Clinical practice guidelines for gynecologic cancers have been developed by many organizations. Although these guidelines have much in common in terms of the practice of standard of care for uterine corpus cancer, practice guidelines that reflect the characteristics of patients and healthcare and insurance systems are needed for each country. The Korean Society of Gynecologic Oncology (KSGO) published the first edition of practice guidelines for gynecologic cancer treatment in late 2006; the second edition was released in July 2010 as an evidence-based recommendation. The Guidelines Revision Committee was established in 2015 and decided to produce the third edition of the guidelines as an advanced form based on evidence-based medicine, considering up-to-date clinical trials and abundant qualified Korean data. These guidelines cover screening, surgery, adjuvant treatment, and advanced and recurrent disease with respect to endometrial carcinoma and uterine sarcoma. The committee members and many gynecologic oncologists derived key questions from the discussion, and a number of relevant scientific literatures were reviewed in advance. Recommendations for each specific question were developed by the consensus conference, and they are summarized here, together with other details. The objective of these practice guidelines is to establish standard policies on issues in clinical areas related to the management of uterine corpus cancer based on the findings in published papers to date and the consensus of experts as a KSGO Consensus Statement.
Vitamin D (VtD) endocrine system is associated with obesity. The relationship between VtD and body fat was described originally by Lumb et al. [1]. Subsequently murine experiment and human study revealed that body fat is the major storage site of vitamin D3 and the source for other VtD metabolites during deprivation as well [2,3]. The reasons of VtD insuffi ciency in obese people have been postulated to several factors such as a decrease exposure to sunlight because of low activity level, a negative feedback from elevated active VtD metabolite 1,25-hydroxyvitamin D and parathyroid hormone (PTH) levels on hepatic synthesis of 25-OHD [4], and the metabolic clearance of VtD may increase in obesity with enhanced uptake by adipose tissue [5]. Recently, Worstman et al. [6] also demonstrated that obesity-associated VtD insuffi ciency most likely ORIGINAL ARTICLE Korean J Obstet Gynecol 2012;55(6) Objective Obesity is associated with alterations in vitamin D (VtD) system. We evaluated the correlation between VtD level and body mass index (BMI), a standard for the evaluation of obesity in postmenopausal women. MethodsTo study the relationship between VtD levels and obesity, we recruited 310 healthy postmenopausal women between January 2005 and March 2011 and analyzed the correlation between BMI and serum 25-hydroxyvitamin D (25-OH-VtD) level. We also analyzed the relationship between serum VtD level and bone health status such as bone mineral density measured by dual-energy X-ray absorptiometry, bone turnover marker, and parathyroid hormone (PTH). ResultsWith a cut-off level for VtD deficiency at 30 ng/mL, 98.9% patients showed a VtD deficiency, while 87.8% patients showed a vitamin D defi ciency with a 20-ng/mL cut-off level. VtD levels had no signifi cant correlation with age, height, weight, BMI, or bone turnover markers. PTH level and serum 25-OH-VtD level showed a negative correlation. VtD level showed negative correlation with BMI, but statistically not signifi cant. ConclusionIn this study, most of postmenopausal women (more than 87.8%) had a VtD defi ciency, and VtD level showed negative correlation with BMI, but was not statistically signifi cant.
Ectopic pregnancy is an implantation of the fertilized ovum on a place except the endometrium. Most of the ectopic pregnancies are located at the fallopian tube. Only the 1.4% of ectopic pregnancies are abdominal pregnancies, of which only 15 cases of retroperitoneal pregnancies are reported all over the world. In this case, a 21-year-old woman presented with back pain and amenorrhrea for 5+2 weeks with no past history. During the laparoscopic operation, there was retroperitoneal hematoma which was located between right paracolic gutter and presacral area and there was no adnexal mass or free pelvic fl uid to be found. We stopped the operation and performed computed tomography angiography, in which small peripheral enhanced cystic lesion in pericaval space and large amount of hematoma in perirenal space were revealed. We performed explo-lapratomy, and eliminated the gestational sac which was located between the inferior vena cava and ureter. We report very rare case of retroperitoneal ectopic pregnancy with brief review of literature.
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