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Hot flush (hot flush or facial flush) is the most frequent symptom experienced by women of peri-menopausal age. It may appear on women or even men after surgery or chemotherapy. Hot flush is one of the biggest reason for women to undergo hormone replacement therapy (HRT). It also crucially affects various aspects of life quality such as occupation, social life, daily routine and health awareness. The most effective and fundamental remedy for hot flush is HRT. However, a few women is not responsive to HRT and investigation to elucidate other causes of hot flush is warranted, especially in elderly. The contraindications such as breast cancer mandates other modality of treatment. Variety of treatment for hot flush other than HRT will be discussed herein.

Objectives To analyze the oncologic outcomes of long-term fertility-sparing treatment (FST) in patients with early-stage endometrial cancer (EC) and to determine the optimal duration of FST that would not hamper survival outcomes. Methods Patients undergoing FST for presumed stage IA, grade 1 EC between 2005 and 2018 were retrospectively analyzed. Oncologic outcomes were compared between the group with ≤6 months of FST and the group with >6 months of FST. Segmented regression analysis was used to estimate the dynamic changes in cumulative complete response (CR) rates according to FST duration. Results A total of 122 patients received oral progestin, with concurrent levonorgestrel-releasing intrauterine device use in 108 (88.5%) and 105 (86.1%) achieved CR with a median time to achieve CR of 10 (3–42) months. Of the patients not achieving CR at 6 months of FST, 95.1% (78/82) continued further FST. The overall CR rate (88.9% [32/36] vs. 84.9% [73/86], P = 0.436] was not significantly different between the groups with ≤6 and > 6 months of FST. The changes in cumulative CR rates were significantly different between the two segments divided by 15 months from the initial FST (P = 0.0015, segmented regression analysis). The overall progressive disease (PD) rate was 3.3% (4/122), and PD was first detected during 9–12 months of FST. Conclusion Patients not achieving CR and not showing PD at 6 months of FST could continue further FST. If disease progression is excluded, 15 months of FST can be considered as the cutoff for the optimal FST duration.

Introduction/Background Hormonal management is an alternative treatment for preserving fertility in patients with early stage endometrioid endometrial cancer (EC). The safety and clinical outcome in longer treatment more than 9 months has controversial. This study aimed to define the oncologic outcomes after hormone therapy more than 9 months for endometrioid EC. Methodology We retrospectively analyzed patients presumed to have stage IA, grade 1–2 endometrioid EC who underwent fertility-sparing treatment. Concurrent medroxyprogesterone (MPA) and levonorgestrel-release intrauterine devices were used for treatment. The remission rate and progression free survival were analysed each of the short term treatment who had treatment under 9 months and long term groups who had treatment duration over 9 months. Results One hundred twenty patients presumed to have stage IA, grade 1 endometrioid EC had treated with hormonal medication for fertility sparing. The median age was 33.5 (range 22–43) years old and the median treatment duration was 10.7 (3–102) months. The Complete remission (CR) rate was 84.2% (101/120) and the median time interval to CR was 9.3 (2–84) months. The median follow-up time was 32.9 (1–130) months. The recurrence rate was 31.7% (38/120) and the median time to recurrence was 11 (1–92) months. The cumulative CR rate by 3, 6, 9, 12, 15, 18, 24 months was 21.7%, 36.7%, 50.8%, 61.7%, 70.8%, 74.2%, and 78.3% respectively. The CR rates in group A and B were 86.7% and 82.7% in group A and B. The recurrence rates in two group wrere 35.6% and 29.3%, respectively. Conclusion Fertility sparing treatment with high dose progestin over 9 months in early stage endometrioid EC has showed high rate of CR. However, medical treatment over 9 months should counsel with patients in detail and oncologists should make careful decision. Disclosures I have no conflicts of interest to disclose.

Background To identify sarcopenia as a predictive prognostic factor of ovarian cancer in terms of survival outcome in patients with early-stage ovarian cancer. Methods Data of Konkuk University Medical Center from March 2002 to December 2017 were reviewed retrospectively. Eighty-two patients who underwent surgery due to early-stage (International Federation of Gynecology and Obstetrics stage I/II) ovarian cancer and had computed tomography (CT) images taken at the initial diagnosis were included. The initial CT scan images were analyzed with SliceOmatic software (TomoVision). A sarcopenia cutoff value was defined as a skeletal muscle index of ≤ 38.7 cm2/m2. Overall survival (OS) times were compared according to the existence of sarcopenia, and subgroup analyses were performed. Results A Kaplan-Meier analysis showed a significant survival disadvantage for patients with early-stage ovarian cancer when they had sarcopenia (P < 0.001; log-rank test). Sarcopenia remained a significant prognostic factor for OS in early-stage ovarian cancer, in a Cox proportional hazards model regression analysis (HR, 21.9; 95% CI, 2.0–199.9; P = 0.006). Conclusion This study demonstrated that sarcopenia was predictive of OS in patients with early-stage ovarian cancer. Further prospective studies with a larger number of patients are warranted to determine the extent to which sarcopenia can be used as a prognostic factor in ovarian cancer., Graphical Abstract

Summary: Purpose: The purpose of this study was to evaluate the contributions and limitations of the cervical cancer screening test with accuracy in Korea. Methods: This was a retrospective observational study. The study population consisted of all participants who underwent cervical cancer screening test from 2009 to 2014. The data were obtained from National Health Information Database (NHID) which represents medical use records of most Koreans. As the indices for contributions and limitations of the screening test, crude detection rate, incidence rate of interval cancer, sensitivity, specificity, and positive predictive value were used. Results: The crude detection rate of screening test per 100,000 participants increased from 100.7 in 2009 to 102.1 in 2014. The incidence rate of interval cancer per 100,000 negatives decreased from 13.0 in 2009 to 10.2 in 2014. The sensitivities of screening test were 88.7% in 2009 and 91.2% in 2014, and the specificities were 98.5% in 2009 and 97.7% in 2014. The positive predictive value of screening decreased from 6.2% in 2009 to 4.3% in 2014. Conclusion: The Korean national cervical cancer screening program has improved in accuracy and has contributed to detection of early stage of cervical cancer over the years. Along with efforts to promote participation in cancer screening programs, quality control over the screening program should be enhanced. Keywords: carcinoma in situ, early detection of cancer, Papanicolaou test, sensitivity and specificity, uterine cervical neoplasms

This study aimed to know the distance of the cervicovaginal junction (CVJ) to the anterior peritoneal reflection (APR) as measured in surgical specimens, and assess the distance between the CVJ and APR to ensure safe anterior colpotomy for vaginal hysterectomy among Korean women. Patients who underwent vaginal hysterectomy were included in the analysis. According to the presence of pelvic organ prolapse or menopausal status, the distance from the CVJ to the APR was assessed preoperatively through transvaginal ultrasonography (TV-US), as well as intraoperatively using surgical specimens. The intraclass correlation coefficient was used to determine the reliability between 2 measurements. In total, 171 patients were included. The median distance from the CVJ to the APR measured on TV-US was 19.8 (3.3–41.3) mm. Meanwhile, the median distance from the CVJ to the APR measured using the surgical specimen was 26.0 (12.0–55.0) mm. The intraclass correlation coefficient for the absolute agreement between 2 measurements was 0.353 (95% confidence interval: 0.002–0.570; P

Objectives To assess the effect of adjuvant chemotherapy (AC) or radiotherapy (AR) on the risk of recurrence in surgically treated patients with early-stage uterine leiomyosarcoma (uLMS). Methods We searched the PubMed, EMBASE, and MEDLINE, and Cochrane databases for publications up to March 2019, which compared patients with early-stage uLMS who received AC or AR with those who did not. The primary endpoint was recurrence rate. Random- or fixed-effects models were used for pooled estimates of the effect of adjuvant treatments on recurrence rates. Subgroup analyses were conducted based on study design, surgical staging, AC regimen (gemcitabine/docetaxel regimen), and type of AR. Results Three randomized trials and 9 observational studies (9 studies for AC vs. observation, n = 496; 9 studies for AR vs. observation, n = 425) were included. The meta-analysis indicated that AC did not decrease the risk of recurrence compared with observation (odds ratio [OR] = 0.65, 95% confidence interval [CI] = 0.37–1.15, P = 0.14; P = 0.09 and I2 = 42.1). Similarly, AR did not decrease the risk of recurrence compared with observation (OR = 1.11, 95% CI = 0.56–2.21, P = 0.76; P = 0.10 and I2 = 40.4). Meta-regression analyses revealed no significant association between median follow-up time and recurrence. In subgroup analyses (study design, surgical staging, gemcitabine/docetaxel regimen, type of AR), neither AC nor AR decreased the risk of recurrence significantly. Conclusion AC, including gemcitabine/docetaxel regimen, or AR did not reduce the recurrence rate in patients with early-stage uLMS.

OBJECTIVE Few data exist regarding adjuvant hysterectomy (AH) in locally advanced cervical cancer (LACC) patients treated with chemoradiotherapy. We investigated the effect of AH on prognosis in LACC patients, through meta-analysis. METHODS EMBASE and MEDLINE databases and the Cochrane Library were searched for published studies comparing LACC patients who received AH after chemoradiotherapy with those who did not, through April 2016. Endpoints were mortality and recurrence rates. For pooled estimates of the effect of AH on mortality/recurrence, random- or fixed-effects meta-analytical models were used. RESULTS Two randomized trials and six observational studies (AH following chemoradiotherapy, 630 patients; chemoradiotherapy, 585 patients) met our search criteria. Fixed-effects model-based meta-analysis indicated no significant difference in mortality between the groups (odds ratio [OR]=1.01; 95% confidence interval [CI]=0.58-1.78; p=0.968) with low cross-study heterogeneity (p=0.73 and I²=0.0). This pattern was observed in subgroup analysis for study design, radiation type, response after chemoradiotherapy, and hysterectomy type. The pooled OR for AH and recurrence was 0.59 (95% CI=0.44-0.79; p

TV + ,-./0 1 2 34567892:3 ; ?1 @ A. B$% C1 D EFG H8 I JKL2MG8 2 31N G FOPQ>"# 2RS3TA. $% U, 3 1 V#:W* 'GXYZ CV[\ V?H; ]US ^_`a, * ' bcdJ, efUCgh R1C8 i Vj1kH8lmnA. 9o> + ?pV[\"# qFM b31* 'GX(88-108 MHz)U DMB* 'GX(VHF Ch7~13), FM rGX(76~88MHz: VHF Ch5~6) Nps* 'GX2 bH8YZ31 , tDAB+, HD-Radio, DRM+ Vuvw 2YZ31 8x ./A. B$% C1 ]S^_ Vy3>Nz{1-2|8}cd2~'?>}€ E‚ƒ Vy 2&Z„H8 C gh efU bE 0†RF~k2 ‡3>E A. AbstractThough the digital transition of terrestrial TV has been completed, the transmission system for terrestrial radio has not been determined and terrestrial radio still keeps its analog transmission. This study, under co-orientation model, aims to explore the cognitive difference in recognizing important factors to be considered in deciding the digital radio transmission system between the employees of terrestrial broadcasters and then crucial issues related to the factors are driven. It has been found that the most big cognitive difference among the employees of three major terrestrial broadcasters lies in selecting frequency band for digital radio transmission. But there was little difference of opinion on simultaneous production-transmission, efficiency of frequency usage, broadcast quality and standards of service. The most disputable point in transition to digital radio broadcasting is selecting the frequency band for digital radio between the frequency bands used for FM radio broadcast (88-108MHz), terrestrial DMB (VHF Ch7~13) and FM radio adjacent broadcast band (76~88MHz: VHF Ch5~6). So, the question concludes into the selection issue between DAB+, HD-Radio, and DRM+. To improve the quality of radio broadcasting service and enhance the satisfaction of listeners, it is desirable to allow to operate both production system and transmission station, to enhance high transmission efficiency with minimum transmission facility, and to permit new entrance of broadcasters.Keyword : Digital radio broadcasting, Transmission method, Frequency band, Co-orientation model €(Regular Paper) 20 1 , 2015 1(JBE Vol. 20, No. 1, January 2015)http://dx.doi.org/10.5909/JBE.2015.20.1.122ISSN 2287-9137 (Online) ISSN 1226-7953 (Print)

Objective: In Korean population, information is lacking regarding fetal subcutaneous tissue thickness (SCTT) detected during pregnancy in the normal maternal condition. Thus, the aim of this study is to evaluate SCTT in the basic fetal biometry measurement plane, and to identify the clinical significance of SCTT in estimating fetal weight. Methods: In this retrospective observational study, 856 term pregnant women were recruited between 1st January 2013 and 31st December 2015. Estimated fetal weight (EFW) and fetal SCTT were measured routine ultrasonography within one week before delivery. The women were divided in two groups: SCTT group (n=46) and non-SCTT group (n=810). Pregnancy outcomes including birth weight (BW) and EFW were compared between the two groups. Results: The incidence of SCTT was 5.4% and no significant differences in parity, maternal age, maternal pre-pregnancy body mass index or gestational age at delivery were found between the groups. EFW, BW, amniotic fluid index, and cesarean section rate were higher in the SCTT group than in the non-SCTT group. The difference between EFW and BW was only significant in the SCTT group. Moreover, SCTT and EFW were positively correlated with BW (SCTT group: EFW 3,460±472 g vs. BW 3,779±496 g, P=0.013; non-SCTT group: EFW 3,011±436 g vs. BW 3,090±468 g, P=0.324). Conclusion: Fetal SCTT detected during routine biometric ultrasonography evaluation in the third trimester of pregnancy could suggest larger BW than EFW. Therefore, physicians should pay careful attention in such cases during assessments for delivery.

Although gravid uterine incarceration is typically diagnosed during the early second trimester, we encountered two unusual cases in early pregnancy. A 34-year-old multiparous woman with adenomyosis presented at 7 + 2 weeks of gestation with increased urinary frequency and a sensation of incomplete bladder emptying. The uterine incarceration was successfully reduced by manual reduction and pessary insertion, and she delivered a normal infant at term. In the second case, a 31-year-old nulliparous woman with a large myoma complained of dysuria, acute urinary retention, and intense back pain at 6 weeks of gestation. Manual reduction was successful in the knee-chest position. Subsequent pessary insertion failed; however, a slight reduction in pain was achieved. After a week, the fetus spontaneously aborted. In summary, gravid uterine incarceration is a rare but potentially fatal condition for the fetus, and a suspicion of this condition in patients with urinary symptoms, especially urinary retention and pelvic pain, is important in the early gestation period.

Objective The purpose of this case series was to retrospectively examine records of cases with uterine rupture in pregnancies following myomectomy and to describe the clinical features and pregnancy outcomes. Methods This study was conducted as a multicenter case series. The patient databases at 7 tertiary hospitals were queried. Records of patients with a diagnosis of uterine rupture in the pregnancy following myomectomy between January 2012 and December 2014 were retrospectively collected. The uterine rupture cases enrolled in this study were defined as follows: through-and-through uterine rupture or tear of the uterine muscle and serosa, occurrence from 24+0 to 41+6 weeks' gestation, singleton pregnancy, and previous laparoscopic myomectomy (LSM) or laparotomic myomectomy (LTM) status. Results Fourteen pregnant women experienced uterine rupture during their pregnancy after LSM or LTM. Preterm delivery of less than 34 weeks' gestation occurred in 5 cases, while intrauterine fetal death occurred in 3, and 3 cases had fetal distress. Of the 14 uterine rupture cases, none occurred during labor. All mothers survived and had no sequelae, unlike the perinatal outcomes, although they were receiving blood transfusion or treatment for uterine artery embolization because of uterine atony or massive hemorrhage. Conclusion In women of childbearing age who are scheduled to undergo LTM or LSM, the potential risk of uterine rupture on subsequent pregnancy should be explained before surgery. Pregnancy in women after myomectomy should be carefully observed, and they should be adequately counseled during this period.