Uterine Artery Embolization for the Treatment of Symptomatic Fibroids

Abstract

Uterine fibroids are the most common solid tumors of the female genital tract, and they develop in 20 40% of women of childbearing age (1). Although not all the women with fibroids exhibit symptoms, approximately 10 20% of women with fibroids have symptoms that negatively affect their quality of life (2). Menorrhagia, which often leads to iron-deficiency anemia, and pain during menstruation are the most common complications of uterine leiomyoma. The therapeutic options for the treatment of fibroids include hysterectomy, myomectomy, gonadotropin-releasing hormone agonists and a number of experimental ablative techniques involving energy sources such as focused ultrasound or radiofrequency ablation. Uterine artery embolization Purpose: The aim of this study was to determine the potential usefulness of uterine artery embolization (UAE) for the management of uterine leiomyoma. Materials and Methods: Sixty nine patients (mean age; 40.3 years, age range; 31 52 years) who underwent UAE for symptomatic fibroids (with menorrhagia, dysmenorrhea and bulk-related symptoms) from January 2000 to December 2000 were retrospectively analyzed. The mean follow-up period was 3.5 months (range: 1 8 months).The fibroids ranged in size from 2.0 cm to 13.2 cm with a mean size of 5.8 cm. We performed embolization using polyvinyl alcohol particles (250 710 m). The improvement of the clinical symptoms was analyzed. Reduction of the uterine and predominant fibroid volumes was assessed using MRI. Results: Symptom improvement for the menorrhagia (87.5%), dysmenorrhea (83.3%) and the bulk-related symptoms (79.2%) was reported. Complications included ovarian failure in four patients (5.8% of the total patients, mean age: 43.3 yrs) and infection in three patients (4.3% of the total patients) who underwent conservative management with intravenous antibiotics and analgesics. The volume reduction rate of the uterus and the predominant fibroids after uterine artery embolization were 36.3% and 56.6%, respectively. Conclusion: UAE is a promising new treatment for symptomatic fibroids and may be a valuable alternative to hysterectomy.

A Meta-Analysis on the Effects of Learning with Robots in Early Childhood Education in Korea

“…Technological education expectations have been achieved to increasing degrees, a process that has been summed up in the acronym STEAM (science, technology, engineering, arts, and mathematics),whichcapturestheeffortineducationtophaseintechnologiessuchasrobotsinthe classroomenvironmenttocultivateskilledworkers.Indeed,robotshaveasomewhatsymbolicrole inSTEAMeducation.InSouthKorea,theMinistryofEducationandScienceTechnology(MEST) hasannounced"StrategiesForAdvancementOfEarlyChildhoodEducation,"whichcommittoa future-orientedcurriculuminvolvingfeaturessuchasapplicationofteacherassistantrobotsinearly childhoodeducation.Toachievethisgoal,500robotswereprovidedforKoreankindergartensin 2010,atacostof15milliondollars,anumberexpandedto8,000by2013.KIST(KoreaInstitute ofScienceandTechnology)usestheterm"robotlearning"or"r-learning"todescribetheseefforts. R-learninginKoreaissupportedbyaCenterforR-learningDevelopment,Promotion&Support;after certificationbythiscenter,threekindsofplatformrobots-Genibo,IrobiQ,andKibot-havecome intopreschools,andtheirimpactstheyhaveonyoungchildren'sdevelopmentandlearningaswell astheirteachers'approachesarebeinginvestigatedinaremarkableproliferationofresearchactivity -80studiesfromarticletothesislengthinthefirstfiveyears.WhetherinKoreaorelsewhere,ECE r-learningresearchhastakenplaceinfourmainareas;theKoreanresearchwillbecitedfirstandthe non-Koreanresearchsecond.Thefirstresearchareaispositiveornegativeperceptionsofr-learning amongparentsandteachersandeffectsofr-learningonteachersandinstitutions(e.g., Kim,Park,& Kim,2010;Jung&Han,2012;Hwangetal.,2011).Thesestudieshaveshowningeneralthatteachers areinitiallypuzzledabouthowtoeffectivelyteachwithrobots,butgraduallygetaccustomedtotheir useanddeveloppositiveattitudestowardr-learning.Thesecondareaisclarifyingtheeffectiveness ofr-learningandspecificr-learningtoolsforchildren'sdevelopment-physical,linguistic,perceptual, emotional,social,andcreative-andforteachingandlearning(e.g., Kim,Lee,Ahn,Kim,&Cha, 2012;Kim,Lee,Hyeon,&Park,2011;Seo,2008).Thisresearchsuggeststhattheoveralleffectis positive.Thethirdareaisdesigningr-learningtrainingprogramsforpre-andin-serviceteachers aswellaseducationalmaterialsforusewithrobots,andexaminingtheireffectiveness(e.g., Lee, Lee,Eum,&Jung,2012;Lee,Kang,&Jo,2012;Lee,Kim,&Seo,2011).Thefourthstudyarea isassessinginteractionsbetweenchildrenandauthorizedrobots,includinglookingintorobotsfor childrenwithspecialneeds(e.g., Ku&Lee,2012;Kim,Lee,Jung,&Bae,2011;Park,Jang,&Kim, 2011;Yoon&Hyun,2012;Jang,2011;Jung&Park,2010;Hongetal.,2010).Thesestudiesshow positiveinteractionsespeciallyinthecaseofautisticchildren,forwhomrobotscanmakeasignificant differenceintheirtherapyandeducation.…”