammograms of 44 patients showing clustered microcalcifications without mass were interpreted blindly by five independent observers majoring in breast imaging from different institutions. Twenty two were malignant (10 infiltrating ductal carcinomas, 12 intraductal carcinomas) and 24 were benign (all fibrocystic disease). The observers judge benignancy or malignancy of microcalcifications. The authors assess the accuracy of differential diagnosis of clustered microcalcifications. Of 24 cases proved benign microcalcifications, five radiologists correctly interpreted 20 on average as benign and of malignant 22 cases, 16 on average were correctly interpreted as malignant. The diagnostic accuracy of malignant microcalcifications was 71.8% on average(63.6%{approx}81.8%) and the diagnostic accuracy for benign microcalcifications was 83% on average(71%{approx}92%). It was 9 among total 46 cases that were misinterpreted by more than three radiologists. Among these 9 cases, malignant microcalcifications that had been misinterpreted as benign were seven, benign microcalcifications misinterpreted as malignant were two. The diagnostic accuracy of clustered malignant microcalcifications(71.8%) without mass on mammogram was lower than that of benign microcalcifications(83.3%). So, in case of suspected malignant microcalcification on mammogram, it is preferable that along with magnification view, histopathologic confirmation by core biopsy must be obtained.

  4. College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference on good laboratory practices in gynecologic cytology: background, rationale, and organization.

    Science.gov (United States)

    Tworek, Joseph A; Henry, Michael R; Blond, Barbara; Jones, Bruce Allen

    2013-02-01

    Gynecologic cytopathology is a heavily regulated field, with Clinical Laboratory Improvement Amendments of 1988 mandating the collection of many quality metrics. There is a lack of consensus regarding methods to collect, monitor, and benchmark these data and how these data should be used in a quality assurance program. Furthermore, the introduction of human papilloma virus testing and proficiency testing has provided more data to monitor. To determine good laboratory practices in quality assurance of gynecologic cytopathology. Data were collected through a written survey consisting of 98 questions submitted to 1245 Clinical Laboratory Improvement Amendments-licensed or Department of Defense laboratories. There were 541 usable responses. Additional input was sought through a Web posting of results and questions on the College of American Pathologists Web site. Four senior authors who authored the survey and 28 cytopathologists and cytotechnologists were assigned to 5 working groups to analyze data and present statements on good laboratory practices in gynecologic cytopathology at the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference. Ninety-eight attendees at the College of American Pathologists Gynecologic Cytopathology Quality Consensus Conference discussed and voted on good laboratory practice statements to obtain consensus. This paper describes the rationale, background, process, and strengths and limitations of a series of papers that summarize good laboratory practice statements in quality assurance in gynecologic cytopathology.

  5. The role of selenium, vitamin C, and zinc in benign thyroid diseases and of selenium in malignant thyroid diseases: Low selenium levels are found in subacute and silent thyroiditis and in papillary and follicular carcinoma

    Directory of Open Access Journals (Sweden)

    Starzinger Matthias

    2008-01-01

    Full Text Available Abstract Background Thyroid physiology is closely related to oxidative changes. The aim of this controlled study was to evaluate the levels of nutritional anti-oxidants such as vitamin C, zinc (Zn and selenium (Se, and to investigate any association of them with parameters of thyroid function and pathology including benign and malignant thyroid diseases. Methods This controlled evaluation of Se included a total of 1401 subjects (1186 adults and 215 children distributed as follows: control group (n = 687, benign thyroid disease (85 children and 465 adults; malignant thyroid disease (2 children and 79 adults. Clinical evaluation of patients with benign thyroid disease included sonography, scintigraphy, as well as the determination of fT3, fT4, TSH, thyroid antibodies levels, Se, Zn, and vitamin C. Besides the routine oncological parameters (TG, TSH, fT4, ultrasound Se was also determined in the cases of malignant disease. The local control groups for the evaluation of Se levels were taken from a general practice (WOMED as well as from healthy active athletes. Blood samples were collected between 8:00 and 10:30 a.m. All patients lived in Innsbruck. Statistical analysis was done using SPSS 14.0. The Ho stated that there should be no differences in the levels of antioxidants between controls and thyroid disease patients. Results Among the thyroid disease patients neither vitamin C, nor Zn nor Se correlated with any of the following parameters: age, sex, BMI, body weight, thyroid scintigraphy, ultrasound pattern, thyroid function, or thyroid antibodies. The proportion of patients with benign thyroid diseases having analyte concentrations below external reference cut off levels were 8.7% of cases for vitamin C; 7.8% for Zn, and 20.3% for Se. Low Se levels in the control group were found in 12%. Se levels were significantly decreased in cases of sub-acute and silent thyroiditis (66.4 ± 23.1 μg/l and 59.3 ± 20.1 μg/l, respectively as well as in

  6. Benign breast myoepithelioma

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    L Khan

    2013-01-01

    Full Text Available Myoepithelioma of the breast is very rare. Breast myoepithelioma can develop in women from their early 20s right up to their 80s, but it is most common in women over 50. We report a case of 20-year-old female, who presented with a well-defined breast lump of 3 × 3 cm in size. Fine needle aspiration was performed. The cytological findings revealed good cellularity comprising monomorphic loosely cohesive sheets of plasmacytoid, round to polygonal cells with round to ovoid eccentrically placed nuclei, finely dispersed chromatin, and moderate amount of cytoplasm. On the basis of cytological findings, a diagnosis of benign myoepithelioma (plasmacytoid type was made which was confirmed on histopathologic examination. The breast is a very rare localization for this type of tumor. The benign character of the disease in conjunction with its slow progression could delay its detection and diagnosis. A detailed pathology examination is a prerequisite for avoidance of misleading diagnosis.

  7. Benign cystic mesothelioma of the appendix presenting in a woman: a case report

    Directory of Open Access Journals (Sweden)

    Beddy David

    2010-12-01

    Full Text Available Abstract Introduction Benign cystic mesothelioma or peritoneal inclusion cysts are rare benign abdominal tumors usually occurring in females of reproductive age. These cysts present as abdominopelvic pain or masses but are often found on imaging or incidentally at surgery. They are commonly associated with pelvic inflammatory disease, endometriosis, or ovarian cysts. We report what is, to the best of our knowledge, the first case of a benign cystic mesothelioma complicating a presentation of acute appendicitis. Case Presentation A 19-year-old Irish Caucasian woman presented with abdominal pain. Imaging suggested appendicitis with abscess formation. She was treated with antibiotics and scheduled for interval appendicectomy. At laparoscopy, an unusual cystic mass was found arising from the appendix. Histology revealed benign cystic mesothelioma. Conclusion We report what is, to the best of our knowledge, the first case of a benign cystic mesothelioma arising from the appendix and complicating a presentation of acute appendicitis. This is a benign pathology, but recurrences are not uncommon. Benign cystic mesothelioma should be included in the differential when investigating pelvic masses or abscesses associated with either appendicitis or pelvic inflammatory disease in women.

  8. Benign cystic mesothelioma of the appendix presenting in a woman: a case report

    LENUS (Irish Health Repository)

    O' Connor, Donal B

    2010-12-03

    Abstract Introduction Benign cystic mesothelioma or peritoneal inclusion cysts are rare benign abdominal tumors usually occurring in females of reproductive age. These cysts present as abdominopelvic pain or masses but are often found on imaging or incidentally at surgery. They are commonly associated with pelvic inflammatory disease, endometriosis, or ovarian cysts. We report what is, to the best of our knowledge, the first case of a benign cystic mesothelioma complicating a presentation of acute appendicitis. Case Presentation A 19-year-old Irish Caucasian woman presented with abdominal pain. Imaging suggested appendicitis with abscess formation. She was treated with antibiotics and scheduled for interval appendicectomy. At laparoscopy, an unusual cystic mass was found arising from the appendix. Histology revealed benign cystic mesothelioma. Conclusion We report what is, to the best of our knowledge, the first case of a benign cystic mesothelioma arising from the appendix and complicating a presentation of acute appendicitis. This is a benign pathology, but recurrences are not uncommon. Benign cystic mesothelioma should be included in the differential when investigating pelvic masses or abscesses associated with either appendicitis or pelvic inflammatory disease in women.

  9. ADC mapping of benign and malignant breast tumors

    International Nuclear Information System (INIS)

    Woodhams, R.; Matsunaga, Keiji; Kan, Shinichi; Hata, Hirofumi; Iwabuchi, Keiichi; Kuranami, Masaru; Watanabe, Masahiko; Hayakawa, Kazushige; Ozaki, Masanori

    2005-01-01

    The purpose of this study was to investigate the utility of diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) value in differentiating benign and malignant breast lesions and evaluating the detection accuracy of the cancer extension. We used DWI to obtain images of 191 benign and malignant lesions (24 benign, 167 malignant) before surgical excision. The ADC values of the benign and malignant lesions were compared, as were the values of noninvasive ductal carcinoma (NIDC) and invasive ductal carcinoma (IDC). We also evaluated the ADC map, which represents the distribution of ADC values, and compared it with the cancer extension. The mean ADC value of each type of lesion was as follows: malignant lesions, 1.22±0.31 x 10 -3 mm 2 /s; benign lesions, 1.67±0.54 x 10 -3 mm 2 /s; normal tissues, 2.09±0.27 x 10 -3 mm 2 /s. The mean ADC value of the malignant lesions was statistically lower than that of the benign lesions and normal breast tissues. The ADC value of IDC was statistically lower than that of NIDC. The sensitivity of the ADC value for malignant lesions with a threshold of less than 1.6 x 10 -3 mm 2 /s was 95% and the specificity was 46%. A full 75% of all malignant cases exhibited a near precise distribution of low ADC values on ADC maps to describe malignant lesions. The main causes of false negative and underestimation of cancer spread were susceptibility artifact because of bleeding and tumor structure. Major histologic types of false-positive lesions were intraductal papilloma and fibrocystic diseases. Fibrocystic diseases also resulted in overestimation of cancer extension. DWI has the potential in clinical appreciation to detect malignant breast tumors and support the evaluation of tumor extension. However, the benign proliferative change remains to be studied as it mimics the malignant phenomenon on the ADC map. (author)

  10. Differential expression of proteomics models of colorectal cancer, colorectal benign disease and healthy controls

    Directory of Open Access Journals (Sweden)

    Zhang Shu-Jun

    2010-03-01

    Full Text Available Abstract Background Colorectal cancer (CRC is often diagnosed at a late stage with concomitant poor prognosis. The hypersensitive analytical technique of proteomics can detect molecular changes before the tumor is palpable. The surface-enhanced laser desorption/ionization-time of flight-mass spectra (SELDI-TOF-MS is a newly-developed technique of evaluating protein separation in recent years. The protein chips have established the expression of tumor protein in the serum specimens and become the newly discovered markers for tumor diagnosis. The objective of this study was to find new markers of the diagnosis among groups of CRC, colorectal benign diseases (CBD and healthy controls. The assay of SELDI-TOF-MS with analytical technique of protein-chip bioinformatics was used to detect the expression of protein mass peaks in the sera of patients or controls. One hundred serum samples, including 52 cases of colorectal cancer, 27 cases of colorectal benign disease, and 21 cases of healthy controls, were examined by SELDI-TOF-MS with WCX2 protein-chips. Results The diagnostic models (I, II and III were setup by analyzed the data and sieved markers using Ciphergen - Protein-Chip-Software 5.1. These models were combined with 3 protein mass peaks to discriminate CRC, CBD, and healthy controls. The accuracy, the sensitivity and the particularity of cross verification of these models are all highly over 80%. Conclusions The SELDI-TOF-MS is a useful tool to help diagnose colorectal cancer, especially during the early stage. However, identification of the significantly differentiated proteins needs further study.

  11. Circulating Prostate Cells Found in Men with Benign Prostate Disease Are P504S Negative: Clinical Implications

    Directory of Open Access Journals (Sweden)

    Nigel P. Murray

    2013-01-01

    Full Text Available Introduction. Developments in immunological and quantitative real-time PCR-based analysis have enabled the detection, enumeration, and characterization of circulating tumor cells (CTCs. It is assumed that the detection of CTCs is associated with cancer, based on the finding that CTCs can be detected in all major cancer and not in healthy subjects or those with benign disease. Methods and Patients. Consecutive men, with suspicion of prostate cancer, had blood samples taken before prostate biopsy; mononuclear cells were obtained using differential gel centrifugation and CPCs detecting using anti-PSA immunocytochemistry. Positive samples underwent further classification with anti-P504S. Results. 329 men underwent prostate biopsy; of these men 83 underwent a second biopsy and 44 a third one. Of those with a biopsy negative for cancer, 19/226 (8.4% had CPCs PSA (+ P504S (− detected at first biopsy, 6/74 (8.1% at second biopsy, and 5/33 (15.2% at third biopsy. Men with cancer-positive biopsies did not have PSA (+ P504S (− CPCs detected. These benign cells were associated with chronic prostatitis. Conclusions. Patients with chronic prostatitis may have circulating prostate cells detected in blood, which do not express the enzyme P504S and should be thought of as benign in nature.

  12. Benign positional vertigo

    Science.gov (United States)

    Vertigo - positional; Benign paroxysmal positional vertigo; BPPV: dizziness- positional ... Benign positional vertigo is also called benign paroxysmal positional vertigo (BPPV). It is caused by a problem in the inner ear. ...

  13. Imaging of gynecological disorders in infants and children

    Energy Technology Data Exchange (ETDEWEB)

    Mann, Gurdeep S. [Alder Hey Children' s Hospital, Liverpool (United Kingdom). Dept. of Paediatric Radiology; Blair, Joanne C. [Alder Hey Children' s Hospital, Liverpool (United Kingdom). Dept. of Paediatric Endocrinology; Garden, Anne S. (eds.) [Alder Hey Children' s Hospital, Liverpool (United Kingdom). Dept. of Paediatric Gynaecology; Lancaster Univ. (United Kingdom). Lancaster Medical School

    2012-07-01

    This textbook provides a comprehensive review of gynecological imaging in infancy, childhood, and adolescence. Experts from the disciplines of pediatric radiology, gynecology, surgery, and endocrinology have come together to produce a textbook that, while written primarily from the perspective of the radiologist, will be of interest to all professionals involved in the management of these patients. The normal development of the female reproductive tract is described in detail through embryological development, normal childhood appearances, and puberty. Congenital abnormalities are addressed in chapters reviewing structural abnormalities of the reproductive tract and disorders of sex development. A symptoms-based approach is followed in chapters devoted to the assessment of the patient with gynecological pain and disorders of menstruation. Disorders of the breast and the imaging of patients with gynecological neoplasia are considered in dedicated chapters. The specialty of pediatric gynecology is evolving rapidly, drawing on the skills and expertise of professionals from a wide range of specialties. This textbook should prove valuable to all who are involved in this new field of medicine. (orig.)

  14. Imaging of gynecological disorders in infants and children

    International Nuclear Information System (INIS)

    Mann, Gurdeep S.; Blair, Joanne C.; Garden, Anne S.; Lancaster Univ.

    2012-01-01

    This textbook provides a comprehensive review of gynecological imaging in infancy, childhood, and adolescence. Experts from the disciplines of pediatric radiology, gynecology, surgery, and endocrinology have come together to produce a textbook that, while written primarily from the perspective of the radiologist, will be of interest to all professionals involved in the management of these patients. The normal development of the female reproductive tract is described in detail through embryological development, normal childhood appearances, and puberty. Congenital abnormalities are addressed in chapters reviewing structural abnormalities of the reproductive tract and disorders of sex development. A symptoms-based approach is followed in chapters devoted to the assessment of the patient with gynecological pain and disorders of menstruation. Disorders of the breast and the imaging of patients with gynecological neoplasia are considered in dedicated chapters. The specialty of pediatric gynecology is evolving rapidly, drawing on the skills and expertise of professionals from a wide range of specialties. This textbook should prove valuable to all who are involved in this new field of medicine. (orig.)

  15. Simulation laboratories for training in obstetrics and gynecology.

    Science.gov (United States)

    Macedonia, Christian R; Gherman, Robert B; Satin, Andrew J

    2003-08-01

    Simulations have been used by the military, airline industry, and our colleagues in other medical specialties to educate, evaluate, and prepare for rare but life-threatening scenarios. Work hour limits for residents in obstetrics and gynecology and decreased patient availability for teaching of students and residents require us to think creatively and practically on how to optimize their education. Medical simulations may address scenarios in clinical practice that are considered important to know or understand. Simulations can take many forms, including computer programs, models or mannequins, virtual reality data immersion caves, and a combination of formats. The purpose of this commentary is to call attention to a potential role for medical simulation in obstetrics and gynecology. We briefly describe an example of how simulation may be incorporated into obstetric and gynecologic residency training. It is our contention that educators in obstetrics and gynecology should be aware of the potential for simulation in education. We hope this commentary will stimulate interest in the field, lead to validation studies, and improve training in and the practice of obstetrics and gynecology.

  16. Association of E-Cadherin Gene 3_-UTR C/T Polymorphism with ...

    African Journals Online (AJOL)

    Endometriosis (EM) is one of the most frequent diseases in gynecology; endometriotic cells display invasive characteristics,despite their benign histological appearance. Epithelial-cadherin (Ecadherin)is a cell-cell adhesive molecule which maintains cell integrity and communication between the intracellular and ...

  17. [Application of support vector machine-recursive feature elimination algorithm in Raman spectroscopy for differential diagnosis of benign and malignant breast diseases].

    Science.gov (United States)

    Zhang, Haipeng; Fu, Tong; Zhang, Zhiru; Fan, Zhimin; Zheng, Chao; Han, Bing

    2014-08-01

    To explore the value of application of support vector machine-recursive feature elimination (SVM-RFE) method in Raman spectroscopy for differential diagnosis of benign and malignant breast diseases. Fresh breast tissue samples of 168 patients (all female; ages 22-75) were obtained by routine surgical resection from May 2011 to May 2012 at the Department of Breast Surgery, the First Hospital of Jilin University. Among them, there were 51 normal tissues, 66 benign and 51 malignant breast lesions. All the specimens were assessed by Raman spectroscopy, and the SVM-RFE algorithm was used to process the data and build the mathematical model. Mahalanobis distance and spectral residuals were used as discriminating criteria to evaluate this data-processing method. 1 800 Raman spectra were acquired from the fresh samples of human breast tissues. Based on spectral profiles, the presence of 1 078, 1 267, 1 301, 1 437, 1 653, and 1 743 cm(-1) peaks were identified in the normal tissues; and 1 281, 1 341, 1 381, 1 417, 1 465, 1 530, and 1 637 cm(-1) peaks were found in the benign and malignant tissues. The main characteristic peaks differentiating benign and malignant lesions were 1 340 and 1 480 cm(-1). The accuracy of SVM-RFE in discriminating normal and malignant lesions was 100.0%, while that in the assessment of benign lesions was 93.0%. There are distinct differences among the Raman spectra of normal, benign and malignant breast tissues, and SVM-RFE method can be used to build differentiation model of breast lesions.

  18. Clinical statistics of gynecologic cancers in Japan

    Science.gov (United States)

    Nagase, Satoru

    2017-01-01

    Cervical, endometrial, and ovarian cancers, have both high morbidity and mortality among the gynecologic malignant tumors in Japan. The present study was conducted using both the population-based cancer registry and the gynecologic cancer registry to elucidate the characteristics of gynecologic malignant tumors in Japan. Based on nationwide estimates from the population-based cancer registry in Japan, the morbidities and mortality of cervical, endometrial, and ovarian cancers were obtained and used for analysis. Clinicopathologic factors for cervical cancer, endometrial cancer, ovarian cancer, including age, clinical stage, postsurgical stage, histological type, therapeutic strategy, and prognosis were retrieved from the gynecologic cancer registry published by the Japan Society of Obstetrics and Gynecology and used for analysis. The morbidities of cervical, endometrial, and ovarian cancers were 10,908, 13,606, and 9,384 women in 2012, respectively. The prevalence of endometrial cancer has significantly and consistently been increasing and represents the most common gynecologic malignant tumor in Japan. The mortalities of cervical, endometrial, and ovarian cancers were 2.1, 1.3, and 3.2 per 100,000 in 2012, respectively. In 2014, 52.2% of cervical cancer patients were classified as stage I, 22.5% as stage II, 10.2% as stage III, and 11.2% as stage IV. In addition, 71.9% of endometrial cancer patients were classified as stage I, 6.0% as stage II, 13.3% as stage III, and 7.5% as stage IV. Finally, 43.2% of ovarian cancer patients were classified as stage I, 9.1% as stage II, 27.6% as stage III, and 7.2% as stage IV. Twelve-point six percent of ovarian cancer patients received neoadjuvant chemotherapy. PMID:28198168

  19. ANALYSIS OF QUALITY MANAGEMENT OF GYNECOLOGIC SURGERY

    Directory of Open Access Journals (Sweden)

    Borut Kobal

    2003-12-01

    Full Text Available Background. The »Quality Management Project«, prepared by the Slovene Medical Chamber, served as the basis for determination of the quality-control indicators for gynecologic surgery. The authors have created a questionnaire that enables the analysis of these indicators. A pilot data entry was carried out between April and October 2001; since January 2002 the data entry has been done regularly in all departments of obstetrics and gynecology in Slovenia. At the National Congress of Obstetricians and Gynecologists of Slovenia, the analysis of quality-control indicators for gynecologic surgery will be presented and discussed in order to determine the standards of quality management in this field.

  20. Leiomyoma of Testis –Rare Benign Mimicker of Testicular Malignancy

    Directory of Open Access Journals (Sweden)

    Asif Baliyan

    2017-10-01

    Full Text Available Leiomyomas are benign tumours that originate from any organ containing smooth muscles. The testis is an extremely rare site. We report a case of testicular leiomyoma in a 50-year-old. Testis-associated leiomyomas are a benign and rare disease presenting as a painless, slowly-growing mass. Only histological examination with immunohistochemistry can validate the diagnosis.

  1. EMMPRIN in gynecologic cancers: pathologic and therapeutic aspects.

    Science.gov (United States)

    Liu, Dan-tong

    2015-07-01

    The highly glycosylated transmembrane protein extracellular matrix metalloproteinase inducer (EMMPRIN) is associated with several pathological conditions, including various types of cancers. In different gynecological malignancies, such as ovarian, cervical, and endometrial cancers, EMMPRIN plays significant roles in cell adhesion modulation, tumor growth, invasion, angiogenesis, and metastasis by inducing the production of various molecules, including matrix metalloproteinases and vascular endothelial growth factor. Because of its high level of expression, EMMPRIN can possibly be used as a diagnostic marker of gynecological cancers. Recent studies have showed that targeting EMMPRIN, especially by RNA interference (RNAi) technology, has promising therapeutic potential in basic research on gynecological cancer treatments, which make a platform for the future clinical success. This review study focused on the association of EMMPRIN in gynecological cancers in the perspectives of pathogenesis, diagnosis, and therapeutics.

  2. Interphase ribosomal RNA cistron staining in thyroid epithelial cells in Grave's disease, Hashimoto's thyroiditis and benign and malignant tumours of the thyroid gland

    OpenAIRE

    Mamaev, N N; Grynyeva, E N; Blagosklonnaya, Y V

    1996-01-01

    Aim—To evaluate the expression of ribosomal cistrons in human thyroid epithelial cells (TECs) of patients with Grave's disease, Hashimoto's thyroiditis and benign and malignant tumours of the thyroid gland.

  3. Does gender discrimination exist in a gynecology training program in a private hospital?

    Science.gov (United States)

    Geisler, J P; Mernitz, C S; Geisler, M J; Harsha, C G; Eskew, P N

    1999-01-01

    Does gender discrimination by attending physicians exists in a residency in regard to residents' opportunities to perform complete/operative management of hysterectomies versus just being surgical assistants? The program studied is a 4-year program in obstetrics and gynecology residency with 3 residents per year. All cases involving a resident were recorded in a computer program designed by one of the authors (C.S.M.) to collect data for Residency Review Committee reports. Data were able to be sorted in a variety of methods including level of management, date of procedure, Physicians' Current Procedural Terminology codes, and attending physician name or resident name. Only intrafascial and extrafascial hysterectomies for benign disease were included in the study. Data were collected from July 1, 1996 to March 31, 1997. Five hundred and forty-nine hysterectomies with residents participating as primary surgeon (complete/operative management) or surgical assistant were performed during the study period. Complete/operative management was performed by the resident in 82.5% of cases while the resident was surgical assistant in 17.5%. Male residents were responsible for complete/operative management in 81.6% of cases and female residents in 83.2% of cases (P = 0.33). Male attending physicians were more likely to allow residents (male or female) to participate as the primary surgeon in abdominal hysterectomies (95.3%) and vaginal hysterectomies (68.5%) than female attending physicians (abdominal, 87.0% and vaginal, 57.3%) (P gender discrimination.

  4. Stenting of the Cystic Duct in Benign Disease: A Definitive Treatment for the Elderly and Unwell

    Energy Technology Data Exchange (ETDEWEB)

    Hersey, N., E-mail: naomi.hersey@sth.nhs.uk [Sheffield Teaching Hospitals NHS Trust, Department of Radiology, Northern General Hospital (United Kingdom); Goode, S. D., E-mail: s.goode@sheffield.sc.uk [Sheffield Teaching Hospitals NHS Trust, Sheffield Vascular Institute (United Kingdom); Peck, R. J., E-mail: robert.peck@sth.nhs.uk; Lee, F., E-mail: fred.lee@sth.nhs.uk [Sheffield Teaching Hospitals NHS Trust, Department of Radiology, Northern General Hospital (United Kingdom)

    2015-08-15

    PurposeThere have been few case reports describing cystic duct stent insertion in the management of acute cholecystitis secondary to benign disease with no case series published to date. We present our series demonstrating the role of cystic duct stents in managing benign gallbladder disease in those patients unfit for surgery.Materials and MethodsThirty three patients unfit for surgery in our institution underwent cystic duct stent insertion for the management of acute cholecystitis in the period June 2008 to June 2013. Patients underwent a mixture of transperitoneal and transhepatic gallbladder puncture. The cystic duct was cannulated with a hydrophilic guidewire which was subsequently passed through the common bile duct and into the duodenum. An 8Fr 12-cm double-pigtail stent was placed with the distal end lying within the duodenum and the proximal end within the gallbladder.ResultsTen patients presented with gallbladder perforation, 21 patients with acute cholecystitis, 1 with acute cholangitis and 1 with necrotising pancreatitis. The technical success rate was 91 %. We experienced a 13 % complication rate with 3 % mortality rate at 30 days.ConclusionCystic duct stent insertion can be successfully used to manage acute cholecystitis, gallbladder empyema or gallbladder perforations in those unfit for surgery and should be considered alongside external gallbladder drainage as a definitive mid-term treatment option.

  5. Stenting of the Cystic Duct in Benign Disease: A Definitive Treatment for the Elderly and Unwell

    International Nuclear Information System (INIS)

    Hersey, N.; Goode, S. D.; Peck, R. J.; Lee, F.

    2015-01-01

    PurposeThere have been few case reports describing cystic duct stent insertion in the management of acute cholecystitis secondary to benign disease with no case series published to date. We present our series demonstrating the role of cystic duct stents in managing benign gallbladder disease in those patients unfit for surgery.Materials and MethodsThirty three patients unfit for surgery in our institution underwent cystic duct stent insertion for the management of acute cholecystitis in the period June 2008 to June 2013. Patients underwent a mixture of transperitoneal and transhepatic gallbladder puncture. The cystic duct was cannulated with a hydrophilic guidewire which was subsequently passed through the common bile duct and into the duodenum. An 8Fr 12-cm double-pigtail stent was placed with the distal end lying within the duodenum and the proximal end within the gallbladder.ResultsTen patients presented with gallbladder perforation, 21 patients with acute cholecystitis, 1 with acute cholangitis and 1 with necrotising pancreatitis. The technical success rate was 91 %. We experienced a 13 % complication rate with 3 % mortality rate at 30 days.ConclusionCystic duct stent insertion can be successfully used to manage acute cholecystitis, gallbladder empyema or gallbladder perforations in those unfit for surgery and should be considered alongside external gallbladder drainage as a definitive mid-term treatment option

  6. The role of diet in the development of breast cancer: a case-control study of patients with breast cancer, benign epithelial hyperplasia and fibrocystic disease of the breast.

    Science.gov (United States)

    Ingram, D. M.; Nottage, E.; Roberts, T.

    1991-01-01

    A case-control study was undertaken to investigate the role of diet in women with breast cancer, and in two groups of women with benign breast disease: epithelial hyperplasia, and fibrocystic disease without hyperplasia. The study provides data which suggest that the consumption of red meat, savoury meals (pizza, pies, stew, etc.) and of starches is disadvantageous, while the consumption of chicken and fish, and of fruit, appears to be beneficial. These patterns were present for both the breast cancer patients and the patients with benign epithelial hyperplasia. One-third of breast cancer patients had changed their diet after their diagnosis, compared to only around 12% in controls and patients with benign breast disease. Overall, the women studied had changed their diet to reduce their intake of sugars, dairy products and meat, and increased their intake of poultry, fish, fruit and vegetables over the past decade; but the breast cancer group was less likely to have made this change. PMID:1854621

  7. Does a robotic surgery approach offer optimal ergonomics to gynecologic surgeons?: a comprehensive ergonomics survey study in gynecologic robotic surgery.

    Science.gov (United States)

    Lee, Mija Ruth; Lee, Gyusung Isaiah

    2017-09-01

    To better understand the ergonomics associated with robotic surgery including physical discomfort and symptoms, factors influencing symptom reporting, and robotic surgery systems components recommended to be improved. The anonymous survey included 20 questions regarding demographics, systems, ergonomics, and physical symptoms and was completed by experienced robotic surgeons online through American Association of Gynecologic Laparoscopists (AAGL) and Society of Robotic Surgery (SRS). There were 289 (260 gynecology, 22 gynecology-oncology, and 7 urogynecology) gynecologic surgeon respondents regularly practicing robotic surgery. Statistical data analysis was performed using the t-test, χ² test, and logistic regression. One hundred fifty-six surgeons (54.0%) reported experiencing physical symptoms or discomfort. Participants with higher robotic case volume reported significantly lower physical symptom report rates (pergonomic settings not only acknowledged that the adjustments were helpful for better ergonomics but also reported a lower physical symptom rate (pergonomic settings (32.7%), took a break (33.3%) or simply ignored the problem (34%). Fingers and neck were the most common body parts with symptoms. Eye symptom complaints were significantly decreased with the Si robot (pergonomics were microphone/speaker, pedal design, and finger clutch. More than half of participants reported physical symptoms which were found to be primarily associated with confidence in managing ergonomic settings and familiarity with the system depending on the volume of robotic cases. Optimal guidelines and education on managing ergonomic settings should be implemented to maximize the ergonomic benefits of robotic surgery. Copyright © 2017. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology

  8. Does a "one-stop" gynecology screening clinic for women in hereditary nonpolyposis colorectal cancer families have an impact on their psychological morbidity and perception of health?

    Science.gov (United States)

    Wood, N J; Munot, S; Sheridan, E; Duffy, S R

    2008-01-01

    Screening programs can reduce the burden of disease, however, they can be associated with raised levels of anxiety. The risk of endometrial and ovarian cancer is increased in hereditary nonpolyposis colorectal cancer (HNPCC). There is no prospective evidence to support screening for gynecological disease in HNPCC, however, current recommendations include the use of ultrasound and endometrial biopsy. This study assesses the impact of screening for gynecological cancer on self-reported symptoms of anxiety, depression, and perceptions of health. Women from HNPCC families attending gynecological screening (n = 26) completed the Hospital Anxiety and Depression Scale and the ShortForm36v2 questionnaires prior to screening with transvaginal ultrasound, outpatient/office hysteroscopy, endometrial biopsy, and ovarian tumor marker assessment (CA125). The same questionnaires were completed at 3 and 6 months following screening (15/26). Women in HNPCC families attending for gynecological screening did not have excess symptoms of anxiety or depression at baseline in subjective comparison to other populations. The process of screening and false positive screening results had no significant impact on symptoms of anxiety and depression or perceptions of health. We conclude that within the limitations of analysis in this small study group, screening for gynecological disease in HNPCC does not appear to be associated with any psychological morbidity.

  9. Scientific research in obstetrics and gynecology: changes in the trends over three decades

    Directory of Open Access Journals (Sweden)

    Kassem GA

    2014-12-01

    Full Text Available Gamal A Kassem Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University, Zagazig, Egypt Aim: The aim of this work was to assess scientific research of master’s and doctoral theses and essays in the Department of Obstetrics and Gynecology, Zagazig University, Egypt. Materials and methods: All master’s and doctoral theses and essays since the foundation of Department of Obstetrics and Gynecology, Zagazig University, Egypt, in 1975 till end of 2012 were reviewed. Results: A total of 703 theses and essays were reviewed. The important topics in the specialty of obstetrics and gynecology were covered and updated. Infertility, in vitro fertilization–embryo transfer (IVF-ET and related techniques, and polycystic ovarian disease were the most common gynecologic topics (27.2%, followed by gynecologic oncology (18.5%. Preeclampsia was the most common obstetrics topic (18.8%, followed by issues of high-risk pregnancy, fetal growth restriction, and fetal well-being (11.6%. The number of researches that allow the candidates to learn skills was 183 and it was increased from 4.4% of all research in the period 1979–1988 to 33.2% in period 1989–2000 then slightly decreased to 31.2% in period 2001–2012. Ultrasonography was on the top and was present in 99 out of 183 (54.1% followed by laparoscopy (30, 16.4%, hysteroscopy (25, 13.7%, IVF-ET and related techniques (16, 8.7% and colposcopy (13, 7.1% researches. Multi-disciplinary research was decreased by 61.7% in the period 2001–2012. Researches in academic fields were abandoned and in some clinically important areas like preeclampsia were decreased. Conclusion: Scientific research of master’s and doctoral theses and essays was comprehensive, updated, and had some autonomy independent of plans. Research which enable the candidate to learn skills were increased on the expense of academic, clinical and multidisciplinary research. It could be recommended that plans for scientific

  10. Treatment of selected primary gynecologic and pelvic malignancies with 241Americium

    International Nuclear Information System (INIS)

    Chung, Joyce Y.; Peschel, Richard E.; Kacinski, Barry; Nath, Ravinder; Pourang, Rauman; Roberts, Kenneth; Fischer, Diana; Chambers, Joseph; Schwartz, Peter E.; Wilson, Lynn

    1995-01-01

    Purpose: To evaluate the efficacy of encapsulated 241 Am in the treatment of primary gynecological malignancies and in previously irradiated patients with recurrent disease in the pelvis. Materials and Methods: Encapsulated 241 Am primarily emits 60keV photons which are effectively shielded by thin layers of high atomic number materials. Dose distributions in water are similar to those produced by Cs-137 photons but with a half-value layer that is considerably less. Cases of 28 patients (12-primary, 16-recurrent) who have been treated with 241 Am at the Yale University School of Medicine since 1986 were retrospectively reviewed. Data concerning dosimetry, disease site, prior treatment, recurrence, disease-free survival, overall survival, and complications were evaluated. Results: Median follow up for the 12 patients with primary gynecological tumors was 19 months (7mo-51mo). There were 6 vulvar, 3 vaginal, 2 cervical and 1 endometrial carcinomas. Median surface dose of 241 Am was 42.2 Gy (23.3Gy-106.6Gy). As part of their initial therapy 11 received pelvic external beam radiation therapy, 6 underwent surgery and 2 received other forms of intracavitary brachytherapy. Of these 12 patients, 11 achieved a complete response (CR) with the duration of CR ranging from 7 to 51 months. Actuarial disease-free survival at 3 years was 66% (S.E.=.16) and actuarial overall survival at 3 years was 91% (S.E.=.08). Median follow up for the 16 patients with recurrent pelvic malignancies was 72 months (20mo-99mo). There were 9 cases of endometrial, 3 vulvar, 3 colorectal, and 1 cervical carinomas. Fifteen of 16 received some form of surgery and radiotherapy prior to their treatment with 241 Am. Median surface dose of 241 Am was 40.3 (17.6Gy-141.7Gy). Of these 16 patients, 10 achieved a CR with the duration of CR ranging from 3 to 88 months. Actuarial disease-free survival at 5 years was 51% (S.E.=.16) and actuarial overall survival at 5 years was 43% (S.E.=.14). Complications were

  11. Proportion of gynecologic cancer patients using complementary and alternative medicine.

    Science.gov (United States)

    Supoken, Amornrat; Chaisrisawatsuk, Thitima; Chumworathayi, Bandit

    2009-01-01

    Complementary and alternative medicine (CAM) for treatment of cancer and for supportive care of cancer patients must be clearly separated. There is encouraging evidence for CAM in the latter area, such as acupuncture and progressive muscle relaxation for chemotherapy-related nausea and vomiting, and aromatherapy for decreasing anxiety and increasing quality of life. However, there are limited data about CAM used by gynecologic cancer patients, especially in Thai women. Therefore, the authors aimed to investigate the proportion and types of CAM using in our gynecologic cancer patients. This cross-sectional survey was conducted between October to December, 2008. Totals of 50 admitted and 50 walk-in gynecologic cancer patients 1 month after diagnosis, aged more than 20 years and able to give informed consent, were selected for one-by-one interview by random walking survey. Among the 100 interviewed patients, aged 21-69 (mean=50.12), there were 46 cases of cervical cancers, 35 of ovarian cancers, 18 of endometrial cancers (two of these also had ovarian cancers), 2 of malignant gestational trophoblastic diseases, 1 of vulvar cancer, and 1 liver cancer (in a patient with ovarian cancer). Some 67% (95% CI, 57.8-76.2%) of them used CAM. As diet modifications, 11 used Chinese vegetarian, 8 common vegetarian, 5 Cheewajit, and 1 macrobiotics. Five of them used dietary supplements while colonic detoxification was emplyed in three. As herbal medicines, 27 used Thai herbs, 4 Chinese herbs, and 1 a herbal sauna. Twelve were receiving Thai massage. As exercises, 23 used aerobics and 5 stretching. Interestingly, 62 of them used Buddhist praying while only 3 employed native magic. The three most common forms of CAM used by our gynecologic cancer patients were Buddhist praying (62/67, 92.5%), followed by herbal medicines (27/67, 40.3%) and exercises (25/67, 37.3%).

  12. Differences in C-type lectin receptors and their adaptor molecules in the peritoneal fluid of patients with endometriosis and gynecologic cancers.

    Science.gov (United States)

    Yeo, Seung Geun; Won, Yong Sung; Kim, Sang Hoon; Park, Dong Choon

    2018-01-01

    Endometriosis, although not malignant, has clinically demonstrated properties of invasiveness and metastasis. The pathogenesis of endometriosis, however, has not yet been elucidated. The immunological differences between endometriosis and malignant gynecologic tumors were analyzed by assessing C-type lectin receptors, which are associated with innate immunity, and immunoglobulin secretion, which is associated with B cell adaptive immunity, in the peritoneal fluid of these patients. Peritoneal fluid samples were obtained from 42 patients with benign masses (control group), 38 with endometriosis, and 43 with gynecologic (ovarian, uterine, and cervical) cancers. The levels of expression in these samples of mRNAs encoding the C-type lectin receptors Dectin-1, MR1, MR2, DC-SIGN, Syk, Card 9, Bcl 10, Malt 1, src, Dec 205, Galectin, Tim 3, Trem 1, and DAP 12, were measured by real-time reverse transcription polymerase chain reaction, and the concentrations of IgG, IgA and IgM were measured by enzyme-linked immunosorbent assays (ELISA). Findings in the three groups were compared. The level of galectin mRNA was significantly lower, and the levels of MR2 and DAP 12 mRNAs significantly higher, in the endometriosis than in the control group (pgynecologic cancer group, the level of Bcl 10 mRNA was significantly lower, and the levels of MR1, MR2, Syk, Card 9, Malt 1, Dec 205, Tim 3, and DAP 12 mRNAs significantly higher, in the endometriosis group (pcontrol group (pgynecologic cancer groups. IgA and IgG concentrations in peritoneal fluid were significantly lower in the gynecologic cancer than in the control group (p0.05). C-type lectin receptors and immunoglobulins act cooperatively and are closely associated in the pathogenesis of endometriosis. The decreased expression of galectin mRNA in the peritoneal fluid of the endometriosis group suggests that endometriosis and gynecologic cancers have similar immunologic characteristics.

  13. An analysis of the impact of pathology review in gynecologic cancer

    International Nuclear Information System (INIS)

    Chafe, Susan; Honore, Louis; Pearcey, Robert; Capstick, Valerie

    2000-01-01

    Purpose: To analyze the impact of pathology review in gynecologic malignancies. Methods and Materials: For all new gynecologic patients seen between December 2, 1993 and January 4, 1996, we conducted a retrospective chart review to determine if a pathology review by the institute's consultant pathologist changed the diagnosis, and if so whether the change altered patient management. A total of 514 patients were seen, of whom 120 had cervical cancer, 226 had endometrial cancer, 122 had a primary ovarian or peritoneal malignancy, 9 had a vaginal malignancy, 28 had vulvar cancer, and 9 had a miscellaneous gynecologic malignancy. Results: On pathology review the diagnosis changed for 200 of 599 specimens (33%). This altered management for 63 of 514 patients (12%). For patients with cervical cancer, the grade of tumor was the main change in pathologic diagnosis, with occasional change in the presence of lymph vascular invasion. These did not translate into patient management alterations. Eight patients (1.5%) had management alterations. The changes in depth of invasion and vascular invasion altered management for 3 patients. Changes in pap smears resulted in two management alterations, and changes in histologic diagnoses altered management for 3 cases. For endometrial primaries the changes in pathologic diagnosis included grade, depth of invasion, and the presence of cervical involvement. This did alter management in 40 cases (8%). For the ovarian malignancies, the main changes were grade, extent of disease, or histologic classification, some of which (10 patients, 2%) resulted in altered management. One patient with a vaginal lesion had the diagnosis changed, which did alter management. Of the patients diagnosed with vulvar cancer, the pathologic diagnosis changed for 11 patients. This included changes in grade and depth of invasion. This altered management of 2 patients. The remaining miscellaneous gynecologic malignancies had only two diagnosis changes that altered

  14. Gynecologic examination and cervical biopsies after (chemo) radiation for cervical cancer to identify patients eligible for salvage surgery

    International Nuclear Information System (INIS)

    Nijhuis, Esther R.; Zee, Ate G.J. van der; Hout, Bertha A. in 't; Boomgaard, Jantine J.; Hullu, Joanne A. de; Pras, Elisabeth; Hollema, Harry; Aalders, Jan G.; Nijman, Hans W.; Willemse, Pax H.B.; Mourits, Marian J.E.

    2006-01-01

    Purpose: The aim of this study was to evaluate efficacy of gynecologic examination under general anesthesia with cervical biopsies after (chemo) radiation for cervical cancer to identify patients with residual disease who may benefit from salvage surgery. Methods and Materials: In a retrospective cohort study data of all cervical cancer patients with the International Federation of Gynecology and Obstetrics (FIGO) Stage IB1 to IVA treated with (chemo) radiation between 1994 and 2001 were analyzed. Patients underwent gynecologic examination under anesthesia 8 to 10 weeks after completion of treatment. Cervical biopsy samples were taken from patients judged to be operable. In case of residual cancer, salvage surgery was performed. Results: Between 1994 and 2001, 169 consecutive cervical cancer patients received primary (chemo) radiation, of whom 4 were lost to follow-up. Median age was 56 years (interquartile range [IQR], 44-71) and median follow-up was 3.5 years (IQR, 1.5-5.9). In each of 111 patients a biopsy sample was taken, of which 90 (81%) showed no residual tumor. Vital tumor cells were found in 21 of 111 patients (19%). Salvage surgery was performed in 13 of 21 (62%) patients; of these patients, 5 (38%) achieved long-term, complete remission after salvage surgery (median follow-up, 5.2 years; range, 3.9-8.8 years). All patients with residual disease who did not undergo operation (8/21) died of progressive disease. Locoregional control was more often obtained in patients who underwent operation (7 of 13) than in patients who were not selected for salvage surgery (0 of 8 patients) (p < 0.05). Conclusions: Gynecologic examination under anesthesia 8 to 10 weeks after (chemo) radiation with cervical biopsies allows identification of those cervical cancer patients who have residual local disease, of whom a small but significant proportion may be salvaged by surgery

  15. Insulinoma: A retrospective study analyzing the differences between benign and malignant tumors.

    Science.gov (United States)

    Câmara-de-Souza, A B; Toyoshima, M T K; Giannella, M L; Freire, D S; Camacho, C P; Lourenço, D M; Rocha, M S; Bacchella, T; Jureidini, R; Machado, M C C; Almeida, M Q; Pereira, M A A

    2018-04-01

    Insulinoma is a rare pancreatic tumor and, usually, a benign disease but can be a malignant one and, sometimes, a highly aggressive disease. The aim of this study was to determine differences between benign and malignant tumors. Retrospective study of 103 patients with insulinoma treated in a tertiary center. It was analyzed demographic, clinical, laboratory, localization and histologic analysis of tumor and follow up data of subjects in order to identify differences between individuals benign and malignant disease. Almost all patients (87%) had a benign tumor and survival rates of 100% following pancreatic tumor surgery. Those with malignant tumors (13%) have a poor prognosis, 77% insulinoma-related deaths over a period of 1-300 months after the diagnosis with a survival rate of 24% in five years. The following factors are associated with an increased risk of malignant disease: duration of symptoms < 24 months, fasting time for the occurrence of hypoglycemia < 8 h, blood plasma insulin concentration ≥ 28 μU/mL and C-peptide ≥ 4.0 ng/mL at the glycemic nadir and tumor size ≥ 2.5 cm. Our data help to base the literature about these tumors, reinforcing that although insulinoma is usually a single benign and surgically treated neoplasia, the malignant one is difficult to treat. We highlight the data that help predict a malignancy behavior of tumor and suggest a long follow up after diagnosis in these cases. Copyright © 2018 IAP and EPC. Published by Elsevier B.V. All rights reserved.

  16. Role of interstitial implantation in gynecological cancer

    International Nuclear Information System (INIS)

    Nori, D.; Hilaris, B.S.

    1987-01-01

    Recurrent cancer at any site carries a gloomy prognosis. Cancer of the cervix that recurs after radical surgery or curative radiation therapy is a perplexing problem confronting both gynecological and radiation oncologists. In the authors' series, 45% of the patients survived disease-free at 1 year and 10% survived without disease at 5 years or longer following interstitial implantation for recurrent cervical cancer. The optimal utilization of this procedure seems to depend on the site of recurrence, the extent of the disease in the pelvis, and the status of para-aortic node involvement. This retrospective analysis enabled the authors to identify the prognostic factors. The most favorable group benefited by this technique were those who presented with either central recurrence or unilateral, localized pelvic side wall recurrent disease. The least morbidity was noticed in those patients with minimal surgical manipulations at the time of the interstitial implantation. The authors recommended that only a limited and essential surgical procedure should accompany interstitial implantation, since the associated morbidity and mortality is high and survival brief

  17. Subspecialist training in surgical gynecological oncology in the nordic countries

    DEFF Research Database (Denmark)

    Antonsen, Sofie L; Avall-Lundqvist, Elisabeth; Salvesen, Helga B

    2011-01-01

    To survey the centers that can provide subspecialty surgical training and education in gynecological oncology in the Nordic countries we developed an online questionnaire in cooperation with the Nordic Society of Gynecological Oncology. The link to the survey was mailed to 22 Scandinavian...... (74%) centers were interested in being listed for exchange of fellows. Our data show a large Nordic potential and interest in improving the gynecologic oncology standards and can be used to enhance the awareness of gynecological oncology training in Scandinavia and to facilitate the exchange...

  18. Benign fibroosseous lesions

    Directory of Open Access Journals (Sweden)

    Cansu Köseoğlu Seçgin

    2016-05-01

    Full Text Available Benign fibroosseous lesions represent a group of lesions that share the same basic evolutive mechanism and are characterized by replacement of normal bone with a fibrous connective tissue that gradually undergoes mineralization. These lesions are presented by a variety of diseases including developmental, reactive-dysplastic processes and neoplasms. Depending on the nature and amount of calcified tissue, they can be observed as radiolucent, mixed or radiopaque. Their radiographic features could be well-defined or indistinguishable from the surrounding bone tissue. They can be asymptomatic as in osseous dysplasias and can be detected incidentally on radiographs, or they can lead to expansion in the affected bone as in ossifying fibroma. All fibroosseous lesions seen in the jaws and face are variations of the same histological pattern. Therefore, detailed clinical and radiographic evaluation in differential diagnosis is important. In this review, fibroosseous benign lesions are classified as osseous dysplasia, fibrous dysplasia and fibroosseous tumors; and radiographic features and differential diagnosis of these lesions are reviewed taking into account this classification.

  19. Gynecologic imaging: Current and emerging applications

    Directory of Open Access Journals (Sweden)

    Iyer V

    2010-01-01

    Full Text Available Common diagnostic challenges in gynecology and the role of imaging in their evaluation are reviewed. Etiologies of abnormal uterine bleeding identified on pelvic sonography and sonohysterography are presented. An algorithmic approach for characterizing an incidentally detected adnexal mass and use of magnetic resonance imaging for definitive diagnosis are discussed. Finally, the role of F18-fluorodeoxyglucose positron emission tomography in the management of gynecological malignancies, and pitfalls associated with their use are examined.

  20. The association of gynecological symptoms with psychological distress in women of reproductive age: a survey from gynecology clinics in Beirut, Lebanon

    OpenAIRE

    Chaaya, M. M.; Bogner, H. R.; Gallo, J. J.; Leaf, P. J.

    2003-01-01

    To date there has been no previous research into a possible association between psychological distress and gynecologic symptoms in the Arab world. We hypothesized that psychological distress would be associated with specific gynecologic complaints as well as with psychosocial factors.

  1. Ultrasonography in obstetrics and gynecology, 2nd edition

    International Nuclear Information System (INIS)

    Callen, P.W.

    1988-01-01

    A text on obstetric and gynecologic ultrasound for radiologists, OB/GYN practitioners, and radiologic technicians. The second edition places greater emphasis on diagnosis of specific systemic disorders in the fetus, as well as the most current applications of ultrasound in gynecologic diagnosis

  2. Retreatment with bevacizumab in patients with gynecologic malignancy is associated with clinical response and does not increase morbidity

    Directory of Open Access Journals (Sweden)

    Laskey RA

    2014-03-01

    Full Text Available Robin A Laskey,1 Scott D Richard,2 Ashlee L Smith,1 Jeff F Lin,1 Tiffany L Beck,3 Jamie L Lesnock,1 Joseph L Kelley 3rd,1 Alexander B Olawaiye,1 Paniti Sukumvanich,1 Thomas C Krivak4 1Division of Gynecologic Oncology, Magee-Womens Hospital of UPMC, Pittsburgh, 2Division of Gynecologic Oncology, Drexel University College of Medicine/Hahnemann University Hospital, Philadelphia, 3Department of Obstetrics, Gynecology and Reproductive Sciences, Magee-Womens Hospital of UPMC, Pittsburgh, 4Division of Gynecologic Oncology, Western Pennsylvania Hospital, Pittsburgh, PA, USA Purpose: Bevacizumab (Bev is associated with improved progression-free survival in advanced epithelial ovarian cancer. The use of Bev in patients with gynecologic malignancy is increasing; however, little is known about cumulative toxicity and response in patients retreated with Bev. Our goal was to determine cumulative side effects and response in patients retreated with Bev. Patients and methods: Women with recurrent gynecologic malignancy treated with Bev between January 2007 and March 2012 at a single institution were identified, including a subset who received Bev in a subsequent regimen. The primary outcome was Bev-associated toxicity, and the secondary outcome was response. Results: Of 83 patients that received Bev for recurrent disease, 23 were retreated with Bev and four received Bev maintenance. Three patients (13% developed grade 3 or 4 hypertension; all had a history of chronic hypertension. One (4.3% patient developed grade 3 proteinuria, and one (4.3% developed an enterovaginal fistula. Four patients discontinued Bev secondary to toxicity. Toxicity was not related to the cumulative number of cycles. Twenty-six percent of patients responded to Bev retreatment. On univariate analysis, there was a significant (P=0.003 overall survival advantage when the Bev-free interval was >9 months (95% confidence interval [CI] 4.9–43.7 compared to ≤9 months (95% CI 2.1–11.5, 24

  3. Pharmacological treatment of the benign prostatic hyperplasia

    International Nuclear Information System (INIS)

    Perez Guerra, Yohani; Molina Cuevas, Vivian; Oyarzabal Yera, Ambar; Mas Ferreiro, Rosa

    2011-01-01

    Benign prostatic hyperplasia is a common disease in over 50 years-old men consisting in uncontrolled and benign growth of prostatic gland that leads to lower urinary tract symptoms. The etiology of benign prostatic hyperplasia is multifactoral involving the increased conversion of testosterone in dihydrotestosterone by the prostatic 5α-reductase action, which brought about events that encourage the prostate growth (static component) and the increase of the bladder and prostate smooth muscle tone (dynamic component) regulated by the aα 1 -adrenoceptors (ADR). The pharmacological treatment of the benign prostatic hyperplasia includes the prostatic 5aα-reductase inhibitors, the aα 1 -adrenoreceptor blockers, their combined therapy and the phytotherapy. This paper was aimed at presenting the most relevant aspects of the pharmacology of drugs used for treating the benign prostatic hyperplasia, and providing elements to analyze their efficacy, safety and tolerability. To this end, a review was made of the different drugs for the treatment of this pathology and they were grouped according to their mechanism of action. Natural products were included as lipid extracts from Serenoa repens and Pygeum africanum as well as D-004, a lipid extract from Roystonea regia fruits, with proved beneficial effects on the main etiological factors of benign prostatic hyperplasia. D-004 is a prostatic 5a-reductase inhibitor, an aα 1 -adrenoceptor antagonist, aα 5-lipooxygenase inhibitor and has antioxidant action, all of which reveals a multifactoral mechanism. The results achieved till now indicate that D-004 is a safe and well-tolerated product

  4. Benign ovarian and endometrial uptake on FDG PET-CT. Patterns and pitfalls

    International Nuclear Information System (INIS)

    Liu, Y.

    2009-01-01

    Increased ovarian or endometrial uptake may cause a dilemma in the interpretation of whole body F18-fluorodeoxyglucose-positron emission tomography (FDG-PET) imaging or even misdiagnosis of malignant disease. Knowledge of benign FDG uptake of the ovaries and uterus is important for daily practice of nuclear medicine radiologists. Increased uptake in the ovaries or uterus indicates a pathologic or neoplastic process in postmenopausal patients. In premenopausal women, increased ovarian or endometrial uptake can be functional or malignant. Benign functional uptake of premenopausal ovaries or uterus is related to the menstrual cycle; therefore, information about the patient's menstrual status is crucial for interpretation. In addition, correlation with computed tomography (CT), especially diagnostic CT acquired at the same time of PET/CT is very useful in clarifying the location of the uptake and the existence or disappearance of the discrete lesion. Increased ovarian uptake may also be identified in histologically different benign tumor entities. Nonmenstrual-related endometrial uptake may be present in many benign diseases as well. (author)

  5. Pelvic Surgical Site Infections in Gynecologic Surgery

    Directory of Open Access Journals (Sweden)

    Mark P. Lachiewicz

    2015-01-01

    Full Text Available The development of surgical site infection (SSI remains the most common complication of gynecologic surgical procedures and results in significant patient morbidity. Gynecologic procedures pose a unique challenge in that potential pathogenic microorganisms from the skin or vagina and endocervix may migrate to operative sites and can result in vaginal cuff cellulitis, pelvic cellulitis, and pelvic abscesses. Multiple host and surgical risk factors have been identified as risks that increase infectious sequelae after pelvic surgery. This paper will review these risk factors as many are modifiable and care should be taken to address such factors in order to decrease the chance of infection. We will also review the definitions, microbiology, pathogenesis, diagnosis, and management of pelvic SSIs after gynecologic surgery.

  6. Solitary, multiple, benign, atypical, or malignant: the "Granular Cell Tumor" puzzle.

    Science.gov (United States)

    Machado, Isidro; Cruz, Julia; Lavernia, Javier; Llombart-Bosch, Antonio

    2016-05-01

    The clinical evolution and biology of granular cell tumors (GCT) are poorly understood and treatment remains an issue of discussion. The majority of GCT are benign, although some display malignant behavior. The distinction between benign, atypical, and malignant GCT is controversial due to morphological and immunohistochemical overlap and lack of consistent histological and phenotypic criteria that predict behavior. Although histological criteria may indicate increased risk of malignant evolution, some GCT with evident benign appearance exceptionally progress towards metastatic disease. In this review, we discuss current knowledge on GCT, including histologic, immunophenotypic, and molecular characteristics and differential diagnosis. We focus on the following problematic items in GCT: (1) evolution of classification, (2) neural versus non-neural GCT, (3) neoplastic versus reactive disease, (4) malignant transformation of benign GCT, and (5) multiple versus metastatic GCT. We conclude that although a Ki-67 index >10 % and the presence of mitoses and/or of necrosis are frequently associated with malignant behavior, metastasis remains the only unequivocal sign of malignancy in GCT. An infiltrative growth pattern and vascular and/or perineural invasion are not indicative of malignancy. GCT with atypical/uncertain features almost never metastasize, and many of these tumors either behave in a benign fashion or only recur locally (similar to incompletely excised benign tumors). We therefore propose that classical and atypical histological variants form a single group of GCT. GCT with various unfavorable histological features might be labeled as "GCT with increased risk of metastasis" rather than malignant GCT.

  7. Evaluation of T1/T2 ratios in a pilot study as a potential biomarker of biopsy: proven benign and malignant breast lesions in correlation with histopathological disease stage.

    Science.gov (United States)

    Malikova, Marina A; Tkacz, Jaroslaw N; Slanetz, Priscilla J; Guo, Chao-Yu; Aakil, Adam; Jara, Hernan

    2017-08-01

    Early breast cancer detection is important for intervention and prognosis. Advances in treatment and outcome require diagnostic tools with highly positive predictive value. To study the potential role of quantitative MRI (qMRI) using T1/T2 ratios to differentiate benign from malignant breast lesions. A cross-sectional study of 69 women with 69 known or suspicious breast lesions were scanned with mixed-turbo spin echo pulse sequence. Patients were grouped according to histopathological assessment of disease stage: untreated malignant tumor, treated malignancy and benign disease. Elevated T1/T2 means were observed for biopsy-proven malignant lesions and for malignant lesions treated prior to qMRI with chemotherapy and/or radiation, as compared with benign lesions. The qMRI-obtained T1/T2 ratios correlated with histopathology. Analysis revealed correlation between elevated T1/T2 ratio and disease stage. This could provide valuable complementary information on tissue properties as an additional diagnostic tool.

  8. Hysterectomy for benign conditions in a university hospital in Saudi Arabia

    International Nuclear Information System (INIS)

    Sait, K.; Al-Khattabi, M.; Boker, A.; Al-Hashemi, J.

    2008-01-01

    Hysterectomy is a common surgical procedure among women with a lifetime prevalence of 10%. The indications and complications of this procedure have not been previously reported from a teaching institution in Saudi Arabia. We examined the indications for hysterectomy and the surgical morbidity for women undergoing hysterectomy at a university hospital in Saudi Arabia. We reviewed the records of women who underwent hysterectomies for benign gynecological conditions between January 1990 and December 2002, at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia, comparing patient characteristics, indications for hysterectomy and the rate of complications in women undergoing abdominal hysterectomy (AH) versus vaginal hysterectomy (VH). Of 251 women 199 (79%) underwent AH and 52 (21%) underwent VH. An estimated blood loss of >=500 mL occurred in 104 patients (52.3%) in the AH group and in 20 patients (38.5%) in the VH group (difference not statistically significant). The most common indications for hysterectomy were uterine fibroids (n=107, 41.6%) and dysfunctional uterine bleeding (n=68, 27.1%). The most common indication for VH was uterine prolapsed (n=45, 86.5%). The overall complication rates were 33.5%, 15.4% and 30.4% in women who underwent the AH group and in 51 patients in the VH group (20.3%). Postoperative infection occurred in 42/199 (21.6%) in the AH group and 5/52 (9.6%) in the VH group (difference not statistically significant). We describe a large series of hysterectomies, which provides information for surgeons on the expected of complications following hysterectomy for benign conditions. We describe a large series of hysterectomies, which provides information for surgeons on the expected rate of complications following hysterectomy for benign conditions. We found that the rate of complications was not significantly higher than other centers internationally. (author)

  9. Pancreatic insufficiency after different resections for benign tumours.

    Science.gov (United States)

    Falconi, M; Mantovani, W; Crippa, S; Mascetta, G; Salvia, R; Pederzoli, P

    2008-01-01

    Pancreatic resections for benign diseases may lead to long-term endocrine/exocrine impairment. The aim of this study was to compare postoperative and long-term results after different pancreatic resections for benign disease. Between 1990 and 1999, 62 patients underwent pancreaticoduodenectomy (PD), 36 atypical resection (AR) and 64 left pancreatectomy (LP) for benign tumours. Exocrine and endocrine pancreatic function was evaluated by 72-h faecal chymotrypsin and oral glucose tolerance test. The incidence of pancreatic fistula was significantly higher after AR than after LP (11 of 36 versus seven of 64; P = 0.028). The long-term incidence of endocrine pancreatic insufficiency was significantly lower after AR than after PD (P insufficiency was more common after PD (P endocrine and exocrine insufficiency was higher for PD and LP than for AR (32, 27 and 3 per cent respectively at 1 year; 58, 29 and 3 per cent at 5 years; P pancreatic resections are associated with different risks of developing long-term pancreatic insufficiency. AR represents the best option in terms of long-term endocrine and exocrine function, although it is associated with more postoperative complications. Copyright (c) 2007 British Journal of Surgery Society Ltd.

  10. Esophageal stenting for benign and malignant disease: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline.

    Science.gov (United States)

    Spaander, Manon C W; Baron, Todd H; Siersema, Peter D; Fuccio, Lorenzo; Schumacher, Brigitte; Escorsell, Àngels; Garcia-Pagán, Juan-Carlos; Dumonceau, Jean-Marc; Conio, Massimo; de Ceglie, Antonella; Skowronek, Janusz; Nordsmark, Marianne; Seufferlein, Thomas; Van Gossum, André; Hassan, Cesare; Repici, Alessandro; Bruno, Marco J

    2016-10-01

    This Guideline is an official statement of the European Society of Gastrointestinal Endoscopy (ESGE), endorsed by the European Society for Radiotherapy and Oncology (ESTRO), the European Society of Digestive Endoscopy (ESDO), and the European Society for Clinical Nutrition and Metabolism (ESPEN). The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was adopted to define the strength of recommendations and the quality of evidence. Main recommendations for malignant disease 1 ESGE recommends placement of partially or fully covered self-expandable metal stents (SEMSs) for palliative treatment of malignant dysphagia over laser therapy, photodynamic therapy, and esophageal bypass (strong recommendation, high quality evidence). 2 For patients with longer life expectancy, ESGE recommends brachytherapy as a valid alternative or in addition to stenting in esophageal cancer patients with malignant dysphagia. Brachytherapy may provide a survival advantage and possibly a better quality of life compared to SEMS placement alone. (Strong recommendation, high quality evidence.) 3 ESGE recommends esophageal SEMS placement as the preferred treatment for sealing malignant tracheoesophageal or bronchoesophageal fistula (strong recommendation, low quality evidence). 4 ESGE does not recommend the use of concurrent external radiotherapy and esophageal stent treatment. SEMS placement is also not recommended as a bridge to surgery or prior to preoperative chemoradiotherapy. It is associated with a high incidence of adverse events and alternative satisfactory options such as placement of a feeding tube are available. (Strong recommendation, low quality evidence.) Main recommendations for benign disease 1 ESGE recommends against the use of self-expandable stents (SEMSs) as first-line therapy for the management of benign esophageal strictures because of the potential for adverse events, the availability of alternative therapies, and costs (strong

  11. Topical PDT in the Treatment of Benign Skin Diseases: Principles and New Applications

    Directory of Open Access Journals (Sweden)

    Miri Kim

    2015-09-01

    Full Text Available Photodynamic therapy (PDT uses a photosensitizer, light energy, and molecular oxygen to cause cell damage. Cells exposed to the photosensitizer are susceptible to destruction upon light absorption because excitation of the photosensitizing agents leads to the production of reactive oxygen species and, subsequently, direct cytotoxicity. Using the intrinsic cellular heme biosynthetic pathway, topical PDT selectively targets abnormal cells, while preserving normal surrounding tissues. This selective cytotoxic effect is the basis for the use of PDT in antitumor treatment. Clinically, PDT is a widely used therapeutic regimen for oncologic skin conditions such as actinic keratosis, squamous cell carcinoma in situ, and basal cell carcinoma. PDT has been shown, under certain circumstances, to stimulate the immune system and produce antibacterial, and/or regenerative effects while protecting cell viability. Thus, it may be useful for treating benign skin conditions. An increasing number of studies support the idea that PDT may be effective for treating acne vulgaris and several other inflammatory/infective skin diseases, including psoriasis, rosacea, viral warts, and aging-related changes. This review provides an overview of the clinical investigations of PDT and discusses each of the essential aspects of the sequence: its mechanism of action, common photosensitizers, light sources, and clinical applications in dermatology. Of the numerous clinical trials of PDT in dermatology, this review focuses on those studies that have reported remarkable therapeutic benefits following topical PDT for benign skin conditions such as acne vulgaris, viral warts, and photorejuvenation without causing severe side effects.

  12. Robot-assisted surgery in gynecological oncology

    DEFF Research Database (Denmark)

    Kristensen, Steffen E; Mosgaard, Berit J; Rosendahl, Mikkel

    2017-01-01

    INTRODUCTION: Robot-assisted surgery has become more widespread in gynecological oncology. The purpose of this systematic review is to present current knowledge on robot-assisted surgery, and to clarify and discuss controversies that have arisen alongside the development and deployment. MATERIAL...... was performed by screening of titles and abstracts, and by full text scrutiny. From 2001 to 2016, a total of 76 references were included. RESULTS: Robot-assisted surgery in gynecological oncology has increased, and current knowledge supports that the oncological safety is similar, compared with previous...

  13. Resistive index in breast tumors; usefulness on differentiation between benign and malignant lesions

    International Nuclear Information System (INIS)

    An, Eun Joo; Choi, Hye Young; Baek, Seung Yon; Kim, Ah Young; Choe, Du Hwan

    1996-01-01

    We assessed the usefulness of resistive index(RI) on spectral analysis of doppler sonography for differential diagnosis of benign and malignant breast lesions. We retrospectively reviewed 29 benign and 22 malignant lesions of breast, which were examined preoperatively with color and duplex Doppler and were confirmed by histopathologically after operation. We analyzed the average and distribution of RI in benign and malignant lesions. Although, there was no difference in the average values of RI in benign and malignant breast lesions, the distribution of RI was below 0.7 in eighteen cases (62%) of benign lesions, and above 0.7 in eighteen cases (82%) of malignant lesions. Thus, RI is valuable for differentiation between benign and malignant lesions of breast. Measurement of RI in breast disease using color and duplex Doppler study is useful modality adjunct to the conventional ultrasonographic differentiation of benign and malignant lesions

  14. Malignant transformation from benign papillomatosis of the external auditory canal.

    Science.gov (United States)

    Miah, Mohammed S; Crawford, Mairi; White, Sharon J; Hussain, Syed Shah Musheer

    2012-06-01

    Report a case of malignant transformation of benign ear canal papillomatosis to malignant squamous cell carcinoma (SCC) of the temporal bone. A 73-year-old with papillomata involving the posterior and inferior walls of the right external auditory canal (EAC), which subsequently transformed into SCC. Radical mastoidectomy and excision of the tumor and then radical radiotherapy. Loco-regional disease control. Recovery of facial nerve function. Approximately 20 months post-treatment, the patient remains disease free. No recovery of facial nerve function. Malignant transformation of a benign EAC papilloma to SCC of the temporal bone has not been reported previously. The association of human papillomavirus with temporal bone SCC has been reported in small number of studies with human papillomavirus subtypes 16 and 18 isolated in a high proportion of cases. With the increased availability in genotyping, the question over whether there should be further genetic analysis of benign lesions to assess their susceptibility to malignant transformation has merit.

  15. Two-port cholecystectomy maintains safety and feasibility in benign gallbladder diseases: a comparative study.

    Science.gov (United States)

    Lee, Sang Chul; Choi, Byeong-Jo; Kim, Say-June

    2014-01-01

    In an effort to overcome the limitations of single-port laparoscopic cholecystectomy (LC) while preserving the cosmetic benefits of reduced ports cholecystectomy, we have developed a 2-port LC that allows for the full, unrestricted use of 4 laparoscopic instruments. We retrospectively analyzed data of patients who had undergone either 4-port LC or 2-port LC for benign gallbladder diseases between March 2007 and March 2013. Two incisions of 2-port LC were composed of an umbilical incision as the manner of single-port laparoscopic surgery and a 5-mm epigastric incision. These two incisions were utilized for comfortable bimanual manipulation under the liver-elevated vision provided by a liver retractor. During the study period, 766 patients underwent LC; 263 (34.3%) started with 4-port LC, and 503 (65.7%) started with 2-port LC. Of patients started with 2-port LC, 486 patients (96.6%) was ended up with 2-port without open conversion or addition of port(s). The two groups had similar operative time, open conversion rate, incidence of complications, analgesic requirement, and length of postoperative hospital stay. Multivariate analyses revealed that the independent factors related to prolonged operative time (≥ 90 th percentile) in 2-port LC were the presence of cholecystitis (odds ratio [OR] 2.412, 95% CI 1.246-4.668, p = 0.009) and admission through the emergency department (OR 2.132, 95% CI 1.135-4.004, p = 0.019). This study suggests that 2-port LC for benign gallbladder diseases is as safe and feasible as 4-port LC when it is performed by surgeons trained in conventional laparoscopic techniques. Copyright © 2014 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

  16. Ongoing strategies and updates on pain management in gynecologic oncology patients.

    Science.gov (United States)

    Hacker, Kari E; Reynolds, R Kevin; Uppal, Shitanshu

    2018-05-01

    The opioid crisis in the United States has been declared a public health emergency. Various governmental agencies, cancer care organizations and the Centers for Disease Control and Prevention have issued guidelines in hopes of managing this crisis. Curbing over-prescription of opioids by medical professionals has been a central theme in many of these guidelines. Gynecologic oncologists encounter patients with a variety of pain sources, including acute pain secondary to the underlying malignancy or surgical procedures as well as chronic pain related to the malignancy and the sequelae of treatments rendered. In this review, we discuss the various etiologies of pain experienced by gynecologic oncology patients and discuss modalities frequently used to treat this pain. We highlight strategies to reduce the number of opioids prescribed and focus on incorporating non-opioid pain relief management principles in this review. We also discuss the mechanisms and etiology of various types of pain, with a focus on multimodal treatment strategies including preoperative counseling, strategies to identify individuals at risk of developing opioid dependence, and the role of symptom management and palliative care teams. Finally, we provide a blueprint for gynecologic oncology practices to develop their practice-specific pain management contracts to engage patients in a meaningful conversation around the addictive potential of opioids. Copyright © 2018 Elsevier Inc. All rights reserved.

  17. Treatment of selected primary gynecologic and pelvic malignancies with {sup 241}Americium

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Joyce Y; Peschel, Richard E; Kacinski, Barry; Nath, Ravinder; Pourang, Rauman; Roberts, Kenneth; Fischer, Diana; Chambers, Joseph; Schwartz, Peter E; Wilson, Lynn

    1995-07-01

    Purpose: To evaluate the efficacy of encapsulated {sup 241}Am in the treatment of primary gynecological malignancies and in previously irradiated patients with recurrent disease in the pelvis. Materials and Methods: Encapsulated {sup 241}Am primarily emits 60keV photons which are effectively shielded by thin layers of high atomic number materials. Dose distributions in water are similar to those produced by Cs-137 photons but with a half-value layer that is considerably less. Cases of 28 patients (12-primary, 16-recurrent) who have been treated with {sup 241}Am at the Yale University School of Medicine since 1986 were retrospectively reviewed. Data concerning dosimetry, disease site, prior treatment, recurrence, disease-free survival, overall survival, and complications were evaluated. Results: Median follow up for the 12 patients with primary gynecological tumors was 19 months (7mo-51mo). There were 6 vulvar, 3 vaginal, 2 cervical and 1 endometrial carcinomas. Median surface dose of {sup 241}Am was 42.2 Gy (23.3Gy-106.6Gy). As part of their initial therapy 11 received pelvic external beam radiation therapy, 6 underwent surgery and 2 received other forms of intracavitary brachytherapy. Of these 12 patients, 11 achieved a complete response (CR) with the duration of CR ranging from 7 to 51 months. Actuarial disease-free survival at 3 years was 66% (S.E.=.16) and actuarial overall survival at 3 years was 91% (S.E.=.08). Median follow up for the 16 patients with recurrent pelvic malignancies was 72 months (20mo-99mo). There were 9 cases of endometrial, 3 vulvar, 3 colorectal, and 1 cervical carinomas. Fifteen of 16 received some form of surgery and radiotherapy prior to their treatment with {sup 241}Am. Median surface dose of {sup 241}Am was 40.3 (17.6Gy-141.7Gy). Of these 16 patients, 10 achieved a CR with the duration of CR ranging from 3 to 88 months. Actuarial disease-free survival at 5 years was 51% (S.E.=.16) and actuarial overall survival at 5 years was 43% (S

  18. Diagnosis and Treatment of Benign Paroxysmal Positional Vertigo

    Directory of Open Access Journals (Sweden)

    Muhammed Dagkiran

    2015-12-01

    Full Text Available Benign paroxysmal positional vertigo is the cause of peripheral vertigo, which only takes seconds posed by certain head and body position and led to severe attacks of vertigo. Therefore, it is a disturbance that causes a continuous fear of fall and anxiety in some patients. Although benign paroxysmal positional vertigo is the most common cause of peripheral vertigo, it may cause unnecessary tests, treatment costs and the loss of labor due to the result of the delay in the diagnosis and treatment stages. Diagnosis and treatment of this disease is easy. High success rates can be achieved with appropriate repositioning maneuvers after taking a detailed medical history and accurate assessment of accompanying nystagmus. The aim of this paper was to review the updated information about benign paroxysmal positional vertigo. [Archives Medical Review Journal 2015; 24(4.000: 555-564

  19. Prevalence of benign tumors among patients with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Aryan Rafiee Zadeh

    2015-10-01

    Full Text Available Multiple sclerosis (MS, an inflammatory autoimmune disease, affects almost 1% of world’s population in which myelin sheaths of neurons are targeted by immune cells. Association of different factors and diseases with MS provides new insights into possible pathogenesis and treatment for this disease. In this regard, we investigated the association of benign tumors with MS disease by studying total Isfehan multiple sclerosis (TIMS records for MS patients registered in Isfahan Multiple Sclerosis Society (IMSS who had developed any kind of benign tumors whether before MS diagnosis or after it. This study was performed in Isfahan province, third large province of Iran, with 4,815,863 populations located 1590 meters above sea level between latitudes 30 and 34 degrees north of the equator, and longitude 49-55 east. Among 4950 registered patients, 28 patients were discovered to have three types of benign tumors; pituitary adenoma in 22, meningioma in 5 and lipoma in 1 patient. The incidence rate of developing pituitary adenoma and meningioma were higher than in general population (OR 95%CI: 1.110; range: 0.731-1.685 and 1.035; range: 0.431-2.487 respectively but these findings were not statistically significant (p= 0.624 for pituitary adenoma and p= 0.939 for meningioma. But the incidence rate for lipoma was lower among MS patients (OR 95%CI: 0.020; range: 0.003-0.143 which was statistically significant (p <0.001.

  20. Study on the application of PET-CT in gynecology tumors

    International Nuclear Information System (INIS)

    Wen Lilian

    2012-01-01

    Gynecology tumors seriously threatened the health of female. With the development of imageology, PET, a functionality examination method, has been widely used in the early diagnosis and monitoring of curative effect in gynecology tumors. PET-CT has the good future in its development because it combined with the advantage of functional and structural imaging. The characters and application of PET-CT in gynecology tumors were reviewed in this paper. (author)

  1. Sexual Self-Schema and Sexual Morbidity Among Gynecologic Cancer Survivors

    OpenAIRE

    Andersen, Barbara L.; Woods, Xichel A.; Copeland, Larry J.

    1997-01-01

    Longitudinal research indicates that approximately 50% of women treated for gynecologic cancer have sexual dysfunctions as they recover and become cancer survivors. This outcome occurs in the context of satisfactory quality of life in other domains. This study, comparing gynecologic cancer survivors (n = 61) and gynecologically healthy women (n = 74), documents the reliability of the latter observations with measures of quality of life (general, depressive symptoms, social contacts, and stres...

  2. Evaluation of the cases of benign disease with high accumulation on the examination of [sup 18]F-fluorodeoxyglucose PET

    Energy Technology Data Exchange (ETDEWEB)

    Okazumi, Shinichi; Enomoto, Kazuo; Fukunaga, Toru (Chiba Univ. (Japan). School of Medicine) (and others)

    1993-12-01

    In this study 39 cases of abdominal benign disease were examined by PET using [sup 18]F-fluorodeoxyglucose (FDG), and 11 cases of them (i.e. 4 cases of liver abscess, 1 of pelvic abscess, 1 of omental abscess, 2 of chronic pancreatitis, 1 of inflammatory pseudotumor of liver, 1 of retroperitoneal leiomyoma and 1 of solid and cystic tumor of pancreas) which showed as high accumulation of FDG as malignant lesion were investigated of their clinical and pathological feature. We used Ci/Cp ratio as index to express the accumulation of FDG in the lesion, which was calculated from radioactivities of the lesion (Ci) and the plasma (Cp) at 60 mins after injection of FDG. The Ci/Cp ratio of the 11 cases was 3.64[+-]0.77. The pathological feature of the 9 inflammatory cases was high accumulation of inflammatory cells and that of the 2 benign tumor cases was solid proliferation of tumor cells. The serum of the 9 inflammatory cases showed high CRP value. It was considered that the high accumulation of FDG in inflammatory lesions was due to piles of FDG uptake of the many inflammatory cells, while the 2 benign tumors of high accumulation were considered that the tumor cell had as high glucose metabolism as malignancies. (author).

  3. Benign breast lesions in Bayelsa State, Niger Delta Nigeria: a 5 year multicentre histopathological audit.

    Science.gov (United States)

    Uwaezuoke, Stanley Chibuzo; Udoye, Ezenwa Patrick

    2014-01-01

    There has been no previous study to classify benign breast lesions in details based on histopathologically confirmed diagnosis in Bayelsa State, Nigeria. This study therefore aims to review all cases of benign breast lesions seen in all the three centres in Bayelsa State with histopathology services over a five year period for a comprehensive baseline data in our community for management, research and education. This is a multicentre retrospective descriptive study based on histopathological diagnosed benign breast lesions from January 2009 to December 2013. Archival results and slides on benign breast lesions were retrieved and analysed using simple statistical methods. A total of 228 benign breast lesions (68.3%) were seen among 334 histopathologically diagnosed breast diseases. The male to female ratio was 19.7:1. Peak age incidence was the third decade (43%) with a mean age of 29.1years. Fibroadenoma was the most common benign breast disease (BBD) accounting for 45.6% of all the cases followed by fibrocystic change (23.1%). The mean ages of fibroadenoma and fibrocystic change were 23.1years and 31.1years respectively. Inflammatory breast lesions constituted 8.3%. We recorded only 2 cases (0.9%) of atypical ductal hyperplasia (ADH) with no case of atypical lobular hyperplasia (ALH) within the study period. Gynaecomastia (4%) was the main male breast lesion in the study. Benign breast diseases are the most common breast lesions in Bayelsa State. Fibroadenoma is the most common lesion followed by fibrocystic change. The incidence of atypical hyperplasia recorded was rather low in the state.

  4. Danazol treatment of benign breast disease: a survey of U.S.A. multi-centre studies.

    Science.gov (United States)

    Brookshaw, J D

    1979-01-01

    514 patients with benign breast disease provided records from multicentre studies in the U.S.A. Results showed that a high proportion responded with either decrease or elimination of symptoms, response usually being apparent 15 to 45 days after commencing treatment. Dosage schedules varied between 50 and 400 mg danazol daily and length of treatment between 15 and 196 days. There was a tendency for patients with more severe symptoms to respond better to the higher dosages, and for the elimination rate for all grades of severity to improve with time. Side effects were not severe, and of the expected type including weight gain, oiliness of skin and hair, and acne.

  5. Radiotherapy for the eye - Tolerance issues and therapeutic strategies for benign and malignant problems

    International Nuclear Information System (INIS)

    Brady, Luther W.

    1997-01-01

    In general, there has been a reluctance on the part of radiation oncologists to undertake the responsibilities of treatment of patients with malignant and benign diseases involving the eye and periorbital tissues. With the changing technologies in diagnosis, alternative modalities for treatment as well as the significant impact of computed tomography and magnetic imaging technologies in the management of patients with eye tumors, there has been a resurgence of interest in treating not only malignant but benign ocular diseases. The refresher course will deal with the latest developments in the diagnosis and therapy of retinoblastomas, uveal melanomas, and malignant lymphomas with emphasis on optimization dosimetry as well as treatment planning along with presentation of the utilization of radioactive eye plaques in management of malignant tumors of the eye. The effects and side effects of radiation therapy will be discussed with emphasis on electron beam, photon beam, and plaque irradiation as well as proton beam irradiation of eye diseases with emphasis on minimization of those side effects. The resurgence of interest in treating benign diseases in the eye will be covered with emphasis on the treatment of the wet type of age related macular degeneration. Finally, the course will also cover radiotherapy for other benign conditions such as pterygium, choroidal and retinal hemangiomas

  6. Impact of preventive therapy on the risk of breast cancer among women with benign breast disease.

    Science.gov (United States)

    Cuzick, Jack; Sestak, Ivana; Thorat, Mangesh A

    2015-11-01

    There are three main ways in which women can be identified as being at high risk of breast cancer i) family history of breast and/or ovarian cancer, which includes genetic factors ii) mammographically identified high breast density, and iii) certain types of benign breast disease. The last category is the least common, but in some ways the easiest one for which treatment can be offered, because these women have already entered into the treatment system. The highest risk is seen in women with lobular carcinoma in situ (LCIS), but this is very rare. More common is atypical hyperplasia (AH), which carries a 4-5-fold risk of breast cancer as compared to general population. Even more common is hyperplasia of the usual type and carries a roughly two-fold increased risk. Women with aspirated cysts are also at increased risk of subsequent breast cancer. Tamoxifen has been shown to be particularly effective in preventing subsequent breast cancer in women with AH, with a more than 70% reduction in the P1 trial and a 60% reduction in IBIS-I. The aromatase inhibitors (AIs) also are highly effective for AH and LCIS. There are no published data on the effectiveness of tamoxifen or the AIs for breast cancer prevention in women with hyperplasia of the usual type, or for women with aspirated cysts. Improving diagnostic consistency, breast cancer risk prediction and education of physicians and patients regarding therapeutic prevention in women with benign breast disease may strengthen breast cancer prevention efforts. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. Long-Term Survivors Using Intraoperative Radiotherapy for Recurrent Gynecologic Malignancies

    International Nuclear Information System (INIS)

    Tran, Phuoc T.; Su Zheng; Hara, Wendy; Husain, Amreen; Teng, Nelson; Kapp, Daniel S.

    2007-01-01

    Purpose: To analyze the outcomes of therapy and identify prognostic factors for patients treated with surgery followed by intraoperative radiotherapy (IORT) for gynecologic malignancies at a single institution. Methods and Materials: We performed a retrospective review of 36 consecutive patients treated with IORT to 44 sites with mean follow-up of 50 months. The primary site was the cervix in 47%, endometrium in 31%, vulva in 14%, vagina in 6%, and fallopian tubes in 3%. Previous RT had failed in 72% of patients, and 89% had recurrent disease. Of 38 IORT sessions, 84% included maximal cytoreductive surgery, including 18% exenterations. The mean age was 52 years (range, 30-74), mean tumor size was 5 cm (range, 0.5-12), previous disease-free interval was 32 months (range, 0-177), and mean IORT dose was 1,152 cGy (range, 600-1,750). RT and systemic therapy after IORT were given to 53% and 24% of the cohort, respectively. The outcomes measured were locoregional control (LRC), distant metastasis-free survival (DMFS), disease-specific survival (DSS), and treatment-related complications. Results: The Kaplan-Meier 5-year LRC, DMFS, and DSS probability for the whole group was 44%, 51%, and 47%, respectively. For cervical cancer patients, the Kaplan-Meier 5-year LRC, DMFS, and DSS estimate was 45%, 60%, and 46%, respectively. The prognostic factors found on multivariate analysis (p ≤ 0.05) were the disease-free interval for LRC, tumor size for DMFS, and cervical primary, previous surgery, and locoregional relapse for DSS. Our cohort had 10 Grade 3-4 complications associated with treatment (surgery and IORT) and a Kaplan-Meier 5-year Grade 3-4 complication-free survival rate of 72%. Conclusions: Survival for pelvic recurrence of gynecologic cancer is poor (range, 0-25%). IORT after surgery seems to confer long-term local control in carefully selected patients

  8. Differential diagnosis between benign and malignant pleural effusion with dual-energy spectral CT.

    Science.gov (United States)

    Zhang, Xirong; Duan, Haifeng; Yu, Yong; Ma, Chunling; Ren, Zhanli; Lei, Yuxin; He, Taiping; Zhang, Ming

    2018-01-01

    To investigate the value of spectral CT in the differential diagnosis of benign from malignant pleural effusion. 14 patients with benign pleural effusion and 15 patients with malignant pleural effusion underwent non-contrast spectral CT imaging. These patients were later verified by the combination of disease history, clinical signs and other information with the consensus of surgeons and radiologists. Various Spectral CT image parameters measured for the effusion were as follows: CT numbers of the polychromatic 140kVp images, monochromatic images at 40keV and 100keV, the material density contents from the water, fat and blood-based material decomposition images, the effective atomic number and the spectral curve slope. These values were statistically compared with t test and logistic regression analysis between benign and malignant pleural effusion. The CT value of benign and malignant pleural effusion in the polychromatic 140kVp images showed no differences (12.61±3.39HU vs. 14.71±5.03HU) (P>0.05), however, they were statistically different on the monochromatic images at 40keV (43.15±3.79 vs. 39.42±2.60, p = 0.005) and 100keV (9.11±1.38 vs. 6.52±2.04, p<0.001). There was difference in the effective atomic number value between the benign (7.87±0.08) and malignant pleural effusion (7.90±0.02) (P = 0.02). Using 6.32HU as the threshold for CT value measurement at 100keV, one could obtain sensitivity of 100% and specificity of 66.7% with area-under-curve of 0.843 for differentiating benign from malignant effusion. In addition, age and disease history were potential confounding factors for differentiating malignant pleural effusion from benign, since the older age (61.13±12.51 year-old vs48.57±12.33 year-old) as well as longer disease history (70.00±49.28 day vs.28.36±21.64 day) were more easily to be found in the malignant pleural effusion group than those in the benign pleural effusion group. By combining above five factors, one could obtain sensitivity

  9. Reasons for diagnostic delay in gynecological malignancies

    DEFF Research Database (Denmark)

    Vandborg, Mai Partridge; Christensen, René dePont Christensen; Kragstrup, Jakob

    2011-01-01

    (≤ or > 60 years), performance of gynecological examination by the GP and notification of cancer suspicion on first referral from GP’s on the diagnostic delay (short delay ≤90 days and long delay >90 days). Results Across cancer type a median total delay of 101 days was observed. The 10% of women......Aim The primary aim of this study was to identify and describe different delay types in women with gynecologic cancer, and to analyze the relationship between diagnostic delay and a number of characteristics for patients, cancers and the health care system. Setting A cohort study of women newly......) and The Danish Gynecological Cancer Database (DGCD). 161 women were included; ovarian cancer: 63, endometrial cancer: 50, cervical cancer: 34 and vulvar cancer: 14. Outcome measures were different delay types counted in days and the influence of four clinical important variables: Presence of alarm symptoms, age...

  10. Benign metastasizing leiomyoma in triple location: lungs, parametria and appendix

    Directory of Open Access Journals (Sweden)

    Renata Raś

    2016-07-01

    Full Text Available Benign metastasizing leiomyoma (BML usually are situated in one organ, most often in lungs. BML patients typically have a history of uterine leiomyoma treated with hysterectomy, myomectomy or subtotal hysterectomy. The aim of the study was to present the case of a 53-year-old woman with triple location in the lungs, parametria and appendix. She had undergone a myomectomy 26 years earlier. In 2015, she was admitted to the surgical department because of abdominal pain, whereupon a cholecystectomy was performed. CT scans showed pelvic mass with pulmonary metastasis. Upon discharge the patient was referred to the Gynecology Clinic, where a laparotomy was performed. The intraoperative findings were: 1 uterus with multiple leiomyomas, 2 four tumors in the parametria, 3 tumor connected to the appendix. A subtotal hysterectomy, with a bilateral salpingo-oophorectomy, removal of the tumors from the parametria and appendectomy was performed. Pathology confirmed the diagnosis based on morphology and immunohistochemical staining (strongly positive for estrogen receptors and SMA, while Ki67 was very low, below 1%. Upon postoperative recovery, the patient was referred to the Thoracic Surgery Department. During the thoracotomy, multiple nodes, surrounded by lung parenchyma, were revealed. Wedge resection was performed, for localized pulmonary lesions, and sent for pathological examination. The final pathological diagnosis was benign metastasizing leiomyomatosis. In conclusion, the triple location of BML could possibly be a result of a parallel different metastasizing mechanism, although it is impossible to exclude one mechanism, which may be the cause of the metastases in three locations.

  11. Diagnostic imaging in the staging of gynecologic cancers

    International Nuclear Information System (INIS)

    Forstner, R.; Graf, A.

    1999-01-01

    The prognosis in patients with gynecologic cancers depends not only on the stage but also on a wide spectrum of other findings. Cross-sectional imaging modalities, including sonography, CT and MRI, have increasingly been used for optimal treatment planning in gynecologic cancers. Their staging criteria are based on the well-established FIGO staging system. CT and MRI compete with sonography, which plays a pivotal role in the valuation of the female pelvis. This paper reviews the role of sonography, CT and MRI in the staging of gynecologic malignancies. It puts the emphasis on MRI, which has been established as imaging modality of choice in the preoperative evaluation of cervical and endometrial cancer, and which seems slightly superior to CT in the staging of ovarian cancer. (orig.) [de

  12. [150 cases of vedio-laparoscopic gynecologic surgery].

    Science.gov (United States)

    Liu, Y; Hui, N

    1994-04-01

    From September 1992 to September 1993, 150 patients aged 15-68 years underwent laparoscopic gynecologic surgery. These patients included 63 patients with acute abdominal diseases (46 had ectopic pregnancy, 9 rupture of ovary, and 8 torsion of ovarian cyst), which consisted of 90% of total patients with acute abdomen in corresponding period, 63 patients with mass of adnexa, which made up 72% of total patients with ovarian tumors, and 24 patients with uterine diseases. We successfully performed laparoscopic salpingostomy, fallotomy, removal of ovarian cyst, oophorosalpingectomy, myomectomy and laparoscopy assisted vaginal hysterectomy (LAVH) with 2-4 puncture technic after general anesthesia. The largest ovarian tumor and the enlarged uterus were 14 and 16 cm in diameter respectively. Four patients had laparotomy because of severe pelvic adhesions and the laparotomy rate was about 2.6%. The procedure lasted 20-240 minutes and bleeding was less than 200ml. No major surgical complication was encountered.

  13. Pelvic floor disorders in gynecological malignancies. An overlooked problem?

    Directory of Open Access Journals (Sweden)

    Oana M. Bodean

    2018-04-01

    Full Text Available Cervical, endometrial, ovarian, vulvar, and vaginal cancers affect women of a broad age spectrum. Many of these women are still sexually active when their cancer is diagnosed. Treatment options for gynecological malignancies, such as gynecological surgery, radiation, and chemotherapy, are proven risk factors for pelvic floor dysfunction. The prevalence of urinary incontinence, fecal incontinence, and sexual dysfunction before cancer treatment is still unclear. Hypotheses have been raised in the literature that these manifestations could represent early symptoms of pelvic cancers, but most remain overlooked even in cancer surviving patients. The primary focus of therapy is always cancer eradication, but as oncological and surgical treatment options become more successful, the number of cancer survivors increases. The quality of life of patients with gynecological cancers often remains an underrated subject. Pelvic floor disorders are not consistently reported by patients and are frequently overlooked by many clinicians. In this brief review we discuss the importance of pelvic floor dysfunction in patients with gynecological malignant tumors.

  14. Endometriose intestinal: uma doença benigna? Bowel endometriosis: a benign disease?

    Directory of Open Access Journals (Sweden)

    Marco Antonio Bassi

    2009-01-01

    Full Text Available A despeito do caráter benigno da endometriose, estima-se que 1% dos casos esteja relacionado com câncer, especialmente quando ambas as condições ocorrem nos ovários. Lesões extra-ovarianas encontradas no septo retovaginal, cólon, bexiga, vagina e peritônio da região pélvica também já foram associadas com neoplasias malignas. Várias características do tecido endometrial ectópico o aproximam do fenótipo neoplásico, e a própria endometriose possui comportamento tipicamente neoplásico com capacidade de invasão do estroma adjacente e associação com lesões à distância. Esta revisão atualiza conhecimentos diagnósticos, clínicos e terapêuticos dos implantes intestinais de tecido endometriótico, bem como sua relação com processos neoplásicos para melhor compreensão de seu caráter benigno ou de seu eventual potencial para malignidade.Endometriosis is generally assumed to be a benign disease, but it is estimated that 1% of cases are associated with cancer, especially when both conditions are present in the ovary. Extra-ovarian lesions in the rectovaginal septum, colon, bladder, vagina and peritoneum were already associated with malign neoplasia. Several characteristics of endometrial tissue are very similar to the neoplasia phenotype. Endometriosis itself typically behaves as a neoplasia process, spreading over adjacent stroma and being associated with distant lesions. This is an update on the diagnostic, clinical, and therapeutic knowledge of, management of bowel implants of endometrial tissue, as well as the relation with neoplastic processes to better understand its benign nature or eventual potential for malignancy.

  15. Gynecological cancer in Indonesia.

    Science.gov (United States)

    Aziz, M Farid

    2009-03-01

    To overview the status of gynecologic cancer in Indonesia. Information regarding Indonesia obtained from World Bank Report and Statistical Yearbook of Indonesia 2007, epidemiological data obtained from Histopathological Data of Cancer in Indonesia 2002, Department of Health-Registry Body of Indonesian Specialist of Pathology Association-Indonesian Cancer Society; Various Hospitals in big Cities in Indonesia. Indonesia is an Archipelago with a total area of 1,922,570.00 km(2), the population is 222,192,000 (2006), the fourth world rank. Female is 49.86% with life expectancy 69 years. Gross National Product per Capita is 690.00 USD. Histopathological report in 2002 revealed that cervical cancer, ovarian cancer and uterine cancer were the most frequent cancer among female, which were the first (2,532 cases), the third (829 cases) and the eighth (316 cases) rank respectively. The peak age for cervical, uterine and ovarian cancer was 45-54 years. HPV 16, 18 were found in 82% of invasive cervical. Data from various academic hospitals in 2007 showed that cervical cancer is the most common malignancy followed by ovary, uterus, vulva and vagina. Five-year survival rate of stage I, II, III, IV cervical cancer were 50%, 40%, 20%, and 0% respectively. Overall five-year survival rate of carcinoma of the ovary was 54.8%. If sub-classified by stage, five-year survival rate are 94.3%, 75.0%, 31%, and 11.7% for stage I, II, III, and IV respectively. Five-year disease-free survival rate of endometrial cancer was 71.9%. Indonesia is the biggest Archipelago with a dense population but the income per capita still low (poor country). The most common gynecologic cancer is cervical cancer, followed by ovarian and uterine cancer. These cancers are included in top ten cancers in Indonesia. HPV 16, 18 were the most cause of cervical cancer. The five-year survival rates are comparable with world report.

  16. Late sarcoma development after curettage and bone grafting of benign bone tumors

    International Nuclear Information System (INIS)

    Picci, Piero; Sieberova, Gabriela; Alberghini, Marco; Balladelli, Alba; Vanel, Daniel; Hogendoorn, Pancras C.W.; Mercuri, Mario

    2011-01-01

    Background and aim: Rarely sarcomas develop in previous benign lesions, after a long term disease free interval. We report the experience on these rare cases observed at a single Institution. Patients and methods: 12 cases curetted and grafted, without radiotherapy developed sarcomas, between 1970 and 2005, 6.5-28 years from curettage (median 18, average 19). Age ranged from 13 to 55 years (median 30, average 32) at first diagnosis; tumors were located in the extremities (9 GCT, benign fibrous histiocytoma, ABC, and solitary bone cyst). Radiographic and clinic documentation, for the benign and malignant lesions, were available. Histology was available for 7 benign and all malignant lesions. Results: To fill cavities, autogenous bone was used in 4 cases, allograft in 2, allograft and tricalcium-phosphate/hydroxyapatite in 1, autogenous/allograft in 1, heterogenous in 1. For 3 cases the origin was not reported. Secondary sarcomas, all high grade, were 8 osteosarcoma, 3 malignant fibrous histiocytoma, and 1 fibrosarcoma. Conclusions: Recurrences with progression from benign tumors are possible, but the very long intervals here reported suggest a different cancerogenesis for these sarcomas. This condition is extremely rare accounting for only 0.26% of all malignant bone sarcomas treated in the years 1970-2005 and represents only 8.76% of all secondary bone sarcomas treated in the same years. This incidence is the same as that of sarcomas arising on fibrous dysplasia, and is lower than those arising on bone infarcts or on Paget's disease. This possible event must be considered during follow-up of benign lesions.

  17. Late sarcoma development after curettage and bone grafting of benign bone tumors

    Energy Technology Data Exchange (ETDEWEB)

    Picci, Piero, E-mail: piero.picci@ior.it [Bone Tumor Center, Istituto Ortopedico Rizzoli, Bologna (Italy); Sieberova, Gabriela [Dept. of Pathology, National Cancer Institute, Bratislava (Slovakia); Alberghini, Marco; Balladelli, Alba; Vanel, Daniel [Bone Tumor Center, Istituto Ortopedico Rizzoli, Bologna (Italy); Hogendoorn, Pancras C.W. [Dept. of Pathology, Leiden University Medical Center, Leiden (Netherlands); Mercuri, Mario [Bone Tumor Center, Istituto Ortopedico Rizzoli, Bologna (Italy)

    2011-01-15

    Background and aim: Rarely sarcomas develop in previous benign lesions, after a long term disease free interval. We report the experience on these rare cases observed at a single Institution. Patients and methods: 12 cases curetted and grafted, without radiotherapy developed sarcomas, between 1970 and 2005, 6.5-28 years from curettage (median 18, average 19). Age ranged from 13 to 55 years (median 30, average 32) at first diagnosis; tumors were located in the extremities (9 GCT, benign fibrous histiocytoma, ABC, and solitary bone cyst). Radiographic and clinic documentation, for the benign and malignant lesions, were available. Histology was available for 7 benign and all malignant lesions. Results: To fill cavities, autogenous bone was used in 4 cases, allograft in 2, allograft and tricalcium-phosphate/hydroxyapatite in 1, autogenous/allograft in 1, heterogenous in 1. For 3 cases the origin was not reported. Secondary sarcomas, all high grade, were 8 osteosarcoma, 3 malignant fibrous histiocytoma, and 1 fibrosarcoma. Conclusions: Recurrences with progression from benign tumors are possible, but the very long intervals here reported suggest a different cancerogenesis for these sarcomas. This condition is extremely rare accounting for only 0.26% of all malignant bone sarcomas treated in the years 1970-2005 and represents only 8.76% of all secondary bone sarcomas treated in the same years. This incidence is the same as that of sarcomas arising on fibrous dysplasia, and is lower than those arising on bone infarcts or on Paget's disease. This possible event must be considered during follow-up of benign lesions.

  18. Incidence and risk factors for surgical site infections in obstetric and gynecological surgeries from a teaching hospital in rural India

    Directory of Open Access Journals (Sweden)

    Ashish Pathak

    2017-06-01

    Full Text Available Abstract Background Surgical site infections (SSI are one of the most common healthcare associated infections in the low-middle income countries. Data on incidence and risk factors for SSI following surgeries in general and Obstetric and Gynecological surgeries in particular are scare. This study set out to identify risk factors for SSI in patients undergoing Obstetric and Gynecological surgeries in an Indian rural hospital. Methods Patients who underwent a surgical procedure between September 2010 to February 2013 in the 60-bedded ward of Obstetric and Gynecology department were included. Surveillance for SSI was based on the Centre for Disease Control (CDC definition and methodology. Incidence and risk factors for SSI, including those for specific procedure, were calculated from data collected on daily ward rounds. Results A total of 1173 patients underwent a surgical procedure during the study period. The incidence of SSI in the cohort was 7.84% (95% CI 6.30–9.38. Majority of SSI were superficial. Obstetric surgeries had a lower SSI incidence compared to gynecological surgeries (1.2% versus 10.3% respectively. The risk factors for SSI identified in the multivariate logistic regression model were age (OR 1.03, vaginal examination (OR 1.31; presence of vaginal discharge (OR 4.04; medical disease (OR 5.76; American Society of Anesthesia score greater than 3 (OR 12.8; concurrent surgical procedure (OR 3.26; each increase in hour of surgery, after the first hour, doubled the risk of SSI; inappropriate antibiotic prophylaxis increased the risk of SSI by nearly 5 times. Each day increase in stay in the hospital after the surgery increased the risk of contacting an SSI by 5%. Conclusions Incidence and risk factors from prospective SSI surveillance can be reported simultaneously for the Obstetric and Gynecological surgeries and can be part of routine practice in resource-constrained settings. The incidence of SSI was lower for Obstetric surgeries

  19. Scientific research in obstetrics and gynecology: changes in the trends over three decades.

    Science.gov (United States)

    Kassem, Gamal A

    2015-01-01

    The aim of this work was to assess scientific research of master's and doctoral theses and essays in the Department of Obstetrics and Gynecology, Zagazig University, Egypt. All master's and doctoral theses and essays since the foundation of Department of Obstetrics and Gynecology, Zagazig University, Egypt, in 1975 till end of 2012 were reviewed. A total of 703 theses and essays were reviewed. The important topics in the specialty of obstetrics and gynecology were covered and updated. Infertility, in vitro fertilization-embryo transfer (IVF-ET) and related techniques, and polycystic ovarian disease were the most common gynecologic topics (27.2%), followed by gynecologic oncology (18.5%). Preeclampsia was the most common obstetrics topic (18.8%), followed by issues of high-risk pregnancy, fetal growth restriction, and fetal well-being (11.6%). The number of researches that allow the candidates to learn skills was 183 and it was increased from 4.4% of all research in the period 1979-1988 to 33.2% in period 1989-2000 then slightly decreased to 31.2% in period 2001-2012. Ultrasonography was on the top and was present in 99 out of 183 (54.1%) followed by laparoscopy (30, 16.4%), hysteroscopy (25, 13.7%), IVF-ET and related techniques (16, 8.7%) and colposcopy (13, 7.1%) researches. Multi-disciplinary research was decreased by 61.7% in the period 2001-2012. Researches in academic fields were abandoned and in some clinically important areas like preeclampsia were decreased. Scientific research of master's and doctoral theses and essays was comprehensive, updated, and had some autonomy independent of plans. Research which enable the candidate to learn skills were increased on the expense of academic, clinical and multidisciplinary research. It could be recommended that plans for scientific research should be flexible and should leave a space for local departmental views. Proper training of residents during their rotation in these subspecialties may help to revive the lost

  20. Guideline for radioiodine therapy for benign thyroid diseases (version 3)

    Energy Technology Data Exchange (ETDEWEB)

    Dietlein, M.; Schicha, H. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. zu Koeln (Germany); Dressler, J. [Nuklearmedizinische Klinik der Henriettenstiftung, Hannover (Germany); Gruenwald, F. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Frankfurt (Germany); Leisner, B. [Abt. fuer Nuklearmedizin des Allg. Krankenhauses St. Georg, Hamburg (Germany); Moser, E. [Abt. fuer Nuklearmedizin der Radiologischen Universitaetsklinik Freiburg (Germany); Reiners, C.; Schneider, P. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Wuerzburg (Germany); Schober, O. [Klinik und Poliklinik fuer Nuklearmedizin der Univ. Muenster (Germany)

    2004-12-01

    The version 3 of the guideline for radioiodine therapy for benign thyroid diseases presents first of all a revision of the version 2. The chapter indication for radioiodine therapy, surgical treatment or antithyroid drugs bases on an interdisciplinary consensus. The manifold criteria for decision making consider the entity of thyroid disease (autonomy, Graves' disease, goitre, goitre recurrence), the thyroid volume, suspicion of malignancy, cystic nodules, risk of surgery and co-morbidity, history of subtotal thyroidectomy, persistent or recurrent thyrotoxicosis caused by Graves' disease including known risk factors for relapse, compression of the trachea caused by goitre, requirement of direct therapeutic effect as well as the patient's preference. Because often some of these criteria are relevant, the guideline offers the necessary flexibility for individual decisions. Further topics are patients' preparation, counseling, dosage concepts, procedural details, results, side effects and follow-up care. The prophylactic use of glucocorticoids during radioiodine therapy in patients without preexisting ophthalmopathy as well as dosage and duration of glucocorticoid medication in patients with preexisting ophthalmopathy need to be clarified in further studies. The pragmatic recommendations for the combined use of radioiodine and glucocorticoids remained unchanged in the 3{sup rd} version. (orig.) [German] Die Version 3 der Leitlinie zur Radioiodtherapie (RIT) bei benignen Schilddruesenerkrankungen stellt im Wesentlichen eine redaktionelle Ueberarbeitung der Version 2 dar. Im Kapitel Indikation und Empfehlungen fuer eine Radioiodtherapie, eine Operation oder eine thyreostatische Therapie bei gutartigen Schilddruesenerkrankungen basiert die Leitlinie auf einem interdisziplinaer abgestimmten Konzept. Die Entscheidungskriterien sind multifaktoriell und beruecksichtigen die Art der Schilddruesenerkrankung (Autonomie, Morbus Basedow, Struma, Rezidivstruma

  1. Challenges associated with the management of gynecological cancers in a tertiary hospital in South East Nigeria

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    Iyoke CA

    2014-01-01

    Full Text Available Chukwuemeka Anthony Iyoke,1 George Onyemaechi Ugwu,1 Euzebus Chinonye Ezugwu,1 Frank Okechukwu Ezugwu,2 Osaheni Lucky Lawani,3 Azubuike Kanayo Onyebuchi3 1Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, 2Department of Obstetrics and Gynaecology, Enugu State University Teaching Hospital, Park Lane, Enugu, 3Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria Background: There are reports of increasing incidence of gynecological cancers in developing countries and this trend increases the need for more attention to gynecological cancer care in these countries. Objective: The purpose of this study was to describe the presentation and treatment of gynecological cancers and identify barriers to successful gynecological cancer treatment in a tertiary hospital in South East Nigeria. Methods: This study was a retrospective longitudinal analysis of the presentation and treatment of histologically diagnosed primary gynecological cancers from 2000 to 2010. Analysis was by descriptive and inferential statistics at the 95% level of confidence using Statistical Package for the Social Sciences version 17 software. Results: Records of 200 gynecological cancers managed during the study period were analyzed. Over 94% of cervical cancers presented in advanced stages of the disease and received palliative/symptomatic treatment. Only 1.9% of cervical cancer patients had radical surgical intervention, and postoperative mortality from these radical surgeries was 100%. Approximately 76% of patients with ovarian cancer had debulking surgery as the mainstay of treatment followed by adjuvant chemotherapy. Postoperative mortality from ovarian cancer surgery was 63%. Cutting edge cytotoxic drugs were not used as chemotherapy for ovarian and chorionic cancers. Compliance with chemotherapy was poor, with over 70% of ovarian cancer patients failing to complete the

  2. Clinical Impact of Re-irradiation with Carbon-ion Radiotherapy for Lymph Node Recurrence of Gynecological Cancers.

    Science.gov (United States)

    Shiba, Shintaro; Okonogi, Noriyuki; Kato, Shingo; Wakatsuki, Masaru; Kobayashi, Daijiro; Kiyohara, Hiroki; Ohno, Tatsuya; Karasawa, Kumiko; Nakano, Takashi; Kamada, Tadashi

    2017-10-01

    To evaluate the safety and efficacy of re-irradiation with carbon-ion radiotherapy (C-ion RT) for lymph node recurrence of gynecological cancers after definitive radiotherapy. Data regarding patients with unresectable and isolated recurrent lymph node from gynecological cancer after definitive radiotherapy were analyzed. Total dose of C-ion RT was 48-57.6 Gy (RBE) in 12 or 16 fractions. Sixteen patients received re-irradiation by C-ion RT were analyzed. Median follow-up was 37 months. Median tumor size was 27 mm. None developed Grade 1 or higher acute toxicities and Grade 3 or higher late toxicities. The 3-year overall survival, local control and disease-free survival rates after C-ion RT were 74%, 94% and 55%, respectively. Re-irradiation with C-ion RT for lymph node recurrence of gynecological cancers after definitive radiotherapy can be safe and effective. This result suggested that C-ion RT could be a curative treatment option for conventionally difficult-to-cure patients. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  3. Chronic Subdural Hematoma in Elderly Patients: Is This Disease Benign?

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    Uno, Masaaki; Toi, Hiroyuki; Hirai, Satoshi

    2017-08-15

    As the world population becomes progressively older, the overall incidence of chronic subdural hematoma (CSDH) is increasing. Peak age of onset for CSDH has also increased, and recently the 80-year-old level has a peak. Many patients with CSDH have had prior treatment with anticoagulants and antiplatelet drugs, which have an accompanying risk of CSDH. In elderly patients with CSDH, symptoms of cognitive change (memory disturbance, urinary incontinence, and decreased activity) and disturbance of consciousness at admission were more frequent compared to younger patients with CSDH. The literature actually offers conflicting advice regarding CSDH treatment; however, burr hole surgery with drainage under local anesthesia is the most common surgical procedure, even in elderly patients. The recurrence rate of CSDH has not decreased over recent decades, and it has ranged from 0.36-33.3%. Outcomes in patients over 75 years old was significantly worse than for those younger than 75. Moreover, long-term outcomes for elderly patients with CSDH are poor. CSDH in the elderly is no longer a benign disease. In the future, it will be important for us to understand the mechanisms of onset and recurrence of CSDH and to develop more effective medical treatments and noninvasive surgical techniques for elderly patients.

  4. CLINICO PATHOLOGICAL STUDY OF BENIGN BREAST LUMP – A HOSPITAL BASED STUDY

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    Anindita

    2016-03-01

    Full Text Available BACKGROUND Despite the fact that in majority of cases the initial symptom of benign breast disease is a lump, which can be easily detected by the patient herself by self-examination they generally present at a very late stage and this poses a great difficulty in their management. Early and appropriate diagnosis of breast disease is of utmost importance. AIM The aim of the study was to find out the relative frequency and commonest site of occurrence of benign breast disorder and their relationship with age, parity, menstrual cycle, and socio-economic status and also to find out the accuracy of investigative procedures in their diagnosis. DESIGN This is a cross sectional, interventional. Hospital based study. MATERIALS AND METHOD This study was done in 58 female patients in the age group 10 yrs. to 55 yrs. presenting with clinically benign breast lumps randomly chosen from outpatient department and indoor wards of The Calcutta Medical Research Institute, Kolkata. After taking an accurate history and proper clinical examination these patients were sequentially studied by radiological methods (Ultrasonography and mammography, fine needle aspiration cytology (FNAC and histopathology of removed specimen. Patients were enquired about their age, chief complaints, menstrual history, and use of oral pill, marital status, parity, lactation and socioeconomic status. RESULTS 79% of the benign breast lumps were found to be between 10–35 years, Fibro adenoma being the commonest one (41.38% and fibrocystic disease the second most common (29.31%. Breast lump were more common among unmarried and nulliparous females (48.27%, commonest site being upper and outer quadrant (38.8%. 69% patients were associated with an abnormal menstrual status. 76% of the cases were accurately diagnosed by clinical examination, 70% by mammography, 88% by FNAC and 84% by ultrasonography. CONCLUSION This clinicopathological study of benign breast lump is a small endeavour on our part

  5. Medical prescription adherence among patient visiting gynecology department

    International Nuclear Information System (INIS)

    Rafique, M.; Arshad, H.; Tabassum, H.; Khan, N. U. S.; Qamar, K.

    2017-01-01

    Objective: The aim of this study was to explore the level of Medical prescription adherence among gynecological patients of Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: The study was conducted in Punjab province and data were collected from June 2015 to April 2016. Material and Methods: This cross-sectional study was carried out in main cities of Punjab province of Pakistan; Lahore, Gujranwala, Faisalabad and Sheikhupura. The survey data was collected from different location of cities. Patients visiting the gynecological and going to chemists for getting the prescribed medicine were selected through probability based random sampling for this study. The questionnaire consisted on the extent to which they adhere to time, dose, frequency and procedure prescribed from their doctors. The questions were asked in native language (Urdu). The data analysis was performed by using SPSS software (Ver.21). Results: Results of this study, based on sample from four big cities of Punjab province of Pakistan, showed that the level of medical prescription was associated with the age, qualification and background of the patients. Adherence level of patients reporting with rural background was observed higher than the adherence level of patients from urban areas. Conclusion: Over all the patient require counseling regarding adherence to medical prescription irrespective of the nature of the disease. (author)

  6. Sexuality in gynecological patients undergoing radiation therapy treatments

    International Nuclear Information System (INIS)

    Dolan, M.E.

    1987-01-01

    The gynecology patient undergoing radiation therapy treatments may experience physiological and psychological problems related to sexuality. The needs of this group must be met by the radiation oncology staff by their being informed, interested, and experienced in dealing with sexual problems created by radiation therapy treatments. Opportunities to obtain information and for discussion about how the disease and its treatments will affect sexual functioning must be provided for the patient and partner. It is important to remember that the ability to seek and preserve gratifying sexual function is of great importance to almost all women, regardless of age. The patient may feel much personal distress related to the disease, the treatments, and how they affect the way she feels as a sexual human being. Opportunities must be provided to share the feelings created by the treatment process and trained therapists should be available when intensive sexual counseling is needed

  7. Caveolin-1 expression in benign and malignant lesions of the breast

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    Kiesel Ludwig

    2007-10-01

    Full Text Available Abstract Background Caveolin-1 is thought to have an important impact on both signal transduction and mediation of intracellular processes. Furthermore, it has been suggested that Caveolin-1 may contribute to certain steps of carcinogenesis in various types of cancer. We examined the potential clinical relevance of Caveolin-1 in normal, benign and malignant breast tissue specimens. Methods Using tissue microarray (TMA technology cases of invasive breast cancer, DCIS, benign breast disease (i.e. fibroadenoma, sclerosing adenosis, ductal hyperplasia and radial scar and normal breast tissue were evaluated for Caveolin-1 expression. Immunohistochemical staining with an anti-Caveolin-1-antibody was performed. Staining intensity was quantified semiquantitatively. In invasive lesions staining results were correlated with clinical and pathological data. Results No Caveolin-1 expression was observed in epithelial cells of normal breast tissue (n = 5, benign breast disease (n = 295 and DCIS (n = 108. However, Caveolin-1 expression was found in 32 of 109 cases of invasive breast carcinomas (29.4%. Caveolin-1 expression in invasive breast cancer could neither be correlated with survival parameters such as overall or disease-free survival nor with established clinical and pathological markers. Conclusion In this study we demonstrated expression of Caveolin-1 in one third of invasive breast cancers. A significant increase in Caveolin-1 expression was observed comparing invasive breast cancer to both benign breast tissue and non-invasive breast cancer. Since inhibitors of Caveolin-1 signalling are available, targeting Caveolin-1 in breast cancer may represent a potential option for future breast cancer treatment.

  8. FDG-PET Assessment of Other Gynecologic Cancers.

    Science.gov (United States)

    Faria, Silvana; Devine, Catherine; Viswanathan, Chitra; Javadi, Sanaz; Korivi, Brinda Rao; Bhosale, Priya R

    2018-04-01

    PET and PET/computed tomography play a role in the staging, monitoring of response to therapy, and surveillance for cervical and ovarian cancers. Currently, it is also an integral part of the assessment of patients with endometrial cancer and other gynecologic malignancies, such as vaginal and vulvar cancers and uterine sarcomas. In this article, we discuss in detail and highlight the potential role of PET and PET/computed tomography in evaluating these gynecologic malignancies using illustrative cases with relevant imaging findings. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Robotics in Gynecology: Why is this Technology Worth pursuing?

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    Rodrigo Ayala-Yáñez

    2013-01-01

    Full Text Available Robotic laparoscopy in gynecology, which started in 2005 when the Da Vinci Surgical System (Intuitive Surgical Inc was approved by the US Food and Drug Administration for use in gynecologic procedures, represents today a modern, safe, and precise approach to pathology in this field. Since then, a great deal of experience has accumulated, and it has been shown that there is almost no gynecological surgery that cannot be approached with this technology, namely hysterectomy, myomectomy, sacrocolpopexia, and surgery for the treatment of endometriosis. Albeit no advantages have been observed over conventional laparoscopy and some open surgical procedures, robotics do seem to be advantageous in highly complicated procedures when extensive dissection and proper anatomy reestablishment is required, as in the case of oncologic surgery. There is no doubt that implementation of better logistics in finance, training, design, and application will exert a positive effect upon robotics expansion in gynecological medicine. Contrary to expectations, we estimate that a special impact is to be seen in emerging countries where novel technologies have resulted in benefits in the organization of health care systems.

  10. Immunotherapy in Gynecologic Cancers: Are We There Yet?

    Science.gov (United States)

    Pakish, Janelle B; Jazaeri, Amir A

    2017-08-24

    Immune-targeted therapies have demonstrated durable responses in many tumor types with limited treatment options and poor overall prognosis. This has led to enthusiasm for expanding such therapies to other tumor types including gynecologic malignancies. The use of immunotherapy in gynecologic malignancies is in the early stages and is an active area of ongoing clinical research. Both cancer vaccines and immune checkpoint inhibitor therapy continue to be extensively studied in gynecologic malignancies. Immune checkpoint inhibitors, in particular, hold promising potential in specific subsets of endometrial cancer that express microsatellite instability. The key to successful treatment with immunotherapy involves identification of the subgroup of patients that will derive benefit. The number of ongoing trials in cervical, ovarian, and endometrial cancer will help to recognize these patients and make treatment more directed. Additionally, a number of studies are combining immunotherapy with standard treatment options and will help to determine combinations that will enhance responses to standard therapy. Overall, there is much enthusiasm for immunotherapy approaches in gynecologic malignancies. However, the emerging data shows that with the exception of microsatellite unstable tumors, the use of single-agent immune checkpoint inhibitors is associated with response rates of 10-15%. More effective and likely combinatorial approaches are needed and will be informed by the findings of ongoing trials.

  11. PREIMPLANTATION GENETIC DIAGNOSIS – 4 YEARS’ EXPERIENCE AT THE DEPARTMENT OF GYNECOLOGY, UNIVERSITY MEDICAL CENTRE LJUBLJANA

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    Karin Writzl

    2018-02-01

    Full Text Available Background. Preimplantation genetic diagnosis offers early investigation of embryos in couples with a high risk for offspring affected by a genetic disease. We report indications and results associated with the PGD program conducted at Gynecology Clinic Ljubljana from June 2004 to December 2008. Methods. The retrospective analysis includes sixty cycles performed in 34 couples enrolled in the PGD programe. Embryos were biopsied on the third day and the genetic analysis was performed using the FISH and PCR methods. Embryo transfers were carried out on the fifth day. Results. The main indications were chromosomal abnormalities (67 %, followed by recurrent miscarriages (16 %, autosomal dominant and recessive diseases (9 %, and X-linked diseases (6 %. Sixty cycles were performed and 48 embryo transfer procedures. There were 15 clinical pregnancies resulting in clinical pregnancy rate 25 % per cycle and 37.5 % per embryo transfer. A total of eight unaffected children were born, and two pregnancies are still ongoing. Conclusions. PGD is technically a very challenging procedure. Superior knowledge and communication between geneticists and reproductive medicine scientists is mandatory for successful PGD procedures. PGD has gained a place among the choices offered at Gynecology Clinic Ljubljana to couples at risk of transmission of genetic disease.

  12. Radioimmunological detection of the tumor marker CA 12-5 in the serum of patients with benign and malignant pleural effusions

    International Nuclear Information System (INIS)

    Scherer, J.H.; Krause, F.J.; Geier, G.

    1988-01-01

    In 44 patients with benign diseases and 16 patients with malignant diseases the tumour associated antigen CA 12-5 was determined in sera and pleural effusions. In 97% of the investigated pleural effusions and in 89% of the investigated sera we found pathologically elevated CA 12-5-concentrations. It could be shown, that the determination of CA 12-5 in sera of patients with pleural effusions does not permit to discriminate between benign and malignant origin, because there is no significant difference of the CA 12-5-concentrations between patient sera with benign diseases and patient sera with malignant diseases, when they have pleural effusions. (orig.) [de

  13. Ectopic pregnancy: a life-threatening gynecological emergency

    Directory of Open Access Journals (Sweden)

    Lawani OL

    2013-08-01

    Full Text Available Osaheni L Lawani, Okechukwu B Anozie, Paul O Ezeonu Department of Obstetrics and Gynecology, Federal Teaching Hospital, Abakaliki, Nigeria Background: Ectopic pregnancy is a life-threatening gynecological emergency, and a significant cause of maternal morbidity and mortality in Nigeria. Objective: The aim of this work was to determine and evaluate the incidence, clinical presentation, risk factors, and management outcomes of ectopic pregnancies at Ebonyi State University Teaching Hospital (EBSUTH in Abakaliki. Methods: This was a retrospective, descriptive study of ectopic pregnancies managed in EBSUTH during the study period (June 1, 2002 to May 31, 2012. The medical records of the patients managed for ectopic pregnancy as well as the total birth record and gynecological admission records during the period under review were retrieved, and data were collected with the aid of data-entry forms designed for this purpose. There were 4,610 gynecological admissions and 9,828 deliveries, with 215 cases of ectopic pregnancies. A total of 205 cases were suitable for analysis after excluding cases with incomplete records. The relevant data collected were analyzed with SPSS version 15.0 for Windows. Results: Ectopic pregnancy constituted 4.5% of all gynecological admissions, and its incidence was 2.1%. The mean age of the patients was 27 ± 2 years, 196 of 205 (95.6% had ruptured ectopic pregnancies, and the remaining nine (4.4% were unruptured. The commonest (166 of 205, 80.0% clinical presentation was abdominal pain, and the commonest (105 of 205, 51.2% identified risk factor was a previous history of induced abortion. Three deaths were recorded, giving a case-fatality rate of 1.4% (three of 205. Conclusion: Ectopic pregnancy is a recognized cause of maternal morbidity and mortality and has remained a reproductive health challenge to Nigerian women, as well as a threat to efforts in achieving the UN's Millennium Development Goal 5 in sub-Saharan Africa

  14. [Benign Metastasizing Leiomyoma of the Lung;Report of a Case].

    Science.gov (United States)

    Sawada, Takahiro; Yamamoto, Satoshi; Sugihara, Hajime; Iwasaki, Akinori

    2017-02-01

    A 71-year-old woman, in whom computed tomography revealed a solitary mass shadow at the base of the left lung, underwent resection of the mass. Histopathological examination showed estrogen receptor-positive leiomyoma cells growing in cords and mixed with glandular structures composed of alveolar cells. These findings led to a diagnosis of benign metastatic leiomyoma. Benign metastatic leiomyoma is a rare disease in which histologically benign uterine leiomyoma cells metastasize to different sites of the body. However, in this patient, the presence of uterine myoma was not confirmed in the past or at present. She had a history of cervical conization, which suggests that a small amount of the leiomyoma component contained in cervical tissue may have been forced into blood vessels during surgical manipulation, causing lung metastasis.

  15. Assessing the safety and efficacy of combined abdominoplasty and gynecologic surgery.

    Science.gov (United States)

    Sinno, Sammy; Shah, Samir; Kenton, Kimberly; Brubaker, Linda; Angelats, Juan; Vandevender, Darl; Cimino, Victor

    2011-09-01

    Combined surgery is an attractive option for both patients and surgeons. Unfortunately, it remains unclear to patients whether plastic surgery can be combined safely and efficaciously with other surgeries, particularly gynecologic surgery. The goal of this study was to determine the safety and efficacy of combined abdominoplasty and gynecologic surgery. A case-control study of 25 patients undergoing combined abdominoplasty and intra-abdominal gynecologic surgery was performed. These combined patients were compared with control group patients undergoing abdominoplasty alone and gynecologic surgery alone. Demographic data, operative time, estimated blood loss, pre- and postoperative hemoglobin, length of hospitalization, and complications were compared between combined and control groups. Statistically significant reductions were seen in operative time, estimated blood loss, and total days of hospitalization when comparing the combined group to the sum of the control groups. In this study, no major complications, including the need for blood transfusion or pulmonary embolus, were noted in any of the patients. These results demonstrate success in performing abdominoplasty with gynecologic surgery, which may be an acceptable option for patients.

  16. Sexuality, intimacy, and gynecological cancer

    NARCIS (Netherlands)

    Weijmar Schultz, W.C.M.; van de Wiel, H.B.M.

    2003-01-01

    On a psychological level, not all changes in sexual functioning following gynecological cancer treatment automatically lead to sexual problems or dysfunctions. Whether sexual dissatisfaction occurs will also depend on personal factors, social factors, and the context in which these negative changes

  17. Gynecologic examination and cervical biopsies after (chemo) radiation for cervical cancer to identify patients eligible for salvage surgery

    NARCIS (Netherlands)

    Nijhuis, Esther R.; van der Zee, Ate G. J.; In 't Hout, Bertha A.; Boomgaard, Jantine J.; de Hullu, Joanne A.; Pras, Elisabeth; Hollema, Harry; Aalders, Jan G.; Jijman, Hans W.; Willemse, Pax H. B.; Mourits, Marian J. E.

    2006-01-01

    Purpose: The aim of this study was to evaluate efficacy of gynecologic examination under general anesthesia with cervical biopsies after (chemo) radiation for cervical cancer to identify patients with residual disease who may benefit from salvage surgery. Methods and Materials: In a retrospective

  18. Gynecologic examination and cervical biopsies after (chemo) radiation for cervical cancer to identify patients eligible for salvage surgery.

    NARCIS (Netherlands)

    Nijhuis, E.R.; Zee, A.G. van der; Hout, B.A. van; Boomgaard, J.J.; Hullu, J.A. de; Pras, E.; Hollema, H.; Aalders, J.G.; Nijman, H.W.; Willemse, P.H.B.; Mourits, M.J.E.

    2006-01-01

    PURPOSE: The aim of this study was to evaluate efficacy of gynecologic examination under general anesthesia with cervical biopsies after (chemo) radiation for cervical cancer to identify patients with residual disease who may benefit from salvage surgery. METHODS AND MATERIALS: In a retrospective

  19. A new method for analyzing diagnostic delay in gynecological cancer

    DEFF Research Database (Denmark)

    Vandborg, Mai Partridge; Edwards, Kasper; Kragtrup, Jakob

    2012-01-01

    AND METHODS: Six women with a diagnostic delay of 6 weeks or more before treatment of gynecological cancer at a specialized regional department (the Department of Gynecology and Obstetrics, Odense University Hospital, Denmark) were included in the study. Maps of existing processes were performed for each...

  20. A New Method for Analyzing Diagnostic Delay in Gynecological Cancer

    DEFF Research Database (Denmark)

    Vandborg, Mai Partridge; Edwards, Kasper; Kragstrup, Jakob

    2012-01-01

    AND METHODS: Six women with a diagnostic delay of 6 weeks or more before treatment of gynecological cancer at a specialized regional department (the Department of Gynecology and Obstetrics, Odense University Hospital, Denmark) were included in the study. Maps of existing processes were performed for each...

  1. Comparison of the composition of bile acids in bile of patients with adenocarcinoma of the pancreas and benign disease.

    Science.gov (United States)

    Rees, David O; Crick, Peter J; Jenkins, Gareth J; Wang, Yuqin; Griffiths, William J; Brown, Tim H; Al-Sarireh, Bilal

    2017-11-01

    Bile acids have been implicated in the development of gastrointestinal malignancies. Both the specific nature of individual bile acids and their concentration appear key factors in the carcinogenic potency of bile. Using liquid chromatography mass spectrometry (LC-MS) we performed quantitative profiling of bile extracted directly from the common bile duct in 30 patients (15 patients with pancreatic cancer and 15 patients with benign disease). Separation and detection of bile acids was performed using a 1.7μm particle size reversed-phase C 18 LC column at a flow rate of 200μL/min with negative electrospray ionization MS. A significant difference (p=0.018) was seen in the concentration of unconjugated cholic acid in the malignant group (0.643mmol/L) compared to the benign group (0.022mmol/L), with an overall significant difference (p=0.04) seen in the level of total unconjugated bile acids in the malignant group (1.816mmol/L) compared to the benign group (0.069mmol/L). This finding may offer the possibility of both understanding the biology of cancer development in the pancreas, as well as offering a potential diagnostic avenue to explore. However, a larger study is necessary to confirm the alterations in bile acid profiles reported here and explore factors such as diet and microbial populations on the bile acid profiles of these patient groups. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  2. Modulation of inflammation by low and high doses of ionizing radiation: Implications for benign and malign diseases.

    Science.gov (United States)

    Frey, Benjamin; Hehlgans, Stephanie; Rödel, Franz; Gaipl, Udo S

    2015-11-28

    Inflammation is a homeostatic mechanism aiming to maintain tissue integrity. The underlying immunological mechanisms and the interrelationship between ionizing radiation and inflammation are complex and multifactorial on cellular and chemical levels. On the one hand, radiation with single doses exceeding 1 Gy might initiate inflammatory reactions and thereby impact on tumor development. On the other hand, radiation is capable of attenuating an established inflammatory process, which is clinically used for the treatment of inflammatory and degenerative diseases with low-dose radiotherapy (single dose modulates inflammatory events in benign inflammatory and in malign diseases. A special focus is set on the role of tumor infiltrating lymphocytes and macrophages as biomarkers to predict treatment response and anti-tumor immunity and on mechanisms implicated in the anti-inflammatory effects of low-dose radiation therapy. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. Significance of isolated vasculitis in the gynecological tract: what clinicians do with the pathologic diagnosis of vasculitis?

    Science.gov (United States)

    Roma, Andres A; Amador-Ortiz, Catalina; Liapis, Helen

    2014-08-01

    Vasculitides includes a heterogeneous group of disorders with the common histologic findings of vascular wall inflammation. Systemic or localized disease (eg, renal vasculitis) has serious consequences. The incidence of isolated gynecologic vasculitis diagnosed on pathology specimens and its significance is little known. We performed a 20 year retrospective review including 53 cases with vasculitis diagnosis affecting the female genital tract identified in pathology reports. None had prior symptoms or were diagnosed with generalized vasculitis, while one patient had prior diagnosis of fibromyalgia. Most patients presented with abnormal bleeding and were treated for conditions unrelated to vasculitis. The different types of vasculitis were: predominantly lymphocytic (nonspecific) 30 cases, necrotizing 17 cases and granulomatous 6 cases. Only 2 patients had additional serologic tests. None of the patients with isolated gynecologic vasculitis received corticosteroids or additional treatment related to the vasculitis. None of the patients developed systemic vasculitis at follow-up (2 months-19.5 years; mean, 5.5 years). Isolated gynecologic vasculitis diagnosed on pathology slides is rarely associated with systemic vasculitis. Potential isolated gynecologic vasculitis causes include: previous surgical interventions and vascular inflammation secondary to local neoplasm. In almost all cases, clinicians did not perform a thorough laboratory analysis to exclude systemic vasculitis and therapy was not required in any case, suggesting minimal clinical significance. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. [Endometriosis Update 2016].

    Science.gov (United States)

    Imesch, Patrick; Fink, Daniel

    2016-03-02

    Endometriosis is a common gynecologic benign disease, affecting 6–10% of women of reproductive age. The disease is often associated with dysmenorrhea, dyspareunia, chronic pelvic pain and infertility. The exact mechanism of the pathogenesis of endometriosis has not yet been fully elucidated, therefore, current medical therapeutic options are more symptom-oriented than causal. The aim of the present work is to summarize the current diagnostic and therapeutic options.

  5. Plasminogen and angiostatin levels in female benign breast lesions

    Directory of Open Access Journals (Sweden)

    A. A. Tykhomyrov

    2015-10-01

    Full Text Available It is known that benign breast tissue exhibit relatively low angiogenic capacity. Activation of angiogenesis in mammary pre-malignant lesions could be associated with disease progression and high risk of transformation into the breast cancer. However, insight into the underlying molecular mechanisms involved in angiogenesis regulation in non-cancerous breast pathologies is still poorly defined. The purpose of the present study was to determine levels of plasminogen and its proteolytic fragments (angiostatins in mammary dysplasia (mastopathy and breast cyst and benign neoplasms (fibroadenomas. Plasminogen and angiostatins were analyzed using immunoblotting and quantified by densitometric scanning. The significant increase in plasminogen levels was found in fibrocystic, cysts, and non-proliferatious fibroadenoma masses (4.7-, 3.7-, and 3.5-fold, respectively compared to healthy breast tissues (control. In the same benign lesions, 6.7-, 4-, and 3.7-fold increase in plasminogen 50 kDa fragment (angiostatin levels as compared with control were also observed. Activation of matrix metalloproteinase-9, which was detected using gelatine zymography, could be responsible for plasminogen cleavage and abundance of angiostatin in fibrocystic and cyst masses. In contrast, dramatic decrease of both plasminogen and angiostatin levels (3.8- and 5.3-folds, respectively was shown in tissues of proliferatious form of fibroadenoma in comparison with that of the dormant type of this neoplasm. Based on the obtained results, we concluded that angiostatin, a potent vessel growth inhibitor and anti-inflammatory molecule, can play a crucial role in pathophysiology of non-cancerous breast diseases. Further studies are needed to evaluate potential diagnostic and clinical implications of these proteins for prediction and therapy of benign breast pathologies.

  6. Therapy: a new nonsurgical therapy option for benign thyroid nodules?

    DEFF Research Database (Denmark)

    Hegedüs, Laszlo

    2009-01-01

    Despite the increasing implementation of iodization programs, benign nodular thyroid disease will remain a prevalent therapeutic concern for decades. recent research suggests that nonsurgical therapy, including radioactive iodine, radiofrequency thermal ablation and percutaneous laser ablation, m...

  7. Expression of c-kit in common benign and malignant breast lesions.

    Science.gov (United States)

    Kondi-Pafiti, Agatha; Arkadopoulos, Nikolaos; Gennatas, Constantinos; Michalaki, Vassiliki; Frangou-Plegmenou, Matrona; Chatzipantelis, Paschalis

    2010-01-01

    c-kit (CD117) is a transmembrane tyrosine kinase that acts as a type III receptor for mast cell growth factor. In recent years, the role of c-kit in the development of preinvasive and invasive breast carcinomas has been investigated. The aim of our study was to detect c-kit expression in the entire spectrum of common benign and malignant breast lesions in correlation with a well-studied myoepithelial or stem-cell like marker (p63). We evaluated 270 cases of benign and malignant breast lesions including fibrocystic disease, fibroadenoma, sclerosing adenosis, atypical ductal hyperplasia, ductal/lobular carcinoma in situ, and ductal/lobular/mixed type carcinoma. C-kit staining was evaluated in the cytoplasm/cell membrane in epithelial and myoepithelial cells and p63 in the nuclei of myoepithelial cells. c-kit was highly expressed (85.3%) in benign lesions (fibrocystic disease, sclerosing adenosis, fibroadenoma), and p63 expression was 95.5% in the aforementioned lesions. c-kit distribution in preinvasive and invasive lesions was as follows: ductal/lobular carcinoma in-situ, 43%/35%; ductal/lobular carcinoma, 36%/39%; and mixed type carcinoma, 20%. c-kit was highly expressed in myofibroblast/fibroblast cells only in grade III ductal/lobular carcinomas. c-kit was totally absent in stromal cells in benign lesions and in situ carcinomas whereas expression was weak in grade I and II carcinomas. Combined overexpression of c-kit and p63 is indicative of benign breast lesions. In contrast, there is reduced expression of c-kit in in situ and invasive breast carcinomas, with simultaneous overexpression in the stromal cells. This suggests that c-kit may play a role in breast cancer progression.

  8. [Japanese who affected modern medicine in Taiwan: obstetrics and gynecology].

    Science.gov (United States)

    Wang, Ming-Tung

    2009-12-01

    This text describes the leaders who established the modem obstetrics and gynecology for Taiwan. during the Japan-colonizing period (1895-1945). These leaders are Mr. Kawasoye, M., Mr. Mukae K., and Mr. Magara M. The lives of these leaders were different, but they all strongly contributed to the development of modem obstetrics and gynecology in Taiwan. With regard to the passage of time, Mr. Kawasoye contributed the initial efforts, Mr. Mukae worked during the flourishing period of the clinic; and Mr. Magara worked during the mature period, emphasizing research. These three periods are closely correlated with the course of the development of modem obstetrics and gynecology in Taiwan.

  9. ASCO 2017-highlights of gynecological cancer.

    Science.gov (United States)

    Radl, Bianca; Mlineritsch, Brigitte

    2017-01-01

    At this year's ASCO annual meeting several important studies in the field of gynecological cancer were presented. Here we report a personal selection of the most interesting and clinically relevant data.

  10. Retroperitoneoscopic nephrectomy in benign pathology.

    Science.gov (United States)

    Quintela, Rodrigo S; Cotta, Leonardo R; Neves, Marcelo F; Abelha, David L; Tavora, Jose E

    2006-01-01

    We report our experience with 43 retroperitoneal laparoscopic nephrectomy for benign kidney disease. All patients had a poor function from obstructive uropathology and renal atrophy. None of these patients had a previous lumbotomy. Retroperitoneoscopy was performed with 4 trocar port technique in a lateral position. The retroperitoneal space is created by using a Gaur's balloon made of sterile glove. The approach to vascular pedicle was done posteriorly and vessels were clipped by metal and Hem-o-lock (Weck Closure Systems, North Carolina, USA) clips. The sample was intact extracted in an Endo-Bag prolonging one trocar incision. Median operative time was 160 minutes and median blood loss was 200 mL. Four cases (9%) were converted to open surgery: one case due to bleeding and 3 cases due to technical difficulties regarding perirenal adherences. Most patients (39) checked out from the Hospital in day two. Four of them were left over 3 days due to wound complications. Retroperitoneoscopy offers a safe, effective and reproductive access to nephrectomy for benign pathologies.

  11. Cost analysis of prophylactic intraoperative cystoscopic ureteral stents in gynecologic surgery.

    Science.gov (United States)

    Fanning, James; Fenton, Bradford; Jean, Geraldine Marie; Chae, Clara

    2011-12-01

    Prophylactic intraoperative ureteral stent placement is performed to decrease operative ureteric injury, though few data are available on the effectiveness of this procedure, and no data are available on its cost. To analyze the cost of prophylactic intraoperative cystoscopic ureteral stents in gynecologic surgery. All cases of prophylactic ureteral stent placement performed in gynecologic surgery during a 1-year period were identified and retrospectively reviewed through the electronic medical records database of Summa Health System. Costs were obtained through the Healthcare Cost Accounting System. The principles of cost-effective analysis were used (ie, explicit and detailed descriptions of costs and cost-effectiveness statistics). Importantly, we evaluated cost and not charges or financial model estimates. In addition, we obtained the contribution margins (ie, the hospital's net profit or loss) for prophylactic ureteral stent placement. Other gynecologic procedures were also analyzed. Among 792 major inpatient gynecologic procedures, 18 cases of prophylactic intraoperative ureteral stents were identified. Median costs were as follows: additional cost of prophylactic intraoperative ureteral stenting, $1580; additional cost of surgical resources, $770; cost of ureteral catheters, $427; cost of surgeons, $383. The contribution margins per case for various gynecologic surgical procedures were as follows: oophorectomy, $2804 profit; abdominal hysterectomy, $2649 profit; laparoscopically assisted vaginal hysterectomy (LAVH), $1760 profit. When intraoperative ureteral stenting was added, the contribution margins changed to the following: oophorectomy, $782 profit; abdominal hysterectomy, $627 profit; LAVH, $262 loss. Overall, the contribution margin profit was decreased by about 85%, from $2400 to $380. Prophylactic intraoperative ureteral stenting in gynecologic surgery decreases a hospital's contribution margin. Because of the expense of this procedure, as well as

  12. Genetics of Breast and Gynecologic Cancers (PDQ®)—Health Professional Version

    Science.gov (United States)

    Genetics of Breast and Gynecologic Cancers includes information on BRCA1 and BRCA2 variants (breast and ovarian cancer) and Lynch syndrome (endometrial cancer). Get more information about hereditary breast and gynecologic cancer syndromes in this clinician summary.

  13. Hope pictured in drawings by women newly diagnosed with gynecological cancer

    DEFF Research Database (Denmark)

    Hammer, Kristianna; Hall, Elisabeth; Mogensen, Ole

    2013-01-01

    BACKGROUND:: In mysterious ways, hope makes life meaningful even in chaotic and uncontrolled situations. When a woman is newly diagnosed with gynecologic cancer, hope is ineffable and needs exploring. Drawings help express ineffable phenomena. OBJECTIVE:: The aim of the study was to explore how...... women newly diagnosed with gynecologic cancer express the meaning of hope in drawings. METHOD:: Participants were 15 women who on the same day had received the diagnosis of gynecologic cancer. They were between 24 and 87 years (median, 52 years) with a variety of gynecologic cancer diagnoses. Data from...... 15 drawings and postdrawing interviews with the women were analyzed using visual and hermeneutic phenomenology. RESULTS:: Three themes emerged: hope as a spirit to move on, hope as energy through nature, and hope as a communion with families. CONCLUSION:: Hope as pictured in drawings often appears...

  14. Gynecological applications of helical CT using SmartPrep

    Energy Technology Data Exchange (ETDEWEB)

    Sakurada, Akira; Kakizaki, Dai; Abe, Kimihiko [Tokyo Medical Coll. (Japan)

    1999-11-01

    SmartPrep is software program for scanning a given region of interest (ROI) at optimal contrast density. An operator can arbitrarily define ROI and preset the CT value at which scanning should be started. After the injection of a contrast medium, system conducts continuous monitoring of the ROI and the operator starts helical scanning of the planned region when the present CT value has been reached. In comparison with conventional helical CT that requires a period of time from the beginning of contrast medium injection to the beginning of scanning, SmartPrep minimizes personal error and better depicts the artery-predominant phase under optimal conditions. In this study we examine the usefulness of contrast-enhanced helical CT using SmartPrep in the evaluation of gynecological disease. When the contrast medium was injected into the dorsal vein of the hand at a rate of 3 ml/sec, strong staining of pelvic arteries was observed in the CT images started at 17 to 23 sec after injection. The early-phase helical CT obtained under these conditions provided good depiction of lesions in cases of placenta accreta and invasive mole, as well as clear demonstration of tumor angiogenesis and evaluation of laterality in cases of cervical cancer. Comparison of the early and delayed phase also facilitated easier evaluation of lymph nodes than conventional comparison of simple and contrast-enhanced CT. The results thus suggest the usefulness of contrast-enhanced helical CT using SmartPrep in gynecology. (author)

  15. Prominent papilla of vater at CT: differentiation between benign and malignant lesion

    International Nuclear Information System (INIS)

    Park, Sun Won; Han, Joon Koo; Choi, Byung Ihn and others

    1998-01-01

    To establish the criteria for differential diagnosis between malignant tumor and benign prominence of papilla of Vater, as seen on CT. Sixteen consecutive patients with prominent patilla of Vater, as seen on CT during a ten-month period were included in this study. Final diagnosis was papilla of Vater cancer (n=3D5), chronic inflammation (n=3D3), benign tumor (n=3D3), or and normal (n=3D5), and this was confirmed by surgery in 11 cases, and endoscopy in five. Papilla size and attenuation, the presence of accompanied dilatation of the bile or pancreatic duct, and lymph node enlargement were analyzed by two experienced radiologists, who reached a concensus. A past history of stone disease, laboratory findings such as serum bilirubin, serum alkaline phosphatase, or endoscopic findings of duodenal diverticulum were additionally analyzed. Papilla size was the only significantly different CT finding between malignant and benign lesions, and serum alkaline phosphatase levels were also significantly different between the two groups. The smallest malignant tumor was 18 mm and the largest benign lesion was 15 mm. The presence of bile or pancreatic duct dilatation, serum bilirubin level, attenuation of the mass, a history of stone disease, and lymph node enlargement were not significantly different between the two groups. In patients with prominent papilla of Vater, as seen on CT, a mass larger than 18 mm is the only reliable radiologic finding to indicate malignant tumor of papilla of Vater. Serum alkaline phosphatase levels can, in addition, be helpful for the differential diagnosis of benign and malignant lesions.=20

  16. Structure and distribution of gynaecological diseases for girls and teenage girls in the Zaporizhzhia area

    Directory of Open Access Journals (Sweden)

    N. V. Avramenko

    2016-08-01

    Full Text Available Background. In recent years the question of gynecological diseases in women and teenage girls becomes more and more relevance. Girls of pubertal age should become mothers of new generation, but the health of adolescents continues to deteriorate. Aim. To study the structure of gynecological diseases among children and teens in the Zaporizhzhia region, to develop the main ways of improving the provision of specialized gynecological medical care in the region. Methods. The analysis of major morbidity, prevalence and patterns of gynecological diseases among girls and adolescent girls in the Zaporozhye region over the past 5 years has been done. Results. The analysis showed that the indicator of gynecological morbidity remain high and increases. Main gynecologic pathologies are: menstrual function disorders, sexual development disorders, inflammatory diseases of external and internal genitalia. Detection of pathology among girls who turned to the doctor meets in average 23-24% of cases. In girls, of the youngest age (under 10 years inflammatory diseases of the external genitalia (vulvovaginitis, vulvitis dominate in most cases. In teenage girls the menstrual dysfunction is prevalent. Among menstrual dysfunction the hypomenstrual syndrome is prevalent in 70% (oligomenorrhea, opsomenorrhea, amenorrhea. The Department of Health of Zaporizhzhia Regional State Administration has prepared the order of 15.02.2016r. №158 «On improvement of specialized gynecological care for children of the region", which provides specialized gynecological care to girls and teenage girls, and indications for gynecologist consultation of children and adolescent. Conclusions: In the analysis of morbidity during 5 years a significant increase in the incidence of gynecological morbidity of girls and teenage girls has revealed. Risk factors of menstrual function disorders are: thyreiod gland pathology, diabetis mellitas, bronchial asthma, congenital heart diseases, chronic

  17. IOTA Simple Rules in Differentiating between Benign and Malignant Adnexal Masses by Non-expert Examiners.

    Science.gov (United States)

    Tinnangwattana, Dangcheewan; Vichak-Ururote, Linlada; Tontivuthikul, Paponrad; Charoenratana, Cholaros; Lerthiranwong, Thitikarn; Tongsong, Theera

    2015-01-01

    To evaluate the diagnostic performance of IOTA simple rules in predicting malignant adnexal tumors by non-expert examiners. Five obstetric/gynecologic residents, who had never performed gynecologic ultrasound examination by themselves before, were trained for IOTA simple rules by an experienced examiner. One trained resident performed ultrasound examinations including IOTA simple rules on 100 women, who were scheduled for surgery due to ovarian masses, within 24 hours of surgery. The gold standard diagnosis was based on pathological or operative findings. The five-trained residents performed IOTA simple rules on 30 patients for evaluation of inter-observer variability. A total of 100 patients underwent ultrasound examination for the IOTA simple rules. Of them, IOTA simple rules could be applied in 94 (94%) masses including 71 (71.0%) benign masses and 29 (29.0%) malignant masses. The diagnostic performance of IOTA simple rules showed sensitivity of 89.3% (95%CI, 77.8%; 100.7%), specificity 83.3% (95%CI, 74.3%; 92.3%). Inter-observer variability was analyzed using Cohen's kappa coefficient. Kappa indices of the four pairs of raters are 0.713-0.884 (0.722, 0.827, 0.713, and 0.884). IOTA simple rules have high diagnostic performance in discriminating adnexal masses even when are applied by non-expert sonographers, though a training course may be required. Nevertheless, they should be further tested by a greater number of general practitioners before widely use.

  18. Health utilities in gynecological oncology and mastology in Germany.

    Science.gov (United States)

    Hildebrandt, Thomas; Thiel, Falk C; Fasching, Peter A; Graf, Christiane; Bani, Mayada R; Loehberg, Christian R; Schrauder, Michael G; Jud, Sebastian M; Hack, Carolin C; Beckmann, Matthias W; Lux, Michael P

    2014-02-01

    Cost increases in the healthcare system are leading to a need to distribute financial resources in accordance with the value of each service performed. Health-economic decision-making models can support these decisions. Due to the previous unavailability of health utilities in Germany (scored states of health as a basis for calculating quality-adjusted life-years, QALYs) for women undergoing treatment, international data are often used for such models. However, these may widely deviate from the values for a woman actually living in Germany. It is, therefore, necessary to collect and analyze health utilities in Germany. In a questionnaire survey, health utilities were collected, along with data for a healthy control group, for 580 female patients receiving treatment in the fields of mastology and gynecological oncology using a German version of the EuroQol questionnaire (EQ-5D) and a visual analogue scale (VAS). Data were also collected for the patients' medical history, tumor disease, and treatment. Significant differences with regard to quality of life were measured in relation to the individual tumor entities and in comparison to the controls. Apart from the healthy control group, patients with breast or cervical carcinoma had the best quality of life. In patients with recurrent and metastatic disease, those with breast carcinoma experienced the greatest impairment of their quality of life. According to current treatment, the most important impairment of life quality occurred in patients under radiotherapy and after surgical treatment. There are significant differences from the health utilities recorded for other countries - for example, the state of health declines much more markedly in patients with metastatic disease among American women with breast carcinoma than among German women, in whom recurrent disease and a first diagnosis of metastasis were comparable. Overall, the VAS was able to distinguish more adequately than the EQ-5D questionnaire between the

  19. Large differences in proportions of harmful and benign amino acid substitutions between proteins and diseases.

    Science.gov (United States)

    Schaafsma, Gerard C P; Vihinen, Mauno

    2017-07-01

    Genes and proteins are known to have differences in their sensitivity to alterations. Despite numerous sequencing studies, proportions of harmful and harmless substitutions are not known for proteins and groups of proteins. To address this question, we predicted the outcome for all possible single amino acid substitutions (AASs) in nine representative protein groups by using the PON-P2 method. The effects on 996 proteins were studied and vast differences were noticed. Proteins in the cancer group harbor the largest proportion of harmful variants (42.1%), whereas the non-disease group of proteins not known to have a disease association and not involved in the housekeeping functions had the lowest number of harmful variants (4.2%). Differences in the proportions of the harmful and benign variants are wide within each group, but they still show clear differences between the groups. Frequently appearing protein domains show a wide spectrum of variant frequencies, whereas no major protein structural class-specific differences were noticed. AAS types in the original and variant residues showed distinctive patterns, which are shared by all the protein groups. The observations are relevant for understanding genetic bases of diseases, variation interpretation, and for the development of methods for that purpose. © 2017 Wiley Periodicals, Inc.

  20. Simple diagnosis of benign acute childhood myositis: Lessons from a case report.

    Science.gov (United States)

    Terlizzi, Vito; Improta, Federica; Raia, Valeria

    2014-01-01

    Acute muscle pain and walking difficulty are symptoms compatible with both benign and severe degenerative diseases. As a consequence, in some cases invasive tests and hospitalizations are improperly scheduled. We report the case of a 7-year-old child suffering from acute calf pain and abnormal gait following flu-like symptoms. A review of the literature will be helpful to better define differential diagnosis in cases of muscle pain in children. Daily physical examination and urine dipstick are sufficient to confirm the diagnosis of benign acute childhood myositis (BACM) during the acute phase, to promptly detect severe complications and to rule out degenerative diseases. Children with BACM do not require hospitalization, medical interventions or long-term follow-up.

  1. Erythrocyte membrane fatty acids in benign and progressive forms of multiple sclerosis

    NARCIS (Netherlands)

    Koch, M; Ramsaransing, GSM; Fokkema, MR; Heersema, DJ; De Keyser, J

    2006-01-01

    BACKGROUND: There is no good explanation why a proportion of patients with multiple sclerosis (MS) have a relatively benign form of the disease. An imbalance between saturated and unsaturated fatty acids (FA) might influence the disease course of MS. AIM: To assess whether the erythrocyte membrane

  2. A comparison of ultrasound, computed tomography and endoscopic retrograde cholangiopancreatography in the differential diagnosis of benign and malignant jaundice and cholestasis

    International Nuclear Information System (INIS)

    Pasanen, P.A.; Alhava, E.M.; Partanen, K.P.; Pirinen, A.E.; Pikkarainen, P.H.; Janatuinen, E.K.

    1993-01-01

    To assess the accuracy of ultrasonography (US), computed tomography (CT), and endoscopic retrograde cholangiopancreatography (ERCP) in distinguishing between benign and malignant causes of jaundice and cholestasis without jaundice, a consecutive series of patients with jaundice or cholestasis without jaundice were studied. The most common benign disease was choledocholithiasis and the most common malignant disease was carcinoma of pancreas. The benign nature of the extrahepatic obstruction was correctly defined by US, CT, and ERCP in 53%, 53%, and 90% of patients, respectively, and the corresponding figure for choledocholithiasis were 22%, 25%, and 79%. Intrahepatic benign diseases were diagnosed by US and CT in a third of cases. Malignant extrahepatic obstruction was correctly diagnosed in 57%, 80%, and 83%, respectively and the corresponding figures for pancreatic cancer were 60%, 97% and 89%. Intrahepatic malignant lesions were diagnosed by US, CT, and ERCP in 100%, 77%, and 60% of patients, respectively. When the obstruction was benign and extrahepatic ERCP was the most accurate, but when it was malignant CT was comparable. Intrahepatic disease was best diagnosed by US and CT. The results emphasise that the three methods of imaging are complementary

  3. Distinguishing benign from malignant gallbladder wall thickening using FDG-PET

    International Nuclear Information System (INIS)

    Oe, Ai; Kawabe, Joji; Torii, Kenji

    2006-01-01

    Because thickening of the gallbladder wall is observed not only in patients with gallbladder cancer but also in those with benign diseases such as chronic cholecystitis and gallbladder adenomyosis, it is difficult to distinguish between benign and malignant gallbladder wall thickening by conventional techniques of diagnostic imaging such as computed tomography (CT), magnetic resonance imaging (MRI), and abdominal ultrasonography (US). In the present study, we attempted to distinguish between benign and malignant gallbladder wall thickening by means of fluorine-18-fluorodeoxyglucose (FDG)-Positron emission tomography (PET). FDG-PET was performed in 12 patients with gallbladder wall thickening detected by CT or US, to determine whether it was benign or malignant. Emission scans were taken, beginning 45 minutes after intravenous administration of FDG, and standardized uptake value (SUV) was calculated as an indicator of glucose metabolism. Of the 12 patients, 4 showed positive uptake of FDG in the gallbladder wall. Of these 4 patients, 3 had gallbladder cancer. The remaining one, who had chronic cholecystitis, had false-positive findings. The other 8 patients had negative uptake of FDG in the gallbladder wall. Two of these 8 underwent surgical resection, which yielded a diagnosis of chronic cholecystitis. The other 6 patients exhibited no sign of gallbladder malignancy and have been followed without active treatment. FDG-PET appears able to distinguish between benign and malignant gallbladder wall thickening. (author)

  4. Responses of advanced directives by Jehovah's Witnesses on a gynecologic oncology service

    Directory of Open Access Journals (Sweden)

    Nagarsheth NP

    2014-12-01

    Full Text Available Nimesh P Nagarsheth,1,2 Nikhil Gupta,3 Arpeta Gupta,4 Erin Moshier,5 Herbert Gretz,1 Aryeh Shander6 1Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, New York, NY, USA; 2Englewood Hospital and Medical Center, Englewood, NJ, USA; 3Department of Urology, North Shore – Long Island Jewish Health Service, New Hyde Park, NY, USA; 4Department of Endocrinology, Diabetes and Metabolism, St Luke's Hospital of Kansas City, Kansas City, MO, 5Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Medical Center, New York, NY, USA; 6Department of Anesthesiology, Englewood Hospital and Medical Center, Englewood, NJ, USA Objectives: To review the responses of advance directives signed by Jehovah's Witness patients prior to undergoing surgery at a gynecologic oncology service. Study design: A retrospective chart review of gynecologic oncology patients undergoing surgery at a bloodless surgery center from 1998–2007 was conducted. Demographic, pathologic, and clinical data were recorded. The proportion of patients who accepted and refused various blood-derived products was determined and was compared to previously published results from a similar study of labor and delivery unit patients. Results: No gynecologic oncology patients agreed to accept transfusions of whole blood, red cells, white cells, platelets, or plasma under any circumstance, whereas 9.8% of pregnant patients accepted transfusion (P=0.0385. However, 98% of gynecologic oncology patients agreed to accept some blood products, including fractions such as albumin, immunoglobulins, and clotting factors, while only 39% of pregnant patients agreed (P<0.0001. In addition, all gynecologic oncology patients (100% accepted intraoperative hemodilution, compared to 55% of pregnant patients (P<0.0001. Conclusion: Our results confirm the commonly held belief

  5. A comparison of quality outcome measures in patients having a hysterectomy for benign disease: robotic vs. non-robotic approaches.

    Science.gov (United States)

    Martino, Martin A; Berger, Elizabeth A; McFetridge, Jeffrey T; Shubella, Jocelyn; Gosciniak, Gabrielle; Wejkszner, Taylor; Kainz, Gregory F; Patriarco, Jeremy; Thomas, M Bijoy; Boulay, Richard

    2014-01-01

    To measure procedure-related hospital readmissions within 30 days after discharge for patients who have a hysterectomy for benign disease. Secondary outcome quality measures evaluated were cost, estimated blood loss, length of stay and sum of costs associated with readmissions. Retrospective cohort study (Canadian Task Force classification II-2). Academic community hospital. Patients who underwent hysterectomy to treat benign disease from January 2008 to December 2012. Patients were grouped according to route of hysterectomy: robotic-assisted laparoscopic hysterectomy (robotic), laparoscopic hysterectomy (laparoscopic), abdominal hysterectomy (open via laparotomy), and vaginal hysterectomy (vaginal). Inclusion criteria were met by 2554 patients: 601 in the robotic group, 427 in the laparoscopic group, 1194 in the abdominal group, and 332 in the vaginal group. Readmission rates in the robotic cohort were significantly less (probotic cohorts: Robotic (1%), laparoscopic (2.5%), open (3.5%), vaginal (2.4%). Estimated blood loss, length of stay, and sum of readmission costs were also significantly less in the robotic cohort (probotic-assisted laparoscopic hysterectomy have a significantly lower chance of readmission robotics cohort also experienced a shorter length of stay, less estimated blood loss, and a cost savings associated with readmissions when compared to non-robotic approaches. Prospective registries describing quality outcomes, total sum of costs including 30 days follow-up, as well as patient-related quality of life benefits are recommended to confirm these findings and determine which surgical route offers the highest patient and societal value. Copyright © 2014. Published by Elsevier Inc.

  6. Multi-disciplinary summit on genetics services for women with gynecologic cancers: A Society of Gynecologic Oncology White Paper.

    Science.gov (United States)

    Randall, Leslie M; Pothuri, Bhavana; Swisher, Elizabeth M; Diaz, John P; Buchanan, Adam; Witkop, Catherine T; Bethan Powell, C; Smith, Ellen Blair; Robson, Mark E; Boyd, Jeff; Coleman, Robert L; Lu, Karen

    2017-08-01

    To assess current practice, advise minimum standards, and identify educational gaps relevant to genetic screening, counseling, and testing of women affected by gynecologic cancers. The Society of Gynecologic Oncology (SGO) organized a multidisciplinary summit that included representatives from the American College of Obstetricians and Gynecologists (ACOG), the American Society Clinical Oncology (ASCO), the National Society of Genetic Counselors (NSGC), and patient advocacy groups, BrightPink and Facing our Risk of Cancer Empowered (FORCE). Three subject areas were discussed: care delivery models for genetic testing, barriers to genetic testing, and educational opportunities for providers of genetic testing. The group endorsed current SGO, National Comprehensive Cancer Network (NCCN), and NSGC genetic testing guidelines for women affected with ovarian, tubal, peritoneal cancers, or DNA mismatch repair deficient endometrial cancer. Three main areas of unmet need were identified: timely and universal genetic testing for women with ovarian, fallopian tube, and peritoneal cancers; education regarding minimum standards for genetic counseling and testing; and barriers to implementation of testing of both affected individuals as well as cascade testing of family members. Consensus building among all stakeholders resulted in an action plan to address gaps in education of gynecologic oncology providers and delivery of cancer genetics care. Copyright © 2017. Published by Elsevier Inc.

  7. Will patients benefit from regionalization of gynecologic cancer care?

    Directory of Open Access Journals (Sweden)

    Kathleen F Brookfield

    Full Text Available OBJECTIVE: Patient chances for cure and palliation for a variety of malignancies may be greatly affected by the care provided by a treating hospital. We sought to determine the effect of volume and teaching status on patient outcomes for five gynecologic malignancies: endometrial, cervical, ovarian and vulvar carcinoma and uterine sarcoma. METHODS: The Florida Cancer Data System dataset was queried for all patients undergoing treatment for gynecologic cancers from 1990-2000. RESULTS: Overall, 48,981 patients with gynecologic malignancies were identified. Endometrial tumors were the most common, representing 43.2% of the entire cohort, followed by ovarian cancer (30.9%, cervical cancer (20.8%, vulvar cancer (4.6%, and uterine sarcoma (0.5%. By univariate analysis, although patients treated at high volume centers (HVC were significantly younger, they benefited from an improved short-term (30-day and/or 90-day survival for cervical, ovarian and endometrial cancers. Multivariate analysis (MVA, however, failed to demonstrate significant survival benefit for gynecologic cancer patients treated at teaching facilities (TF or HVC. Significant prognostic factors at presentation by MVA were age over 65 (HR = 2.6, p<0.01, African-American race (HR = 1.36, p<0.01, and advanced stage (regional HR = 2.08, p<0.01; advanced HR = 3.82, p<0.01, respectively. Surgery and use of chemotherapy were each significantly associated with improved survival. CONCLUSION: No difference in patient survival was observed for any gynecologic malignancy based upon treating hospital teaching or volume status. Although instances of improved outcomes may occur, overall further regionalization would not appear to significantly improve patient survival.

  8. Cancer or no cancer: the influence of trait anxiety and diagnosis on quality of life with breast cancer and benign disease: a prospective, longitudinal study

    NARCIS (Netherlands)

    Keyzer-Dekker, Claudia M. G.; de Vries, Jolanda; Mertens, Marlies C.; Roukema, Jan A.; van der Steeg, Alida F. W.

    2013-01-01

    High trait anxiety (HTA) causes an impaired quality of life (QOL) and fatigue in women with breast cancer (BC) and benign breast disease (BBD). We examined whether the lowered QOL was determined solely by the personality characteristic HTA or by the combination of personality and diagnosis. In a

  9. Clinical outcomes of self-expandable stent placement for benign esophageal diseases: A pooled analysis of the literature

    NARCIS (Netherlands)

    van Halsema, Emo E.; van Hooft, Jeanin E.

    2015-01-01

    AIM: To analyze the outcomes of self-expandable stent placement for benign esophageal strictures and benign esophageal leaks in the literature. METHODS: The PubMed, Embase and Cochrane databases were searched for relevant articles published between January 2000 and July 2014. Eight prospective

  10. Low 25-OH vitamin D levels at time of diagnosis and recurrence of ovarian cancer.

    Science.gov (United States)

    Granato, Teresa; Manganaro, Lucia; Petri, Luca; Porpora, Maria Grazia; Viggiani, Valentina; Angeloni, Antonio; Anastasi, Emanuela

    2016-02-01

    The objective of this study was to evaluate the correlation between 25-OH vitamin D and ovarian cancer as a diagnostic marker or recurrence disease marker. We studied the following: (1) 61 women without gynecologic diseases, (2) 45 women affected by benign ovarian disease, (3) 46 women with recent diagnosis of ovarian cancer, (4) 26 follow-up women with recurrent ovarian cancer, and (5) 32 follow-up women with stable ovarian cancer. The 25-OH vitamin D was quantified with LUMIPULSE® G 25-OH vitamin D on LUMIPULSE® G 1200 (Fujirebio, Japan). As a threshold value, identified by ROC curve analysis, 20.2 ng/mL (sensitivity 73.3 %, specificity 84 %) was chosen corresponding to the limit between sufficient and insufficient 25-OH vitamin D according to the WHO. Low 25-OH vitamin D levels were observed in 26 % of women without gynecologic diseases, in 80 % of women with recent diagnosis of ovarian cancer and in 24 % women affected by benign ovarian diseases (p < 0.001). The follow-up study showed an insufficient level of 25-OH vitamin D in 73 % women with recurrent ovarian cancer and in 47 % women with stable ovarian cancer (p < 0.0003). This study showed that patients with ovarian cancer are often insufficient in 25-OH vitamin D compared to women with benign ovarian diseases. The women with recurrent ovarian cancer presented more often low levels compared to women with stable ovarian cancer. This study suggests that 25-OH vitamin D, due to its antiproliferative properties, can be a good marker for ovarian cancer also.

  11. Treatment of Benign Tracheal Stenosis Using Endoluminal Spray Cryotherapy.

    Science.gov (United States)

    Bhora, Faiz Y; Ayub, Adil; Forleiter, Craig M; Huang, Chyun-Yin; Alshehri, Khalid; Rehmani, Sadiq; Al-Ayoubi, Adnan M; Raad, Wissam; Lebovics, Robert S

    2016-11-01

    Tracheal stenosis is a debilitating disorder with heterogeneity in terms of disease characteristics and management. Repeated recurrences substantially alter patients' quality of life. There is limited evidence for the use of spray cryotherapy (SCT) in the management of benign airway disease. To report our early results for the use of SCT in patients with benign tracheal stenosis. Data were extracted from the medical records of a consecutive series of patients with benign airway stenosis secondary to granulomatosis with polyangiitis (GPA) (n = 13), prior tracheotomy or tracheal intubation (n = 8), and idiopathic strictures (n = 5) treated from September 1, 2013, to September 30, 2015, at a tertiary care hospital. Airway narrowing was quantified on a standard quartile grading scale. Response to treatment was assessed by improvement in airway caliber and the time interval for reintervention. Delivery of 4 5-second SCT cycles and 2 balloon dilatations. Twenty-six patients (median [range] age, 53 [16-83] years; 20 [77%] female) underwent 48 SCT sessions. Spray cryotherapy was successfully used without any substantial intraoperative or postoperative complications in all patients. In a median (range) follow-up of 11 (1-26) months, all patients had improvement in symptoms. Before the institution of SCT, 23 patients (88%) had grade III or IV stenosis. At the last evaluation after induction of SCT, 4 (15%) had grade III or IV stenosis, with a mean (SD) change of 1.39 (0.51) (P benign tracheal stenosis. Although efficacy evidence is limited for SCT, it may be useful for patients who have experienced treatment failure with conventional modalities. Further analysis of this cohort will determine the physiologic durability of the reported short-term changes. Additional trials are warranted for further evaluation of this modality.

  12. Effect of Intraperitoneal Bupivacaine on Postoperative Pain in the Gynecologic Oncology Patient.

    Science.gov (United States)

    Rivard, Colleen; Vogel, Rachel Isaksson; Teoh, Deanna

    2015-01-01

    To evaluate if the administration of intraperitoneal bupivacaine decreased postoperative pain in patients undergoing minimally invasive gynecologic and gynecologic cancer surgery. Retrospective cohort study (Canadian Task Force classification II-3). University-based gynecologic oncology practice operating at a tertiary medical center. All patients on the gynecologic oncology service undergoing minimally invasive surgery between September 2011 and June 2013. Starting August 2012, intraperitoneal administration of .25% bupivacaine was added to all minimally invasive surgeries. These patients were compared with historical control subjects who had surgery between September 2011 and July 2012 but did not receive intraperitoneal bupivacaine. One-hundred thirty patients were included in the study. The patients who received intraperitoneal bupivacaine had lower median narcotic use on the day of surgery and the first postoperative day compared with those who did not receive intraperitoneal bupivacaine (day 0: 7.0 mg morphine equivalents vs 11.0 mg, p = .007; day 1: .3 mg vs 1.7 mg, p = .0002). The median patient-reported pain scores were lower on the day of surgery in the intraperitoneal bupivacaine group (2.7 vs 3.2, p = .05) CONCLUSIONS: The administration of intraperitoneal bupivacaine was associated with improved postoperative pain control in patients undergoing minimally invasive gynecologic and gynecologic cancer surgery and should be further evaluated in a prospective study. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

  13. Resident Education Curriculum in Pediatric and Adolescent Gynecology: The Short Curriculum 2.0.

    Science.gov (United States)

    Talib, Hina J; Karjane, Nicole; Teelin, Karen; Abraham, Margaret; Holt, Stephanie; Chelvakumar, Gayaythri; Dumont, Tania; Huguelet, Patricia S; Conner, Lindsay; Wheeler, Carol; Fleming, Nathalie

    2018-04-01

    The degree of exposure to pediatric and adolescent gynecology (PAG) varies across residency programs in obstetrics and gynecology and pediatrics. Nevertheless, these programs are responsible for training residents and providing opportunities within their programs to fulfill PAG learning objectives. To that end, the North American Society for Pediatric and Adolescent Gynecology has taken a leadership role in PAG resident education by creating and systematically updating the Short Curriculum. This curriculum outlines specific learning objectives that are central to PAG education and lists essential resources for learners' reference. This updated curriculum replaces the previous 2014 publication with added content, resources, and updated references. Additionally, attention to the needs of learners in pediatrics and adolescent medicine is given greater emphasis in this revised North American Society for Pediatric and Adolescent Gynecology Short Curriculum 2.0. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  14. Palliative care in advanced gynecological cancers: Institute of palliative medicine experience

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    Sushmita Pathy

    2008-01-01

    Full Text Available Aim: To study the epidemiological profile, clinical symptoms and referral patterns of patients with gynecological malignancy. To evaluate pain symptoms, response to treatment and factors affecting management in patients with advanced gynecological malignancies. Methods: A retrospective analysis was performed of the gynecological malignancy cases registered at the Pain and Palliative Care Clinic, Calicut, over a 12-month period between January 2006 and December 2006.Patient characteristics, symptoms and response to treatment were evaluated in detail. Results: A total of 1813 patients registered, of which 64 had gynecological malignancies. Most of the cases were referred from the Oncology Department of the Calicut Medical College. Fifty-five percent of the patients were unaware of their diagnosis. Psychosocial issues and anxiety were observed in 48%. Insomnia was seen in 52% of the cases. Pain was the most common and most distressing symptom. Adequate pain relief was achieved in only 32% of the patients. Conclusions: The number of gynecological malignancy cases attending the Pain and Palliative Care Clinic is small. Pain is the most common and distressing symptom, with only 32% of the patients achieving adequate pain relief. Poor drug compliance, incomplete assessment of pain and the lack of awareness of morphine therapy were identified as the most common causes for poor pain control.

  15. Diagnostic Utility of Endoscopic Retrograde Cholangiography/Intraductal Ultrasound (ERC/IDUS) in Distinguishing Malignant from Benign Bile Duct Obstruction.

    Science.gov (United States)

    Chen, Lu; Lu, Yi; Wu, Jia-Chuan; Bie, Like; Xia, Lu; Gong, Biao

    2016-02-01

    Accurately differentiating malignant diseases from benign ones in patients having bile duct obstruction is of significant importance and remains a major clinical problem. This study investigated the diagnostic yield of endoscopic retrograde cholangiography/intraductal ultrasound (ERC/IDUS) in distinguishing malignant from benign bile duct obstruction and assessed some image findings from ERC/IDUS which might be useful in differentiation. From January 2008 to January 2015, patients who underwent ERC/IDUS for bile duct obstruction were enrolled. Patient's ERC/IDUS diagnosis was compared with the final diagnosis determined by pathologic findings and/or clinical outcome of follow-up. One hundred and ninety-three patients with bile duct obstruction were included. IDUS correctly identified 94 of 97 malignant diseases and 76 of 96 benign diseases with sensitivity, specificity, and accuracy rate of 96.91, 79.17, and 88.08 %, respectively. Additionally, the accuracy rate of IDUS for diagnosis of proximal bile duct obstruction was higher than that of distal bile duct obstruction (98.08 vs. 82.73 %, p = 0.006). Besides, there was a significant difference in the length at the obstruction site between benign and malignant diseases (13.76 ± 7.37 vs. 19.97 ± 11.37 mm, p 7 mm without extrinsic compression had a positive predictive value (PPV) of 100 % for including malignancy, while length ≧20 mm demonstrated a PPV of 93.44 %. ERC/IDUS is effective in distinguishing malignant from benign bile duct obstruction, thus helping in further clinical management.

  16. Differentiation between benign and malignant breast lesions using fat-suppressed dynamic MR imaging

    International Nuclear Information System (INIS)

    Koshiishi, Takeshi; Isomoto, Ichirou; Nakamura, Kazukuni; Kajiwara, Yoshifumi; Izawa, Kunihide

    1998-01-01

    To assess the value and problems of fat-suppressed dynamic MR imaging in differentiating between benign and malignant lesions. In twenty-nine patients who underwent excisional biopsy or surgical resection, fat-suppressed dynamic MR imaging was performed with a 0.5 T superconducting magnet. Pre- and post-contrast 3D-spoiled gradient echo sequences were employed with fat suppression. We calculated and evaluated the contrast-to-noise ratio (CNR) and contrast enhancement ratio (CER) at each contrast determination time (CDT), which is the intermediate time in the scan. Time intensity curves of CNR showed no statistically significant difference between cancers and other benign lesions. The difference in CER between malignant and benign disease was highly significant (p=0.006) at CDT 45 sec., but there was great overlap in the time intensity curve of CER after CDT 45 sec. When we attempt to differentiate malignant from benign breast lesions by dynamic MR imaging, comparison of CNR is impertinent, and we should evaluate the differential diagnosis of cancer versus benign lesions by means of CER at CDT points of about 45 sec. (author)

  17. SOCIAL REPRESENTATIONS DEL GYNECOLOGICAL CANCER IN THE KNOWLEDGE OF THE BRAZILIAN NURSING

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    Sílvio Éder Dias da Silva

    2014-02-01

    Full Text Available One is a documentary investigation whose objective to characterize the social representations on the gynecological cancer gifts in theses and dissertations of the Brazilian infirmary in the period from 2001 to 2007. The investigation source was the Bank of Thesis and Dissertations of the Brazilian Association of Infirmary. 51 studies had been identified. The analysis of the dices originated the following thematic categories: Imaginary the Social one of Women in front of the Gynecological Cancer; The daily one of the mastectomizada woman; The gynecological cancer and its treatment; Prevention of the gynecological cancer in the vision of the infirmary. The studies caused to apprehend the aspects of the psycho-social context, so important and necessary in the sense more atenciosamente to watch the welfare practice of the infirmary.

  18. Menopause education: needs assessment of American obstetrics and gynecology residents.

    Science.gov (United States)

    Christianson, Mindy S; Ducie, Jennifer A; Altman, Kristiina; Khafagy, Ayatallah M; Shen, Wen

    2013-11-01

    This study aims to understand the current teaching of menopause medicine in American obstetrics and gynecology residency programs. A Web-based survey was e-mailed to all American obstetrics and gynecology residency directors, with a request that they forward it to their residents. Of 258 residency program directors contacted, 79 (30.6%) confirmed forwarding the survey. In all, 1,799 people received the survey, with 510 completions, for a response rate of 28.3%. Most residents reported that they had limited knowledge and needed to learn more about these aspects of menopause medicine: pathophysiology of menopause symptoms (67.1%), hormone therapy (68.1%), nonhormone therapy (79.0%), bone health (66.1%), cardiovascular disease (71.7%), and metabolic syndrome (69.5%). Among fourth-year residents who will be entering clinical practice soon, a large proportion also reported a need to learn more in these areas: pathophysiology of menopause symptoms (45.9%), hormone therapy (54.2%), nonhormone therapy (69.4%), bone health (54.2%), cardiovascular disease (64.3%), and metabolic syndrome (63.8%). When asked to rate the most preferred modalities for learning about menopause, the top choice was supervised clinics (53.2%), followed by case presentations (22.2%), formal lectures (21.3%), small groups (14.7%), Web-based learning (7.8%), and independent reading (5.2%). Only 20.8% of residents reported that their program had a formal menopause medicine learning curriculum, and 16.3% had a defined menopause clinic as part of their residency. It seems that some American residency programs do not fulfill the educational goals of their residents in menopause medicine. A curriculum would be beneficial for increasing knowledge and clinical experience on menopause issues.

  19. [Comparison of robotic surgery documentary in gynecological cancer].

    Science.gov (United States)

    Vargas-Hernández, Víctor Manuel

    2012-01-01

    Robotic surgery is a surgical technique recently introduced, with major expansion and acceptance among the medical community is currently performed in over 1,000 hospitals around the world and in the management of gynecological cancer are being developed comprehensive programs for implementation. The objectives of this paper are to review the scientific literature on robotic surgery and its application in gynecological cancer to verify its safety, feasibility and efficacy when compared with laparoscopic surgery or surgery classical major surgical complications, infections are more common in traditional radical surgery compared with laparoscopic or robotic surgery and with these new techniques surgical and staying hospital are lesser than the former however, the disadvantages are the limited number of robot systems, their high cost and applies only in specialized centers that have with equipment and skilled surgeons. In conclusion robotic surgery represents a major scientific breakthrough and surgical management of gynecological cancer with better results to other types of conventional surgery and is likely in the coming years is become its worldwide.

  20. Gynecological cancers: A summary of published Indian data

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    Amita Maheshwari

    2016-01-01

    Full Text Available Gynecological cancers are among the most common cancers in women and hence an important public health issue. Due to the lack of cancer awareness, variable pathology, and dearth of proper screening facilities in developing countries such as India, most women report at advanced stages, adversely affecting the prognosis and clinical outcomes. Ovarian cancer has emerged as one of the most common malignancies affecting women in India and has shown an increase in the incidence rates over the years. Although cervical cancer is on a declining trend, it remains the second most common cancer in women after breast cancer. Many researchers in India have published important data in the field of gynecologic oncology, covering all domains such as basic sciences, preventive oncology, pathology, radiological imaging, and clinical outcomes. This work has given us an insight into the in-depth understanding of these cancers as well as the demographics and survival rates in the Indian population. This aim of this review is to discuss the important studies done in India for all gynecological cancers.

  1. Gynecological cancers: A summary of published Indian data.

    Science.gov (United States)

    Maheshwari, Amita; Kumar, Neha; Mahantshetty, Umesh

    2016-01-01

    Gynecological cancers are among the most common cancers in women and hence an important public health issue. Due to the lack of cancer awareness, variable pathology, and dearth of proper screening facilities in developing countries such as India, most women report at advanced stages, adversely affecting the prognosis and clinical outcomes. Ovarian cancer has emerged as one of the most common malignancies affecting women in India and has shown an increase in the incidence rates over the years. Although cervical cancer is on a declining trend, it remains the second most common cancer in women after breast cancer. Many researchers in India have published important data in the field of gynecologic oncology, covering all domains such as basic sciences, preventive oncology, pathology, radiological imaging, and clinical outcomes. This work has given us an insight into the in-depth understanding of these cancers as well as the demographics and survival rates in the Indian population. This aim of this review is to discuss the important studies done in India for all gynecological cancers.

  2. Clinical outcomes of self-expandable stent placement for benign esophageal diseases: A pooled analysis of the literature

    Science.gov (United States)

    van Halsema, Emo E; van Hooft, Jeanin E

    2015-01-01

    AIM: To analyze the outcomes of self-expandable stent placement for benign esophageal strictures and benign esophageal leaks in the literature. METHODS: The PubMed, Embase and Cochrane databases were searched for relevant articles published between January 2000 and July 2014. Eight prospective studies were identified that analyzed the outcomes of stent placement for refractory benign esophageal strictures. The outcomes of stent placement for benign esophageal leaks, perforations and fistulae were extracted from 20 retrospective studies that were published after the inclusion period of a recent systematic review. Data were pooled and analyzed using descriptive statistics. RESULTS: Fully covered self-expandable metal stents (FC SEMS) (n = 85), biodegradable (BD) stents (n = 77) and self-expandable plastic stents (SEPS) (n = 70) were inserted in 232 patients with refractory benign esophageal strictures. The overall clinical success rate was 24.2% and according to stent type 14.1% for FC SEMS, 32.9% for BD stents and 27.1% for SEPS. Stent migration occurred in 24.6% of cases. The overall complication rate was 31.0%, including major (17.7%) and minor (13.4%) complications. A total of 643 patients were treated with self-expandable stents mainly for postsurgical leaks (64.5%), iatrogenic perforations (19.6%), Boerhaave’s syndrome (7.8%) and fistulae (3.7%). FC SEMS and partially covered SEMS were used in the majority of patients. Successful closure of the defect was achieved in 76.8% of patients and according to etiology in 81.4% for postsurgical leaks, 86.0% for perforations and 64.7% for fistulae. The pooled stent migration rate was 16.5%. Stent-related complications occurred in 13.4% of patients, including major (7.8%) and minor (5.5%) complications. CONCLUSION: The outcomes of stent placement for refractory benign esophageal strictures were poor. However, randomized trials are needed to put this into perspective. The evidence on successful stent placement for benign

  3. Clinical outcomes of self-expandable stent placement for benign esophageal diseases: A pooled analysis of the literature.

    Science.gov (United States)

    van Halsema, Emo E; van Hooft, Jeanin E

    2015-02-16

    To analyze the outcomes of self-expandable stent placement for benign esophageal strictures and benign esophageal leaks in the literature. The PubMed, Embase and Cochrane databases were searched for relevant articles published between January 2000 and July 2014. Eight prospective studies were identified that analyzed the outcomes of stent placement for refractory benign esophageal strictures. The outcomes of stent placement for benign esophageal leaks, perforations and fistulae were extracted from 20 retrospective studies that were published after the inclusion period of a recent systematic review. Data were pooled and analyzed using descriptive statistics. Fully covered self-expandable metal stents (FC SEMS) (n = 85), biodegradable (BD) stents (n = 77) and self-expandable plastic stents (SEPS) (n = 70) were inserted in 232 patients with refractory benign esophageal strictures. The overall clinical success rate was 24.2% and according to stent type 14.1% for FC SEMS, 32.9% for BD stents and 27.1% for SEPS. Stent migration occurred in 24.6% of cases. The overall complication rate was 31.0%, including major (17.7%) and minor (13.4%) complications. A total of 643 patients were treated with self-expandable stents mainly for postsurgical leaks (64.5%), iatrogenic perforations (19.6%), Boerhaave's syndrome (7.8%) and fistulae (3.7%). FC SEMS and partially covered SEMS were used in the majority of patients. Successful closure of the defect was achieved in 76.8% of patients and according to etiology in 81.4% for postsurgical leaks, 86.0% for perforations and 64.7% for fistulae. The pooled stent migration rate was 16.5%. Stent-related complications occurred in 13.4% of patients, including major (7.8%) and minor (5.5%) complications. The outcomes of stent placement for refractory benign esophageal strictures were poor. However, randomized trials are needed to put this into perspective. The evidence on successful stent placement for benign esophageal leaks, perforations and

  4. Pain Management for Gynecologic Procedures in the Office.

    Science.gov (United States)

    Ireland, Luu Doan; Allen, Rebecca H

    2016-02-01

    Satisfactory pain control for women undergoing office gynecologic procedures is critical for both patient comfort and procedure success. Therefore, it is important for clinicians to be aware of the safety and efficacy of different pain control regimens. This article aimed to review the literature regarding pain control regimens for procedures such as endometrial biopsy, intrauterine device insertion, colposcopy and loop electrosurgical excisional procedure, uterine aspiration, and hysteroscopy. A search of published literature using PubMed was conducted using the following keywords: "pain" or "anesthesia." These terms were paired with the following keywords: "intrauterine device" or "IUD," "endometrial biopsy," "uterine aspiration" or "abortion," "colposcopy" or "loop electrosurgical excisional procedure" or "LEEP," "hysteroscopy" or "hysteroscopic sterilization." The search was conducted through July 2015. Articles were hand reviewed and selected by the authors for study quality. Meta-analyses and randomized controlled trials were prioritized. Although local anesthesia is commonly used for gynecologic procedures, a multimodal approach may be more effective including oral medication, a dedicated emotional support person, and visual or auditory distraction. Women who are nulliparous, are postmenopausal, have a history of dysmenorrhea, or suffer from anxiety are more likely to experience greater pain with gynecologic procedures. Evidence for some interventions exists; however, the interpretation of intervention comparisons is limited by the use of different regimens, pain measurement scales, patient populations, and procedure techniques. There are many options for pain management for office gynecologic procedures, and depending on the procedure, different modalities may work best. The importance of patient counseling and selection cannot be overstated.

  5. Determinants of suicidal ideation in gynecological cancer patients.

    Science.gov (United States)

    Tang, G X; Yan, P P; Yan, C L; Fu, B; Zhu, S J; Zhou, L Q; Huang, X; Wang, Y; Lei, J

    2016-01-01

    Gynecological cancer survivors are at increased risk of psychological problems including suicide risk. Suicidal ideation, which was thought to be precursor to suicide attempts, has not been well studied. This study aimed to investigate the prevalence, and determinants of suicidal ideation for women with gynecological cancer, and then to assess the effect of coping style and social support on suicidal ideation. Patients with cervical, ovarian and endometrial cancers seen at Hunan Provincial Tumor Hospital from September 2012 to June 2013 were consecutively recruited and were asked to complete the Zung Self-Rating Depression Scale, Suicidal Ideation of Self-rating Scale, Medical Coping Modes Questionnaire and Social Support Rating Scale. Path analysis was used to examine the relationship among coping style, social support, depression symptoms and suicidal ideation. A total of 579 (579/623, 93.0%) gynecological cancer patients were enrolled in this study and completed all investigations between September 2012 and June 2013. Among them, 105 (18.1%) patients reported suicidal ideation, with the highest rate in patients with ovarian cancer (30.16%). Suicidal ideation was associated with depression symptoms, care providers, chemotherapy history and acceptance-resignation. Path analysis showed that the acceptance-resignation affected suicidal ideation directly as well as mediated by social support and depression symptoms, while confrontation and avoidance affected suicidal ideation entirely through social support and depression symptoms. Suicidal ideation is high among patients with gynecological cancer, especially among ovarian cancer patients. Coping strategies such as confrontation and avoidance, and social support may be helpful for preventing suicidal ideation among them. Copyright © 2015 John Wiley & Sons, Ltd.

  6. Radical surgical resection and high-dose intraoperative radiation therapy (HDR-IORT) in patients with recurrent gynecologic cancers

    International Nuclear Information System (INIS)

    Gemignani, Mary L.; Alektiar, Kaled M.; Leitao, Mario; Mychalczak, Boris; Chi, Dennis; Venkatraman, Ennapadam; Barakat, Richard R.; Curtin, John P.

    2001-01-01

    Objective: To determine the outcome for patients with recurrent gynecologic tumors treated with radical resection and combined high-dose intraoperative radiation therapy (HDR-IORT). Methods and Materials: Between November 1993 and June 1998, 17 patients with recurrent gynecologic malignancies underwent radical surgical resection and high-dose-rate brachytherapy. The mean age of the study group was 49 years (range 28-72 years). The site of the primary tumor was the cervix in 9 (53%) patients, the uterus in 7 (41%) patients, and the vagina in 1 (6%) patient. The treatment for the primary disease was surgery with or without adjuvant radiation in 14 (82%) patients and definitive radiation in 3 (18%) patients. The current surgery consisted of exenterative surgery in 10 (59%) patients and tumor resection in 7 (41%) patients. Complete gross resection was achieved in 13 (76%) patients. The mean HDR-IORT dose was 14 Gy (range 12-15). Additional radiation in the form of permanent Iodine-125 implant was given to 3 of 4 patients with gross residual disease. The median peripheral dose was 140 Gy. Results: With a median follow-up of 20 months (range 3-65 months), the 3-year actuarial local control (LC) rate was 67%. In patients with complete gross resection, the 3-year LC rate was 83%, compared to 25% in patients with gross residual disease, p<0.01. The 3-year distant metastasis disease-free and overall survival rates were 54% and 54%, respectively. The complications were as follows: gastrointestinal obstruction, 4 (24%); wound complications, 4 (24%); abscesses, 3 (18%); peripheral neuropathy, 3 (18%); rectovaginal fistula, 2 (12%); and ureteral obstruction, 2 (12%). Conclusion: Radical surgical resection and combined IORT for patients with recurrent gynecologic tumors seems to provide a reasonable local-control rate in patients who have failed prior surgery and/or definitive radiation. Patient selection is very important, however, as only those patients with complete gross

  7. Temporal availability of obstetrics and gynecology clinics in Taiwan: A nationwide survey

    Directory of Open Access Journals (Sweden)

    Wei-Ting Chang

    2017-10-01

    Conclusion: Obstetrics–gynecology clinics in Taiwan offered great temporal availability. In addition to the remarkable urban–rural disparity in the distribution of obstetrics–gynecology clinics, the availability of services on Sundays in rural areas demands special attention.

  8. [Observation on analgesia effect of electroacupuncture during gynecologic outpatient operation].

    Science.gov (United States)

    Wang, Xiao-Hui; Wu, Xue-Lei; Jin, Ping-Lin; Wang, Lu-Dong; Zhao, Zhi-En; Qin, Xue-Yu; Zhang, Zhi-Yan; Hu, Xue-Zhu; Cai, Zhen-Lin

    2012-10-01

    To verify the feasibility of electroacupuncture analgesia applied to gynecologic outpatient operation. Two hundred patients were randomly divided into an electroacupuncture analgesia group and an intravenous anesthesia group, 100 cases in each group. Operation types included artificial abortion, diagnostic curettage and remove of intrauterine divice. The electroacupuncture analgesia group was treated with electroacupuncture at bilateral Hegu (LI 4) and Neiguan (PC 6), and the routine gynecologic outpatient operation was performed under patients' waking state. The intravenous anesthesia group was treated with routine gynecologic outpatient operation after intravenous injection of fentanyl and propofol. The excellent rate and the effective rate of analgesia were 88.0% (88/100) and 100.0% (100/100) in the electroacupuncture analgesia group, and 94.0% (94/100) and 100.0% (100/100) in the intravenous anesthesia group, with no statistically significant differences between the two groups (all P > 0.05). There was no adverse reaction in the electroacupuncture anesthesia group, but 11 cases of adverse reactions in the intravenous anesthesia group. Electroacupuncture analgesia can effectively alleviate the pain during gynecologic outpatient operation and it is simple and safe without adverse reactions.

  9. Current status of surgery for benign disorders of the esophagus

    NARCIS (Netherlands)

    Draaisma, Werner Adriaan

    2006-01-01

    This thesis aimed at exploring new techniques for the surgical treatment of benign disorders of the esophagus. Specifically, studies were performed on surgery for gastroesophageal reflux disease and large (type II-IV) hiatal hernia. The chapters presented in this thesis involve studies that have

  10. Selecting aesthetic gynecologic procedures for plastic surgeons: a review of target methodology.

    Science.gov (United States)

    Ostrzenski, Adam

    2013-04-01

    The objective of this article was to assist cosmetic-plastic surgeons in selecting aesthetic cosmetic gynecologic-plastic surgical interventions. Target methodological analyses of pertinent evidence-based scientific papers and anecdotal information linked to surgical techniques for cosmetic-plastic female external genitalia were examined. A search of the existing literature from 1900 through June 2011 was performed by utilizing electronic and manual databases. A total of 87 articles related to cosmetic-plastic gynecologic surgeries were identified in peer-review journals. Anecdotal information was identified in three sources (Barwijuk, Obstet Gynecol J 9(3):2178-2179, 2011; Benson, 5th annual congress on aesthetic vaginal surgery, Tucson, AZ, USA, November 14-15, 2010; Scheinberg, Obstet Gynecol J 9(3):2191, 2011). Among those articles on cosmetic-plastic gynecologic surgical technique that were reviewed, three articles met the criteria for evidence-based medicine level II, one article was level II-1 and two papers were level II-2. The remaining papers were classified as level III. The pertinent 25 papers met the inclusion criteria and were analyzed. There was no documentation on the safety and effectiveness of cosmetic-plastic gynecologic procedures in the scientific literature. All published surgical interventions are not suitable for a cosmetic-plastic practice. The absence of documentation on safety and effectiveness related to cosmetic-plastic gynecologic procedures prevents the establishment of a standard of practice. Traditional gynecologic surgical procedures cannot be labeled and used as cosmetic-plastic procedures, it is a deceptive practice. Obtaining legal trademarks on traditional gynecologic procedures and creating a business model that tries to control clinical-scientific knowledge dissemination is unethical. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings

  11. Lower limb lymphedema in gynecological cancer survivors--effect on daily life functioning.

    Science.gov (United States)

    Dunberger, Gail; Lindquist, Helene; Waldenström, Ann-Charlotte; Nyberg, Tommy; Steineck, Gunnar; Åvall-Lundqvist, Elisabeth

    2013-11-01

    Lower limb lymphedema (LLL) is a common condition after pelvic cancer treatment but few studies have evaluated its effect on the quality of life and its consequences on daily life activities among gynecological cancer survivors. We identified a cohort of 789 eligible women, treated with pelvic radiotherapy alone or as part of combined treatment of gynecological cancer, from 1991 to 2003 at two departments of gynecological oncology in Sweden. As a preparatory study, we conducted in-depth interviews with gynecological cancer survivors and constructed a study-specific questionnaire which we validated face-to-face. The questionnaire covered physical symptoms originating in the pelvis, demographic, psychological, and quality of life factors. In relation to the lymph system, 19 questions were asked. Six hundred sixteen (78 %) gynecological cancer survivors answered the questionnaire and participated in the study. Thirty-six percent (218/606) of the cancer survivors reported LLL. Overall quality of life was significantly lower among cancer survivors with LLL. They were also less satisfied with their sleep, more worried about recurrence of cancer, and more likely to interpret symptoms from the body as recurrence. Cancer survivors reported that LLL kept them from physical activity (45 %) and house work (29 %) and affected their ability to partake in social activities (27 %) or to meet friends (20 %). Lower limb lymphedema has a negative impact on quality of life among gynecological cancer survivors, affecting sleep and daily life activities, yet only a few seek professional help.

  12. Urological injuries following gynecological operations--our experience in a teaching hospital in Nigeria.

    Science.gov (United States)

    Chianakwana, G U; Okafor, P I S; Ikechebelu, J I; Mbonu, Okechukwu O

    2006-01-01

    Various grades of urological injuries occur following gynecological operations. Some are recognized during or after surgery but others pass unnoticed. To study the urological injuries that follow gynecological operations in our centre. Retrospective study. Nnamdi Azikiwe University Teaching Hospital, Nnewi Nigeria, a third generation tertiary institution serving rural, semi-urban, and urban communities. Searching through the records, all the gynecological operations performed in our centre from 1st July 1998 to 30th June 2003 were reviewed. Those patients in whom there were documented evidences of urological injuries were noted. Similarly, all the urological injuries treated in our institution during the same period but resulting from gynecological operations carried out in peripheral hospitals were also noted. From the relevant medical records, the following data were extracted: type of gynecological operation, nature of urological injury, time when injury was detected, status of the surgeon, management modalities, and outcome. A total of 37 urological injuries occurred but, because of incomplete records in five, only 32 patients were included in this study. Ligation of the ureters following hysterectomy was the most common injury and occurred in 28 (87.5%) of the patients. Ureteric ligation is a common urological injury following gynecological operations in our centre.

  13. Domestic violence against women attending gynecologic outpatient clinics.

    Science.gov (United States)

    Nojomi, Marzieh; Agaee, Saideh; Eslami, Samira

    2007-07-01

    Violence against women and threat of violence are some of the main barriers to women's empowerment and equal participation in the society. However, they often go unnoticed and undocumented and therefore unresolved. For women, one of every five years of healthy life lost because of injury, disease, or premature death is attributable to violence. The aim of this study was to identify the prevalence of domestic violence in women attending three obstetric and gynecologic clinics in Tehran, and to determine the association between domestic violence and demographic factors. One thousand women, 15-64 years old, attending three obstetric and gynecologic clinics affiliated to Iran University of Medical Sciences in Tehran were invited to participate in a cross-sectional survey with self-administered questionnaire. The association between demographic factors (age, level of education, religious believes, annual income, job, husband's employment status, drug and alcohol abuse, previous custody of husbands) and domestic violence was assessed by questionnaire. Five hundred and ninety out of the 1000 women had experienced at least one form of violence (physical, mental, not sexual) from their husbands, 196 women had experienced some forms of controlling behavior and mental violence, and 361 women had been physically threatened. Low level of education in women, nongovernmental job, previous custody, psychiatric disorders of men, and coercive marriage for women were associated with an increased risk of domestic violence. With the high prevalence of domestic violence, health workers should not ignore the seriousness of domestic violence. Health and social personnel should be appropriately trained before "asking all cases" becomes a policy within health and social services.

  14. The relationship between serum PSA, six sex hormones and the benign or malignant prostate diseases

    International Nuclear Information System (INIS)

    Xu Yancun

    2008-01-01

    In order to study clinical significance of serum prostate-specific antigen (PSA), free prostate specific antigen (PSA), f/tPSA and six sex hormones in prostate diseases, the serum levels of PSA, fPSA, f/tPSA, T, P, E 2 , PRL, LH and FSH in 72 cases of hyperplasia of prostate patients and 40 patients with prostate cancer were determined by RIA. The results showed that the serum levels of T, E 2 , PRL, LH, FSH in the BPH Group were significantly lower than those of in Pca group, the serum level of P in Pca group were significantly lower than those in BPH group; the levels of fPSA and f/tPSA ratio in BPH Group were significantly higher than those in Pca group. The results suggest that benign and malignant prostate disease (BPH and Pca) was related with the hormone imbalance. The serum total PSA and fPSA can be regarded as important indicators in the diagnosis of BPH and Pea. The combined determination of PSA, fPSA and f/tPSA may improve the diagnostic accuracy of Pca. (authors)

  15. Gynecologic Cancer Information on YouTube: Will Women Watch Advertisements to Learn More?

    Science.gov (United States)

    Cooper, Crystale Purvis; Gelb, Cynthia A; Chu, Jennifer

    2016-09-01

    The quality and accuracy of health content posted on YouTube varies widely. To increase dissemination of evidence-based gynecologic cancer information to US YouTube users, the Centers for Disease Control and Prevention (CDC) sponsored two types of advertisements: (1) pre-roll videos that users had to watch for at least 5 s before seeing a video they selected and (2) keyword-targeted listings that appeared in search results when users entered terms related to gynecologic cancer. From July 2012 to November 2013, pre-roll videos were shown 9.2 million times, viewed (watched longer than the mandatory 5 s) 1.6 million times (17.6 %), and cost $0.09 per view. Keyword-targeted listings were displayed 15.3 million times, viewed (activated by users) 59,766 times (0.4 %), and cost $0.31 per view. CDC videos in advertisements played completely in 17.0 % of pre-roll video views and 44.4 % of keyword-targeted listing views. Advertisements on YouTube can disseminate evidence-based cancer information broadly with minimal cost.

  16. Cosmetic gynecology in the view of evidence-based medicine and ACOG recommendations: a review.

    Science.gov (United States)

    Ostrzenski, Adam

    2011-09-01

    To conduct a methodological review of the existing scientific literature within the field of cosmetic gynecology in the view of evidence-based medicine and to establish their relevance to the ACOG Committee Opinion No. 378. The appropriate medical subject heading terms were selected and applied in the search of the Internet multiple databases since 1900 until January 2010. Articles focusing on cosmetic gynecology were reviewed. Also, anecdotal and advertising literatures were analyzed. A methodological review of the literatures was conducted. In peer review journals, 72 relevant articles related to cosmetic gynecology were identified. Anecdotal information was identified in 3 sources and over 1,100 published marketing literatures were identified on the Internet and no scientific journals. Among reviewed articles on cosmetic gynecology, only two articles met the level II-2 in evidence-based medicine. The absence of documentations on the safety and effectiveness of cosmetic vaginal procedures in the scientific literatures was ACOG's main concern. Practicing cosmetic gynecology within ACOG recommendations is desirable and possible. Currently, the standard of practice of cosmetic gynecology cannot be determined due to the absence of the documentation on safety and effectiveness. Traditional gynecologic surgical procedures cannot be called cosmetic procedures, since it is a deceptive form of practice and marketing. Creating medical terminology trademarks and establishing a business model that tries to control clinical-scientific knowledge dissemination is unethical.

  17. Satisfaction with work-life balance among U.S. gynecologic oncologists, a cross-sectional study

    Science.gov (United States)

    Szender, J Brian; Grzankowski, Kassondra S; Eng, Kevin H; Lele, Shashikant B; Odunsi, Kunle; Frederick, Peter J

    2016-01-01

    Objectives To evaluate the satisfaction with work-life balance (WLB) and career satisfaction of gynecologic oncologists. Methods In August 2014, members of the Society of Gynecologic Oncology (SGO) were sent an anonymous, cross-sectional survey evaluating demographic variables, practice characteristics, career satisfaction, fatigue, and satisfaction with WLB. Fatigue was assessed using a visual-analog scale. Career satisfaction and WLB were assessed with a Likert scale. Inferential statistics were computed with type I error rates of 0.05. Results Out of the 1002 gynecologic oncologists surveyed, 290 (28.9%) responded. Only 18.6% of respondents were satisfied with WLB and there were significant associations between gender (P = 0.0157), time spent in work related activities at home (P = 0.0024), on weekends (P = 0.0017), and in the hospital (P = 0.0001). More than 84% of physicians reported they would choose medicine as a career again and of those 90% would choose to be a gynecologic oncologist again. Fatigue was strongly associated with dissatisfaction with WLB in univariate and multivariate analysis (P < 0.0001). Conclusions Although gynecologic oncologists indicated they are satisfied with their careers, most are not satisfied with their WLB. Given the forecast shortage of gynecologic oncologists and projected increased cancer rates, understanding the factors associated with career satisfaction may assist the SGO in meeting future gynecologic cancer care needs. PMID:27088113

  18. Benign multicystic mesothelioma: a case report of three sisters

    Directory of Open Access Journals (Sweden)

    Thomas Rutherford

    2009-12-01

    Full Text Available Benign multicystic mesothelioma (BMCM is a rare tumor of the abdomen-peritoneum of unknown etiology. This benign tumor was initially described by Plaut in 1928 when he observed loose cysts in the pelvis during a surgery for a uterine leiomyoma.2 The mesothelial origin was later confirmed by electron micro-scopy by Mennemeyer and Smith in 1979.3 To date, there are approximately 140 cases of BMCM reported in the literature.4 This disease primarily occurs in pre-menopausal women and is associated with a history of pelvic inflammatory disease, prior abdominal surgery, and endometriosis.4,5 The pathogenesis of this disease remains controversial, with possible etiologies including a neoplastic versus a reactive process.5 In the literature, a few case reports discuss a possible genetic or familial association with BMCM.6 Specifically, one report describes a man with familial Mediterranean fever who developed BMCM. Although familial Mediter-ranean fever is associated with malignant mesothelioma, he had only BMCM, and did not suffer from malignant mesothelioma.6 A genetic evaluation and chromosomal analysis were not able to identify a specific genetic cause of the family’s pattern of disease. This case report describes two female siblings diagnosed with BMCM. In addition, a third sister also had findings consistent with BMCM, however, the discrete histological diagnosis was never confirmed.

  19. Subspecialty Influence on Scientific Peer Review for an Obstetrics and Gynecology Journal With a High Impact Factor.

    Science.gov (United States)

    Parikh, Laura I; Benner, Rebecca S; Riggs, Thomas W; Hazen, Nicholas; Chescheir, Nancy C

    2017-02-01

    To evaluate whether quality of peer review and reviewer recommendation differ based on reviewer subspecialty in obstetrics and gynecology and to determine the role of experience on reviewer recommendation. We performed a retrospective cohort study of reviews submitted to Obstetrics & Gynecology between January 2010 and December 2014. Subspecialties were determined based on classification terms selected by each reviewer and included all major obstetrics and gynecology subspecialties, general obstetrics and gynecology, and nonobstetrics and gynecology categories. Review quality (graded on a 5-point Likert scale by the journal's editors) and reviewer recommendation of "reject" were compared across subspecialties using χ, analysis of variance, and multivariate logistic regression. There were 20,027 reviews from 1,889 individual reviewers. Reviewers with family planning subspecialty provided higher-quality peer reviews compared with reviewers with gynecology only, reproductive endocrinology and infertility, gynecologic oncology, and general obstetrics and gynecology specialties (3.61±0.75 compared with 3.44±0.78, 3.42±0.72, 3.35±0.75, and 3.32±0.81, respectively, Ppeer reviews (greater than 195) compared with the lowest quintile (one to seven) (adjusted OR 2.85 [2.60-3.12]). Peer review quality differs based on obstetrics and gynecology subspecialty. Obstetrics and gynecology subspecialty and reviewer experience have implications for manuscript rejection recommendation. Reviewer assignment is pivotal to maintaining a rigorous manuscript selection process.

  20. Increasing Awareness of Gynecologic Cancer Risks and Symptoms among Asian, Native Hawaiian and Pacific Islander Women in the US-Associated Pacific Island Jurisdictions

    Science.gov (United States)

    Novinson, Daniel; Puckett, Mary; Townsend, Julie; Reichhardt, Martina; Tareg, Aileen; Palemar, Jennifer; Wichilib, Ritchie; Stewart, Sherri L

    2017-08-27

    Background: Gynecologic cancers are common among Asian/Native Hawaiian/Pacific Islander (A/NH/PI) women. Prevention is important in United States associated Pacific Island jurisdictions (USAPIJ) because there are limited resources to treat cancer. The objective of this study was to educate A/NH/PI women and providers about evidence-based interventions to prevent and control gynecologic cancers in Yap, one of four major islands comprising the Federated States of Micronesia (FSM). This was done through a partnership between Inside Knowledge: Get The Facts About Gynecologic Cancer national campaign and the Yap comprehensive cancer control program, both funded by the Center for Disease Control and Prevention (CDC). Methods: Inside Knowledge educational materials were obtained from the CDC website and used in facilitated educational sessions. Sessions were planned according to leading health education theories, and were implemented and led by local Yap public health practitioners. Pre- and post-session surveys were used to assess changes in gynecologic cancer awareness, confidence and behavioral intentions related to prevention/early detection for gynecologic cancer. Results: Twenty-nine providers and 326 adult women participated in sessions. All participants demonstrated significant increases in knowledge across all measured domains post-session. Public knowledge that HPV causes cervical, vulvar and vaginal cancer increased from 4.9% pre-session to 51.4% post-session (pgynecologic cancer knowledge pre-session compared to 91.7% post-session. Conclusion: Targeted education about gynecologic cancer symptoms and risk factors can be effective at increasing awareness, behavioral intention, confidence and knowledge. These increases can lead to more widespread prevention of these five cancers. Creative Commons Attribution License

  1. Specific and unspecific gynecological alarm symptoms -prevalence estimates in different age groups

    DEFF Research Database (Denmark)

    Balasubramaniam, Kirubakaran; Ravn, Pernille; Larsen, Pia V

    2015-01-01

    OBJECTIVE: To determine prevalence estimates of gynecological alarm symptoms in different age groups and to describe common patterns of gynecological symptoms. DESIGN: Web-based cross-sectional survey study. SETTING: Nationwide in Denmark. POPULATION: A random sample of 51 090 women aged 20 years...

  2. Patient, surgeon, and hospital disparities associated with benign hysterectomy approach and perioperative complications.

    Science.gov (United States)

    Mehta, Ambar; Xu, Tim; Hutfless, Susan; Makary, Martin A; Sinno, Abdulrahman K; Tanner, Edward J; Stone, Rebecca L; Wang, Karen; Fader, Amanda N

    2017-05-01

    Hysterectomy is among the most common major surgical procedures performed in women. Approximately 450,000 hysterectomy procedures are performed each year in the United States for benign indications. However, little is known regarding contemporary US hysterectomy trends for women with benign disease with respect to operative technique and perioperative complications, and the association between these 2 factors with patient, surgeon, and hospital characteristics. We sought to describe contemporary hysterectomy trends and explore associations between patient, surgeon, and hospital characteristics with surgical approach and perioperative complications. Hysterectomies performed for benign indications by general gynecologists from July 2012 through September 2014 were analyzed in the all-payer Maryland Health Services Cost Review Commission database. We excluded hysterectomies performed by gynecologic oncologists, reproductive endocrinologists, and female pelvic medicine and reconstructive surgeons. We included both open hysterectomies and those performed by minimally invasive surgery, which included vaginal hysterectomies. Perioperative complications were defined using the Agency for Healthcare Research and Quality patient safety indicators. Surgeon hysterectomy volume during the 2-year study period was analyzed (0-5 cases annually = very low, 6-10 = low, 11-20 = medium, and ≥21 = high). We utilized logistic regression and negative binomial regression to identify patient, surgeon, and hospital characteristics associated with minimally invasive surgery utilization and perioperative complications, respectively. A total of 5660 hospitalizations were identified during the study period. Most patients (61.5%) had an open hysterectomy; 38.5% underwent a minimally invasive surgery procedure (25.1% robotic, 46.6% laparoscopic, 28.3% vaginal). Most surgeons (68.2%) were very low- or low-volume surgeons. Factors associated with a lower likelihood of undergoing minimally

  3. Family History of Cancer in Benign Brain Tumor Subtypes Versus Gliomas

    Energy Technology Data Exchange (ETDEWEB)

    Ostrom, Quinn T. [Department of Anthropology, Case Western Reserve University, Cleveland, OH (United States); McCulloh, Christopher [Case Western Reserve University School of Medicine, Cleveland, OH (United States); Chen, Yanwen; Devine, Karen; Wolinsky, Yingli, E-mail: qto@case.edu [Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH (United States)

    2012-02-28

    Purpose: Family history is associated with gliomas, but this association has not been established for benign brain tumors. Using information from newly diagnosed primary brain tumor patients, we describe patterns of family cancer histories in patients with benign brain tumors and compare those to patients with gliomas. Methods: Newly diagnosed primary brain tumor patients were identified as part of the Ohio Brain Tumor Study. Each patient was asked to participate in a telephone interview about personal medical history, family history of cancer, and other exposures. Information was available from 33 acoustic neuroma (65%), 78 meningioma (65%), 49 pituitary adenoma (73.1%), and 152 glioma patients (58.2%). The association between family history of cancer and each subtype was compared with gliomas using unconditional logistic regression models generating odds ratios (ORs) and 95% confidence intervals. Results: There was no significant difference in family history of cancer between patients with glioma and benign subtypes. Conclusion: The results suggest that benign brain tumor may have an association with family history of cancer. More studies are warranted to disentangle the potential genetic and/or environmental causes for these diseases.

  4. Family History of Cancer in Benign Brain Tumor Subtypes Versus Gliomas

    International Nuclear Information System (INIS)

    Ostrom, Quinn T.; McCulloh, Christopher; Chen, Yanwen; Devine, Karen; Wolinsky, Yingli

    2012-01-01

    Purpose: Family history is associated with gliomas, but this association has not been established for benign brain tumors. Using information from newly diagnosed primary brain tumor patients, we describe patterns of family cancer histories in patients with benign brain tumors and compare those to patients with gliomas. Methods: Newly diagnosed primary brain tumor patients were identified as part of the Ohio Brain Tumor Study. Each patient was asked to participate in a telephone interview about personal medical history, family history of cancer, and other exposures. Information was available from 33 acoustic neuroma (65%), 78 meningioma (65%), 49 pituitary adenoma (73.1%), and 152 glioma patients (58.2%). The association between family history of cancer and each subtype was compared with gliomas using unconditional logistic regression models generating odds ratios (ORs) and 95% confidence intervals. Results: There was no significant difference in family history of cancer between patients with glioma and benign subtypes. Conclusion: The results suggest that benign brain tumor may have an association with family history of cancer. More studies are warranted to disentangle the potential genetic and/or environmental causes for these diseases.

  5. Family history of cancer in benign brain tumor subtypes versus gliomas

    Directory of Open Access Journals (Sweden)

    Quinn eOstrom

    2012-02-01

    Full Text Available Purpose: Family history is associated with gliomas, but this association has not ben established for benign brain tumors. Using information from newly diagnosed primary brain tumor patients, we describe patterns of family cancer histories in patients with benign brain tumors and compare those to patients with gliomas. Methods: Newly diagnosed primary brain tumor patients were identified as part of the Ohio Brain Tumor Study (OBTS. Each patient was asked to participate in a telephone interview about personal medical history, family history of cancer, and other exposures. Information was available from 33 acoustic neuroma (65%, 78 meningioma (65%, 49 pituitary adenoma (73.1% and 152 glioma patients (58.2%. The association between family history of cancer and each subtype was compared with gliomas using unconditional logistic regression models generating odds ratios (ORs and 95% confidence intervals (95% CI. Results: There was no significant difference in family history of cancer between patients with glioma and benign subtypes. Conclusions: The results suggest that benign brain tumor may have an association with family history of cancer. More studies are warranted to disentangle the potential genetic and/or environmental causes for these diseases.

  6. Ocular vestibular evoked myogenic potential in patients with benign paroxysmal positional vertigo

    Directory of Open Access Journals (Sweden)

    Mozhgan Masoom

    2014-06-01

    Full Text Available Background and Aim: Since utricle is the main damaged organ in benign paroxysmal positional vertigo (BPPV, ocular vestibular evoked myogenic potential (oVEMP may be an appropriate method to evaluate the utricule dysfunction and the effect of disease recurrence rate on it. This study aimed to record myogenic potential in patients with benign paroxysmal positional vertigo.Methods: In a cross-sectional study, ocular myogenic potential was recorded in 25 healthy subjects and 20 patients with benign paroxysmal positional vertigo using 500 Hz-tone bursts (95 dB nHL.Results: In the affected ear, mean amplitude was lower and mean threshold was higher than those in the unaffected ear and in the normal group (p<0.05. Mean amplitude asymmetry ratio of patients was more than the healthy subjects (p0.05. Frequencies of abnormal responses in the affected ears were higher than in unaffected ears and in the normal group (p<0.05. Furthermore, the patients with recurrent vertigo showed more abnormalities than the patients with non-recurrent (p=0.030.Conclusion: In the recurrent benign paroxysmal positional vertigo, ocular vestibular evoked myogenic potential showed more damage in the utricle, suggesting this response could be used to evaluate the patients with benign paroxysmal positional vertigo.

  7. Ways of coping with stress and perceived social support in gynecologic cancer patients.

    Science.gov (United States)

    Yilmaz, Sema Dereli; Bal, Meltem Demirgöz; Beji, Nezihe Kzlkaya; Arvas, Macit

    2015-01-01

    Stress is commonly encountered among cancer patients and may be a challenge affecting immune system resistance. Social support may contribute positively to the health of cancer patients, playing a role in coping with stress. The aim of this study was to determine whether ways of coping are related to social support given to women with gynecologic cancer. The study was performed as a cross-sectional design in a university hospital in Istanbul, Turkey, with 221 women with gynecologic cancer; the data were collected via 3 questionnaires, the first with sociodemographic and clinical features, the second with multidimensional scale of perceived social support, and the third with the scale of ways of coping with stress. Women with gynecologic cancer who were employed and declared their incomes as balanced and reported more years of education were more likely to perceive higher social support and to use the ineffective coping ways with stress at a lower rate (P perceived social support from family, friends, significant other, and total increases (P support from family members is the mainstay of coping with stress by women with gynecologic cancer. Nurses are indispensable in increasing social support required by women with gynecologic cancer. Well-trained clinical nurses via in-service programs should be experienced and aware of women diagnosed with gynecologic cancer in need of social support during hospital visits and provide necessary guidance.

  8. Acoustic radiation force impulse imaging with Virtual Touch™ tissue quantification: mean shear wave velocity of malignant and benign breast masses

    Directory of Open Access Journals (Sweden)

    Wojcinski S

    2013-09-01

    Full Text Available Sebastian Wojcinski,1 Kathrin Brandhorst,2 Gelareh Sadigh,3 Peter Hillemanns,1 Friedrich Degenhardt2 1Department of Obstetrics and Gynecology, Hannover Medical School, Hannover, Germany; 2Department of Obstetrics and Gynecology, Franziskus Hospital, Bielefeld, Germany; 3Department of Radiology, Emory University, Atlanta, GA, USA Abstract: Acoustic radiation force impulse imaging (ARFI with Virtual Touch™ tissue quantification (VTTQ enables the determination of shear wave velocity (SWV in meters per second (m/s. The aim of our study was to describe the mean SWV in normal breast tissue and various breast masses. We performed measurements of SWV with ARFI VTTQ in 145 breast masses (57 malignant, 88 benign and in the adjacent breast parenchyma and adipose tissue. The mean SWV as well as the rate of successful measurements were analyzed. The difference between adipose tissue and parenchyma was statistically significant (3.05 versus 3.65 m/s (P < 0.001. Focusing on breast masses, numerous measurements exceeded the upper limit of possible measurement (≥9.10 m/s, indicated as "X.XX m/s". Nevertheless, the difference between the malignant and benign masses was statistically significant (8.38 ± 1.99 m/s versus 5.39 ± 2.95 m/s (P < 0.001. The best diagnostic accuracy (75.9% was achieved when the cutoff point for malignancy was set to 9.10 m/s in ARFI VTTQ. This implies that the SWV was regarded as suspicious when the upper limit of possible measurement was exceeded and the machine returned the value X.XX m/s. In conclusion, ARFI VTTQ is a feasible method for measurement of SWV in a region of interest. Furthermore, we propose the event of a highly elevated SWV as a significant criterion for malignancy. However, the method is technically not yet fully developed, and the problem of unsuccessful measurements must still be solved. Keywords: ARFI VTTQ, elastography, ultrasound, breast imaging

  9. Comparison of teaching about breast cancer via mobile or traditional learning methods in gynecology residents.

    Science.gov (United States)

    Alipour, Sadaf; Moini, Ashraf; Jafari-Adli, Shahrzad; Gharaie, Nooshin; Mansouri, Khorshid

    2012-01-01

    Mobile learning enables users to interact with educational resources while in variable locations. Medical students in residency positions need to assimilate considerable knowledge besides their practical training and we therefore aimed to evaluate the impact of using short message service via cell phone as a learning tool in residents of Obstetrics and Gynecology in our hospital. We sent short messages including data about breast cancer to the cell phones of 25 residents of gynecology and obstetrics and asked them to study a well-designed booklet containing another set of information about the disease in the same period. The rate of learning derived from the two methods was compared by pre- and post-tests and self-satisfaction assessed by a relevant questionnaire at the end of the program. The mobile learning method had a significantly better effect on learning and created more interest in the subject. Learning via receiving SMS can be an effective and appealing method of knowledge acquisition in higher levels of education.

  10. Expression of the benign HEXA mutations, Arg247Trp and Arg249Trp, associated with beta-hexosaminidase A pseudodeficiency

    Energy Technology Data Exchange (ETDEWEB)

    Cao, Z.; Petroulakis, E.; Salo, T. [Univ. of Manitoba (Canada)] [and others

    1994-09-01

    {beta}-Hexosaminidase (Hex A) is a heterodimer of {alpha} and {beta} subunits encoded by the HEXA and HEXB genes, respectively. Mutations in the HEXA gene typically cause Tay-Sachs disease or less severe forms of G{sub M2} gangliosidosis. However, two benign mutations (Arg247Trp and Arg249Trp) in the {alpha}-subunit of Hex A account for Hex A deficiency in {approximately}36% of non-Jewish enzyme-defined Tay-Sachs disease carriers. These mutations do not result in any apparent clinical phenotype in individuals who are genetic compounds with a second disease-causing mutation. We expressed the {alpha}-subunit harboring each of the benign mutations separately to study activity toward the synthetic substrate, 4-MUGS, for comparison to activity from enzymes containing mutations associated with other forms of G{sub M2} gangliosidosis. The C739T (Arg247Trp;benign), C745T (Arg 249Trp; benign), G805A (Gly269Ser; adult-onset), G749A (Gly250Asp; juvenile), and C508T (Arg170Trp; infantile) mutations were introduced into the {alpha}-subunit cDNA. These were transfected alone, or with the {beta}-subunit cDNA, to generate Hex S ({alpha}{alpha}) or Hex A ({alpha}{beta}), respectively. The activities were monitored using 4-MUGS, and the levels of {alpha}-subunit protein were assessed by Western blotting. Repeated experiments show that the benign mutations produce approximately 35% of normal Hex S and 40% of normal Hex A activity. This level is much higher than that of Hex A harbouring the Gly169Ser adult-onset mutation (12%). A sequential decrease in expressed Hex A activity is observed as mutations associated with more severe phenotypes are expressed. The benign mutations also result in lower levels of mature {alpha}-subunit protein compared to normal, and slightly reduced levels of {alpha}-subunit precursor protein. The Hex A deficiency resulting from benign mutations is not as great as that associated with disease-causing mutations.

  11. Complex Fibroadenoma and Breast Cancer Risk: A Mayo Clinic Benign Breast Disease Cohort Studya

    Science.gov (United States)

    Nassar, Aziza; Visscher, Daniel W.; Degnim, Amy C.; Frank, Ryan D.; Vierkant, Robert A.; Frost, Marlene; Radisky, Derek C.; Vachon, Celine M.; Kraft, Ruth A.; Hartmann, Lynn C.; Ghosh, Karthik

    2015-01-01

    Purpose To examine the breast cancer risk overall among women with simple fibroadenoma or complex fibroadenoma and to examine the association of complex fibroadenoma with breast cancer through stratification of other breast cancer risks. Methods The study included women aged 18 to 85 years from the Mayo Clinic Benign Breast Disease Cohort who underwent excisional breast biopsy from 1967 through 1991. Within this cohort, women who had fibroadenoma were compared to women who did not have fibroadenoma. Breast cancer risk (observed vs expected) across fibroadenoma levels was assessed through standardized incidence ratios (SIRs) by using age- and calendar-stratified incidence rates from the Iowa Surveillance, Epidemiology, and End Results registry. Analyses were performed overall, within subgroups of involution status, with other demographic characteristics (age, year of biopsy, indication for biopsy, and family history), and with histologic characteristics, including overall impression (nonproliferative disease, proliferative disease without atypia [PDWA], or atypical hyperplasia). Results Fibroadenoma was identified in 2,136 women (noncomplex, 1,835 [85.9%]; complex, 301 [14.1%]). SIR for noncomplex fibroadenoma was 1.49 (95% CI, 1.26–1.74); for complex fibroadenoma, it was 2.27 (95% CI, 1.63–3.10) (test for heterogeneity in SIR, P=.02). However, women with complex fibroadenoma were more likely to have other, concomitant high-risk histologic characteristics (eg, incomplete involution and PDWA). In analyses stratified by involution status and PDWA, complex fibroadenoma was not an independent risk marker for breast cancer. Conclusions Complex fibroadenoma does not confer increased breast cancer risk beyond other established histologic characteristics. PMID:26264469

  12. Complex fibroadenoma and breast cancer risk: a Mayo Clinic Benign Breast Disease Cohort Study.

    Science.gov (United States)

    Nassar, Aziza; Visscher, Daniel W; Degnim, Amy C; Frank, Ryan D; Vierkant, Robert A; Frost, Marlene; Radisky, Derek C; Vachon, Celine M; Kraft, Ruth A; Hartmann, Lynn C; Ghosh, Karthik

    2015-09-01

    The purpose of this study is to examine the breast cancer risk overall among women with simple fibroadenoma or complex fibroadenoma and to examine the association of complex fibroadenoma with breast cancer through stratification of other breast cancer risks. The study included women aged 18-85 years from the Mayo Clinic Benign Breast Disease Cohort who underwent excisional breast biopsy from 1967 through 1991. Within this cohort, women who had fibroadenoma were compared to women who did not have fibroadenoma. Breast cancer risk (observed versus expected) across fibroadenoma levels was assessed through standardized incidence ratios (SIRs) by using age- and calendar-stratified incidence rates from the Iowa Surveillance, Epidemiology, and End Results registry. Analyses were performed overall, within subgroups of involution status, with other demographic characteristics (age, year of biopsy, indication for biopsy, and family history), and with histologic characteristics, including overall impression [nonproliferative disease, proliferative disease without atypia (PDWA), or atypical hyperplasia]. Fibroadenoma was identified in 2136 women [noncomplex, 1835 (85.9%); complex, 301 (14.1%)]. SIR for noncomplex fibroadenoma was 1.49 (95% CI 1.26-1.74); for complex fibroadenoma, it was 2.27 (95% CI 1.63-3.10) (test for heterogeneity in SIR, P = .02). However, women with complex fibroadenoma were more likely to have other, concomitant high-risk histologic characteristics (e.g., incomplete involution and PDWA). In analyses stratified by involution status and PDWA, complex fibroadenoma was not an independent risk marker for breast cancer. Complex fibroadenoma does not confer increased breast cancer risk beyond other established histologic characteristics.

  13. Benign mixed tumor of the lacrimal sac

    Directory of Open Access Journals (Sweden)

    Jong-Suk Lee

    2015-01-01

    Full Text Available Neoplasms of the lacrimal drainage system are uncommon, but potentially life-threatening and are often difficult to diagnose. Among primary lacrimal sac tumors, benign mixed tumors are extremely rare. Histologically, benign mixed tumors have been classified as a type of benign epithelial tumor. Here we report a case of benign mixed tumor of the lacrimal sac.

  14. Proposals for common definitions of reference points in gynecological brachytherapy

    International Nuclear Information System (INIS)

    Chassagne, D.; Horiot, J.C.

    1977-01-01

    In May 1975 the report of European Curietherapy Group recommended in gynecological Dosimetry by computer. Use of reference points = lymphatic trapezoid figure with 6 points, Pelvic wall, all points are refering to bony structures. Use of critical organ reference points = maximum rectum dose, bladder dose mean rectal dose. Use of 6,000 rads reference isodose described by height, width, and thickness dimensions. These proposals are the basis of a common language in gynecological brachytherapy [fr

  15. Side effects and risks of radioiodine treatment of benign thyroid diseases. Nebenwirkungen und Risiken bei der Radiojodtherapie gutartiger Schilddruesenerkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Becker, W.; Hohenberger, W.; Wolf, F. (Erlangen-Nuernberg Univ., Erlangen (Germany, F.R.). Nuklearmedizinische Klinik mit Poliklinik Erlangen-Nuernberg Univ., Erlangen (Germany, F.R.). Chirurgische Klinik mit Poliklinik)

    1990-12-01

    Radioiodine treatment is considered to be the treatment of choice in benign thyroid diseases because of its very low side effects. Real and hypothetic risks and side effects have to be differentiated. Both may occur early and late after the treatment. Radioiodinethyroiditis in small volumes at high doses is very rare. Exacerbation of a thyroid storm (0.34%) as well as local compressions accompanied with reactive edema of the thyroid are early real side effects of radioiodine treatment. Late real side effects are failure of treatment (7-30% of thyrotoxicosis) and induction of hypothyroidism (4-20% of functional autonomy and increasing frequency in Graves' diseases with time). Late hypothetic risks are somatic (1-9/10000 bis 1-9/100000) or genetic (1-9/100000). An early risk might be the misdiagnosis of an additional thyroid carcinoma. (orig.).

  16. Benign Duodenocolic Fistula: a Case Report.

    Science.gov (United States)

    Soheili, Marzieh; Honarmand, Shirin; Soleimani, Heshmatollah; Elyasi, Anvar

    2015-08-01

    Benign duodenocolic fistula (DCF), known as a fistula between the duodenum and colon with or without cecum of nonmalignant origin, is an unusual complication of different gastrointestinal diseases. The present paper records a case in which the patient presented with chronic diarrhea, abdominal pain, weight loss as well as having a history of gastric ulcer. Most frequently the condition presents with signs of malabsorption such as weight loss and diarrhea, but other symptoms include nausea, vomiting (sometimes with fecal), and abdominal pain. Gastrointestinal inflammatory conditions are the usual causes. The most common ones are perforated duodenal ulcer and Crohn's disease. Barium enemas are usually diagnostic. Treatment consists of excising the fistula and repairing the duodenal and colonic defects. Closure of the fistula provides quick relief.

  17. Benign Duodenocolic Fistula: a Case Report

    Directory of Open Access Journals (Sweden)

    Marzieh Soheili

    2015-10-01

    Full Text Available Benign duodenocolic fistula (DCF, known as a fistula between the duodenum and colon with orwithout cecum of nonmalignant origin, is an unusual complication of different gastrointestinal diseases. Thepresent paper records a case in which the patient presented with chronic diarrhea, abdominal pain, weight lossas well as having a history of gastric ulcer. Most frequently the condition presents with signs ofmalabsorption such as weight loss and diarrhea, but other symptoms include nausea, vomiting (sometimeswith fecal, and abdominal pain. Gastrointestinal inflammatory conditions are the usual causes. The mostcommon ones are perforated duodenal ulcer and Crohn’s disease. Barium enemas are usually diagnostic.Treatment consists of excising the fistula and repairing the duodenal and colonic defects. Closure of thefistula provides quick relief.

  18. Increased Incidence of Benign Pancreatic Pathology following Pancreaticoduodenectomy for Presumed Malignancy over 10 Years despite Increased Use of Endoscopic Ultrasound

    Directory of Open Access Journals (Sweden)

    Shadi S. Yarandi

    2014-01-01

    Full Text Available Despite using imaging studies, tissue sampling, and serologic tests about 5–10% of surgeries done for presumed pancreatic malignancies will have benign findings on final pathology. Endoscopic ultrasound (EUS is used with increasing frequency to study pancreatic masses. The aim of this study is to examine the effect of EUS on prevalence of benign diseases undergoing Whipple over the last decade. Patients who underwent Whipple procedure for presumed malignancy at Emory University Hospital from 1998 to 2011 were selected. Demographic data, history of smoking and drinking, history of diabetes and pancreatitis, imaging data, pathology reports, and tumor markers were extracted. 878 patients were found. 95 (10.82% patients had benign disease. Prevalence of benign finding had increased over the recent years despite using more EUS. Logistic regression models showed that abdominal pain (OR: 5.829, 95% CI 2.681–12.674, P ≤ 0.001 and alcohol abuse (OR: 3.221, CI 95%: 1.362–7.261, P: 0.002 were predictors of benign diseases. Jaundice (OR: 0.221, 95% CI: 0.084–0.58, P: 0.002, mass (OR: 0.145, 95% CI: 0.043–0.485, P: 0.008, and ductal dilation (OR: 0.297, 95% CI 0.134–0.657, P: 0.003 were associated with malignancy. Use of imaging studies, ERCP, and EUS has not decreased the percentage of benign findings after surgery for presumed pancreatic malignancy.

  19. Nuclear medicine in obstetrics and gynecology

    International Nuclear Information System (INIS)

    Patterson, V.N.

    1975-01-01

    The role of radioisotopes for diagnosis and therapy in obstetrics and gynecology are reviewed. A brief history of the development of nuclear medicine is given along with a discussion of basic concepts. Finally a more detailed overview with graphs and pictures is presented for specific techniques

  20. Benign fibrous histiocytoma of the lumbar vertebrae

    International Nuclear Information System (INIS)

    Demiralp, Bahtiyar; Oguz, Erbil; Sehirlioglu, Ali; Kose, Ozkan; Sanal, Tuba; Ozcan, Ayhan

    2009-01-01

    Benign fibrous histiocytoma is an extremely rare spinal tumor with ten reported cases in the literature. Benign fibrous histiocytoma constitutes a diagnostic challenge because it shares common clinical symptoms, radiological characteristics, and histological features with other benign lesions involving the spine. We present a case of benign fibrous histiocytoma of the lumbar spine and discuss its differential diagnosis and management. (orig.)

  1. The evaluation of the effect of metformin on breast fibrocystic disease.

    Science.gov (United States)

    Talaei, A; Moradi, A; Rafiei, F

    2017-01-01

    Fibrocystic changes (FCC) is the most common benign breast disease. The main pathophysiologic mechanism of FCC, excessive cell proliferation in response to monthly estrogen and progesterone changes. Regarding to antiproliferative of metformin, the aim of this study is the evaluation of the effect of metformin on FCC in women who were referred to gynecology clinics of ArakMETHODS:This study is a double blind placebo control randomized clinical trial. At the first among women who were referred to gynecology of Arak, 186 women with FCC between 18-40 years were selected. The women were randomly classified into three groups. The first group took metformin and the second group as placebo group took vitamin E and the third group did not take any drug during six months. All groups were compared in clinical symptoms based on visual analogue scale (VAS) and the sonographic data also were recorded and compared. Data analysis was performed by unilateral variance, student t and Chi-square. The three groups were not different in aspect of mean of the cysts number, cyst size, tenderness and discharge from breast before the intervention, but after the intervention, there was a significant decrease in metformin group (p value < 0.001) based on variance analysis test. There was not a meaningful difference of pain and the location of cysts between the groups after the intervention. The present study showed that metformin is effective in treatment of FCC and decreasing of clinical symptoms and imaging items.

  2. Italian survey on benign paroxysmal positional vertigo

    OpenAIRE

    Messina, A.; Casani, A.P.; Manfrin, M.; Guidetti, G.

    2017-01-01

    SUMMARY Benign paroxysmal positional vertigo (BPPV) is the most common type of peripheral vertigo. BPPV often relapses after the first episode, with a recurrence rate between 15% and 50%. To date both the aetiopathogenetic processes that lead to otoconia detachment and the factors that make BPPV a relapsing disease are still unclear, but recent epidemiological studies have shown a possible association with cardiovascular risk factors. The aim of the present study (Sesto Senso Survey) was to e...

  3. Percutaneous transhepatic portal vein stenting in a patient with benign non-transplant postoperative portal vein stenosis: A case report

    OpenAIRE

    Madhusudhan, KS; Agrawal, Nikhil; Srivastava, Deep N; Pal, Sujoy; Gupta, Arun K

    2013-01-01

    Extrahepatic portal vein stenosis is caused by a variety of benign and malignant diseases and results in development of symptoms due to portal hypertension. Benign post-surgical adhesions causing portal vein stenosis in non-transplant population is an uncommon etiology of portal hypertension. Endovascular treatment of such patients with angioplasty and stenting is uncommonly reported in literature. We report a case of portal hypertension caused by benign postoperative portal vein fibrosis, su...

  4. Benign breast disease and the risk of breast cancer in the next 15 years.

    Science.gov (United States)

    Socolov, Demetra; Anghelache, Ivona; Ilea, C; Socolov, R; Carauleanu, A

    2015-01-01

    Fibrocystic mastosis (FCM) is defined by the totality of dystrophic changes of the mammary tissue, the grouping in the form of fibrosis of epithelial, cystic, metaplastic and hyperplastic alterations. A very good estimation of the cancer risk is related specifically to the microscopic aspect. Other factors, the family history as well as the presence of an inherited gene determining the increase in the risk of breast cancer are also considered. But, if a woman known with fibrocystic mastosis has not undergone any biopsy, then it is impossible to calculate the specific individual risk of developing cancer. The data collected as a study material and considered refer to: the total num- ber of cases investigated and diagnosed with fibrocystic mastosis, the annual distribution of this disease cases, the distribution of the cases according to age groups, admission reasons, clinical examination, personal pathologic history clinically significant for the basic disease (the main diagnosis), the family medical history significant for the basic disease, the anatomopathological diagnosis. Between 2004 and 2006, at "Cuza Vodă" Obstetrics and Gynecology Hospital of Iaşi, a maximum number of cases is noticed in 2006, when there were 147 cases, and the lowest number of cases was in 2005. There was high frequency of the anatomopathological examinations that highlighted the presence of fibrocystic lesions (both proliferative and non-proliferative), and the second most often diagnosis is fibroadenoma. Though fibrocystic mastosis is not clearly defined, it is still admitted that in order to support this diagnosis it is first compulsory to exclude malignant tumours. Only in 5% of the women with fibrocystic mastosis cellular changes can be revealed in the form of atypical hyperplasia, which are a risk factor for cancer. The lesion that delimits cancer from non-cancer is ductal carcinoma in situ. An incidence of over 20% is present in the countries that use mammographic screening

  5. High school students' opinions of gynecological consultations in Rio de Janeiro, Southeastern Brazil.

    Science.gov (United States)

    Pereira, Sandra de Morais; Taquette, Stella Regina; Pérez, Maurício de Andrade

    2013-02-01

    To analyze sociocultural differences and perceptions of gynecological consultations for high school girls. A transversal study with 418 high school girls from three schools of different profiles in the city of Rio de Janeiro, Southeastern Brazil in 2010. A structured questionnaire encompassing socio-demographic characteristics, sexual behavior and evaluation of gynecological consultations was completed. Yates' Chi-square test and the Student's t-test were utilized adopting a value of p students of private and federal public schools presented similar profiles but both were different from the state school girls. The latter had lower socioeconomic status, and their parents had lower levels of education, the predominance of afro-descendants was observed, as were a larger number of sexual partners, pregnancy and cases of sexual violence. The average age of menarche and sexarche among the students were similar, but the first gynecological consultation was significantly later among the state school students. The majority showed some knowledge of contraception and STDs, although only a minority received guidance from the consultations. Students expressed the desire that the professionals dedicate more time, patience and availability to them during consultations. The provision of gynecological services for teenagers is not satisfactory, according to the teenagers' evaluations. Users of the private health system have gynecological consultations earlier than those who only have access to the public system. It is necessary to create mechanisms that facilitate access and adhesion to a routine of gynecological prevention for this age group.

  6. Expression and significance of cyclooxygenase-2 mRNA in benign and malignant ascites

    Science.gov (United States)

    Lu, Jing; Li, Xiao-Feng; Kong, Li-Xia; Ma, Lin; Liao, Su-Huan; Jiang, Chang-You

    2013-01-01

    AIM: To investigate the mRNA expression of cyclooxygensae-2 (COX-2) in benign and malignant ascites, and to explore the difference in COX-2 mRNA expression among different diseases. METHODS: A total of 36 samples were collected from the Fifth Affiliated Hospital of Sun Yat-Sen University and divided into two experimental groups: benign ascites (n = 21) and malignant ascites (n = 15). Benign ascites included cirrhotic ascites (n = 10) and tuberculous ascites (n = 5). Malignant ascites included oophoroma (n = 7), cancer of colon (n = 5), cancer of the liver (n = 6), gastric cancer (n = 2), and bladder carcinoma (n = 1). The mRNA expression of COX-2 in ascites was examined with reverse transcriptase polymerase chain reaction (RT-PCR) technology, and the positive rate of COX-2 mRNA was compared between different diseases. RESULTS: The positive rate of COX-2 mRNA in malignant ascites was 42.9% (9/21), which was significantly higher than in benign ascites, 6.7% (1/15), difference being significant between these two groups (χ2 = 4.051, P = 0.044). The proportion of the positive rate in the malignant ascites was as follows: ovarian cancers 57.1% (4/7), colon cancer 40.0% (2/5), liver cancer 33.3% (2/6), gastric cancer 50.0% (1/2), and bladder cancer 0.00% (0/1). However, there was no significant difference in COX-2 mRNA expression among various tumors with malignant ascites (χ2 = 1.614, P = 0.806). Among the benign ascites, COX-2 mRNA levels were different between the tuberculous ascites (0/5) and cirrhotic ascites (1/10), but there was no significant difference (P = 1.000). CONCLUSION: COX-2 mRNA, detected by RT-PCR, is useful in the differential diagnosis of benign and malignant ascites, which also has potential value in the clinical diagnosis of tumors. PMID:24187465

  7. [Investigation of the relationship between chronic diseases and residual symptoms of benign paroxysmal positional vertigo].

    Science.gov (United States)

    Zhou, Fengjie; Fu, Min; Zhang, Nan; Xu, Ye; Ge, Ying

    2015-09-01

    To investigate the prognosis-related influence factors of the residual symptoms after the canalith repositioning procedure (CRP) for the benign paroxysmal positional vertigo (BPPV) in the second affiliated hospital of dalian medical university. Among patients who were diagnosed with BPPV and treated by CRP, the one that still show residual symptoms were enrolled in our study, then make a follow-up irregularly about the tendency of their residual symptoms' self-healing,and respectively record in their gender, age and chronic diseases and so on. Single-factor analysis and multi-factors analysis was utilized to investigate the residual symptoms' related influencing factors. In this study, 149 cases of patients were in record, for the residual symptoms, 71 patients can go to self-healing, 78 patients can not; age is 23-88, 30 cases in the young group, 46 cases in the middle aged group, 47 cases in the young elderly group, 26 cases in the elderly group; patients suffering from high blood pressure are 76 cases, 76 cases had diabetes, 47 cases had hyperlipidemia, 110 cases had heart disease, 43 cases had ischemic encephalopathy. The residual symptoms in the elderly females patients and patients suffering from the hypertension, diabetes, heart disease patients and ischemic encephalopathy are not easy to heal by itself, in which, the older and the fact suffering from the hypertension and diabetes are the risk factors influencing the prognosis of the residual symptoms.

  8. Benign paroxysmal positional vertigo and comorbid conditions.

    Science.gov (United States)

    Cohen, Helen S; Kimball, Kay T; Stewart, Michael G

    2004-01-01

    To determine the prevalence of comorbid disease in patients with benign paroxysmal positional vertigo (BPPV) and the relationship of comorbid disease to symptoms of vertigo, disequilibrium, and anxiety. Patients who had posterior semicircular canal BPPV and who had been referred for vestibular rehabilitation at a tertiary care center completed a health status questionnaire and the Vertigo Symptom Scale, answered questions about level of vertigo, and were tested on computerized dynamic posturography. Subjects had high rates of diabetes, mild head trauma, and probable sinus disease. Balance was generally impaired, worse in diabetics and subjects with significant vestibular weakness. Subjects who smoked or had had mild head trauma had higher levels of anxiety. Comorbid conditions, particularly diabetes, mild head trauma, and sinus disease, are unusually prevalent in BPPV patients. Message: Patients with comorbid disease are at risk for having increased vertigo, anxiety, and disequilibrium compared to other patients. Copyright 2004 S. Karger AG, Basel

  9. Benign core biopsy of probably benign breast lesions 2 cm or larger: correlation with excisional biopsy and long-term follow-up

    International Nuclear Information System (INIS)

    Jung, Hyun Kyung; Moon, Hee Jung; Kim, Min Jung; Kim, Eun Kyung

    2014-01-01

    To evaluate the accuracy of benign core biopsy of probably benign breast lesions (category 3) 2 cm or larger on the basis of excisional biopsy and long-term follow-up. We retrospectively reviewed 146 category 3 lesions in 146 patients 2 cm or larger which were diagnosed as benign by ultrasound (US)-guided core biopsy. Patients were initially diagnosed as benign at core needle biopsy and then followed up with excisional biopsy (surgical excision, n=91; US-guided vacuum assisted excision, n=35) or breast ultrasonography (n=20). Of the 126 patients who underwent surgical excision or US-guided vacuum-assisted excision, 114 patients were diagnosed with benign lesions, 10 patients with borderline lesions (benign phyllodes tumor), and two patients with malignant phyllodes tumors. The probabilities of lesions being benign, borderline and malignant were 91.8% (134/146), 6.8% (10/146), and 1.4% (2/146), respectively. Of 13 patients who had growing masses on follow-up ultrasonography, three (23.1%) were non-benign (two benign phyllodes tumors and one malignant phyllodes tumor). US-guided core needle biopsy of probably benign breast mass 2 cm or larger was accurate (98.6%) enough to rule out malignancy. But, it was difficult to rule out borderline lesions even when they were diagnosed as benign.

  10. Comparative study of ultrasound imaging, computed tomography and magnetic resonance imaging in gynecology

    International Nuclear Information System (INIS)

    Ishii, Kenji; Kobayashi, Hisaaki; Hoshihara, Takayuki; Kobayashi, Mitsunao; Suda, Yoshio; Takenaka, Eiichi; Sasa, Hidenori.

    1989-01-01

    We studied 18 patients who were operated at the National Defense Medical College Hospital and confirmed by pathological diagnosis. We compared ultrasound imaging, computed tomography (CT) and magnetic resonance imaging (MRI) of the patients. MRI was useful to diagnose enlargement of the uterine cavity and a small amount of ascites and to understand orientation of the pelvic organs. Ultrasound imaging is the most useful examination to diagnose gynecological diseases. But when it is difficult to diagnose by ultrasound imaging alone, we should employ either CT or MRI, or preferably both. (author)

  11. Practice Patterns, Attitudes, and Barriers to Palliative Care Consultation by Gynecologic Oncologists.

    Science.gov (United States)

    Buckley de Meritens, Alexandre; Margolis, Benjamin; Blinderman, Craig; Prigerson, Holly G; Maciejewski, Paul K; Shen, Megan J; Hou, June Y; Burke, William M; Wright, Jason D; Tergas, Ana I

    2017-09-01

    We sought to describe practice patterns, attitudes, and barriers to the integration of palliative care services by gynecologic oncologists. Members of the Society of Gynecologic Oncology were electronically surveyed regarding their practice of incorporating palliative care services and to identify barriers for consultation. Descriptive statistics were used, and two-sample z-tests of proportions were performed to compare responses to related questions. Of the 145 respondents, 71% were attending physicians and 58% worked at an academic medical center. The vast majority (92%) had palliative care services available for consultation at their hospital; 48% thought that palliative care services were appropriately used, 51% thought they were underused, and 1% thought they were overused. Thirty percent of respondents thought that palliative care services should be incorporated at first recurrence, whereas 42% thought palliative care should be incorporated when prognosis for life expectancy is ≤ 6 months. Most participants (75%) responded that palliative care consultation is reasonable for symptom control at any stage of disease. Respondents were most likely to consult palliative care services for pain control (53%) and other symptoms (63%). Eighty-three percent of respondents thought that communicating prognosis is the primary team's responsibility, whereas the responsibilities for pain and symptom control, resuscitation status, and goals of care discussions were split between the primary team only and both teams. The main barrier for consulting palliative care services was the concern that patients and families would feel abandoned by the primary oncologist (73%). Ninety-seven percent of respondents answered that palliative care services are useful to improve patient care. The majority of gynecologic oncologists perceived palliative care as a useful collaboration that is underused. Fear of perceived abandonment by the patient and family members was identified as a

  12. Preparedness of Ob/Gyn residents for fellowship training in gynecologic oncology

    Directory of Open Access Journals (Sweden)

    David W. Doo

    2015-04-01

    Full Text Available Residency training in obstetrics and gynecology is being challenged by increasingly stringent regulations and decreased operative experience. We sought to determine the perception of preparedness of incoming gynecologic oncology fellows for advanced surgical training in gynecologic oncology. An online survey was sent to gynecologic oncologists involved in fellowship training in the United States. They were asked to evaluate their most recent incoming clinical fellows in the domains of professionalism, level of independence/graduated responsibility, psychomotor ability, clinical evaluation and management, and academia and scholarship using a standard Likert-style scale. The response rate among attending physicians was 40% (n = 105/260 and 61% (n = 28/46 for program directors. Of those who participated, 49% reported that their incoming fellows could not independently perform a hysterectomy, 59% reported that they could not independently perform 30 min of a major procedure, 40% reported that they could not control bleeding, 40% reported that they could not recognize anatomy and tissue planes, and 58% reported that they could not dissect tissue planes. Fellows lacked an understanding of pathophysiology, treatment recommendations, and the ability to identify and treat critically ill patients. In the academic domain, respondents agreed that fellows were deficient in the areas of protocol design (54%, statistical analysis (54%, and manuscript writing (65%. These results suggest that general Ob/Gyn residency is ineffective in preparing fellows for advanced training in gynecologic oncology and should prompt a revision of the goals and objectives of resident education to correct these deficiencies.

  13. Analysis of matrix metalloproteinase-1 gene polymorphisms and expression in benign and malignant breast tumors

    Science.gov (United States)

    Zhou, Jing; Brinckerhoff, Constance; Lubert, Susan; Yang, Kui; Saini, Jasmine; Hooke, Jeffrey; Mural, Richard; Shriver, Craig; Somiari, Stella

    2013-01-01

    A guanine insertion polymorphism in matrix metalloproteinase-1 promoter (MMP-1 2G) is linked to early onset and aggressiveness in cancer. We determined the role of MMP-1 2G on the level of MMP-1 expression and breast cancer severity in benign breast disease, atypical hyperplasia, invasive and non invasive (in situ) breast cancer. We observed no significant difference in genotype distribution among the different breast disease groups. However, the level of MMP-1 expression was significantly higher in atypical ductal hyperplasia compared to benign breast disease; and in invasive breast cancer compared to in situ breast cancer. MMP-1 2G insertion polymorphism in the invasive group also correlated significantly with the expression of MMP-1 and breast cancer prognostic markers HER2 and P53. PMID:22011282

  14. Molecular targets in serous gynecologic cancers

    NARCIS (Netherlands)

    Groeneweg, J.W.

    2015-01-01

    In this thesis we describe a series of studies assessing the effectiveness of targeted therapeutics that inhibit Notch signaling or the HER2 receptor in serous gynecologic cancers. In the first part of the thesis, we have confirmed previous data by showing expression of Notch1 and Notch3 in ovarian

  15. The epidemiologic status of gynecologic cancer in Thailand.

    Science.gov (United States)

    Wilailak, Sarikapan; Lertchaipattanakul, Nuttapong

    2016-11-01

    Between the years of 2010-2012, it was estimated there were a total of 112,392 new cases of cancers in Thailand, thus, the total age-standardized rate (ASR) per 100,000 is 137.6. In regards to the most prevalent types of cancer in female, breast cancer has the highest ASR, followed by cervical cancer (ASR=14.4); liver and bile duct cancer; colon and rectum cancer; trachea, bronchus and lung cancer; ovarian cancer (ASR=6.0); thyroid cancer; non-Hodgkin lymphoma and uterine cancer (ASR=4.3). The trend of cervical cancer in Thailand is decreasing, one key factor in making this possible was the employment of dual tract strategy (Pap smear and visual inspection with acetic acid [VIA]) by the government in 2005. In the future, the government is also considering integrating human papillomavirus (HPV) vaccination into the national immunization program, which may assist in the prevention of cervical cancer. By studying the statistical data of gynecologic cancer, it will be possible to formulate measures for the prevention, control and treatment of gynecologic cancer. Eventually, it will potentially improve the quality of life (QoL) of patients as well as decrease the mortality rate caused by gynecologic cancer.

  16. Hematological Toxicity After Robotic Stereotactic Body Radiosurgery for Treatment of Metastatic Gynecologic Malignancies

    Energy Technology Data Exchange (ETDEWEB)

    Kunos, Charles A., E-mail: charles.kunos@UHhospitals.org [Department of Radiation Oncology, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (United States); Debernardo, Robert [Department of Obstetrics and Gynecology, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (United States); Radivoyevitch, Tomas [Department of Epidemiology and Biostatistics, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (United States); Fabien, Jeffrey; Dobbins, Donald C.; Zhang Yuxia; Brindle, James [Department of Radiation Oncology, University Hospitals Case Medical Center and Case Western Reserve University School of Medicine, Cleveland, Ohio (United States)

    2012-09-01

    Purpose: To evaluate hematological toxicity after robotic stereotactic body radiosurgery (SBRT) for treatment of women with metastatic abdominopelvic gynecologic malignancies. Methods and Materials: A total of 61 women with stage IV gynecologic malignancies treated with abdominopelvic SBRT were analyzed after ablative radiation (2400 cGy/3 divided consecutive daily doses) delivered by a robotic-armed Cyberknife SBRT system. Abdominopelvic bone marrow was identified using computed tomography-guided contouring. Fatigue and hematologic toxicities were graded by retrospective assignment of common toxicity criteria for adverse events (version 4.0). Bone marrow volume receiving 1000 cGy (V10) was tested for association with post-therapy (median 32 days [25%-75% quartile, 28-45 days]) white- or red-cell counts, hemoglobin levels, and platelet counts as marrow toxicity surrogates. Results: In all, 61 women undergoing abdominopelvic SBRT had a median bone marrow V10 of 2% (25%-75% quartile: 0%-8%). Fifty-seven (93%) of 61 women had received at least 1 pre-SBRT marrow-taxing chemotherapy regimen for metastatic disease. Bone marrow V10 did not associate with hematological adverse events. In all, 15 grade 2 (25%) and 2 grade 3 (3%) fatigue symptoms were self-reported among the 61 women within the first 10 days post-therapy, with fatigue resolved spontaneously in all 17 women by 30 days post-therapy. Neutropenia was not observed. Three (5%) women had a grade 1 drop in hemoglobin level to <10.0 g/dL. Single grade 1, 2, and 3 thrombocytopenias were documented in 3 women. Conclusions: Abdominopelvic SBRT provided ablative radiation dose to cancer targets without increased bone marrow toxicity. Abdominopelvic SBRT for metastatic gynecologic malignancies warrants further study.

  17. Hematological Toxicity After Robotic Stereotactic Body Radiosurgery for Treatment of Metastatic Gynecologic Malignancies

    International Nuclear Information System (INIS)

    Kunos, Charles A.; Debernardo, Robert; Radivoyevitch, Tomas; Fabien, Jeffrey; Dobbins, Donald C.; Zhang Yuxia; Brindle, James

    2012-01-01

    Purpose: To evaluate hematological toxicity after robotic stereotactic body radiosurgery (SBRT) for treatment of women with metastatic abdominopelvic gynecologic malignancies. Methods and Materials: A total of 61 women with stage IV gynecologic malignancies treated with abdominopelvic SBRT were analyzed after ablative radiation (2400 cGy/3 divided consecutive daily doses) delivered by a robotic-armed Cyberknife SBRT system. Abdominopelvic bone marrow was identified using computed tomography-guided contouring. Fatigue and hematologic toxicities were graded by retrospective assignment of common toxicity criteria for adverse events (version 4.0). Bone marrow volume receiving 1000 cGy (V10) was tested for association with post-therapy (median 32 days [25%-75% quartile, 28-45 days]) white- or red-cell counts, hemoglobin levels, and platelet counts as marrow toxicity surrogates. Results: In all, 61 women undergoing abdominopelvic SBRT had a median bone marrow V10 of 2% (25%-75% quartile: 0%-8%). Fifty-seven (93%) of 61 women had received at least 1 pre-SBRT marrow-taxing chemotherapy regimen for metastatic disease. Bone marrow V10 did not associate with hematological adverse events. In all, 15 grade 2 (25%) and 2 grade 3 (3%) fatigue symptoms were self-reported among the 61 women within the first 10 days post-therapy, with fatigue resolved spontaneously in all 17 women by 30 days post-therapy. Neutropenia was not observed. Three (5%) women had a grade 1 drop in hemoglobin level to <10.0 g/dL. Single grade 1, 2, and 3 thrombocytopenias were documented in 3 women. Conclusions: Abdominopelvic SBRT provided ablative radiation dose to cancer targets without increased bone marrow toxicity. Abdominopelvic SBRT for metastatic gynecologic malignancies warrants further study.

  18. Gynecologic radiation therapy. Novel approaches to image-guidance and management

    Energy Technology Data Exchange (ETDEWEB)

    Viswanathan, Akila N. [Harvard Medical School, Boston, MA (United States). Dept. of Radiation Oncology; Kirisits, Christian; Poetter, Richard (eds.) [Vienna General Hospital Medical Univ. (Austria). Dept. of Radiotherapy; Erickson, Beth E. [Medical College of Wisconsin Clinics Froedtert Hospital, Milwaukee, WI (United States). Dept. of Radiation Oncology

    2011-07-01

    Recent advances in the treatment of gynecologic malignancies led to a new worldwide consensus to introduce image guidance to gynecologic radiation therapy, particularly to brachytherapy. The book summarizes the changed practice of management: treatment planning for cervical cancer, not modified for over 60 years, has been shifted to an image-based approach, endometrial cancer management with an increase in the use of chemotherapy and vaginal brachytherapy, and vaginal cancer therapy including image guidance and high-dose delivery with IMRT. (orig.)

  19. Distinguishing benign notochordal cell tumors from vertebral chordoma

    International Nuclear Information System (INIS)

    Yamaguchi, Takehiko; Iwata, Jun; Sugihara, Shinsuke; McCarthy, Edward F.; Karita, Michiaki; Murakami, Hideki; Kawahara, Norio; Tsuchiya, Hiroyuki; Tomita, Katsuro

    2008-01-01

    The objective was to characterize imaging findings of benign notochordal cell tumors (BNCTs). Clinical and imaging data for 9 benign notochordal cell tumors in 7 patients were reviewed retrospectively. Conventional radiographs (n = 9), bone scintigrams (n = 2), computed tomographic images (n = 7), and magnetic resonance images (n = 8) were reviewed. Eight of the 9 lesions were stained with hematoxylin-eosin and microscopically examined. There were 3 male and 4 female patients with an age range of 22 to 55 years (average age, 44 years). Two patients had two lesions at different sites. The lesions involved the cervical spine in 4 patients, the lumbar spine in 2, the sacrum in 2, and the coccyx in 1. The most common symptom was mild pain. The lesions of 2 patients were found incidentally during imaging studies for unrelated conditions. Five patients underwent surgical procedures. One patient died of surgical complications. All other patients have been well without recurrent or progressive disease for 13 to 84 months. Radiographs usually did not reveal significant abnormality. Five lesions exhibited subtle sclerosis and 1 showed intense sclerosis. Technetium bone scan did not reveal any abnormal uptake. Computed tomography images had increased density within the vertebral bodies. The lesions had a homogeneous low signal intensity on T1-weighted magnetic resonance images and a high intensity on T2-weighted images without soft-tissue mass. Microscopically, lesions contained sheets of adipocyte-like vacuolated chordoid cells without a myxoid matrix. Benign notochordal cell tumors may be found during routine clinical examinations and do not require surgical management unless they show extraosseous disease. These tumors should be recognized by radiologists, pathologists, and orthopedic surgeons to prevent operations, which usually are extensive. (orig.)

  20. Satisfaction with work-life balance among U.S. gynecologic oncologists, a cross-sectional study.

    Science.gov (United States)

    Szender, J Brian; Grzankowski, Kassondra S; Eng, Kevin H; Lele, Shashikant B; Odunsi, Kunle; Frederick, Peter J

    To evaluate the satisfaction with work-life balance (WLB) and career satisfaction of gynecologic oncologists. In August 2014, members of the Society of Gynecologic Oncology (SGO) were sent an anonymous, cross-sectional survey evaluating demographic variables, practice characteristics, career satisfaction, fatigue, and satisfaction with WLB. Fatigue was assessed using a visual-analog scale. Career satisfaction and WLB were assessed with a Likert scale. Inferential statistics were computed with type I error rates of 0.05. Out of the 1002 gynecologic oncologists surveyed, 290 (28.9%) responded. Only 18.6% of respondents were satisfied with WLB and there were significant associations between gender (P = 0.0157), time spent in work related activities at home (P = 0.0024), on weekends (P = 0.0017), and in the hospital (P = 0.0001). More than 84% of physicians reported they would choose medicine as a career again and of those 90% would choose to be a gynecologic oncologist again. Fatigue was strongly associated with dissatisfaction with WLB in univariate and multivariate analysis (P satisfaction may assist the SGO in meeting future gynecologic cancer care needs.

  1. Benign Orofacial Lesions in Libyan Population: A 17 Years Retrospective Study.

    Science.gov (United States)

    Hatem, Marwa; Abdulmajid, Ziad S; Taher, Elsanousi M; El Kabir, Mohamed A; Benrajab, Mohamed A; Kwafi, Rafik

    2015-01-01

    To analyze the frequency and type of benign orofacial lesions submitted for diagnosis at Tripoli Medical Centre over 17 years period (1997-2013). Entries for specimens from patients were retrieved and compiled into 9 diagnostic categories and 82 diagnoses. During the 17 years period, a total of 975 specimens were evaluated, it comprised a male-female ratio of 0.76:1. The mean age of biopsied patients was 36.3±18.32 years. The diagnostic category with the highest number of specimens was skin and mucosal pathology (22.87%); and the most frequent diagnosis was pyogenic granuloma (14.05%). Pyogenic granuloma, lichen planus, radicular cyst and fibroepithelial polyp were found to be the most predominant diagnoses. Frequencies of most benign orofacial diseases were comparable to similar studies in the literature and to those reported from the eastern region of Libya. Further surveys are needed to define the epidemiology of orofacial diseases in Libyan population.

  2. Dosimetry prior to I-131-therapy of benign thyroid disease

    International Nuclear Information System (INIS)

    Haenscheid, Heribert; Lassmann, Michael; Reiners, Christoph

    2011-01-01

    The activity to be administered in I-131 therapy of benign thyroid disease is determined by the radiation absorbed dose necessary to cure the disease, the target mass, and the residence time of the I-131 in the target volume. Data from 73 patients with complete sets of uptake measurements 2, 6, 24, 48, and 96 (n = 53) or 120 (n = 20) hours after oral administration of 1 MBq I-131 were used to deduce residence times from subsets of 3, 2, or only 1 measurement for each individual. The values were compared to those obtained with the reference method, i.e. a fit of an uptake function based on a 2-compartment model to all 5 measurements, to quantify the errors introduced by the less demanding assessments. Deviations are less than 10% if the 2- compartment uptake function is fitted to only 3 values measured after 6, 24, and 96-120 h. Use of 2, 24, and 96-120 h data results in errors > 20% in individual patients. The effective half-lives as determined from 2 measurements after 24 and 96-120 h correlate well with those deduced from the reference method with larger deviations in individuals with slow iodine kinetics and late maximal uptake. Residence times determined from the 24 h uptake, assuming linear increase during the first day, and the effective half-life limited to maximum 8 days underestimate the actual values systematically in patients with long and short half-lives. These errors can be eliminated by a modification of the calculation method resulting in deviations less than 14% in all but one individual for this procedure. The accuracy of methods based on only one retention value increases with the time of measurement after the administration of I-131. While systematic errors up to a factor of two occur if the 24 h uptake is used for the estimate, deviations are less than 18% for measurements after 120 h. The results suggest that only one late uptake assessment warrants residence time estimates with an acceptable error. Given the high inherent uncertainties in the

  3. [Impact of hypoxen therapy on postoperative course in gynecologic patients].

    Science.gov (United States)

    Dugieva, M Z; Kotenko, K V; Morozova, K V

    2012-01-01

    The aim of the study was to estimate the use of hypoxen (antihypoxant) during the early postoperative course in gynecologic patients. The patients were divided into two groups according to the treatment scheme. 339 patients of the control group were under the routine therapy after the laparatomic gynecologic operations. 52 patients were additionally treated with hypoxen (antioxidant) (the main group). The impact of hypoxen on the antioxidant system and lipid peroxidation and its preventive effect on prolongation of the postoperative pain syndrom were estimated. The results of the study showed that hypoxen inhibited lipid peroxidation and activated the antioxidant system in the postoperative patients vs. the control group. It was also observed that among the patients additionally treated with hypoxen the percentage of those with prolonged postoperative pains was statistically lower (pgynecologic operations. The additional use of hypoxen in the routine therapy of the gynecologic patients prevented prolongation of the postoperative pain syndrom.

  4. [The cause and efficacy of benign tracheal stenosis].

    Science.gov (United States)

    Su, Zhu-quan; Wei, Xiao-qun; Zhong, Chang-hao; Chen, Xiao-bo; Luo, Wei-zhan; Guo, Wen-liang; Wang, Ying-zhi; Li, Shi-yue

    2013-09-01

    To analysis the causes of benign tracheal stenosis and evaluate the curative effect of intraluminal bronchoscopic treatment. 158 patients with benign tracheal stenosis in our hospital from September 2005 to September 2012 were collected to retrospectively analysis the causes and clinic features of tracheal stenosis. Interventional treatments through bronchoscopy were used to treat the benign tracheal stenosis and the curative effects were evaluated. 158 cases of benign tracheal stenosis were recruited to our study, 69.6% of them were young and middle-aged. The main causes of benign tracheal stenosis were as follows: secondary to postintubation or tracheotomy in 61.4% (97/158), tuberculosis in 16% (26/158), benign tumor in 5.1% (8/158) and other 27 cases. 94.3% patients improved in symptoms with alleviation immediately after bronchoscopic treatment, the average tracheal diameter increased form (4.22 ± 2.06) mm to (10.16 ± 2.99) mm (t = 21.48, P benign tracheal stenosis were increasing year by year. The most common cause of benign tracheal stenosis was postintubation and tracheotomy. Interventional treatments through bronchoscopy is effective in treating benign tracheal stenosis, but repeated interventional procedures may be required to maintain the favorable long-term effects.

  5. Benign Ancient Schwannoma of the abdominal wall: An unwanted birthday present

    Directory of Open Access Journals (Sweden)

    Ram Manisha

    2010-01-01

    Full Text Available Abstract Background There has been a recent growth in the use of whole body Computerised Tomography (CT scans in the private sector as a screening test for asymptomatic disease. This is despite scant evidence to show any positive effect on morbidity or mortality. There has been concern raised over the possible harms of the test in terms of radiation exposure as well as the risk and anxiety of further investigation and treatment for the large numbers of benign lesions identified. Case Presentation A healthy 64 year old lady received a privately funded whole body CT scan for her birthday which revealed an incidental mass in the right iliac fossa. This was investigated with further imaging and colonoscopy and as confident diagnosis could not be made, eventually excised. Histology demonstrated this to be a benign ancient schwannoma and we believe this to be the first reported case of an abdominal wall schwannoma in the English literature Conclusions Ancient schwannomas are rare tumours of the peripheral nerve sheaths more usually found in the head, neck and flexor surfaces of extremities. They are a subtype of classical schwannomas with a predominance of degenerative changes. Our case highlights the pitfalls of such screening tests in demonstrating benign disease and subjecting patients to what turns out to be unnecessary invasive investigation and treatment. It provides evidence as to the consequences of the large number of false positive results that are created by blind CT scanning of asymptomatic patients i.e. its tendency to detect pseudodiesease rather than affect survival rates. Should the number of scans increase there may be an unnecessary burden on NHS resources due to the large numbers of benign lesions picked up, that are then referred for further investigation.

  6. Myoepithelioma: Benign or malignant â A diagnostic dilemma

    OpenAIRE

    Boon Chye Gan; Andrew Chin; Nor Shahida Abd Mutalib; Hamidah Mamat; Che Yusfarina Che Yusop; Hisham Abdul Rahman

    2017-01-01

    Malignant myoepithelioma of salivary gland which is also known as myoepithelial carcinoma is a rare disease. It has a relatively poor clarification of its biologic behavior, clinicopathologic features and immunohistochemical profile. Presentation may be the same as other benign salivary gland tumors. A high index of suspicion is required to diagnose this rare but malignant condition early and this is especially imperative when there is a recurrent tumor with histopathological examination repo...

  7. Percutaneous transhepatic portal vein stenting in a patient with benign non-transplant postoperative portal vein stenosis: A case report

    Directory of Open Access Journals (Sweden)

    KS Madhusudhan

    2013-01-01

    Full Text Available Extrahepatic portal vein stenosis is caused by a variety of benign and malignant diseases and results in development of symptoms due to portal hypertension. Benign post-surgical adhesions causing portal vein stenosis in non-transplant population is an uncommon etiology of portal hypertension. Endovascular treatment of such patients with angioplasty and stenting is uncommonly reported in literature. We report a case of portal hypertension caused by benign postoperative portal vein fibrosis, successfully treated by self-expandable metallic stent.

  8. Current situation in gynecological oncology training in Spain: where we are and where we want to go.

    Science.gov (United States)

    Padilla-Iserte, P; Minig, L; Zapardiel, I; Chiva, L; Laky, R; de Santiago, J

    2018-04-01

    It is important to know what a young gynecologic oncologist perceives as a need to achieve a good training in gynecologic oncology. This study aims to evaluate the level of training in gynecologic oncology in Spain. A Web-based anonymous questionnaire was sent via e-mail to Spanish trainees listed in European Network of Young Gynecological Oncology (ENYGO). The survey was developed in four sections: (1) general training in gynecologic oncology, (2) distribution of current clinical activity, (3) surgical training, and (4) perspective future gynecologic oncology. It contained 51 questions, with multiple-choice answers that had to be answered by the ENYGO members. The questionnaire was sent to 64 people listed in the ENYGO database. Of these, 37 members responded (response rate of 58%). Overall, more training in surgery is necessary, to perform radical oncological surgeries. It is claimed a sub-specialty recognition, to ensure an equalitarian and homogeneous training.

  9. A systematic review of sexual concerns reported by gynecological cancer survivors.

    Science.gov (United States)

    Abbott-Anderson, Kristen; Kwekkeboom, Kristine L

    2012-03-01

    To identify physical, psychological and social sexual concerns reported by gynecological (GYN) cancer survivors. A systematic review of the literature was conducted using CINAHL, PubMed and PsycInfo databases. Reference lists from articles provided additional relevant literature. Only research articles from peer-reviewed journals were included. A total of 37 articles were located; 34 explored women's sexual concerns following gynecological cancer diagnosis and treatment and 3 tested interventions for sexual concerns in women with gynecological cancer. Sexual concerns were identified across all dimensions of sexuality. Common concerns in the physical dimension were dyspareunia, changes in the vagina, and decreased sexual activity. In the psychological dimension, common concerns were decreased libido, alterations in body image, and anxiety related to sexual performance. And in the social dimension, common concerns were difficulty maintaining previous sexual roles, emotional distancing from the partner, and perceived change in the partner's level of sexual interest. Of the three psychoeducational intervention studies, two reported improvements in physical aspects of sexual function, and one reported improved knowledge, but without resolution of sexual concerns. Gynecological cancer survivors experience a broad range of sexual concerns after diagnosis and treatment, but the majority of studies emphasized physical aspects of sexuality, and may not adequately represent women's psychological and social sexual concerns. Health care providers should remain mindful of psychological and social sexual concerns when caring for gynecologic cancer survivors. Future research should systematically evaluate the full range of sexual concerns in large, representative samples of GYN cancer survivors and develop and test interventions to address those concerns. Copyright © 2011 Elsevier Inc. All rights reserved.

  10. [Common benign breast tumors including fibroadenoma, phyllodes tumors, and papillary lesions: Guidelines].

    Science.gov (United States)

    Bendifallah, S; Canlorbe, G

    2015-12-01

    To provide guidelines for clinical practice from the French College of Obstetrics and Gynecology (CNGOF), based on the best evidence available, concerning common benign breast tumors: fibroadenoma (FA), phyllodes breast tumors (PBT), and papillary lesions (BPL). Bibliographical search in French and English languages by consultation of PubMed, Cochrane and international databases. In case of percutaneous biopsy diagnosis of FA, clinico-radiologic and pathologic discordance or complex FA or proliferative lesions or atypia with FA, a family history of cancer, it seems legitimate to discuss management in a multidisciplinary meeting. When surgery is proposed for FA, periareolar compared to direct incision is associated with more insensitive nipple but better aesthetic results (LE4). When surgery is proposed for FA, indirect incision is preferable for better cosmetic results (Grade C). Techniques of percutaneous destruction or resection can be used (Grade C). The WHO classification distinguishes three categories of phyllodes tumors (PBT): benign (grade 1), borderline (grade 2) and malignant (grade 3). For grade 1 PBT, the risk of local recurrence after surgical excision increases when PBT lesion is in contact with surgical limits (not in sano). After in sano resection, there is no correlation between margin size and the risk of recurrence (LE4). For grade 2 PBT, local recurrence after surgical excision increases for margins under 10mm margins (LE4). For grade 1-2 PBT, in sano excision is recommended. For grade 2 PBT, 10-mm margins are recommended (Grade C). No lymph node evaluation or neither systematic mastectomy is recommended (Grade C). Breast papillary lesion (BPL) without atypia, complete resection of radiologic signal is recommended (Grade C). For BPL with atypia, complete excisional surgery is recommended (Grade C). Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  11. Care-seeking behavior of Japanese gynecological cancer survivors suffering from adverse effects

    Directory of Open Access Journals (Sweden)

    Oshima Sumiko

    2013-01-01

    Full Text Available Abstract Background Post-treatment follow-up visits for gynecological cancer survivors should provide opportunities for management of adverse physical/psychological effects of therapy and early recurrence detection. However, the adequacy of such visits in Japan is poorly documented. We qualitatively explored care-seeking experiences of Japanese gynecological cancer survivors and deduced factors influencing care-seeking behaviors and treatment access. Methods We conducted 4 semi-structured focus groups comprising altogether 28 Japanese gynecological cancer survivors to collect a variety of participants’ post-treatment care-seeking behaviors through active interaction with participants. Factors influencing access to treatment for adverse effects were analyzed qualitatively. Results Survivors sought care through specialty clinic visits when regular post-treatment gynecological follow-ups were inadequate or when symptoms seemed to be non-treatment related. Information provided by hospital staff during initial treatment influenced patients’ understanding and response to adverse effects. Lack of knowledge and inaccurate symptom interpretation delayed help-seeking, exacerbating symptoms. Gynecologists’ attitudes during follow-ups frequently led survivors to cope with symptoms on their own. Information from mass media, Internet, and support groups helped patients understand symptoms and facilitated care seeking. Conclusions Post-treatment adverse effects are often untreated during follow-up visits. Awareness of possible post-treatment adverse effects is important for gynecological cancer survivors in order to obtain appropriate care if the need arises. Consultation during the follow-up visit is essential for continuity in care.

  12. Stunning in radioiodine therapy of benign thyroid disease. Quantification and therapeutic relevance

    International Nuclear Information System (INIS)

    Krohn, T.; Meyer, P.T.; Knollmann, D.; Nowak, B.; Schaefer, W.M.; Ocklenburg, C.

    2008-01-01

    In radioiodine therapy of benign thyroid disease, a reduction of radioiodine uptake is known for consecutive administrations of 131I, which needs to be considered in therapy planning. Aim: Analysis of uptake reduction with regard on the time interval between radioiodine administration and the delivered dose to the thyroid tissue. Patients, methods: 200 patients were enrolled in the study and distributed into two groups (matched for diagnoses), each containing 32 patients with Graves' disease (target dose 250 Gy), 24 with focal (400 Gy), 44 with disseminated thyroid autonomy (150 Gy). In one group, a second fraction of radioiodine was given after 48 h (2d) due to an unexpected low radioiodine uptake or effective half-life, whereas in the other group the second fraction was given after 96 h (4d). Results: There was no significant difference between delivered doses due to the first fraction after four days: 2d: 86 ± 48 Gy (extrapolated) vs. 4d: 87 ± 41 Gy, p > 0.05. In 2d, delivered dose at time of second administration was significantly lower (51 μ 29 Gy) than in 4d (p < 0.01). The radioiodine uptake of the second fraction relative to the initial uptake was significantly lower in the 4d (4d: 63 ± 25% vs. 2d: 82 ± 24%, p < 0.01). In addition, a correlation between uptake reduction and delivered dose and an influence of the time interval between radioiodine administrations could be shown. Conclusions: Relative uptake of subsequent radioiodine fractions decreases with time after first administration and with increasing delivered dose to the thyroid. If a second fraction of 131I is given at an earlier time, the same therapeutic effect can be reached using lower amounts of activity, minimising radiation exposure and increasing efficiency of radioiodine therapy. (orig.)

  13. Ultrasound in gynecological cancer: is it time for re-evaluation of its uses?

    Science.gov (United States)

    Fischerova, Daniela; Cibula, David

    2015-06-01

    Ultrasound is the primary imaging modality in gynecological oncology. Over the last decade, there has been a massive technology development which led to a dramatic improvement in the quality ultrasound imaging. If performed by an experienced sonographer, ultrasound has an invaluable role in the primary diagnosis of gynecological cancer, in the assessment of tumor extent in the pelvis and abdominal cavity, in the evaluation of the treatment response, and in follow-up. Ultrasound is also a valuable procedure for monitoring patients treated with fertility-sparing surgery. Furthermore, it is an ideal technique to guide tru-cut biopsy for the collection of material for histology. Taking into consideration that besides its accuracy, the ultrasound is a commonly available, non-invasive, and inexpensive imaging method that can be carried out without any risk or discomfort to the patient; it is time to reconsider its role in gynecologic oncology and to allocate resources for a specialized education of future experts in ultrasound imaging in gynecology.

  14. POSSIBILITIES OF USING LOW-MOLECULAR-WEIGHT HEPARIN IN THE COMPLEX TREATMENT OF WOMEN WITH TUMORS OF THE REPRODUCTIVE SYSTEM

    Directory of Open Access Journals (Sweden)

    A. G. Kedrova

    2017-01-01

    Full Text Available Benign and malignant tumors of the organs of the female reproductive system are the most common diseases requiring medical and surgical treatment. They are rarely the cause of acute complications. However, the thromboembolic disease is a serious illness, sometimes causing death due to acute the pulmonary embolism. Venous thromboembolism secondary to Benign and malignant tumors of the organs of the female reproductive system should be considered in a female presenting with abdominal mass and pelvic pressure. Thromboembolic disease secondary to large tumors should be treated with anticoagulation then hysterectomy. The article presents an analysis of modern literature on optimal prevention of the pulmonary thromboembolism in patients with tumors of the female reproductive system. There are analysis data of 17 (0.7 % cases of the pulmonary thromboembolism that occurred of 2358 gynecological and oncogynecologic patients.

  15. Possibilities of electrical impedance tomography in gynecology

    International Nuclear Information System (INIS)

    Trokhanova O V; Chijova Y A; Okhapkin M B; Korjenevsky A V; Tuykin T S

    2013-01-01

    The paper describes results of comprehensive EIT diagnostics of mammary glands and cervix. The data were obtained from examinations of 170 patients by EIT system MEM (multi-frequency electrical impedance mammograph) and EIT system GIT (gynecological impedance tomograph). Mutual dependence is discussed.

  16. Gynecological Surgery and Low Back Pain in Older Women

    Science.gov (United States)

    Ericksen, Jeffery; Pidcoe, Peter E.; Ketchum-McKinney, Jessica M.; Burnet, Evie N.; Huang, Emily; Wilson, James C.; Hoogstad, Vincent

    2010-01-01

    Objective: To determine sacroiliac joint compliance characteristics and pelvic floor movements in older women relative to gynecological surgery history and back pain complaints. Design: Single-visit laboratory measurement. Setting: University clinical research center. Participants: Twenty-five women aged 65 years or older. Outcome Measures: Sacroiliac joint compliance measured by Doppler imaging of vibrations and ultrasound measures of pelvic floor motion during the active straight leg raise test. Results: Doppler imaging of vibrations demonstrated test reliability ranging from 0.701 to 0.898 for detecting vibration on the ilium and sacrum sides of the sacroiliac joint. The presence of low-back pain or prior gynecological surgery was not significantly associated with a difference in the compliance or laxity symmetry of the sacroiliac joints. No significant difference in pelvic floor movement was found during the active straight leg raise test between subject groups. All P values were ≥.4159. Conclusions: Prior gynecological surgery and low-back pain were not significantly associated with side-to-side differences in the compliance of the sacroiliac joints or in significant changes in pelvic floor movement during a loading maneuver in a group of older women. PMID:23569659

  17. Genomic and Expression Profiling of Benign and Malignant Nerve Sheath Profiling of Benign and Malignant Nerve Sheath

    Science.gov (United States)

    2007-05-01

    Benign and Malignant Nerve Sheath Tumors in Neurofibromatosis Patients PRINCIPAL INVESTIGATOR: Matt van de Rijn, M.D., Ph.D. Torsten...Annual 3. DATES COVERED 1 May 2006 –30 Apr 2007 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER Genomic and Expression Profiling of Benign and Malignant Nerve...Award Number: DAMD17-03-1-0297 Title: Genomic and Expression Profiling of Benign and Malignant Nerve Sheath Tumors in Neurofibromatosis

  18. Incidence, reasons, and risk factors for readmission after surgery for benign distal esophageal disease.

    Science.gov (United States)

    Poupore, Amy K; Stem, Miloslawa; Molena, Daniela; Lidor, Anne O

    2016-09-01

    Our aim was to ascertain the incidence of, reasons for, and risk factors associated with hospital readmission after an operation for benign distal esophageal disease. Using the American College of Surgeons National Surgical Quality Improvement Program database (2012-2014), patients with a primary diagnosis of gastroesophageal reflux disease, paraesophageal hiatal hernia, or achalasia who underwent fundoplication, paraesophageal hernia repair, or Heller myotomy were identified. The primary outcome was hospital readmission. Multivariable logistic regression analysis was used to identify risk factors associated with hospital readmission. Of the 14,478 patients included in this study, 801 (5.5%) were readmitted at a median of 11 days (interquartile range 6-17) postprocedure. Intolerance of oral intake (21.8%), respiratory complications (11.6%), abdominal pain (6.0%), and venous thromboembolic events (4.7%) were some of the most common reasons for readmission. Open operative approach (odds ratio 1.34, 95% confidence interval 1.05-1.71), chronic steroid use (odds ratio 1.48, 95% confidence interval 1.10-2.00), emergency admission (odds ratio 1.50, 95% confidence interval 1.01-2.21), and predischarge complication (odds ratio 1.91, 95% confidence interval 1.42-2.59) were associated most strongly with hospital readmission. Implementing standardized perioperative strategies, such as nutritional counseling, early ambulation, intensive pulmonary toilet, and deep vein thrombosis prophylaxis, may help decrease the number of preventable readmissions and enhance the overall quality of care in this patient population. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. The impact of outpatient clinical teaching on students' academic performance in obstetrics and gynecology.

    Science.gov (United States)

    Hassan, Bahaeldin A; Elfaki, Omer A; Khan, Muhammed A

    2017-01-01

    Clinical teaching at outpatient settings is an essential part of undergraduate medical students' training. The increasing number of students in many medical schools and short hospital stays makes inpatient teaching alone insufficient to provide students with the required clinical skills. To make up this shortfall, outpatient clinical teaching has been implemented by our Department of Obstetrics and Gynecology, King Khalid University, KSA, throughout the academic year 2015-2016. The aim of this study was to evaluate the impact of clinical teaching at outpatient settings on the academic performance of our students. In this comparative retrospective study, the effects of outpatient clinical teaching of obstetrics and gynecology on the academic performance of student was assessed through an objective structured clinical examination (OSCE). During their course on obstetrics and gynecology, 58 students had their clinical teaching both at inpatient and outpatient settings and constituted "study group". The remaining 52 students had clinical teaching only at inpatient settings and were considered "control group". Students in both groups sat for OSCE at the end of week 8 of the gynecology course. Students in both groups sat for OSCE at the end of week 8 of the gynecology course. Four stations were used for assessment: obstetric history, gynecological history, obstetric physical examination of pregnant women, and gynecological procedure station. Twenty marks were allocated for each station giving a total score of 80. The OSCE scores for study group were compared with those of the control group using Student's t -test; p performance in OSCE. There is evidence of remarkable improvement in the mastery of clinical skills as manifested in the students' scores in physical examination and procedures stations. These results will encourage us to have clinical teaching in other disciplines at outpatient settings.

  20. [Clinical competence evaluation in undergraduate gynecology and obstetrics].

    Science.gov (United States)

    Larios Mendoza, Heriberto; Trejo Mejía, Juan Andrés; Gaviño Ambriz, Salvador; Cortés Gutiérrez, Ma Teresa

    2002-11-01

    Assess the clinical competence in Gynecology and obstetrics to the Internship students of the Faculty of Medicine, UNAM. The study design was descriptive, transverse type. We assessed 64 students, which had finished their gynecology field rotation with the objective structured clinical examination. The criteria to consider a competent performance level, was arbitrarily set up in 60%, both for individual problems and for the exam's global result. In 15 stations, the result was a 56.2 global average. The best performances were achieved in the following stations: take the pap smear (74.7), Pregnancy diagnostic (67.9), history of Gynecology and obstetrics (67.1), self examination of breast explanation (62.2) preclampsia (61.7) and cervicovaginitis (60). All the rest got a mark lower than 60. The results are lower than the ones obtained in written exams, because these cannot assess clinical skills. It could be observed that a student's performance in a clinical problem does not certainly predict his performance in other, so it seems to be determined more by the specific knowledge and the student's experience related to the case, than by a general problem-solving skill. The results show the advantages of this instrument to assess clinical skills, that justify its application in the formative process. This work evidences that its necessary to improve the acquisition of basic clinical skills trough systematic instructionals strategies and greater opportunities of learning.

  1. Danish gynecologists' opinion about hysterectomy on benign indication: results of a survey

    DEFF Research Database (Denmark)

    Gimbel, Helga; Ottesen, Bent; Tabor, Ann

    2002-01-01

    AIMS: To survey Danish gynecologists' recommendations concerning hysterectomy and its method for benign diseases. METHODS: A questionnaire of seven clinical cases was sent to all gynecologists in Denmark (n = 450). The gynecologists were asked to recommend one of 14 possible treatments as the mos...

  2. Combination of ultrasound-guided percutaneous microwave ablation and radioiodine therapy in benign thyroid disease. A 3-month follow-up study

    Energy Technology Data Exchange (ETDEWEB)

    Korkusuz, H.; Happel, C.; Koch, D.A.; Gruenwald, F. [Frankfurt University Hospital (Germany). Dept. of Nuclear Medicine

    2016-01-15

    Pilot studies of combined therapies treating benign nodular goiters reported promising results. The aim of this study was to investigate the effectiveness of combined microwave ablation (MWA) and radioiodine therapy (RIT) with a special focus on thyroid function at the 3-month follow-up. 15 patients (median age: 55 years) with a large goiter and benign thyroid nodules or Graves' disease were treated with the combined therapy. Serum levels of triiodothyronine (T3), thyroxine (T4), thyrotropin (TSH), thyroglobuline (Tg) and, additionally, antibody levels against thyroglobulin (TgAb), thyrotropin receptors (TRAb) and thyroid peroxidase (TPOAb) were measured at enrollment, post MWA and at the 3-month follow-up (3MFU). Furthermore, the goiter volume, I-131 dose and hospitalization time were analyzed to evaluate effectiveness. MWA was operated under local anesthesia with a system working in a wavelength field of 902 to 928 MHz. TSH, T4, T3 and Tg did not change at 3MFU, except for in two patients in whom the initial TSH levels improved to normal thyroid functioning levels at follow-up. One of the patients developed a high TRAb-level that receded back into the normal range. At 3MFU, the combined therapy showed a mean thyroid volume reduction of 26.4 ml ± 7.9 ml (30.5 % ± 4.6 % (p < 0.05)). By utilizing the combined therapy, administered activity could be reduced by 26.6 % ± 4.8 % (p < 0.05) and hospitalization time by 30.9 % ± 19.9 % (p < 0.05). The data confirmed the effectiveness of the combination of MWA with RIT. The combined therapy is an innovative and conservative approach and could become a safe alternative to surgery for the treatment of very large benign nodular goiters. Due to the short follow-up and the limited number of patients, further studies will be necessary.

  3. Diffuse benign gastric inflammatory hyperplastic polyps presenting ...

    African Journals Online (AJOL)

    Benign gastric inflammatory hyperplasic polyps are benign lesions that rarely occur in young age. We report a case of diffuse benign gastric inflammatory hyperplastic polyps in a 19 year old boy who presented with cough, nausea, and hematamesis. In the presented case symptoms such as nausea and vomiting are non ...

  4. Structural determination and gynecological tumor diagnosis using ...

    African Journals Online (AJOL)

    Purpose: To identify markers for gynecological tumor diagnosis using antibody chip capture. Methods: Marker proteins, including cancer antigen 153 (CA153), CA125, and carcinoembryonic antigen (CEA), were analyzed using antibody chip capture of serum samples. Fifteen agglutinin types that specifically recognized five ...

  5. Imaging of the thyroid in benign and malignant disease.

    Science.gov (United States)

    Intenzo, Charles M; Dam, Hung Q; Manzone, Timothy A; Kim, Sung M

    2012-01-01

    The thyroid gland was one of the first organs imaged in nuclear medicine, beginning in the 1940s. Thyroid scintigraphy is based on a specific phase or prelude to thyroid hormone synthesis, namely trapping of iodide or iodide analogues (ie, Tc99m pertechnetate), and in the case of radioactive iodine, eventual incorporation into thyroid hormone synthesis within the thyroid follicle. Moreover, thyroid scintigraphy is a reflection of the functional state of the gland, as well as the physiological state of any structure (ie, nodule) within the gland. Scintigraphy, therefore, provides information that anatomical imaging (ie, ultrasound, computed tomography [CT], magnetic resonance imaging) lacks. Thyroid scintigraphy plays an essential role in the management of patients with benign or malignant thyroid disease. In the former, the structure or architecture of the gland is best demonstrated by anatomical or cross-sectional imaging, such as ultrasound, CT, or even magnetic resonance imaging. The role of scintigraphy, however, is to display the functional state of the thyroid gland or that of a clinically palpable nodule within the gland. Such information is most useful in (1) patients with thyrotoxicosis, and (2) those patients whose thyroid nodules would not require tissue sampling if their nodules are hyperfunctioning. In neoplastic thyroid disease, thyroid scintigraphy is often standard of care for postthyroidectomy remnant evaluation and in subsequent thyroid cancer surveillance. Planar radioiodine imaging, in the form of the whole-body scan (WBS) and posttherapy scan (PTS), is a fundamental tool in differentiated thyroid cancer management. Continued controversy remains over the utility of WBS in a variety of patient risk groups and clinical scenarios. Proponents on both sides of the arguments compare WBS with PTS, thyroglobulin, and other imaging modalities with differing results. The paucity of large, randomized, prospective studies results in dependence on consensus

  6. Hand-assisted laparoscopic surgery and its applications in gynecology

    Directory of Open Access Journals (Sweden)

    Yueqian Wu

    2016-02-01

    Full Text Available Laparoscopic surgery has been used extensively since it was first applied in the 1980s. The advantages are generally accepted and include less pain, smaller incisions, faster recovery, and shorter hospital stays. However, several limitations associated with standard laparoscopic surgery (SLS have become apparent and include the loss of tactile sensation, problems with the removal of bulky and intact specimens, and the restriction of visualization of the entire operating field. These problems with SLS helped to inspire the development of laparoscopically assisted surgery followed by hand-assisted laparoscopic surgery (HALS. In a hand-assisted laparoscopic procedure, an incision is made in the patient’s abdomen. Then, a uniquely designed appliance is introduced into the abdominal cavity through the incision to maintain pneumoperitoneum. With the inserting hand, surgeons can provide manual exposure, traction, palpation, and dissection because of the feedback of tactile sensation. HALS has gained acceptance for a wide range of abdominal procedures in general surgery and urology and is now feasible for complicated surgeries such as splenectomy, nephroureterectomy, and colectomy. It has been demonstrated in numerous specialties that HALS is a safe and efficacious technique that combines the benefits of laparoscopy with the advantages of a conventional laparotomy. Standard laparoscopic surgery also has limitations in gynecological surgery. A patient may have high risks with conventional laparoscopic surgery when she has deep invasive endometriosis, multiple or massive myoma, or dense pelvic adhesions from prior surgery. HALS overcomes many of the aforementioned limitations, has less conversion to open surgery, and broadens the indications for minimally invasive surgery, not only for benign tumors but also for pelvic malignancies.

  7. Hysterectomy on benign indication in Denmark 1988-1998. A register based trend analysis

    DEFF Research Database (Denmark)

    Gimbel, H; Settnes, A; Tabor, A

    2001-01-01

    BACKGROUND: The aims of the study were to describe the trends in Danish hysterectomy rates from 1988 to 1998 for operations done on benign indication. METHODS: Data from all women (n=67,096) undergoing hysterectomy from 1988 to 1998 were obtained from the Danish National Patient Register. Data...... by 14%. During the study period the number of total abdominal hysterectomies has decreased by 38%, the number of subtotal abdominal hysterectomies has increased by 458%, the number of vaginal hysterectomies has increased by 107% and two new methods of surgical treatment for benign diseases of the uterus...

  8. Coexisting Primary Ovarian and Omental Hydatid Disease Mimicking an Ovarian Neoplasm: A Case Report.

    Science.gov (United States)

    Tas, Emre E; Yegin Akcay, Gulin F; Yildirim, Fatma; Yavuz, Filiz

    2018-05-01

    Hydatid disease is a parasitic infection that most commonly affects the liver and lungs, although the disease can arise in any part of the body. Cysts may mimic many benign and malignant conditions. The diagnosis cannot be confirmed preoperatively in all cases. A 44-yr-old menopausal woman was admitted to the department of gynecology with complaints of abdominal distention. A fixed abdominopelvic mass was identified. Radiology revealed a 20-cm mass with branched septations and solid components. CA-125 level was 55 kU/L, and Risk of Malignancy Index-2 score was 880. These findings suggested the presence of an ovarian neoplasm, and laparotomy was performed. Cystic masses measuring 22 cm and 4 cm, originating from the omentum majus and left ovary, respectively, were found during surgery. Frozen-section analysis revealed hydatid disease. Infracolic omentectomy and total abdominal hysterectomy with bilateral salpingo-oopherectomy were performed. Results of a serum Echinococcus hemagglutination test performed immediately after surgery were negative. The patient was prescribed albendazole for 6 mo and discharged on the third postoperative day with no complaints. The incidence of hydatid disease in the female reproductive system is very rare; however, clinicians must be aware of this disease and take necessary precautions while operating because any spillage may lead to anaphylactic shock and increased risk of recurrence.

  9. The roles of pathology in targeted therapy of women with gynecologic cancers.

    Science.gov (United States)

    Murali, Rajmohan; Grisham, Rachel N; Soslow, Robert A

    2018-01-01

    The role of the pathologist in the multidisciplinary management of women with gynecologic cancer has evolved substantially over the past decade. Pathologists' evaluation of parameters such as pathologic stage, histologic subtype, grade and microsatellite instability, and their identification of patients at risk for Lynch syndrome have become essential components of diagnosis, prognostic assessment and determination of optimal treatment of affected women. Despite the use of multimodality treatment and combination cytotoxic chemotherapy, the prognosis of women with advanced-stage gynecologic cancer is often poor. Therefore, expanding the arsenal of available systemic therapies with targeted therapeutic agents is appealing. Anti-angiogenic therapies, immunotherapy and poly ADP ribose polymerase (PARP) inhibitors are now routinely used for the treatment of advanced gynecologic cancer, and many more are under investigation. Pathologists remain important in the clinical management of patients with targeted therapy, by identifying potentially targetable tumors on the basis of their pathologic phenotype, by assessing biomarkers that are predictive of response to targeted therapy (e.g. microsatellite instability, PD1/PDL1 expression), and by monitoring treatment response and resistance. Pathologists are also vital to research efforts exploring novel targeted therapies by identifying homogenous subsets of tumors for more reliable and meaningful analyses, and by confirming expression in tumor tissues of novel targets identified in genomic, epigenetic or other screening studies. In the era of precision gynecologic oncology, the roles of pathologists in the discovery, development and implementation of targeted therapeutic strategies remain as central as they are for traditional (surgery-chemotherapy-radiotherapy) management of women with gynecologic cancers. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Diabetes mellitus and gynecologic cancer: molecular mechanisms, epidemiological, clinical and prognostic perspectives.

    Science.gov (United States)

    Vrachnis, Nikolaos; Iavazzo, Christos; Iliodromiti, Zoe; Sifakis, Stavros; Alexandrou, Andreas; Siristatidis, Charalambos; Grigoriadis, Charalambos; Botsis, Dimitrios; Creatsas, George

    2016-02-01

    Diabetes mellitus, the prevalence of which has increased dramatically worldwide, may put patients at a higher risk of cancer. The aim of our study is the clarification of the possible mechanisms linking diabetes mellitus and gynecological cancer and their epidemiological relationship. This is a narrative review of the current literature, following a search on MEDLINE and the Cochrane Library, from their inception until January 2012. Articles investigating gynecologic cancer (endometrial, ovarian, and breast) incidence in diabetic patients were extracted. The strong evidence for a positive association between diabetes mellitus and the risk for cancer indicates that energy intake in excess to energy expenditure, or the sequelae thereof, is involved in gynecological carcinogenesis. This risk may be further heightened by glucose which can directly promote the production of tumor cells by functioning as a source of energy. Insulin resistance accompanied by secondary hyperinsulinemia is hypothezised to have a mitogenic effect. Steroid hormones are in addition potent regulators of the balance between cellular differentiation, proliferation, and apoptosis. Inflammatory pathways may also be implicated, as a correlation seems to exist between diabetes mellitus and breast or endometrial carcinoma pathogenesis, although an analogous correlation with ovarian carcinoma is still under investigation. Antidiabetic agents have been correlated with elevated cancer risk, while metformin seems to lower the risk. Diabetes mellitus is associated with an elevation in gynecologic cancer risk. Moreover, there are many studies exploring the prognosis of patients with diabetes and gynecological cancer, the outcome and the overall survival in well-regulated patients.

  11. Assessing Information Needs Regarding Metabolic Syndrome Among Gynecological Cancer Survivors: A Concurrent Mixed Method.

    Science.gov (United States)

    Jang, Insil; Kim, Ji-Su; Kim, Minhae; Lee, Eunkyung

    2018-04-27

    Cancer survivors have an increased risk of non-cancer-related deaths, particularly metabolic syndrome (MetS). We aimed to assess knowledge deficits regarding metabolism-related diseases among gynecological cancer survivors and the preferred source of health information. Using a mixed methods approach, 70 participants responded to a structured modified version of the MetS questionnaire. We conducted 28 semistructured interviews of gynecological cancer survivors with MetS. Responses were independently coded by 2 researchers, including MetS knowledge, behaviors for self-management, and preferred learning methods. Metabolic syndrome was diagnosed in 17% of the participants. More than 50% of the participants wanted to learn about MetS and requested a consultation with healthcare providers, 70% reported that they had heard of MetS, and 61.4% reported that they had MetS-related knowledge (correct answer rate by MetS-related component, ~50%). The level of MetS-related knowledge was poor in both the quantitative and qualitative data. Most of the participants defined MetS-related self-management health behaviors as regular eating and exercise in their own words. Participants mostly wanted exercise management (29% of the participants), followed by dietary life management (27.4%), stress management (17.4%), weight management (13.7%), definition and diagnostic methods of MetS (9.1%), and smoking and drinking management (3.3%). Participants wished to use a handbook in small groups or receive counseling by healthcare providers. We observed poor awareness and knowledge level and the need for information regarding MetS among gynecological cancer survivors. An educational handbook or counseling could effectively improve self-management of health-related behaviors.

  12. [X-ray computed tomographic aspects of benign primary cerebral melanomas. Apropos of 4 cases].

    Science.gov (United States)

    Adam, P; Alberge, Y; Espagno, C; Bouzigues, J Y

    1986-02-01

    Benign primitive melanomas are rare tumours usually involving the leptomeninges. Four cranial localizations are reported: 2 tumours of the foramen magnum, 1 of the cerebellopontine angle and 1 supratentorial. The clinical symptomatology is variable according to the level. Slow medullary compression is frequent. One can emphasize the special and difficult problem of foramen magnum tumours that present with a very variable clinical status frequently simulating a non surgical disease of the central nervous system. The benign and primitive appearance of these tumours is evocated by the slow and favourable evolution and by the absence of extraneurologic melanotic tumour. Our purpose is essentially to emphasize the radiological and particularly the computed tomographic (CT) findings poorly described in the literature. Benign melanomas have resemblance with meningiomas: osseous or meningeal relationship, homogeneity and high density. On the other hand the angiography shows poor vascularization. One can think that a tumor simulating a meningioma by CT but not by angiography is perhaps a benign melanoma. The special problem of the radiological diagnosis of foramen magnum tumours is evocated: Computed myelography, tridimensional imaging by NMR.

  13. Is thrombocytosis a valid indicator of advanced stage and high mortality of gynecological cancer?

    DEFF Research Database (Denmark)

    Andersen, Christen Bertel L; Eskelund, Christian W.; Siersma, Volkert Dirk

    2015-01-01

    Objective: Thrombocytosis has been associated with higher stage and mortality of cancer, however, the evidence is conflicting. We examined the stage distribution and prognosis of gynecologic cancer according to levels of prediagnostic platelet count. Methods: In a primary care resource with blood...... may have an important role in diagnosis and post-diagnostic control of gynecological cancer.......Objective: Thrombocytosis has been associated with higher stage and mortality of cancer, however, the evidence is conflicting. We examined the stage distribution and prognosis of gynecologic cancer according to levels of prediagnostic platelet count. Methods: In a primary care resource with blood...... cell counts from more than 500,000 individuals, we identified 581 women with a primary diagnosis of gynecological cancer. We divided the pre-diagnostic mean platelet count derived from the 3-year period prior to cancer diagnosis into three categories of thrombocytosis (no, 150–400 × 109 /L; mild, N400...

  14. Interventional radiology in benign diseases of the biliary tract

    International Nuclear Information System (INIS)

    Juliani, G.; Gandini, G.

    1986-01-01

    Most references in the literature on interventional radiology of the biliary tract refer to the treatment of cancer; only occasionally are benign conditions mentioned. An updated list of radiosurgical instruments on the market in Italy is presented. The operating technique from the preparation of the patient to the performance of percutaneous transhepatic cholangiography (PTC), biliary drainage, transhepatic bilioplasty, percutaneous extraction and chemical cholelitholisis of biliary calculi and drainage of biliary collections is then described. A personal series is then presented. It consist of 93 patients in whom one or more of the following conditions were diagnosed: exclusively intrahepatic calculosis (3 cases), calculosis of the common bile duct (23 percutaneous treatments), empyema of the gallbladder (6 cases), suppurating cholangitis (46 cases), sclerotic or inflammatory stenosis (16 cases), biliary collections (14 cases). Results are reported and commented on

  15. Subtotal versus total abdominal hysterectomy

    DEFF Research Database (Denmark)

    Andersen, Lea Laird; Ottesen, Bent; Alling Møller, Lars Mikael

    2015-01-01

    OBJECTIVE: The objective of the study was to compare long-term results of subtotal vs total abdominal hysterectomy for benign uterine diseases 14 years after hysterectomy, with urinary incontinence as the primary outcome measure. STUDY DESIGN: This was a long-term follow-up of a multicenter......, randomized clinical trial without blinding. Eleven gynecological departments in Denmark contributed participants to the trial. Women referred for benign uterine diseases who did not have contraindications to subtotal abdominal hysterectomy were randomized to subtotal (n = 161) vs total (n = 158) abdominal...... from discharge summaries from all public hospitals in Denmark. The results were analyzed as intention to treat and per protocol. Possible bias caused by missing data was handled by multiple imputation. The primary outcome was urinary incontinence; the secondary outcomes were pelvic organ prolapse...

  16. [Noninvasive total hemoglobin monitoring based on multiwave spectrophotometry in obstetrics and gynecology].

    Science.gov (United States)

    Pyregov, A V; Ovechkin, A Iu; Petrov, S V

    2012-01-01

    Results of prospective randomized comparative research of 2 total hemoglobin estimation methods are presented. There were laboratory tests and continuous noninvasive technique with multiwave spectrophotometry on the Masimo Rainbow SET. Research was carried out in two stages. At the 1st stage (gynecology)--67 patients were included and in second stage (obstetrics)--44 patients during and after Cesarean section. The standard deviation of noninvasive total hemoglobin estimation from absolute values (invasive) was 7.2 and 4.1%, an standard deviation in a sample--5.2 and 2.7 % in gynecologic operations and surgical delivery respectively, that confirms lack of reliable indicators differences. The method of continuous noninvasive total hemoglobin estimation with multiwave spectrophotometry on the Masimo Rainbow SET technology can be recommended for use in obstetrics and gynecology.

  17. Diagnostic delay experienced among gynecological cancer patients: a nationwide survey in Denmark

    DEFF Research Database (Denmark)

    Robinson, Kirstine M; Ottesen, Bent; Christensen, Karl Bang

    2009-01-01

    OBJECTIVE: To examine diagnostic delay among gynecological cancer patients. DESIGN: Nationwide study. SETTING: The cohort comprised all women receiving their first treatment for cervical, endometrial, or ovarian cancer between 1 October 2006 and 1 December 2007 in four of the five centers...... for gynecological cancer surgery in Denmark. SAMPLE: Of the 911 women alive, 648 participated, resulting in a response rate of 71.1%; of these, 30.1% were diagnosed with cervical cancer, 31.0% with endometrial cancer, and 38.9% with ovarian cancer. METHODS: Questionnaire survey. MAIN OUTCOME MEASURES: Diagnostic...... experiencing very long delays. Ovarian cancer patients experienced significantly shorter delays compared with other gynecological cancer patients in all parts of the health care system. CONCLUSIONS: Delays occur in all parts of the diagnostic process, suggesting that a multifaceted approach should be adopted...

  18. Strategies for Introducing Outpatient Specialty Palliative Care in Gynecologic Oncology.

    Science.gov (United States)

    Hay, Casey M; Lefkowits, Carolyn; Crowley-Matoka, Megan; Bakitas, Marie A; Clark, Leslie H; Duska, Linda R; Urban, Renata R; Creasy, Stephanie L; Schenker, Yael

    2017-09-01

    Concern that patients will react negatively to the idea of palliative care is cited as a barrier to timely referral. Strategies to successfully introduce specialty palliative care to patients have not been well described. We sought to understand how gynecologic oncologists introduce outpatient specialty palliative care. We conducted a national qualitative interview study at six geographically diverse academic cancer centers with well-established palliative care clinics between September 2015 and March 2016. Thirty-four gynecologic oncologists participated in semistructured telephone interviews focusing on attitudes, experiences, and practices related to outpatient palliative care. A multidisciplinary team analyzed interview transcripts using constant comparative methods to inductively develop and refine a coding framework. This analysis focuses on practices for introducing palliative care. Mean participant age was 47 years (standard deviation, 10 years). Mean interview length was 25 minutes (standard deviation, 7 minutes). Gynecologic oncologists described the following three main strategies for introducing outpatient specialty palliative care: focus initial palliative care referral on symptom management to dissociate palliative care from end-of-life care and facilitate early relationship building with palliative care clinicians; use a strong physician-patient relationship and patient trust to increase acceptance of referral; and explain and normalize palliative care referral to address negative associations and decrease patient fear of abandonment. These strategies aim to decrease negative patient associations and encourage acceptance of early referral to palliative care specialists. Gynecologic oncologists have developed strategies for introducing palliative care services to alleviate patient concerns. These strategies provide groundwork for developing system-wide best practice approaches to the presentation of palliative care referral.

  19. The methodological quality of economic evaluation studies in obstetrics and gynecology: a systematic review

    NARCIS (Netherlands)

    Vijgen, Sylvia M. C.; Opmeer, Brent C.; Mol, Ben Willem J.

    2013-01-01

    We evaluated the methodological quality of economic evaluation studies in the field of obstetrics and gynecology published in the last decade. A MEDLINE search was performed to find economic evaluation studies in obstetrics and gynecology from the years 1997 through 2009. We included full economic

  20. Paraneoplastic neurological disorders in children with benign ovarian tumors.

    Science.gov (United States)

    Hsu, Mei-Hsin; Huang, Chao-Ching; Hung, Pi-Lien; Huang, Hsiu-Mei; Huang, Li-Tung; Huang, Chao-Cheng; Sheen, Jiunn-Ming; Huang, Song-Chei; Chang, Ying-Chao

    2014-03-01

    Paraneoplastic neurological diseases (PND) are rare, but potentially treatable disorders. Paraneoplastic encephalitis is rapidly emerging as an important but likely under-recognized condition in children. The aim of this study was to assess the prevalence and spectrum of PND in children with benign ovary tumor and the long-term outcome. We retrospectively reviewed the charts of all female patients below 18years of age diagnosed with a benign ovarian tumor proven by pathology between January 1993 and December 2010. All the clinical symptoms developed within 5years of tumor diagnosis and the related investigations were recorded. There were total 133 children and adolescents with benign ovarian tumors, mostly mature teratoma. Six patients (4.5%) had neuropsychiatric manifestations and all but one were beyond age 10years. The most common neuropsychiatric presentations were depression or low mood (84%), headache (50%), mutism (50%), hypoventilation (50%), seizures (30%), hallucination (30%), vomiting and hypersalivation (30%). Three patients (2.2%) had serious PND including acute disseminated encephalomyelitis in 1 and anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis in 2. Although all of three improved after tumor removal, one without immunotherapy had neurological sequelae and prolonged ICU stay. The prevalence of PND in benign ovary tumor is not so uncommon in children. It is important to survey ovary tumors in female adolescents with subacute presentation of multiple-level involvement of neuraxis where no clear alternate diagnosis is possible. Treatment of serious PND associated with ovary tumors should include immunotherapy in addition to tumor removal. Copyright © 2013 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

  1. Women in leadership positions within obstetrics and gynecology: does the past explain the present?

    Science.gov (United States)

    Baecher-Lind, Laura

    2012-12-01

    To determine whether the proportion of leadership positions in obstetrics and gynecology held by women is consistent with expectations based on the proportion of women entering residency at the time of current leaders. Leadership positions were considered as department chairs affiliated with the Council of University Chairs of Obstetrics and Gynecology, editors of the 20 obstetrics and gynecology journals with the highest impact factors [corrected],and presidents of influential professional societies. Publically available data were accessed to determine sex and the year of medical school graduation for each individual holding each leadership position, as well as to determine the number of men and women entering residency in obstetrics and gynecology per year. Actual and expected proportions of leadership positions held by women were compared using χ² tests. Women should hold 71 of the total 194 leadership positions based on the proportion of women entering residency during the mean graduation year among leaders. Women actually hold 41 of these leadership positions (21.1%; Pwomen should hold 28 of these 74 leadership positions. Women actually hold 20 of the leadership positions from this subset (27.0%; P=.05). Women are underrepresented in leadership positions in obstetrics and gynecology, and this cannot be explained by historical sex imbalances among physicians entering our specialty.

  2. PROVISION OF THE DUTY SERVICE IN GYNECOLOGY AND OBSTETRICS IN SLOVENIA

    Directory of Open Access Journals (Sweden)

    Iztok Takač

    2018-02-01

    Full Text Available Background: Duty service of gyecology and obstetrics in Slovenia is organized on the regional basis and consists of ten regional hospitals, two hospitals for gynecology and obstetrics and two university clinical centres. Methods: Heads of hospitals where duty service is performed, have answered the questionnaires about the doctors who perform duty service. Results: Specialists and trainees in gynecology and obstetrics perform duty service on 21 posts and on 6 on-call posts. In Slovenia there are 287 active specialists in gynecology and obstetrics. 139 (48.4% among them are active on the primary level (outpatient clinics and 148 (51.6% in the hospitals and both clinical centres. Among hospital gynecologists and obstetricians 54 (36.5% of them are older than 55 years. Conclusions: Duty service of gyecology and obstetrics in Slovenia does not meet legislation criteria regard- ing doctors’ work time. Adequate changes for increasing the number of available doctors for duty service are proposed.

  3. Gynecologic symptoms and the influence on reproductive life in 386 women with hypermobility type ehlers-danlos syndrome: a cohort study.

    Science.gov (United States)

    Hugon-Rodin, Justine; Lebègue, Géraldine; Becourt, Stéphanie; Hamonet, Claude; Gompel, Anne

    2016-09-13

    Hypermobile Ehlers-Danlos syndrome (hEDS), is probably the most common disease among heritable connective tissue disorders. It affects women more than men and causes symptoms in multiple organs. It is associated with chronic pain, skin fragility and abnormal bleeding. These characteristics may hamper reproductive life. We conducted a study to evaluate the gynecologic and obstetric outcomes in women with hEDS. We also explored a possible hormonal modulation of the hEDS symptoms. The gynecologic and obstetric history of 386 consecutive women diagnosed with hEDS was collected by a standardized questionnaire and a medical consultation performed by a senior gynecologist in an expert centre for hEDS between May 2012 and December 2014. We observed a high frequency of gynecologic complaints, specifically: menorrhagia (76 %), dysmenorrhea (72 %) and dyspareunia (43 %). Endometriosis was not highly prevalent in this population. The obstetric outcomes were similar to those of the general French population for deliveries by cesarean section (14.6 %) and premature births (6.2 %) but the incidence of multiple spontaneous abortion (13 %) and spontaneous abortion (28 %) were significantly higher. A subset of women were sensitive to hormonal fluctuations with more severe symptoms occurring during puberty, prior to menstruation, during the postpartum period as well as on oral contraception. Increased awareness of the gynecological symptomatology in women with hEDS can help discriminate between endometriosis and thus prevent useless, and potentially dangerous, surgery. This study also suggests that hormonal modulation may be an appropriate treatment for a subset of women with hEDS.

  4. Evaluation of a potential parathyroid dysfunction under treatment with radioactive iodine of benign thyroid diseases; Pruefung einer potentiellen strahleninduzierten Nebenschilddruesenfunktionsstoerung waehrend einer Radioiodtherapie benigner Schilddruesenerkrankung

    Energy Technology Data Exchange (ETDEWEB)

    Schumacher, Serena Christine

    2011-09-28

    The intention of the present thesis was the evaluation of a potential parathyroid dysfunction under treatment with radioactive iodine of benign thyroid diseases. It was to be examined whether a change in the parathyroid function would arise within the first week on treatment. So far there are some minor studies existing describing significant changes in the parathyroid hormone serum level within the first months after radioactive iodine therapy of benign and malignant thyroid diseases. Moreover, it is a fact that external beam-radiotherapy can induce neoplasia and that the risk for the subsequent development of primary hyperparathyroidism doubles or triples after external beam-radiotherapy of the head and neck. Up to now, however, an increased incidence for primary hyperparathyroidism following treatment with radioactive iodine ({sup 131}I) could not be proved. At the department of nuclear medicine of the university hospital Giessen-Marburg GmbH, location Marburg, a prospective cohort study was executed on radioactive iodine therapy of benign thyroid diseases with 105 probands (75 women / 30 men, mean age 60.62 ± 14.3 years). According to their thyroid diseases these 105 probands were classified into following subgroups: thyroid adenoma with 23 patients, multifocal thyroid autonomy with 8 patients, disseminated thyroid autonomy with 37 patients as well as the subgroup Graves' hyperthyroidism (without Graves' ophtalmopathy) and accordingly Graves' disease (with Graves' ophtalmopathy) with 37 patients. The serum level of the intact parathyroid hormone was determined directly before starting the radioactive iodine therapy on the admission day and on day 1, 3 and 5 of the radioactive iodine therapy as well as at the ambulant follow-up examination one month after the start of the therapy. In case of 99 of 105 probands the serum level of parathyroid hormone declined on treatment with {sup 131}I with its nadir on day 3 of therapy (decline by 15.71 ng

  5. Radiation associated hyperthyroidism in patients with gynecological malignancies

    International Nuclear Information System (INIS)

    Katayama, S.; Shimaoka, K.; Piver, M.S.; Osman, G.; Tsukada, Y.; Suh, O.

    1985-01-01

    To determine the effect of abdominal and/or pelvic irradiation for gynecological malignancies on the later development of hyperthyroidism, 1,884 medical records of the patients diagnoses as carcinomas of cervix and corpus uteri, and of ovary were reviewed. Among 1,269 patients with radiation therapy, 5 patients developed hyperthyroidism after irradiation to the abdomen and/or pelvis. This is a statistically significant increase when compared with an epidemiological study. Radiation dose to the thyroid was estimated to be 30 to 200 rads. Two other patients who were irradiated to the nose or supraclavicular region in addition to the abdomen also developed hyperthyroidism. However, none of 581 patients without radiation therapy became hyperthyroid. The results indicate that radiation therapy for treatment of gynecological malignancy gives a significant radiation exposure with an increase in the incidence of subsequent hyperthyroidism

  6. The link between benign prostatic hyperplasia and prostate cancer

    DEFF Research Database (Denmark)

    Ørsted, David Dynnes; Bojesen, Stig E

    2013-01-01

    Benign prostatic hyperplasia (BPH) and prostate cancer are among the most common diseases of the prostate gland and represent significant burdens for patients and health-care systems in many countries. The two diseases share traits such as hormone-dependent growth and response to antiandrogen...... therapy. Furthermore, risk factors such as prostate inflammation and metabolic disruption have key roles in the development of both diseases. Despite these commonalities, BPH and prostate cancer exhibit important differences in terms of histology and localization. Although large-scale epidemiological...... studies have shown that men with BPH have an increased risk of prostate cancer and prostate-cancer-related mortality, it remains unclear whether this association reflects a causal link, shared risk factors or pathophysiological mechanisms, or detection bias upon statistical analysis. Establishing BPH...

  7. Effects of the Affordable Care Act on Young Women With Gynecologic Cancers.

    Science.gov (United States)

    Smith, Anna Jo Bodurtha; Fader, Amanda N

    2018-06-01

    To evaluate the effects of the dependent coverage mandate of the 2010 Affordable Care Act (ACA) on insurance status, stage at diagnosis, and receipt of fertility-sparing treatment among young women with gynecologic cancer. We used a difference-in-differences design to assess insurance status, stage at diagnosis (stage I-II vs III-IV), and receipt of fertility-spearing treatment before and after the 2010 ACA among young women aged 21-26 years vs women aged 27-35 years. We used the National Cancer Database with the 2004-2009 surveys as the pre-ACA years and the 2011-2014 surveys as the post-ACA years. Women with uterine, cervical, ovarian, vulvar, or vaginal cancer were included. We analyzed outcomes for women overall and by cancer and insurance type, adjusting for race, nonrural area, and area-level household income and education level. A total of 1,912 gynecologic cancer cases pre-ACA and 2,059 post-ACA were identified for women aged 21-26 years vs 9,782 cases pre-ACA and 10,456 post-ACA for women aged 27-35 years. The ACA was associated with increased insurance (difference in differences 2.2%, 95% CI -4.0 to 0.1, P=.04) for young women aged 21-26 years vs women aged 27-35 years and with a significant improvement in early stage at cancer diagnosis (difference in differences 3.6%, 95% CI 0.4-6.9, P=.03) for women aged 21-26 years. Receipt of fertility-sparing treatment increased for women in both age groups post-ACA (P for trend=.004 for women aged 21-26 years and .001 for women aged 27-35 years); there was no significant difference in differences between age groups. Privately insured women were more likely to be diagnosed at an early stage and receive fertility-sparing treatment than publicly insured or uninsured women throughout the study period (P<.001). Under the ACA's dependent coverage mandate, young women with gynecologic cancer were more likely to be insured and diagnosed at an early stage of disease.

  8. The effects of a multimodal training program on burnout syndrome in gynecologic oncology nurses and on the multidisciplinary psychosocial care of gynecologic cancer patients: an Italian experience.

    Science.gov (United States)

    Lupo, F N; Arnaboldi, Paola; Santoro, L; D'Anna, E; Beltrami, C; Mazzoleni, E M; Veronesi, P; Maggioni, A; Didier, F

    2013-06-01

    In cancer care, the burden of psycho-emotional elements involved on the patient-healthcare provider relationship cannot be ignored. The aim of this work is to have an impact on the level of burnout experienced by European Institute of Oncology (IEO) gynecologic oncology nurses (N = 14) and on quality of multidisciplinary team work. We designed a 12 session multimodal training program consisting of a 1.5 hour theoretical lesson on a specific issue related to gynecologic cancer patient care, 20 minute projection of a short film, and 1.75 hours of role-playing exercises and experiential exchanges. The Link Burnout Questionnaire (Santinello, 2007) was administered before and after the completion of the intervention. We also monitored the number of patients referred to the Psycho-oncology Service as an indicator of the efficacy of the multidisciplinary approach. After the completion of the program, the general level of burnout significantly diminished (p = 0.02); in particular, a significant decrease was observed in the "personal inefficacy" subscale (p = 0.01). The number of patients referred to the Psycho-oncology Service increased by 50%. Nurses are in the first line of those seeing patients through the entire course of the disease. For this reason, they are at a particularly high risk of developing work-related distress. Structured training programs can be a valid answer to work-related distress, and feeling part of a multidisciplinary team helps in providing patients with better psychosocial care.

  9. Breast Density and Benign Breast Disease: Risk Assessment to Identify Women at High Risk of Breast Cancer.

    Science.gov (United States)

    Tice, Jeffrey A; Miglioretti, Diana L; Li, Chin-Shang; Vachon, Celine M; Gard, Charlotte C; Kerlikowske, Karla

    2015-10-01

    Women with proliferative breast lesions are candidates for primary prevention, but few risk models incorporate benign findings to assess breast cancer risk. We incorporated benign breast disease (BBD) diagnoses into the Breast Cancer Surveillance Consortium (BCSC) risk model, the only breast cancer risk assessment tool that uses breast density. We developed and validated a competing-risk model using 2000 to 2010 SEER data for breast cancer incidence and 2010 vital statistics to adjust for the competing risk of death. We used Cox proportional hazards regression to estimate the relative hazards for age, race/ethnicity, family history of breast cancer, history of breast biopsy, BBD diagnoses, and breast density in the BCSC. We included 1,135,977 women age 35 to 74 years undergoing mammography with no history of breast cancer; 17% of the women had a prior breast biopsy. During a mean follow-up of 6.9 years, 17,908 women were diagnosed with invasive breast cancer. The BCSC BBD model slightly overpredicted risk (expected-to-observed ratio, 1.04; 95% CI, 1.03 to 1.06) and had modest discriminatory accuracy (area under the receiver operator characteristic curve, 0.665). Among women with proliferative findings, adding BBD to the model increased the proportion of women with an estimated 5-year risk of 3% or higher from 9.3% to 27.8% (P<.001). The BCSC BBD model accurately estimates women's risk for breast cancer using breast density and BBD diagnoses. Greater numbers of high-risk women eligible for primary prevention after BBD diagnosis are identified using the BCSC BBD model. © 2015 by American Society of Clinical Oncology.

  10. A person-centered intervention targeting the psychosocial needs of gynecological cancer survivors

    DEFF Research Database (Denmark)

    Olesen, Mette Linnet; Duun-Henriksen, Anne Katrine; Hansson, Eva Helena

    2016-01-01

    , depression, self-esteem, and self-reported ability to monitor and respond to symptoms of recurrence. METHODS: We randomly assigned 165 gynecological cancer survivors to usual care (UC) plus GSD-GYN-C or UC alone. Self-reported QOL-cancer survivor (QOL-CS) total score and subscale scores on physical......PURPOSE: We investigated the effect of a person-centered intervention consisting of two to four nurse-led conversations using guided self-determination tailored to gynecologic cancer (GSD-GYN-C) on gynecological cancer survivors' quality of life (QOL), impact of cancer, distress, anxiety...... and control groups after baseline adjustment. CONCLUSION: We observed higher physical well-being 9 months after randomization in the GSD-GYN-C group, as compared to women receiving usual care. IMPLICATIONS FOR CANCER SURVIVORS: The results suggest that the person-centered intervention GSD-GYN-C may improve...

  11. The work place educational climate in gynecological oncology fellowships across Europe: the impact of accreditation.

    Science.gov (United States)

    Piek, Jurgen; Bossart, Michaela; Boor, Klarke; Halaska, Michael; Haidopoulos, Dimitrios; Zapardiel, Ignacio; Grabowski, Jacek; Kesic, Vesna; Cibula, David; Colombo, Nicoletta; Verheijen, Rene; Manchanda, Ranjit

    2015-01-01

    A good educational climate/environment in the workplace is essential for developing high-quality medical (sub)specialists. These data are lacking for gynecological oncology training. This study aims to evaluate the educational climate in gynecological oncology training throughout Europe and the factors affecting it. A Web-based anonymous survey sent to ENYGO (European Network of Young Gynecological Oncologists) members/trainees to assess gynecological oncology training. This included sociodemographic information, details regarding training posts, and a 50-item validated Dutch Residency Educational Climate Test (D-RECT) questionnaire with 11 subscales (1-5 Likert scale) to assess the educational climate. The χ test was used for evaluating categorical variables, and the Mann-Whitney U (nonparametric) test was used for continuous variables between 2 independent groups. Cronbach α assessed the questionnaire reliability. Multivariable linear regression assessed the effect of variables on D-RECT outcome subscales. One hundred nineteen gynecological oncological fellows responded. The D-RECT questionnaire was extremely reliable for assessing the educational environment in gynecological oncology (subscales' Cronbach α, 0.82-0.96). Overall, trainees do not seem to receive adequate/effective constructive feedback during training. The overall educational climate (supervision, coaching/assessment, feedback, teamwork, interconsultant relationships, formal education, role of the tutor, patient handover, and overall consultant's attitude) was significantly better (P = 0.001) in centers providing accredited training in comparison with centers without such accreditation. Multivariable regression indicated the main factors independently associated with a better educational climate were presence of an accredited training post and total years of training. This study emphasizes the need for better feedback mechanisms and the importance of accreditation of centers for training in

  12. The use of laminarias for osmotic dilation of the cervix in gynecological brachytherapy applications

    International Nuclear Information System (INIS)

    Mayr, Nina A.; Sorosky, Joel I.; Zhen Weining; Weidner, Geoffrey J.; Hussey, David H.; Anderson, Barrie; Buller, Richard E.

    1998-01-01

    Purpose: Osmotic dilators (laminarias) have been used for gradual nontraumatic dilation of the cervical canal for various intrauterine procedures; however, this technique has not been well accepted in gynecological brachytherapy. The purpose of this study was to evaluate the efficacy of osmotic cervical dilation for brachytherapy in gynecologic cancer patients, without the use of general/regional anesthesia, and to assess patient tolerance, complications, and outcome. Methods and Materials: Thirteen brachytherapy procedures were performed in 6 patients with clinical Stages I and II endometrial (5) and Stage IB cervical cancer (1), who were unable to tolerate general/regional anesthesia because of severe medical problems. An osmotic dilator (synthetic laminaria) was inserted into the cervical os 10-12 h before each brachytherapy procedure and removed just before the procedure. Standard Fletcher-Suit-Delclos tandem insertions with vaginal colpostats or cylinders were then performed. Degree of cervical dilation, patient discomfort, procedure time, intra- and postoperative complications were recorded, and local control and survival were assessed. Median follow-up was 31 months (range: 8-35 months). Results: The diameter of the dilated cervical os after laminaria removal was adequate (≥ 5 mm) for tandem insertion, and no additional mechanical dilation was required in all but one procedure (1 of 13). All procedures were performed without general/regional anesthesia. The mean duration of the procedures was 44 min (range, 20-60 min). Discomfort was minimal in all cases. There were no intra- or postoperative complications. All patients maintained local control until death (1 of metastatic disease, 2 of intercurrent disease) or last follow-up (2 with no evidence of disease, 1 alive with metastatic disease). Conclusion: This preliminary study suggests that osmotic cervical dilation with a synthetic laminaria is a useful technique to facilitate intrauterine tandem insertion

  13. The work place educational: climate in gynecological oncology fellowships across Europe: the impact of accreditation

    NARCIS (Netherlands)

    Piek, J.M.J.; Bossart, M.; Boor, K.; Halaska, M.J.; Haidopoulos, D.; Zapardiel, I.; Grabowski, J.P.; Kesic, V.; Cibula, D.; Colombo, N.; Verheijen, RHM; Manchanda, R.

    Background: A good educational climate/environment in the workplace is essential for developing high-quality medical (sub)specialists. These data are lacking for gynecological oncology training. Objective: This study aims to evaluate the educational climate in gynecological oncology training

  14. Building capacity in VA to provide emergency gynecology services for women.

    Science.gov (United States)

    Cordasco, Kristina M; Huynh, Alexis K; Zephyrin, Laurie; Hamilton, Alison B; Lau-Herzberg, Amy E; Kessler, Chad S; Yano, Elizabeth M

    2015-04-01

    Visits to Veterans Administration (VA) emergency departments (EDs) are increasingly being made by women. A 2011 national inventory of VA emergency services for women revealed that many EDs have gaps in their resources and processes for gynecologic emergency care. To guide VA in addressing these gaps, we sought to understand factors acting as facilitators and/or barriers to improving VA ED capacity for, and quality of, emergency gynecology care. Semistructured interviews with VA emergency and women's health key informants. ED directors/providers (n=14), ED nurse managers (n=13), and Women Veteran Program Managers (n=13) in 13 VA facilities. Leadership, staff, space, demand, funding, policies, and community were noted as important factors influencing VA EDs building capacity and improving emergency gynecologic care for women Veterans. These factors are intertwined and cross multiple organizational levels so that each ED's capacity is a reflection not only of its own factors, but also those of its local medical center and non-VA community context as well as VA regional and national trends and policies. Policies and quality improvement initiatives aimed at building VA's emergency gynecologic services for women need to be multifactorial and aimed at multiple organizational levels. Policies need to be flexible to account for wide variations across EDs and their medical center and community contexts. Approaches that build and encourage local leadership engagement, such as evidence-based quality improvement methodology, are likely to be most effective.

  15. Self-expandable metal stents in the treatment of benign anastomotic stricture after rectal resection for cancer.

    Science.gov (United States)

    Lamazza, A; Fiori, E; Sterpetti, A V; Schillaci, A; Scoglio, D; Lezoche, E

    2014-04-01

    To evaluate the use of self-expandable metallic stents to treat patients with symptomatic benign anastomotic stricture after colorectal resection. Ten patients with a benign symptomatic anastomotic stricture after colorectal resection were treated with endoscopic placement of a self-expandable metal stent. The stent was placed successfully in all 10 patients without any major morbidity. At a mean follow-up of 18 months the stenosis was resolved successfully in 7 out 10 patients (70%). The remaining three patients were subsequently treated successfully with balloon dilatation. Self-expandable metal stents represent a valid alternative to balloon dilatation to treat patients with benign symptomatic anastomotic stricture after colorectal resection for cancer. Colorectal Disease © 2013 The Association of Coloproctology of Great Britain and Ireland.

  16. Transvaginal Resection of a Bladder Leiomyoma Misdiagnosed with a Vaginal Mass: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Fu-Fen Yin

    2015-01-01

    Full Text Available Bladder leiomyoma is a rare benign tumor and it could be easily misdiagnosed with many other pelvic diseases, especially obstetrical and gynecological diseases; abdominal, laparoscopic, and transurethral resection of bladder leiomyoma have been reported. Herein, we present a case of bladder leiomyoma misdiagnosed with a vaginal mass preoperatively; the mass was isolated, enucleated from the bladder neck, and removed transvaginally; to the best of our knowledge, this is the first case of intramural leiomyoma of bladder neck that has been enucleated transvaginally only without cystotomy.

  17. Mood and anxiety disorders in women with treated hyperthyroidism and ophthalmopathy caused by Graves' disease.

    Science.gov (United States)

    Bunevicius, Robertas; Velickiene, Dzilda; Prange, Arthur J

    2005-01-01

    To evaluate the prevalence of mood and anxiety disorders in women with treated hyperthyroidism caused by Graves' disease and to compare them with the prevalence of such findings in women without past or present thyroid disease. Thirty inpatient women with treated hyperthyroidism and ophthalmopathy caused by Graves' disease and 45 women hospitalized for treatment of gynecologic disorders such as abnormal vaginal bleeding, benign tumors or infertility were evaluated for the prevalence of mood and anxiety diagnoses using a standard Mini-International Neuropsychiatric Interview and for mood and anxiety ratings using the Profile of Mood States (POMS). At the time of assessment, it was discovered that 14 of 30 women with treated hyperthyroidism caused by Graves' disease were still hyperthyroid, while 16 women were euthyroid. Significantly greater prevalence of social anxiety disorder, generalized anxiety disorder, major depression and total mood and anxiety disorders, as well as higher symptom scores on the POMS, was found in hyperthyroid women with Graves' disease in comparison with the control group. A prevalence of total anxiety disorder, as well as history of mania or hypomania and lifetime bipolar disorder, but not lifetime unipolar depression, was more frequent in both the euthyroid and the hyperthyroid subgroups of study women in comparison with the control group. These results confirm a high prevalence of mood and anxiety disorders in women with treated hyperthyroidism and ophthalmopathy caused by Graves' disease. Hyperthyroidism plays a major role in psychiatric morbidity in Graves' disease.

  18. Benign colonic metaplasia at a previous stoma site in a patient without adenomatous polyposis.

    Science.gov (United States)

    Prouty, Megan; Patrawala, Samit; Vogt, Adam; Kelleher, Michael; Lee, Michael; Parker, Douglas C

    2016-03-01

    There are few reported cases of cutaneous intestinal metaplasia or primary adenocarcinoma arising at the ileostomy site following panproctocolectomy. These complications have been seen almost exclusively in patients with familial adenomatous polyposis and inflammatory bowel disease (IBD). However, benign intraepidermal colonic mucosa at a reversed ileostomy site in a patient without familial adenomatous polyposis or IBD has not been documented. We report a case of a 51-year-old female with a history of colonic adenocarcinoma who presented with pruritic, erythematous, scaly plaques on the right lower abdomen, present since reversal of her ileostomy in 2007. Skin biopsy revealed benign foci of colonic epithelium with no evidence of adenomatous change. Benign intraepidermal colonic mucosa was diagnosed based on histopathologic findings and immunohistochemistry. To our knowledge, this is the first case of intraepidermal benign colonic metaplasia forming in a patient following ostomy reversal. The case emphasizes the importance of patient education and physical examination of the stoma or stoma remnants for detection of unusual or changing lesions due to the risk for malignant transformation. It also demonstrates that benign colonic mucosa should be considered in the differential diagnosis when evaluating lesions near ileostomy sites, regardless of whether the patient has a history of familial adenomatous polyposis or IBD. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Fully covered self-expanding metal stents are effective for benign esophagogastric disruptions and strictures.

    Science.gov (United States)

    Wilson, Jennifer L; Louie, Brian E; Farivar, Alexander S; Vallières, Eric; Aye, Ralph W

    2013-12-01

    Self-expanding fully covered metal stents (CSs) are ideal for use in benign esophagogastric disease. We reviewed our experience with CS to evaluate outcomes, to determine a role for CS in a standard treatment for benign esophageal conditions, and to compare our results with recently published studies. We performed a retrospective chart review from 2005 to 2012. A total of 57 CSs were placed in 44 patients. Indications were stricture (11 patients), anastomotic leak (20), perforation (7), and tracheoesophageal fistulae (6). For GI tract disruptions, open repair or diversion was avoided in 31/33 patients (93.9 %) but required an associated drainage procedure in 22/33 (67 %) patients. Resolution does not depend on achieving radiological control with 6/26 (23 %) having evidence of a persistent leak. Benign strictures were dilated at a mean of 3.7 times prior to stenting. Adjunctive intra-mucosal steroid injections were used in 8/11 patients. Stents were removed at a mean of 33 days. At a mean of 283 days of follow-up, 6/11 (54.5 %) had symptom resolution. The most common complication was stent migration occurring in 17.5 % of patients overall. Covered stents are an effective adjunct in the management of benign upper gastrointestinal tract fistulae, leaks, perforations and benign strictures.

  20. Pharmacological treatment of the benign prostatic hyperplasia; Tratamiento farmacologico en la hiperplasia prostatica benigna

    Energy Technology Data Exchange (ETDEWEB)

    Perez Guerra, Yohani; Molina Cuevas, Vivian; Oyarzabal Yera, Ambar; Mas Ferreiro, Rosa, E-mail: yohani.perez@cnic.edu.c [Centro de Productos Naturales, Centro Nacional de Investigaciones Cientificas (CNIC), La Habana (Cuba)

    2011-07-01

    Benign prostatic hyperplasia is a common disease in over 50 years-old men consisting in uncontrolled and benign growth of prostatic gland that leads to lower urinary tract symptoms. The etiology of benign prostatic hyperplasia is multifactoral involving the increased conversion of testosterone in dihydrotestosterone by the prostatic 5{alpha}-reductase action, which brought about events that encourage the prostate growth (static component) and the increase of the bladder and prostate smooth muscle tone (dynamic component) regulated by the a{alpha}{sub 1} -adrenoceptors (ADR). The pharmacological treatment of the benign prostatic hyperplasia includes the prostatic 5a{alpha}-reductase inhibitors, the a{alpha}{sub 1}-adrenoreceptor blockers, their combined therapy and the phytotherapy. This paper was aimed at presenting the most relevant aspects of the pharmacology of drugs used for treating the benign prostatic hyperplasia, and providing elements to analyze their efficacy, safety and tolerability. To this end, a review was made of the different drugs for the treatment of this pathology and they were grouped according to their mechanism of action. Natural products were included as lipid extracts from Serenoa repens and Pygeum africanum as well as D-004, a lipid extract from Roystonea regia fruits, with proved beneficial effects on the main etiological factors of benign prostatic hyperplasia. D-004 is a prostatic 5a-reductase inhibitor, an a{alpha}{sub 1}-adrenoceptor antagonist, a{alpha} 5-lipooxygenase inhibitor and has antioxidant action, all of which reveals a multifactoral mechanism. The results achieved till now indicate that D-004 is a safe and well-tolerated product