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Total Laparoscopic Hysterectomy for Diagnosis and Treatment of Cervical Cystic Lesions: A Case Series

Open Journal of Obstetrics and Gynecology 2020年第3期10卷 357-364页

作者： Tohru Morisada Kohsei Tanaka tomoko iijima Azumi Nishizawa Hiroshi Nishio Yusuke Kobayashi Masaru Nakamura Shigenori Hayashi Fumio Kataoka Takashi Iwata Daisuke Aoki Department of Obstetrics and Gynecology Keio University School of Medicine Tokyo Japan

Objective: Cervical cystic lesions are often observed in gynecological clinical practice. Many are caused by benign diseases such as lobular endocervical glandular hyperplasia (LEGH), and it is important to differentiate these lesions from those due to malignant diseases such as minimal deviation adenocarcinoma (MDA). In cases in which fertility preservation is not a concern, the final pathology is often confirmed by hysterectomy. To investigate the feasibility and safety of laparoscopic surgery for cervical cystic lesions, we retrospectively examined cases in which total laparoscopic hysterectomy (TLH) was performed for diagnosis and treatment. Methods: The subjects were 28 women who underwent TLH from April 2012 to March 2017 at Keio University Hospital. The pre- and post-operative courses of these patients were examined. Results: The average age was 49.4 (range 39 - 65) years and the mean body mass index was 21.7 (16.8 - 30.5) kg/m2. The average operation time was 159 (101 - 314) min and the average bleeding volume was 106.8 (0 - 600) g. There were no severe perioperative complications. The average hospital stay was 8.4 (7 - 14) days. In postoperative pathological diagnosis, 13 cases had benign diseases such as Nabot cysts, there were 14 cases of LEGH, and one patient was diagnosed with MDA. In the MDA case, additional bilateral salpingo-oophorectomy and pelvic lymph node dissection were performed at a later date. No metastasis was observed in these excised specimens. Conclusions: Our results suggest that TLH for cervical cystic lesions can be performed safely. However, it is important to consider the TLH indication before surgery based on the possibility of malignant disease.

关键词： Lobular Endocervical Glandular Hyperplasia Minimum Deviation Adenocarcinoma Total Laparoscopic Hysterectomy Uterine Cervix

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Exploration of nonpharmacological control in thorough QT/QTc studies

Exploration of nonpharmacological control in thorough QT/QTc...

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第三届中日双边药理学和临床药理学学术会议

作者： SAHASHI Kunihiko KUMAGAI Yuji FUJITA Tomoe IKEDA Yasuhiko HASUNUMA tomoko iijima Hajime KOSUGE Kazuhito OHTANI Yoshio Kitasato University East Hospital Japan Kitasato University East Hospital Japan Kitasato University East Hospital Japan Kitasato University East Hospital Japan Kitasato Institute Japan Kitasato Institute Japan Kitasato Institute Japan Kitasato University East Hospital Japan

＜正＞AIM Drug induced QT prolongation is a risk factor of torsade de pointes,a lethal ventricular tachycar- *** ICH-E14 guideline concerning QT/QTc pro- longation reached step5 in USA and *** the guideline, use of a positive control is recommended to detect changes in QT ***,a pharmacological control such as moxifloxaein is used in a thorough QT/QTc study,how- ever Japanese authority suggests use of nonpharmacological *** studied the possibility of such controls. METHODS The study included 2 parts in healthy male *** part A,effects of standing for 5 min and valsalva maneuver were studied in 74 subjects,and in part B effects of hand grip with 30% of max load for 3 min was studied in 50 *** were recorded for 15 s and QT intervals were measured in lead Ⅱ on *** in- terval was corrected by 2 methods of Bazette （QTcB） and of Fridericia （QTcF）.RESULTS QT interval itself was shortened markedly by standing although corrected QTcs showed changes of opposite *** observed chan- ges were a prolongation in QTcB and a shortening in *** maneuver caused no significant changes. QTcB and QTcF decreased immediately after hand grip but they increased after 3 min’ hand *** Changes in QT by physiological loads may be affected by heart rate,a cautious interpretation is necessary in discus- sing the possibility of such loads as positive controls.

关键词： QT interval ICH-E14 positive control standing,hand grip

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