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Posterior Reversible Encephalopathy Syndrome Occurring After Uterine Artery Embolization for Uterine Myoma  

International Nuclear Information System (INIS)

This case report describes posterior reversible encephalopathy syndrome (PRES) occurring after uterine artery embolization (UAE) for uterine myoma. This is the first report of PRES occurring after uterine vascular radiologic intervention. The mechanism by which UAE induced PRES is unclear.

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MRI evaluation for conservative treatment in endometriosis and uterine myoma  

International Nuclear Information System (INIS)

Eighteen patients with endometriosis or uterine myoma underwent MRI before and after conservative treatment with Danazol (400 mg/day) or Buserelin (900 ?g/day to examine pathological changes. Of 8 patients with endometrial chocolate cyst, 7 patients were given Dazazol for 3 to 7 months, in whom high signal intensity indicative of mass tended to decrease after chemotherapy especially on T2-weighted images. In addition, the area of cyst was reduced by 31% to 100%. In the remaining one patient receiving Buserelin for 8 months, the reduction rate of cyst was 31%. Ten patients with adenomyosis were classified into the group given Danazol for 5 to 15 months (n=4) and the group given Buserelin for 3 to 8 months (n=6). Low intensity area was decreased by 9% to 25% in the Danazol group and by 20% to 69% in the Buserelin group. Uterine area was reduced by 10% to 32% in the Danazol group and by 4.5% to 51% in the Buserelin group. MRI was helpful in the management of these diseases during conservative treatment. (N.K.)

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State and development of uterine myoma embolization in Germany  

International Nuclear Information System (INIS)

To evaluate the current situation and implementation of embolization of uterine leiomyomas into the treatment concept in women with symptomatic uterine leiomyomas in Germany. A questionnaire addressing the clinical background of uterine myomas, recommended treatment concepts, preclinical evaluation, technical approach and complications was sent to 164 departments of gynecology and radiology in Germany. 33 radiological departments and 19 gynecological departments submitted a completed questionnaire. Only 7 departments of radiology reported to have own experience with embolization of uterine leiomyomas, while only 2 departments of gynecology considered embolization as an alternative treatment option in patients with symptomatic leiomyomas. 18/33 radiological departments offer this treatment option but get no patient referrals. Agreement was found concerning the indications for treatment, preclinical evaluation by ultrasound and MRI, preferable location of treatable fibroids, technical approach and pain management. The embolization of uterine leiomyomas in patients with symptomatic myomas is regardless of the well documented high efficacy and low complication rate not yet an established treatment option in Germany. Interventional radiologists and gynecologists have to evaluate the indications for the embolization of uterine leiomyomas together before the procedure is advised to the patient, because it seems mandatory to add this procedure to the standard armamentarium ofprocedure to the standard armamentarium of treatment options in uterine myomas. (orig.)

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Immunocytochemical characteristics of submucosal uterine myomas  

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Full Text Available Background/Aim. Myomas of the uterus, the most common benign tumors, have been studied for decades from the aspects of different basic and clinical disciplines. Despite this fact, their pathogenesis is still poorly understood. The aim of this study was to determine immunocytochemical characteristics of smooth muscle cells and connective tissue components of submucosal myomas of the uterus. Method. During the course of this study, 25 samples of submucosal myomas of the uterus were analyzed, all of them obtained during the surgery, after abdominal histerctomy by Aldridge. The samples were fixed in 4% formalin and embedded in paraffin. Sections of 5 ?m thickness were stained immunocytochemically using the DAKO LSAB+/HRP technique to identify ?- smooth muscle actin (?-SMA, vimentin, desmin, CD34, CD45, CD68 and PCNA (DAKO specification. Results. Our results suggest that submucosal myomas of the uterus are build-up of smooth muscle cells which are immunoreactive to ?-SMA and desmin, but also to a certain number of smooth muscle cells which are immunoreactive to ?-SMA and vimentin. Some of vimentin-immunoreactive cells also show an immunoreactivity of PCNA. In the build-up of connective stroma CD34-immunoreactive fibroblasts and neovascular formations are also present. By examining the distribution of CD45 antigen, at all the analyzed samples we observed a weak reaction. Conclusion. Submucosal myomas of the uterus are made-up of smooth muscle cells of the highly differentiated contractile phenotype (?-SMA- and desminimmunoreactivity, as well as smooth muscle cell of the synthetic phenotype which proliferate (?-SMA-, vimentin- and PCNA-immunoreactivity. In submucosal myoma of the uterus there is a significant presence of connective tissue as a result of synthetic activity of fibroblasts, which clearly differ in their immunocytochemical characteristics from smooth muscle cells of the synthetic phenotype.

Mladenovi?-Mihailovi? Aleksandra

2010-01-01

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Histological and immunohistochemical evaluation of leiomyoma and endometrial tissue in patients with uterine leiomyoma and endometrial hyperplasia  

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Full Text Available Background. Uterine leiomyoma and endometrial hyperplasia are commonly found disorders because of quite similar pathogenic pathways associated with action of sex steroids such as estradiol and progesterone. The gold standard of treatment of combination of uterine leiomyoma and endometrial hyperplasia is myomectomy with further prescription of gestagens. Objective. Histological and immunohistochemical evaluation of leiomyoma and endometrial tissue in patients with uterine leiomyoma and endometrial hyperplasia. Methods. In this study histological and immunohistochemical analysis of leiomyoma and endometrium samples were conducted in 30 patients with uterine leiomyoma and endometrial hyperplasia. Further evaluation with transvaginal ultrasound end endometrial biopsy was conducted in 6 and 12 months after surgery. Results. In women with combined endometrial hyperplasia and uterine leiomyoma there is an increased risk of myoma relapse (23.3% and treatment failure of endometrial hyperplasia (36.7% after traditional treatment with gestagens. Among 7 patients with leiomyoma recurrence there was persistence of endometrial hyperplasia what was associated with increased proliferation, angiogenesis and decreased apoptosis. Conclusion. During a comprehensive immunohistochemical study of endometrial biopsies and uterine leiomyoma in women with histologically verified uterine leiomyoma and endometrial hyperplasia common immunohistochemical features had been identified such as increased expression of ki-67 and VEGF and bcl-2. It was proposed that traditional scheme using derivatives of progesterone should be avoided in such patients. In order to optimize treatment outcomes in women with such findings proposed treatment of choice should be drugs with severe suppressive action on proliferation, angiogenesis with simultaneous stimulating action on apoptosis. Drug of choice in such case should be GnRH agonist what should be assessed in future research. Citation: Potapov VA, Donskaya YuV, Medvedev MV. [Histological and immunohistochemical evaluation of leiomyoma and endometrial tissue in patients with uterine leiomyoma and endometrial hyperplasia]. Morphologia. 2014;8(1:80-4. Ukrainian.

Potapov V.A.

2014-03-01

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Non-puerperal uterine inversion due to submucous myoma in a young woman: a case report  

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Full Text Available Abstract Introduction Inversion of the uterus is an uncommon complication of the puerperium and it is an even rarer complication of the non-puerperal period. A submucous myoma is mostly the cause of the non-puerperal inversion but diagnosis can be difficult. In young women, non-puerperal uterine inversion is likely associated with a malignancy. Case presentation A 19-year-old nulliparous woman presented with abnormal vaginal bleeding, dysmenorrhoea, and a large mass protruding from her cervix. The mass was interpreted as a prolapsed pedunculated submucosal myoma. After extirpation of the mass by clamping and twisting its pedicle, a laparotomy was required under suspicion of a uterine rupture. The diagnosis was confirmed and the patient's uterus could be preserved. Pathological examination revealed a submucous myoma. The uterine inversion happened when the uterus retracted to expel the submucous myoma with fundal attachment. By extirpating the stalk the fundus was also resected, causing a uterine rupture. Conclusion We report a case of non-puerperal uterine inversion associated with a benign submucous myoma. Non-puerperal uterine inversion is very uncommon in women of reproductive age and is usually caused by a malignant tumour. However, uterine-sparing surgery should be attempted in young women until the final pathology is known.

Perquin Denise

2010-01-01

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Receptors of Hypothalamic-Pituitary-Ovarian-Axis Hormone in Uterine Myomas  

Science.gov (United States)

In this study the expression of GnRH, FSH, LH, ER-?, ER-?, and PR receptors was examined in uterine myomas of women in reproductive and perimenopausal age. In cases of GnRH and tropic hormones a membranous and cytoplasmic immunohistochemical reaction was detected, in cases of ER-? and PR the reaction was located in cell nucleus, and in the case of ER-? it manifested also a cytoplasmic location. In some of the examined cases the expression was detected in endometrium, myocytes, and endothelium of blood vessels, in uterine glands and myoma cells. In myometrium the level of GnRH and LH receptors increases with age, whereas the level of progesterone and both estrogen receptors decreases. In myomas of women in reproductive age, independently of their size, expression of GnRH, FSH, and LH receptors was more pronounced than in myometrium. In women of perimenopausal age, independently of myoma size, expression of LH and estrogen ? receptors was higher while expression of GnRH receptors was lower than in myometrium. FSH receptor expression was not observed. Expression of estrogen receptor ? was not affected by age of the woman or size of myoma. Analysis of obtained results indicates on existing in small myomas local feedback axis between GnRH-LH-progesterone. PMID:25050358

Plewka, Danuta; Marczynski, Jacek; Morek, Michal; Bogunia, Edyta

2014-01-01

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Prevalence of urinary incontinence and other lower tract urinary symptoms in patients with uterine myomas  

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Full Text Available To study the prevalence and risk factors of the overactive bladder, urinary incontinence and other lower tract urinary symptoms in patients with uterine myomas, female patients with established diagnosis of the uterine myomas presenting to gynecology clinic were invited to answer a self-administered questionnaire, which included questions on evidence of lower urinary tract symptoms [modified Overactive Bladder-Validated 8-question Screener (OAB-V8]. Demographic data, relevant medical and surgical history, and pelvic ultrasound findings were reviewed from the patients charts. Statistical significance of relationship between OAB, stress incontinence and urge incontinence in relation to body mass index (BMI, uterine volume and size of dominant myoma were analyzed using 2-taild exact Fisher test and Wilcoxon test. Ninty-eight patients (28 to 81 years completed the questionnaire over a period of 3 months. The majority were premenopausal and had detectable myomas on ultrasound. OAB was present in 47.9% women. No significant statistical relation between size and volume of the uterus and overactive bladder, urge incontinence, stress incontinence and mixed incontinence was noted. Observation of OAB subtypes with urge and stress incontinence in premenopausal patients with uterine myomas was statistically significant in comparison with premenopausal women studied (60.8% vs 15.3 and 63% vs 6.8, respectively; P<0.001. Overall prevalence of OAB was similar in both groups. Our study showed the higher prevalence of overactive bladder than in the general population, however overall OAB prevalence related to fibroids did not show statistical significance. OAB-stress incontinence and OABurge incontinence subtypes were associated with uterine myomas.

Wellman W. Cheung

2011-07-01

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Evaluation on the safety of transcatheter uterine artery embolization for uterine myoma  

International Nuclear Information System (INIS)

Objective: To observe complications of transcatheter uterine artery embolization (TUAE) for uterine fibroids and to evaluate its long-term safety. Methods: One hundred and ninety-eight women with uterine fibroids were treated by TUAE. The bilateral TUAE were performed using lipiodol-pingyangmycineemulsion (LPE) and gelatin sponge particles in 186 women. Among them, 138 patients were followed up for 1 to 3 year and complications were observed. Results: Complications included ecchymosis and ulceration on buttock (n=1); ulcer of labia minora (n=1); urinary retention (n=12); urinary tract infection (n=1); expelling of necrotic fibroids via vagina (n=5); secondary infection of chocolate cyst of ovary (n=1); increasing in endometrial thickness and calcification (n=1) and amenorrhea (n=2). Conclusion: TUAE is a treatment with long-term safety, while severe complications or sequelae may occur to a few patients, so strict indication should be insisted in patient selection. (authors)

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Our experience with intraoperative cell salvage during cesarean delivery in women with uterine myomas: Four case reports  

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Full Text Available Introduction. Cesarean section is more frequent in pregnant women with uterine myomas, and is usually complicated with perioperative hemorrhage. In some cases, cesarean myomectomy represents an inevitable surgery, adding risk of hemorrhage occurrence. Massive obstetric hemorrhage is the most common cause of maternal mortality and morbidity. The aim of this study was to show our experience and results of the implementation of intraoperative blood salvage during cesarean section in the patients with uterine myomas. Material and Methods. The study encompassed four patients with uterine myomas who had cesarean delivery at our Department in the period from 2010 to 2011. Results. Postoperative transfusion of packed red blood cells was given to one patient. No complications resulting form the intraoperative blood salvage were recorded in our research. Conclusion. Intraoperative blood salvage should be applied in patients with uterine myoma, and certainly in those who are planned for cesarean myomectomy and particularly in cases when massive intraoperative hemorrhage is expected.

Spari? Radmila

2014-01-01

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Polymorphisms of the GSTT1 and GSTM1 genes in women of central Serbia: Absence of association with uterine myoma  

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Since glutathione S-transferase (GST) enzymes are involved in cellular protection, we aimed to determine the distribution of GSTT1 and GSTM1 null genotypes in women in central Serbia in order to assess the risk of development of uterine myoma. The study consisted of 34 clinically diagnosed uterine myoma patients and 35 healthy control women. Analyses of GST polymorphism were carried out by multiplex PCR. Our results showed no significant differences in the GSTT1 and GSTM1 null genotypes...

Arsenijevi? S.; Ljuji? Biljana; Stoši? Ivana; Gruji?i? D.; Marinkovi? D; Miloševi?-?or?evi? Olivera

2013-01-01

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Endometrial pinopodes and uterine receptivity.  

Science.gov (United States)

The human endometrium is an extremely sensitive target for steroid hormones. During the menstrual cycle, this tissue undergoes dynamic changes which are reflected on the surface morphology of the epithelium, and which can be followed by scanning electron microscopy. The morphological changes peak at the midsecretory phase, with the formation of the so-called pinopodes. Increasing evidence suggests that these pinopodes are accurate markers for endometrial receptivity, and their detection may be of high clinical utility for the preparation of endometrium before embryo transfer. PMID:14644817

Nikas, George; Makrigiannakis, Antonis

2003-11-01

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Presentación de un caso de mioma uterino gigante / Report of a case of giant uterine myoma  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se presenta el caso de una paciente de 30 años de edad, que acudió a la consulta de ginecología en enero de 1999, refiriendo que su abdomen estaba muy grande y pensaba en un embarazo. Al examinarla se encontró un tumor abdominal que clínicamente impresionó: un mioma uterino, que después se corroboró [...] por la práctica de una ultrasonografía e histerosalpingografía. Abstract in english The case of a 30-year-old female patient that was seen at the gynecologist's office in 1999 because her abdomen was very big and she thought she was pregnant is presented. On examining her, it was found an abdominal tumor that was clinically impressive: a uterine myoma that was later confirmed by ul [...] trasonography and histerosalpingography.

María del Carmen, Leal Soliguera.

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Presentación de un caso de mioma uterino gigante Report of a case of giant uterine myoma  

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Full Text Available Se presenta el caso de una paciente de 30 años de edad, que acudió a la consulta de ginecología en enero de 1999, refiriendo que su abdomen estaba muy grande y pensaba en un embarazo. Al examinarla se encontró un tumor abdominal que clínicamente impresionó: un mioma uterino, que después se corroboró por la práctica de una ultrasonografía e histerosalpingografía.The case of a 30-year-old female patient that was seen at the gynecologist's office in 1999 because her abdomen was very big and she thought she was pregnant is presented. On examining her, it was found an abdominal tumor that was clinically impressive: a uterine myoma that was later confirmed by ultrasonography and histerosalpingography.

María del Carmen Leal Soliguera

2008-12-01

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Ultrasound interstitial thermal therapy (USITT) for the treatment of uterine myomas  

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Uterine myomas (fibroids) are the most common pelvic tumors occurring in women, and are the leading cause of hysterectomy. Symptoms can be severe, and traditional treatments involve either surgical removal of the uterus (hysterectomy), or the fibroids (myomectomy). Interstitial ultrasound technologies have demonstrated potential for hyperthermia and high temperature thermal therapy in the treatment of benign and malignant tumors. These ultrasound devices offer favorable energy penetration allowing large volumes of tissue to be treated in short periods of time, as well as axial and angular control of heating to conform thermal treatment to a targeted tissue, while protecting surrounding tissues from thermal damage. The goal of this project is to evaluate interstitial ultrasound for controlled thermal coagulation of fibroids. Multi-element applicators were fabricated using tubular transducers, some of which were sectored to produce 180° directional heating patterns, and integrated with water cooling. Human uterine fibroids were obtained after routine myomectomies, and instrumented with thermocouples spaced at 0.5, 1.0, 1.5, 2.0, 2.5 and 3.0 cm from the applicator. Power levels ranging from 8-15 W per element were applied for up to 15 minute heating periods. Results demonstrated that therapeutic temperatures >50° C and cytotoxic thermal doses (t 43) extended beyond 2 cm radially from the applicator (>4 cm diameter). It is anticipated that this system will make a significant contribution toward the treatment of uterine fibroids.

Nau, William H., Jr.; Diederich, Chris J.; Simko, Jeff; Juang, Titania; Jacoby, Alison; Burdette, E. C.

2007-02-01

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Focused ultrasound for treatment of uterine myoma: From experimental model to clinical practice  

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Full Text Available It is well known that focused ultrasound has a biologic effect on tissue. High intensity focused ultrasound (HIFU on a small target area raises the temperature of the tissue enough to denaturate proteins and cause irreversible cell damage. The tight focus of the ultrasound energy allows delivery of the intended dose to a very precise location. The resulting coagulation necrosis is relatively painless. The application of this method in the human clinical setting has required pilot studies on an animal model. Although the treatment had a high success rate, there was a significant percentage of complications, mainly attributed to the technical drawbacks of the procedure. Therefore, this method has been modified for use in humans, and the HIFU is now guided, monitored and controlled by magnetic resonance imaging (MRI. In October 2004, Food and Drug Adiministration (FDA approved MRI guided focused ultrasound treatment of uterine fibroids in humans. Since then, successful treatment of uterine myomas by HIFU has been performed in thousands of women.

Terzi? Milan

2008-01-01

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[The "Bizzare" leiomyoma in histopathological examination of the uterine myoma: dilemma of the range of operative treatment].  

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The very rare case of leiomyoma sarcomatosum was presented and differentiated to "bizzare" leiomyoma at 39 years old woman, who was conservative preoperation diagnosis of uterine myoma. To get the after-operation prognosis the following elements of tumour have been studied: mitotic index, presence and type of necrosis, separation of the tumour and perivascular infiltration. A decision of conservative treatment was confirmed by shown world wide literature. PMID:9695325

Matuszewski, W; Stojko, R; Wieczorek, J; Koza, K; Luciak, M

1998-05-01

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DNA flow cytometry in uterine endometrial carcinoma  

DEFF Research Database (Denmark)

The DNA content was investigated by means of flow cytometry in frozen tumor specimens from 33 patients with uterine endometrial carcinoma. The association was tested between ploidy and S-phase fraction on one hand and clinico-pathological parameters on the other. Aneuploidy appeared in 15 (45%) of the patients, and the average S-phase fraction was 0.18 (0.04-0.34). There was a highly significant correlation between DNA-Index (DI) and histologic differentiation (p = 0.01) and a less significant correlation between DI and estrogen receptor content (p = 0.04). DNA ploidy measured by flow cytometry is a highly reproducible parameter that in addition to routine histopathological examination may provide useful information. Further studies are needed to establish the prognostic importance of the flow cytometric parameters.

Jacobsen, Marianne; HØyer, Morten

1991-01-01

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Cervical Myomas  

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... Health Issues > Noncancerous Gynecologic Abnormalities 4 Cervical Myomas Cervical myomas are smooth, benign tumors in the cervix. A myoma may bleed, become infected, interfere with urinating, or cause pain during sexual intercourse. Doctors can see or feel ...

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Delayed uterine fluid clearance and reduced uterine perfusion in bitches with endometrial hyperplasia and clinical management with postmating antibiotic.  

Science.gov (United States)

In many species a transient uterine inflammatory response follows mating and is proposed to remove excess spermatozoa, bacteria, and other contaminants from the uterus. Similar events have been documented in the bitch involving increased uterine contractions, polymorphonuclear neutrophil influx and uterine artery vasodilation. Some healthy bitches with endometrial hyperplasia have increased numbers of uterine luminal polymorphonuclear neutrophils after mating and reduced fertility; it is purported that this represents a presumed postmating endometritis. This study used B-mode and Doppler ultrasonography at the time of mating to measure uterine contractions, clearance of ejaculated fluid, and uterine artery velocity in normal bitches and those with endometrial hyperplasia. Mating resulted in an increase in the number of uterine contractions, although fewer mating-induced contractions were noted in bitches with endometrial hyperplasia. Interestingly, uterine fluid cleared significantly more slowly after mating from the bitches with endometrial hyperplasia than the normal bitches (P = 0.01). In a further study, Doppler ultrasonography showed that in normal bitches there was a significant increase in uterine artery blood velocity (P = 0.04) and a decrease in the resistance index after mating (P = 0.04), indicating vasodilation. In bitches with endometrial hyperplasia the baseline resistance index was significantly higher than normal bitches (P = 0.05), and furthermore, although there was a significant decrease in resistance index after mating, in the bitches with endometrial hyperplasia this was of a smaller magnitude that in normal bitches. These findings indicate lower baseline uterine perfusion, and a blunted vasodilation response to mating in bitches with endometrial hyperplasia. Short-duration postmating administration of systemic antibiotic increased pregnancy rates in bitches with endometrial hyperplasia (P bitches with endometrial hyperplasia were lower than those of normal bitches both before and after treatment with postmating antibiotic (P = 0.04 and bitches with endometrial hyperplasia appears to affect fertility by reducing the uterine vasodilatory response to mating and delaying clearance of uterine fluid as a result of decreased uterine contractions but the effect can be ameliorated in part by the postmating administration of antibiotic. PMID:22980089

England, G C W; Moxon, R; Freeman, S L

2012-10-15

 
 
 
 
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Alcoolização de miomas uterinos: uma nova estratégia terapêutica / Ethanol sclerotherapy for uterine myomas: A new therapeutic strategy  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese O estudo avaliou a segurança, eficácia e resultados da técnica de alcoolização para tratamento da miomatose uterina. Analisou-se uma série de 20 pacientes (idade variando entre 20 e 40 anos) submetidas a alcoolização para tratamento de miomatose uterina sintomática. O procedimento foi realizado sob [...] anestesia geral, guiado por ultra-sonografia transvaginal. Realizou-se seguimento clínico e ultra-sonográfico (ultra-sonografia transvaginal e doppler colorido) com um e seis meses depois do tratamento. Analisaram-se os parâmetros: frequência de sintomas, mapa vascular (doppler) e tamanho da tumoração. Utilizaram-se os testes do qui-quadrado e Mann-Whitney. Significância p Abstract in english The aim of this study was to evaluate the safety, efficacy and outcome of ethanol sclerotherapy for uterine myomata. This is a series of 20 patients (aged 20 to 40 years) with symptomatic uterine myomata submitted to ethanol sclerotherapy. The procedure was performed under sedation and guided by tra [...] nsvaginal ultrasound. The patients were followed clinically and ultrasonically (transvaginal sonography and color Doppler evaluation) one month and six months after treatment. The frequency of symptoms, intratumoral color flow mapping and tumoral size were analyzed. Chi-square and Mann-Whitney tests were used at a 5% level of significance. Postprocedure complications were not observed. A significant relief of dysmenorrhea was observed with one and six months and the frequency of pelvic pain and menorrhagia was significantly reduced with six months. A significant reduction of tumoral size was observed, from 89,4 cm3 (inicial volume) to 73,5 cm3 e 69,9 cm3 (one and six months, respectively). The frequency of intratumoral high blood flow was 80% before and 15% and 20% one and six months after the procedure (p=0,0001). It can be concluded that these preliminary results indicate that transvaginal ultrasound-guided ethanol sclerotherapy can be an effective treatment for uterine myomas when conservative management is preferable. Patient satisfaction was high and the procedure might become an accepted option for the treatment of uterine myomata.

Lucilo, Ávila; Mirela, Ávila; Fernando, Gurgel; Melania, Amorim.

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Uterine artery embolization for the treatment of symptomatic myomas in Brazilian women / Embolização da artéria uterina para o tratamento de miomas sintomáticos em mulheres brasileiras  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese CONTEXTO: Miomas uterinos são tumores benignos que ocorrem na idade reprodutiva das mulheres com uma freqüência que varia entre 20% a 25%. Quando presentes os sintomas, estes se caracterizam por aumento do fluxo menstrual, dor e sinais de compressão. Têm sido propostas novas formas de tratamento, de [...] stacando-se a embolização das artérias uterinas. OBJETIVO: Avaliar os efeitos do tratamento com embolização das artérias uterinas em mulheres portadoras de miomas sintomáticos e os volumes uterino e do mioma dominante, antes e após 12 semanas após o procedimento. TIPO DE ESTUDO: Ensaio clínico aberto. LOCAL: Hospital Leonor Mendes de Barros, São Paulo, Brasil. PARTICIPANTES: 32 mulheres com diagnóstico de mioma sintomático, único ou múltiplo, do corpo uterino, atendidas no Ambulatório de Ginecologia do Hospital Leonor Mendes de Barros, entre maio de 2000 e setembro de 2001. VARIÁVEIS ESTUDADAS: As mulheres foram submetidas a exame ginecológico seguido de ultra-sonografia abdominal, pélvica e endovaginal, repetidos 12 semanas após o procedimento. A embolização da artéria uterina com PVA (partículas de álcool polivinil de 355 a 700 µ) foi realizada através da cateterização da artéria femoral direita em 30 mulheres e, em duas mulheres, a cateterização foi bilateral. RESULTADOS: A média do volume uterino de 32 mulheres antes da embolização foi 455 cm³ e a média do volume do mioma dominante foi de 150 cm³ antes da embolização. Após 12 semanas de embolização, média do volume uterino e do mioma dominante foram 256 cm³ e 91 cm³ respectivamente. A redução dos volumes uterino e do mioma dominante foi estatisticamente significativa (p Abstract in english CONTEXT: Uterine myomas are benign tumors that mostly occur in women of reproductive age at a frequency ranging from 20 to 25%. The symptoms are increased menstrual flow, pain and compressive signs. New treatments have been proposed and uterine artery embolization is one of them. OBJECTIVE: To evalu [...] ate the effects of treatment by embolization of the uterine artery, in women with symptomatic myomas. Uterine and dominant myoma volumes and the major symptoms were evaluated before treatment and 12 weeks later. TYPE OF STUDY: Open clinical trial. SETTING: A tertiary-care women's hospital. PARTICIPANTS: The study was conducted on 32 women with symptomatic single or multiple myomas of the uterine body, seen at the outpatient unit from May 2000 to September 2001. MAIN MEASUREMENTS: The patients were submitted to gynecological examination and abdominal and endovaginal pelvic ultrasonography, and the examinations were repeated 12 weeks after the first procedure. Uterine artery embolization using PVA (polyvinyl alcohol) particles of 355-700 µ was performed by catheterization of the right femoral artery in 30 women and by bilateral catheterization in two. RESULTS: Before embolization, the mean uterine volume of the 32 women was 455 cm³ and the mean volume of the dominant myoma was 150 cm³. Twelve weeks after embolization, the mean uterine volume was 256 cm³ and the mean volume of the dominant myoma was 91 cm³, with p

Maurício, Sena-Martins; Cecilia Maria, Roteli-Martins; Valdir, Tadini; Gustavo Antonio de, Souza; Nestor, Kisilevzky; Felipe, Lazar Junior.

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Presentación de una paciente con mioma gigante del útero / Report of a Patient with Giant Uterine Myoma  

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Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish Se presentó una paciente de 32 años de edad, de la raza negra, con historia obstétrica de dos abortos espontáneos en el primer trimestre del embarazo, nulípara, que acudió a la Consulta de Ginecología en enero de 2010 en el Hospital de Kabgayi, Rwanda, África, y refirió aumento de volumen del abdome [...] n y además, constipación, tenesmo vesical y sangrados abundantes, que le causaban anemia severa. Después del interrogatorio y examen físico se encontró una tumoración gigante de la cavidad abdominal que ocupaba todo el hemiabdomen inferior y sobrepasaba la cicatriz umbilical que parecía ser un mioma uterino, diagnóstico que se corroboró posteriormente con la ultrasonografía abdominal. Se decidió tratamiento quirúrgico con histerectomía total, y se obtuvo una pieza correspondiente a un mioma uterino con un peso de 4,7 kg. Abstract in english A 32- year- old patient of black race, with obstetrical history of two spontaneous abortions in the first trimester of pregnancy, nullipara, who was attended at Gynecology Service in January 2010, Kabgayi Hospital in Rwanda, Africa. The patient´s abdomen increased and the clinical manifestations wer [...] e constipation, vesiacal tenesmus and profuse bleeding that caused severe anemia. After the patient’s interview application and the physical examination was done a giant tumor of the abdominal cavity was found that filled the lower abdomen and surpassed the umbilicus that clinically impressed: a uterine myoma that was later confirmed by abdominal ultrasonography. Surgical treatment was performed with total hysterectomy, and showed a giant tumor of 4.7 kg

Jorge Luís, Hiralda Martínez.

2013-09-01

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Parasitic myoma after supracervical laparoscopic histerectomy  

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Full Text Available Parasitic myoma is a condition defined as a myoma of extrauterine nourishing. It may occur spontaneously or as a consequence of surgical iatrogeny, after myomectomy or videolaparoscopic supracervical hysterectomy, due to remaining residues of uterine tissue fragments in the pelvic cavity after morcellation. The authors describe two cases in which the patients were submitted to videolaparoscopic supracervical hysterectomy and uterine body removal through morcellation. The sites of development of the parasitic myomas were next to the cervix stump in Case 1, and next to the right round ligament in Case 2. These parasitic myomas were removed by videolaparoscopy. After myomectomies or videolaparoscopic supracervical hysterectomies followed by uterine fragments removal from the pelvic cavity through morcellation, meticulous searching for residues or fragments of uterine tissue is mandatory to prevent the occurrence of parasitic myomas.

Maurício Paulo Angelo Mieli

2013-06-01

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The effects of alpha and ndash;tocopherol on endometrial uterine vascularization, uterine cervix oxidative stress and proliferation in female rats exposed to tobacco smoke  

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Conclusion:Administration of and #61537; and ndash;tocopherolcan increase the vascularization in endometrial uterine of rats exposed to tobacco smoke. Besides, and #61537; and ndash;tocopherolinhibit uterine cervix oxidative stress, but can't induces the proliferation of uterine cervix epithelial cells. [Cukurova Med J 2014; 39(4.000: 689-696

Agnes Erna Taulina Purba

2014-08-01

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Correlation of endometrial thickness, cycle day and histopathology in women with abnormal uterine bleeding.  

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An endometrial thickness of <5 mm in women with postmenopausal bleeding could mean that curettage can be avoided. No definite cut-off value could be assigned for the menstruating women. Transvaginal sonography is a good initial screening tool in the evaluation of women with abnormal uterine bleeding. Hysteroscopy and histological examination is indicated in cases of abnormal or inconclusive sonograms or if complaints persist after a normal sonogram. Transvaginal sonography seems to be an effective procedure to exclude endometrial and intrauterine abnormalities.

Vlasta Vaclavinkova

2005-02-01

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Prevalence and characteristics of endometrial polyps in patients with abnormal uterine bleeding  

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Full Text Available Background/Aim. The prevalence of endometrial polyps (EPs in the general female population is about 24%. Abnormal uterine bleeding is frequently the presenting symptom of EPs. The aim of this study was to determine the prevalence and characteristics of EPs in patients with abnormal uterine bleeding. Methods. The prevalence and characteristics of EPs were investigated in 961 patients with abnormal uterine bleeding who underwent dilatation and curettage between January and December 2006. Regarding histopathological features of EPs (presence of atypical hyperplasia or endometrial carcinoma, patients were divided into two groups: group A - patients who had EPs and EPs with hyperplasia without atypia (n = 204 and group B - patients who had EPs with atypical hyperplasia and EPs with carcinoma (n = 7. Results. In 211 (21.94% patients EPs were found with abnormal uterine bleeding. Histopathologically, there were 175 (82.94% EPs, 29 (13.74% EPs with hyperplasia without atypia, 5 (2.37% EPs with atypical hyperplasia, and 2 (0.95% EPs with endometrial carcinoma. Contrary to the patients with EPs and EPs with hyperplasia without atypia (group A, patients who had EPs with atypical hyperplasia and EPs with carcinoma (group B were older (p < 0.05, and more commonly postmenopausal (p < 0.05 and with hypertension (p < 0.05, all of statistical significance. Conclusion. The prevalence of endometrial polyps in patients with abnormal uterine bleeding according to our data was 21.95%. Atypical hyperplasia and endometrial carcinoma were rarely confined to a polyp. Older age, postmenopausal period and hypertension may increase the risk of premalignant and malignant changes in endometrial polyps.

?or?evi? Biljana

2008-01-01

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Study of the Impact of Uterine Artery Embolization (UAE) on Endometrial Microvessel Density (MVD) and Angiogenesis  

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PurposeTo investigate the influence of uterine artery embolization (UAE) on endometrial microvessel density (MVD) and angiogenesis.MethodsSixty female guinea pigs were divided into two groups, the control group (n = 15) and the UAE treatment group (n = 45). In the UAE group, tris–acryl gelatin microspheres were used to generate embolization. Animals were further divided into three subgroups, A1, A2, and A3 (n = 15 for each subgroup), with uterine specimens collected at 7–15, 16–30, and 31–45 days after UAE, respectively. Immunostaining for factor VIII and CD105 was performed to identify total endometrial MVD (MVDFVIII) and CD105-positive angiogenesis (MVDCD105) at the indicated time points after UAE.ResultsQuantitative analysis revealed that MVDFVIII significantly decreased in the A1 (11.40 ± 2.76, p CD105-positive angiogenesis in the A1 group (9.33 ± 2.37, p CD105 value returned to normal in the A3 group (8.07 ± 1.97).ConclusionUAE caused a temporal decrease in endometrial MVD that reversed over time as a result of the increase of CD105-positive angiogenesis. Although the UAE-induced reduction of endomenduced reduction of endometrial MVD was reversible, its long-term effect on endometrial receptivity still needs further study

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Diagnostic value of transcervical endometrial biopsies in domestic dogs compared with full-thickness uterine sections.  

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Transcervical endometrial biopsy is a useful tool for obtaining information about uterine health in some species. The clinical application of information gained from histopathological interpretations of endometrial biopsies in the bitch has not been validated. We hypothesized that transcervical endometrial biopsy samples would be as diagnostic as full-thickness uterine sections in identifying cystic endometrial hyperplasia (CEH), inflammation and periglandular fibrosis. Endometrial biopsies were obtained from 20 female adult dogs. Vaginal swabs, gross appearance of the vulva and vaginal tract, and serum progesterone values were used to determine the stage of the oestrous cycle at the time of sampling. The uteri were removed between 1 and 6 days after the biopsy procedure, and full-thickness sections were collected from each uterine horn and ovary and processed for histopathology. Two pathologists, blinded to the origin of each sample, compared full-thickness sections from the excised uteri to the biopsy samples collected via the transcervical technique. Pathologic features noted included: CEH, inflammation and periglandular fibrosis. Pathological diagnoses obtained from the biopsy sections were compared with those obtained from the full-thickness sections, as well as comparing diagnoses between the two pathologists, using McNemar's test. Of the 59 total biopsy samples obtained, 54 were considered diagnostic. All stages of the canine oestrous cycle were represented (anoestrus, proestrus, oestrus and dioestrus). Pyometra was not noted in any of the transcervical biopsy sections, but was noted in many of the full-thickness sections collected from dogs in dioestrus, suggesting either that biopsy is not a sensitive indicator of pyometra or that the procedure may induce pyometra in dioestrous dogs. Transcervical endometrial biopsy showed similar sensitivity as full-thickness sections in detecting CEH, inflammation and fibrosis. No differences in describing lesions were detected between pathologists. PMID:23279534

Christensen, B W; Schlafer, D H; Agnew, D W; Wang, C; Kozlowski, C; Asa, C S

2012-12-01

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Impacto da embolização arterial do leiomioma uterino no volume uterino, diâmetro do mioma dominante e na função ovariana / Impact of the myoma arterial embolization by uterine volume, diameter myoma greater and in the ovarian function  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese RESUMO OBJETIVO: Avaliar o impacto da embolização arterial de miomas (EAM) sobre o volume uterino (VU), na função ovariana. MÉTODOS: Trinta pacientes com leiomioma se submeteram à EAM. Foram realizados exames de USPTV e FSH antes e três meses após a EAM. Foram analisados o VU em cm³, o diâmetro do m [...] ioma dominante (DMD) em cm e o FSH em UI/mL, expressos por média desvio padrão (DP) e submetidos a análise estatística pelo teste não paramétrico de Mann-Whitney. RESULTADOS: Foram incluidos na análise 29 casos. A média do VU pré-EAM foi 402,4 165,9 cm³, DMD pré-EAM 5,9 2,1 cm. O VU pós-EAM foi 258,9 118,6 cm³, DMD pós-EAM foi 4,6 1,8 cm. A média da dosagem de FSH pré-EAM foi 4,9 3,5 UI/mL e pós-EAM foi 5,5 4,7 UI/mL com p=0,5. Houve redução de 35% do VU, de 22% no DMD e a EAM não alterou significativamente os valores de FSH após três meses. CONCLUSÃO: O procedimento diminui significativamente o VU e DMD e, não há aumento significativo dos níveis séricos de FSH, não havendo, portanto, alterações na função ovariana. Abstract in english PURPOSE: To evaluate the impact of uterine artery embolization (UAE) on uterine volume (UV), greater myoma diameter (GMD) and ovarian function three months after the procedure, by transvaginal pelvic ultrasonography (TVPUS) and by the determination of follicle-stimulating hormone (FSH). METHODS: Thi [...] rty patients with leiomyomas were submitted to UAE. TVPUS and FSH determination were performed before and three months after UAE. UV was determined in cm³, GMD in cm and FSH in IU/mL. Data are reported as as mean standard deviation (SD) and were analyzed statistically by the nonparametric Mann-Whitney test. RESULTS: Twenty-nine patients were analyzed. Before UAE, mean UV was 402.4 165.9 cm³ and GMD was 5.9 2.1 cm. After UAE, mean UV was 258.9 118.6 cm³ and GMD was 4.6 1.8 cm. Mean FSH concentration was 4.9 3.5 IU/mL before UAE and 5.5 4.7 IU/mL after UAE, with p=0.5. There was a 35% reduction of UV and a 22% reduction of GMD, with no changes in FSH values after three months. CONCLUSION: The procedure significantly reduced UV and GMD but did not cause a significant increase in FSH levels, thus causing no changes in ovarian function.

André, Bernardo; Mariano Tamura Vieira, Gomes; Rodrigo Aquino, Castro; Manoel João Batista Castello, Girão; Claudio Emilio, Bonduki; Claudio Atsushi, Yokoyama.

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Impacto da embolização arterial do leiomioma uterino no volume uterino, diâmetro do mioma dominante e na função ovariana / Impact of the myoma arterial embolization by uterine volume, diameter myoma greater and in the ovarian function  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese RESUMO OBJETIVO: Avaliar o impacto da embolização arterial de miomas (EAM) sobre o volume uterino (VU), na função ovariana. MÉTODOS: Trinta pacientes com leiomioma se submeteram à EAM. Foram realizados exames de USPTV e FSH antes e três meses após a EAM. Foram analisados o VU em cm³, o diâmetro do m [...] ioma dominante (DMD) em cm e o FSH em UI/mL, expressos por média desvio padrão (DP) e submetidos a análise estatística pelo teste não paramétrico de Mann-Whitney. RESULTADOS: Foram incluidos na análise 29 casos. A média do VU pré-EAM foi 402,4 165,9 cm³, DMD pré-EAM 5,9 2,1 cm. O VU pós-EAM foi 258,9 118,6 cm³, DMD pós-EAM foi 4,6 1,8 cm. A média da dosagem de FSH pré-EAM foi 4,9 3,5 UI/mL e pós-EAM foi 5,5 4,7 UI/mL com p=0,5. Houve redução de 35% do VU, de 22% no DMD e a EAM não alterou significativamente os valores de FSH após três meses. CONCLUSÃO: O procedimento diminui significativamente o VU e DMD e, não há aumento significativo dos níveis séricos de FSH, não havendo, portanto, alterações na função ovariana. Abstract in english PURPOSE: To evaluate the impact of uterine artery embolization (UAE) on uterine volume (UV), greater myoma diameter (GMD) and ovarian function three months after the procedure, by transvaginal pelvic ultrasonography (TVPUS) and by the determination of follicle-stimulating hormone (FSH). METHODS: Thi [...] rty patients with leiomyomas were submitted to UAE. TVPUS and FSH determination were performed before and three months after UAE. UV was determined in cm³, GMD in cm and FSH in IU/mL. Data are reported as as mean standard deviation (SD) and were analyzed statistically by the nonparametric Mann-Whitney test. RESULTS: Twenty-nine patients were analyzed. Before UAE, mean UV was 402.4 165.9 cm³ and GMD was 5.9 2.1 cm. After UAE, mean UV was 258.9 118.6 cm³ and GMD was 4.6 1.8 cm. Mean FSH concentration was 4.9 3.5 IU/mL before UAE and 5.5 4.7 IU/mL after UAE, with p=0.5. There was a 35% reduction of UV and a 22% reduction of GMD, with no changes in FSH values after three months. CONCLUSION: The procedure significantly reduced UV and GMD but did not cause a significant increase in FSH levels, thus causing no changes in ovarian function.

André, Bernardo; Mariano Tamura Vieira, Gomes; Rodrigo Aquino, Castro; Manoel João Batista Castello, Girão; Claudio Emilio, Bonduki; Claudio Atsushi, Yokoyama.

2011-08-01

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Impacto da embolização arterial do leiomioma uterino no volume uterino, diâmetro do mioma dominante e na função ovariana Impact of the myoma arterial embolization by uterine volume, diameter myoma greater and in the ovarian function  

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Full Text Available RESUMO OBJETIVO: Avaliar o impacto da embolização arterial de miomas (EAM sobre o volume uterino (VU, na função ovariana. MÉTODOS: Trinta pacientes com leiomioma se submeteram à EAM. Foram realizados exames de USPTV e FSH antes e três meses após a EAM. Foram analisados o VU em cm³, o diâmetro do mioma dominante (DMD em cm e o FSH em UI/mL, expressos por média desvio padrão (DP e submetidos a análise estatística pelo teste não paramétrico de Mann-Whitney. RESULTADOS: Foram incluidos na análise 29 casos. A média do VU pré-EAM foi 402,4 165,9 cm³, DMD pré-EAM 5,9 2,1 cm. O VU pós-EAM foi 258,9 118,6 cm³, DMD pós-EAM foi 4,6 1,8 cm. A média da dosagem de FSH pré-EAM foi 4,9 3,5 UI/mL e pós-EAM foi 5,5 4,7 UI/mL com p=0,5. Houve redução de 35% do VU, de 22% no DMD e a EAM não alterou significativamente os valores de FSH após três meses. CONCLUSÃO: O procedimento diminui significativamente o VU e DMD e, não há aumento significativo dos níveis séricos de FSH, não havendo, portanto, alterações na função ovariana.PURPOSE: To evaluate the impact of uterine artery embolization (UAE on uterine volume (UV, greater myoma diameter (GMD and ovarian function three months after the procedure, by transvaginal pelvic ultrasonography (TVPUS and by the determination of follicle-stimulating hormone (FSH. METHODS: Thirty patients with leiomyomas were submitted to UAE. TVPUS and FSH determination were performed before and three months after UAE. UV was determined in cm³, GMD in cm and FSH in IU/mL. Data are reported as as mean standard deviation (SD and were analyzed statistically by the nonparametric Mann-Whitney test. RESULTS: Twenty-nine patients were analyzed. Before UAE, mean UV was 402.4 165.9 cm³ and GMD was 5.9 2.1 cm. After UAE, mean UV was 258.9 118.6 cm³ and GMD was 4.6 1.8 cm. Mean FSH concentration was 4.9 3.5 IU/mL before UAE and 5.5 4.7 IU/mL after UAE, with p=0.5. There was a 35% reduction of UV and a 22% reduction of GMD, with no changes in FSH values after three months. CONCLUSION: The procedure significantly reduced UV and GMD but did not cause a significant increase in FSH levels, thus causing no changes in ovarian function.

André Bernardo

2011-08-01

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The effect of progesterone on uterine fluid ph &endometrial nhe-1 protein expression in rats  

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Full Text Available A precise regulation of the uterine fluid volume and pH is essential for a successful embryo implantation. Progesterone has been reported to participate in uterine fluid volume regulation during this period, however its effect on the uterine fluid pH is unknown. As endometrial fluid absorption has been proposed to occur secondary to sodium (Na+ absorption under progesterone mediated effect, we therefore hy-pothesize that there may be a concomitant changes in fluid volume and pH if sodium-hydrogen exchanger (NHE, a protein responsible for both luminal Na+ absorption and H+ extrusion is involved. In view of these, our study aimed to investigate the possibility that progesterone affect the uterine fluid pH and endometrial NHE expression. Ovariectomised female Sprague- Dawley (SD rats were treated with peanut oil (vehicle, oestradiol-3-benzoate and progesterone for three consecutive days. On the fourth day, in-vivo uterine perfusions were performed on anaesthetized rats. The collected perfusate were analyzed for the changes in pH. The effect of amiloride, a non-specific Na+-channel blocker on the pH was investigated. The expression of uterine NHE-1 protein was detected by Western blotting and immunohistochemistry. Our findings indicate that the fluid pH is the lowest in progesterone-treated group and amiloride ad-ministration significantly increased the pH in the same treatment group (p < 0.05. NHE-1 proteins were significantly expressed in the progesterone-treated group. In conclusion, progesterone induces a reduction of the uterine fluid pH and is amiloride-sensitive. The up-regulation of NHE-1 under a common proge-sterone effect may explain the role of this ex-changer in regulating the uterine fluid pH.

Salleh Naguib

2011-01-01

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Analysis of 258 cases of uterine endometrial carcinoma in 18 years  

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We investigated 258 cases of uterine endometrial cancer diagnosed and treated from 1980 through 1997 at our institution. Disease outcome, adjuvant therapies, and histologic features were analyzed. Patients' ages ranged from 20 to 90 years (mean, 57.0±10.8 years). The 5-year survival rates were 97.5% for stage I disease, 81.7% for stage II disease, 69.8% for stage III disease, and 0% for stage IV disease. Patients with stage III disease who received both chemotherapy and radiation therapy as adjuvant therapies survive slightly, but not significantly, longer than did patients who received chemotherapy alone or radiation alone or no adjuvant therapy. The 136 patients (59.9%) with well-differentiated (G1) endometrioid carcinomas were significantly younger (mean age, 55.9±10.3 years) than the 58 (25.6%) patients with moderately differentiated carcinomas (G2, 59.9±10.4 years, p=0.01) and the 33 patients (14.5%) with poorly differentiated (G3, 59.9±8.2 years, p=0.04) endometrioid carcinomas. The 60 cases of endometrial carcinoma from 1994 through 1997 were examined to determine whether endometrial hyperplasia and adenocarcinoma coexist. Endometrial hyperplasia was present in 23 (38%) of the 60 cases. The patients with both endometrial hyperplasia and adenocarcinoma were significantly younger (mean age, 47.7±10.9 years) than the patients with endometrial adenocarcinoma alone (mean age, 59.5±9.5 years, p<0.001). (author)

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Chromohysteroscopy—A new technique for endometrial biopsy in Abnormal Uterine Bleeding (AUB  

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Full Text Available Objective: To evaluate the role of chromohysteroscopy in improving diagnostic accuracy of endometrial biopsy in cases of AUB. Design: Cross sectional interventional study. Materials and Methods: This study was conducted on 60 women with AUB in Dept. of Obst. & Gyne at King George Medical University, Lucknow over a period of one year. All cases underwent diagnostic hysteroscopy followed by chromohysteroscopy using 2% methylene blue dye. Hysteroscopic guided biopsy was taken from stained and unstained areas followed by an endometrial aspiration biopsy from whole uterine cavity. The histopathology results of three samples were compared and analyzed in relation with staining pattern and type of AUB. Data analysis was done on SPSS version 15 of windows 2007. Results: Out of 60 cases, 11cases were found to have non hormonal pathology after chromohysterosopic biopsy. Eight (72.72% cases were diagnosed by stained endometrial tissue, one (9.09% by unstained tissue and three (27.27% by endometrial aspiration. The diagnostic ability of stained tissue biopsy was significantly higher (p = 0.006 than unstained biopsy and endometrial aspiration. Conclusion: Chromohysteroscopy is a simple and effective technique for diagnosing endometrial pathology in cases of AUB.

Bharti Singh

2013-07-01

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Discovery and characterization of endometrial epithelial messenger ribonucleic acids using the ovine uterine gland knockout model.  

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Prolonged exposure of the developing neonatal ovine uterus to a progestin from birth prevents uterine gland development and creates an adult endometrial phenotype characterized by the absence of glandular epithelium, the uterine gland knockout (UGKO) phenotype. This study used endometrium from normal and UGKO sheep to identify messenger RNAs (mRNAs) expressed differentially in the endometrial epithelium using the molecular techniques of mRNA differential display PCR (DD-PCR) and suppression subtractive complementary DNA (cDNA) hybridization (SSH). Sequence analyses of DD- and SSH-identified and cloned cDNAs indicated similarity of some to known mRNAs, including beta-lactoglobulin, alkaline phosphatase, type B and D endogenous sheep retroviruses, gp330/megalin, matrix Gla protein, and others. Other cDNAs were not similar to any known sequences and are considered novel, although some of these match human expressed sequence tags. In situ hybridization analyses of uteri from cyclic and pregnant ewes indicated that all DD-PCR- and SSH-identified mRNAs were expressed in either the endometrial lumenal and/or glandular epithelium, although some were also expressed in other uterine cell types. Northern and in situ hybridization analyses revealed that patterns of mRNA expression for most clones were affected by the day of the estrous cycle and pregnancy in a manner consistent with regulation by progesterone. Studies demonstrate the utility of the ovine UGKO model as a tool with which to identify known and novel uterine epithelial-specific genes. Cloned cDNAs identified here are expressed sequence tags useful for comparative and physical genetic mapping and may be used to reveal new factors and pathways regulating endometrial function. PMID:10465278

Spencer, T E; Stagg, A G; Joyce, M M; Jenster, G; Wood, C G; Bazer, F W; Wiley, A A; Bartol, F F

1999-09-01

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Sunitinib Malate in Treating Patients With Recurrent or Metastatic Endometrial Cancer  

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Endometrial Adenocarcinoma; Endometrial Papillary Serous Carcinoma; Recurrent Endometrial Carcinoma; Recurrent Uterine Sarcoma; Stage IVA Endometrial Carcinoma; Stage IVA Uterine Sarcoma; Stage IVB Endometrial Carcinoma; Stage IVB Uterine Sarcoma; Uterine Carcinosarcoma

2014-11-15

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Assisted reproductive technologies and uterine factors influencing their success.  

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Congenital and acquired uterine factors are known to influence the success of assisted reproductive technologies (ARTs). Several studies analyzed the role of uterine septa, adenomyosis, myomas, endometrial polyps and intrauterine adhesions in female infertility. All of them might cause defective endometrial receptivity and consequently decreased embryo implantation and pregnancy rate. In particular, septate uterus represents the most frequent Müllerian anomaly leading to an increased risk of abortion. Many studies evaluated the role of hysteroscopic metroplasty on fertility outcomes, but this topic remains controversial. The role of adenomyosis in infertility is still debated and, even if different mechanisms have been described to explain implantation failure, there are still conflicting findings on the impact of adenomyosis on ART. The effects of myomas on fertility mainly depend on their type, so that submucous have a detrimental impact on fertility, subserous seem to have no effect, while there is no clear consensus regarding the effect of intramural. Consequently, the potential influence of myomectomy on fertility outcomes depends on the type, being mandatory only the hysteroscopic treatment of submucous myomas. The effect of endometrial polyps on endometrial receptivity and fertility is not clear, even if some studies identified improvement in pregnancy rates after hysteroscopic polipectomy. In presence of intrauterine adhesions, infertility represents the most common manifestation and the restoring of normal uterine cavity should be always pursued when possible. PMID:24096288

Savasi, V; Leone, F P G; Fusè, F; Parisi, F; Cetin, I

2013-10-01

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Diagnostic Value of Endometrial Sampling with Pipelle Suction Curettage for Identifying Endometrial Lesions in Patients with Abnormal Uterine Bleeding  

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Full Text Available Background: While determining the cause of abnormal uterine bleeding, sampling from the endometrium is necessary. Considering that pipelle suction curettage can be performed on an out patient basis and does not require hospitalization, using anesthesia and cervical dilatation, we performed this study. The aim of this study was to compare the diagnostic value of dilatation and curettage (D&C with pipelle suction curettage. Methods: This study was quasiexperimental on 200 pre and postmenopausal patients with abnormal uterine bleeding who refered to Shabihkhani hospital in Kashan, Iran. Endometrial sampling was performed in all patients with two methods namely pipelle and D&C. A pathologist examined the samples each having a predetermined code. Results: The mean age of subjects was 46.2 ±6.2 years, minimum age was 35 years and the maximum was 70 years. The various pathological lab findings were proliferative endometrium, secretory endometrium, athrophic, decidua, cystic and adenomatous hyperplasia. The reports were the same in two methods except for 2 cases where they were different: secretory endometrium with D&C but cystic hyperplasia in pipelle method. Conclusions: The result of our study shows the comparability of obtaining endometrial sample by pipelle with D&C. Due to comfort and convenience of patients in pipelle methode especially in the office setting which does not need anesthesia, pipelle method can easily be employed instead of D&C. Keywords: Pipelle Suction Curette, Dilatation and Curettage, Premenopause, Postmenopause.

F Behnamfar

2004-06-01

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Study of the Impact of Uterine Artery Embolization (UAE) on Endometrial Microvessel Density (MVD) and Angiogenesis  

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PurposeTo investigate the influence of uterine artery embolization (UAE) on endometrial microvessel density (MVD) and angiogenesis.MethodsSixty female guinea pigs were divided into two groups, the control group (n = 15) and the UAE treatment group (n = 45). In the UAE group, tris-acryl gelatin microspheres were used to generate embolization. Animals were further divided into three subgroups, A1, A2, and A3 (n = 15 for each subgroup), with uterine specimens collected at 7-15, 16-30, and 31-45 days after UAE, respectively. Immunostaining for factor VIII and CD105 was performed to identify total endometrial MVD (MVD{sub FVIII}) and CD105-positive angiogenesis (MVD{sub CD105}) at the indicated time points after UAE.ResultsQuantitative analysis revealed that MVD{sub FVIII} significantly decreased in the A1 (11.40 {+-} 2.76, p < 0.05) and A2 (15.37 {+-} 3.06, p < 0.05) groups compared to the control group (19.40 {+-} 2.50), and was restored to normal in the A3 group (18.77 {+-} 2.69). UAE caused a temporal up-regulation of MVD{sub CD105}-positive angiogenesis in the A1 group (9.33 {+-} 2.37, p < 0.05) and the A2 group (11.63 {+-} 1.56, p < 0.05) compared to the control group (7.12 {+-} 1.67), and the MVD{sub CD105} value returned to normal in the A3 group (8.07 {+-} 1.97).ConclusionUAE caused a temporal decrease in endometrial MVD that reversed over time as a result of the increase of CD105-positive angiogenesis. Although the UAE-induced reduction of endometrial MVD was reversible, its long-term effect on endometrial receptivity still needs further study.

Tan Guosheng; Xiang Xianhong; Guo Wenbo; Zhang Bing; Chen Wei; Yang Jianyong, E-mail: kerisgz@126.com [The First Affiliated Hospital of Sun Yat-sen University, Department of Interventional Radiology (China)

2013-08-01

 
 
 
 
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Atypical Polypoid Adenomyoma (APAM of the Uterine: Relationship with Endometrial Cancer  

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Full Text Available Atypical polypoid adenomyoma (APAM is a rare polypoid tumor that generally occurs in women of reproductive age who have abnormal genital bleeding. The tumor was reported as a new disease concept by Mazur in 1981. Pathologically, APAM consist of irregularly proliferated endometrial gland cells and interlacing bundles of smooth muscle cells within the stroma, and have a similar form to adenocarcinoma, adenofibroma, adenosarcoma, and carcinosarcoma. Therefore, differential diagnosis is required in many cases. APAM is pathologically classified as a benign lesion and clinically has a comparatively favorable outcome. However, treatment and follow-up observation should be performed carefully because recurrence and residual lesions occur in many patients after conservative treatment. Concomitant development of endometrial adenocarcinoma also occurs in many cases and it is difficult to differentiate this disease from APAM. Thus, diagnosis of APAM should be made carefully, particularly since the number of cases of endometrial adenocarcinoma has increased in recent years. Furthermore, APAM tends to develop during a woman’s reproductive years, and fertility sparing treatment should be considered. Here, we review the clinicopathological characteristics of APAM, including the difficulty of diagnosis as a benign or malignant uterine tumor, and we examine the relationship between APAM and endometrial cancer.

Iori Kisu

2011-10-01

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Uterine smooth muscle cells increase invasive ability of endometrial carcinoma cells through tumor-stromal interaction.  

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The incidence of lymph node metastasis by endometrial carcinoma (EMCA) increases with the depth of myometrial invasion, and this depth of invasion has been found to have a major impact on the outcome. In the present study, we assessed the effect of tumor-stromal interactions on the invasive behavior of EMCA cells and examined the involvement of SDF-1alpha/CXCL12-CXCR4 in the interaction of EMCA cells and uterine smooth muscle cells (UtSMCs). We investigated whether SDF-1alpha/CXCL12 produced and secreted from UtSMCs induces EMCA cell migration by using 5 human EMCA cell lines such as AMEC and RL95 cells. The SDF-1alpha/CXCL12 concentration in conditioned medium (CM) of UtSMCs(was 4,120 +/- 530 pg/ml. Treatments with CM of UtSMCs and plated UtSMCs significantly induced both AMEC and RL95 cell migration. The induced cell migrations were significantly inhibited by CXCR4 mAb (12G5) and CXCR4 antagonist (AMD3100) pre-treatments. Treatments with UtSMCs CM to AMEC and RL95 cells stimulated Akt phosphorylation in a time-dependent manner. Pre-treatment of AMEC and RL95 cells with wortmannin as a PI3K inhibitor significantly inhibited UtSMCs CM-induced cell migration. The SDF-1alpha/CXCL12-CXCR4 chemokine axis between UtSMCs and EMCA played an important role in the muscular infiltration of endometrial cancer through activation of PI3K-Akt signaling pathway. Suppression of this pathway could be an effective target for the treatment of early uterine body cancer in particular. PMID:17587187

Tsukamoto, Hirohisa; Shibata, Kiyosumi; Kajiyama, Hiroaki; Terauchi, Mikio; Nawa, Akihiro; Kikkawa, Fumitaka

2007-01-01

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Factors associated with uterine endometrial hyperplasia and pyometra in wild canids: implications for fertility.  

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The ability to safely and effectively manage reproduction is central to the success of AZA captive-breeding programs. Although the AZA Wildlife Contraception Center routinely monitors contraceptive safety, there have been no studies that compare the effects of contraceptive use to separation of males from females, the other option for preventing reproduction. We used retrospective medical records and pathology reports submitted by AZA and related facilities for the seven AZA-managed canid species to assess rates of uterine pathology relative to female reproductive life histories. Our results showed that the prevalence of both pyometra and endometrial hyperplasia (EH) was associated not only with treatment with the two most common contraceptives (Suprelorin® and MGA implants) but also with the number of years barren (i.e., not producing a litter and not contracepted). Rates of pyometra and EH were especially high in African painted dogs and red wolves, but lowest in swift and fennec foxes. The number of years producing a litter had a low association, suggesting it could be protective against uterine pathology. A more recently developed Suprelorin® protocol using Ovaban® to prevent the initial stimulation phase, followed by implant removal when reversal is desired, may be a safer contraceptive option. These results concerning the relationship between reproductive management and uterine health have important implications for AZA-managed programs, since the unsustainability of many captive populations may be due at least in part to infertility. Managing a female's reproductive lifespan to optimize or maintain fertility will require a reconsideration of how breeding recommendations are formulated. PMID:23553688

Asa, Cheryl S; Bauman, Karen L; Devery, Sarah; Zordan, Martín; Camilo, Gerardo R; Boutelle, Sally; Moresco, Anneke

2014-01-01

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Effect of pregnancy on endometrial sex steroid receptors and on prostaglandin F2? release after uterine biopsy in heifers  

International Nuclear Information System (INIS)

The effect of pregnancy on oestrogen receptor (ER) and progesterone receptor (PR) endometrial expression in heifers was studied. Holstein heifers were not inseminated (controls, n = 8) or inseminated (n = 21). Endometrial biopsies were taken at Day 17 h from the uterine horn ipsilateral to the corpus luteum. Hourly samples were taken on the day of the biopsy in 12 animals (controls = 4 and inseminated = 8) to analyze 15-ketodihydro-PGF2? (PGFM) and progesterone concentrations. Pregnancy determined by ultrasonography diagnosed 6 pregnant cows. The uterine biopsy increased PGFM concentrations, which remained high for 2 to 4 hours, followed by a transient decrease in progesterone concentrations, but the procedure neither provoked luteolysis nor blocked pregnancy. PGFM concentrations were higher in cyclic than in pregnant cows. No differences in PR mRNA expression were observed among groups, but ER mRNA in pregnant heifers tended to be lower than controls, suggesting that this pathway is implicated in maintenance of pregnancy. (author)

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A Comparison of Endometrial Biopsy, Transvaginal Ultrasonography and Dilation and Curettage in Diagnosis of Abnormal Uterine Bleeding  

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Full Text Available Background: Abnormal uterine bleeding (AUB is a common presenting symptom indicative of abnormal menstrual bleeding patterns that may occur in anovulatory or ovulatory women.There are different ways to diagnose AUB, all requiring much time and energy. The purpose of this study was to evaluate and compare the value of endometrial biopsy, transvaginal ultrasonography with dilation and curettage (D&C which is the current gold standard procedure. Methods: A prospective-descriptive study was conducted on fifty patients referred to our center for refractory abnormal uterine bleeding who were candidates for hysterectomy. All patients underwent endometrial biopsy and transvaginal ultrasonography , followed by D&C as a Gold standard procedure in operating room just before surgery. Results: Mean age of patients was 46.62 years. Transvaginal utrasonography offered a sensitivity of 70% and specificity of 68% demonstrating the lowest numbers compared to D&C. Endometrial biopsy had a sensitivity of 70% and specificity of 75% that was better than sonography alone. Conclusion: D&C was the most useful and valuable procedure and addition of endometrial biopsy with transvaginal ultrasonography will not be of high value in diagnosis.

M. Dadyar

2006-07-01

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ASSESSMENT OF ENDOMETRIAL-SUBENDOMETRIAL BLOOD FLOW DETECTED BY COLOR DOPPLER SONOGRAPHY AND UTERINE RECEPTIVITY IN INFERTILE WOMEN  

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Full Text Available "nndometrial vasculature has been shown to play an important role in the early endometrial response to the implanting blastocyst, and vascular changes may contribute to uterine receptivity. The aim of this study was to investigate the role of endometrial and subendometrial vascularity and thickness in uterine receptivity in infertile women treated with assisted reproductive technologies (ART. A total of 175 women were recruited from our ART program from June 2005 to May 2006. In the first stage, down regulation was done using GnRH-a and then ovarian hyperstimulation was initiated with human menopausal gonadotrophin and in vitro fertilization (IVF procedures were performed. Then, the endometrial-subendometrial blood flow distribution pattern was determined by color Doppler ultrasonography and its characteristics were compared between pregnant (n = 56 and non-pregnant (n = 119 women.  Zones 1, 2 and 3 of vascular penetration were found in 15.4%, 22.3%, and 62.3% of patients, respectively. The number of implanted embryos was 62 and implantation rate was 11.61%. There was no significant association between implantation rate and endometrial thickness or zone of vascular penetration. Among all women, fertility occurred in 56 (32.2% women. Zone 1 of vascular penetration was found in 10.71% and 10.08% (P = 0.898, zone 2 in 16.07% and 13.44% (P = 0.643, and zone 3 in 41.07% and 41.17% (P = 0.989 of pregnant and non-pregnant groups, respectively. Endometrial-subendometrial blood flow (according the findings of Doppler ultrasonography in women undergoing ART could not predict endometrial receptivity and IVF outcome.

M Aghahoseini

2008-12-01

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Does the radiofrequency impedance-controlled endometrial ablation have any morphologic effects on uterine leiomyomata?: Report of 3 cases  

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Full Text Available Abstract A variety of novel endometrial ablation technologies are now in routine use. A subset of uteri that had previously undergone these treatments will ultimately be evaluated by the pathologist. However, the full spectrum of histologic changes that may result from these treatments has received only sporadic attention. The NovaSure™ [Hologic Corporation, Marlborough, MA, USA] endometrial ablation system is one of several available second-generation technologies and its particular endometrial ablative power is based on the delivery of radiofrequency energy. The present analysis was designed to decipher any histologic changes (if any associated with the NovaSure™ endometrial ablation system relative to benign smooth muscle tumors of the uterine corpus. Over a one-year period, 3 uteri that had previously undergone the NovaSure™ endometrial ablation and which also had leiomyomatous mass lesions were evaluated. The leiomyomatous mass lesions were extensively sampled and were evaluated for cellular shapes (epithelioid change, cellular rounding, extraordinary cytoplasmic eosinophilia, clear cell change, cytoplasmic vacuolation, nuclear changes (nucleomegaly, nucleolomegaly, multinucleation, hyperchromasia, symplastic changes, necrosis (coagulative and/or infarct, mitotic activity, apoptotic bodies or pyknotic cells, myxoid change, hyalinization. The three uteri were resected 61, 47 and 74 (mean 60.7 days post-ablation. After a detailed evaluation of multiple submucosal, intramural and subserosal leiomyomata from these 3 uteri, no noteworthy histologic changes were identified in the tumors. Since the presence or absence of tumor necrosis is one histologic criterion by which malignant potential is assigned to uterine smooth muscle neoplasms, defining any extrinsic processes that may establish, or contribute to this finding is clinically relevant. The findings reported herein suggests that if a leiomyoma that was obtained from a patient that had recently undergone the NovaSure™ endometrial ablation displays any degenerative changes such as necrosis, the changes are probably not attributable to the ablation.

Fadare Oluwole

2008-07-01

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Decreased expression of survivin, estrogen and progesterone receptors in endometrial tissues after radiofrequency treatment of dysfunctional uterine bleeding  

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Full Text Available Abstract Background The purpose of the research is to study the histopathology and expression of survivin, estrogen and progesterone receptors (ER/PR in the endometrium of patients with dysfunctional uterine bleeding (DUB treated with radiofrequency endometrial ablation (REA. Methods A total of 98 DUB patients were enrolled in this case–control study. Among them, 66 underwent REA treatment and 32 optioned for hormone therapy as the control group. Immunohistochemical analysis for survivin, ER and PR expression was carried out on endometrial tissue samples collected before and 6 to 7?months after treatment for both groups. Results Both hormone and REA treatment ameliorated menstrual bleeding of DUB patients, with the latter showing a significantly higher effective rate. Endometrial surface tissue was replaced by fibrosis tissue in the REA treatment group. REA treatment also significantly reduced the expression of survivin, ER, and PR. Endometrial surface tissues collected from the hormone-treated control group neither showed any apparent morphological alteration nor in the expression of those receptors. Conclusions REA treatment changed endometrial surface tissue type from gland rich to gland poor, and significantly decreased the expression of survivin, ER, and PR. This may be an important contributing mechanism for the long-term curative effect and prevention of DUB recurrence.

Yin Geping

2012-06-01

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Presence of uterine pinopodes at the embryo-endometrial interface during human implantation in vitro.  

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In order to study changes occurring on the surfaces of human endometrial epithelial cells in the presence of an implanted blastocyst, we used scanning electron microscopy for investigation of five endometrial biopsies and three human implantation sites obtained in vitro. All specimens showed areas with endometrial pinopodes, separated by cells displaying microvilli or cilia at the apical surface. Pinopode formation was more pronounced in endometrial biopsies than in cell cultures. All blastocysts adhered to pinopode presenting cells. Endometrial surface changes were not seen around the blastocysts. The results of this study demonstrate that cultured endometrial epithelial cells are capable of pinopode formation. Furthermore, endometrial epithelial pinopodes, generally considered as a marker of endometrial receptivity, seem to be directly involved in the adhesion of the blastocyst to the endometrial surface. PMID:10100003

Bentin-Ley, U; Sjögren, A; Nilsson, L; Hamberger, L; Larsen, J F; Horn, T

1999-02-01

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Endometrial blood flow measured by xenon 133 clearance in women with normal menstrual cycles and dysfunctional uterine bleeding  

International Nuclear Information System (INIS)

Endometrial blood flow was measured through the menstrual cycle in nonpregnant women (28 studies of 17 women with normal menstrual cycles and 32 studies of 20 women with dysfunctional uterine bleeding) with use of a clearance technique in which 100 to 400 microCi of the gamma-emitting isotope, xenon 133 in saline solution was instilled into the uterine cavity. The mean (+/- SEM) endometrial blood flow in normal cycles was 27.7 +/- 2.6 ml/100 gm/min, with a significant elevation in the middle to late follicular phase, followed by a substantial fall and a secondary slow luteal phase rise that was maintained until the onset of menstruation. There was a significant correlation between plasma estradiol levels and endometrial blood flow in the follicular but not the luteal phase. Blood flow patterns in women with ovulatory dysfunctional bleeding were similar to normal, except for a significantly lower middle follicular rate. Women with anovulatory dysfunctional bleeding exhibited exceedingly variable flow rates

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A Trial for Patients With Advanced/Recurrent Endometrial Cancer  

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Neoplasms; Neoplasms by Site; Urogenital Neoplasms; Genital Neoplasms, Female; Uterine Neoplasms; Endometrial Neoplasms; Cancer of Endometrium; Endometrial Cancer; Cancer of the Endometrium; Endometrium Cancer; Neoplasms, Endometrial

2009-11-13

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INFLUENCE OF THE MENOPAUSAL STATUS TO THE FREQUENCY AND PATHOHISTOLOGICAL FEATURES OF ENDOMETRIAL HYPERPLASIA AND CARCINOMA IN PATIENTS WITH ABNORMAL UTERINE BLEEDING  

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Full Text Available The aim of the study was to determine the frequency and pathohistological features of endometrial hyperplasia and carcinoma in premenopausal and postmenopausal patients with abnormal uterine bleeding (AUB.The frequency and pathohistological features of endometrial hyperplasia and carcinoma were investigated in 961 patients with AUB who underwent dilatation and curettage (D&C between January and December 2006. Regarding the menopausal status, patients were divided into two groups: group of premenopausal patients (n=808 and group of postmenopausal patients (n=153.Endometrial hyperplasia was significantly (p<0,05 more frequent cause of AUB in premenopausal patients (23,4% than in postmenopausal patients (13,7%. AUB caused by endometrial carcinoma was significantly (p<0,001 more common in postmenopausal patients (18,9% than in premenopausal patients (1,4%. Compared to the postmenopausal patients, endometrial hyperplasia without atypia was significantly (p<0,01 more frequent, while atypical hyperplasia was significantly (p<0,05 less frequent in premenopausal patients. In contrast to the premenopausal patients, endometrioid type and non-endometrioid type of endometrial carcinoma and carcinoma localized in endometrial polyp were significantly more common in postmenopausal patients (p<0,001, p<0,001, p<0,05, respectively.Endometrial hyperplasia (diffuse or localized to the polyp is more frequent cause of AUB in premenopausal patients than in postmenopausal patents. Compared to the premenopausal patients, atypical hyperplasia and endometrial carcinoma are more frequent causes of AUB in postmenopausal patients. In contrast to the premenopause, there were higher risks for developing endometrioid type and non-endometrioid type of endometrial carcinoma and carcinoma localized in endometrial polyp in postmenopause.

Biljana Djordjevic

2008-04-01

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Contribution of spiral artery blood flow changes assessed by transvaginal color Doppler sonography for predicting endometrial pathologies  

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Full Text Available ive: To investigate the diagnostic value of blood flow measurements in spiral artery by transvaginal color Doppler sonography (CDS in predicting endometrial pathologies.Methods: Ninety-seven patients presenting with abnormal uterine bleeding and requiring endometrial assessment were included in this prospective observational study. Endometrial thickness, structure and echogenicity were recorded. Pulsatility index (PI and resistive index (RI of the spiral artery were measured by transvaginal CDS. Endometrial sampling was performed for all subjects. Sonographic and hystopathologic findings were compared.Results: The histopathological diagnoses were as follows; 39 cases (40.2% endometrial polyp, 9 cases (9.3% endometrial hyperplasia, 10 cases (10.3 submucous myoma, 7 cases (7.2% endometrium cancer, and 32 cases (33% nonspecific findings. The spiral artery PI in endometrium cancer group was highly significantly lower than other groups (p<0.01. The spiral artery RI was also significantly lower in the patients with malignant histology (p<0.05. Conclusion: Endometrial pathologies are associated significantly with endometrial spiral artery Doppler changes.Key words: Spiral artery, Doppler ultrasonography, endometrium

Suna Kabil Kucur

2013-01-01

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[Exploring the effects of Chinese medicine in improving uterine endometrial blood flow for increasing the successful rate of in vitro fertilization and embryo transfer].  

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Endometrial blood flow is directly related to endometrial receptivity thereby affecting in vitro fertilization and embryo transfer (IVF-ET) outcomes. In recent years a growing number of studies have shown that traditional Chinese medicine (TCM) can play a role to improve endometrial blood flow and embryo transfer. Studies have confirmed that formulas based on reinforcing kidney and activating blood can promote the formation of uterine endometrial blood vessels by adjusting expressions of a variety of vessel growth factors, and regulating nitric oxide level for inhibition of vascular smooth muscle contraction of the uterus. Treatments based on differentiation of syndromes are key to the theory of TCM. Differentiation of syndromes should be combined with biomedical disease diagnosis. It is also necessary to further clarify other endometrial blood flow disorders using TCM diagnostic methods. In these cases, drugs for reinforcing kidney and activating blood are relevant, but other medicines for smoothing liver qi and nourishing blood, as well as tonifying the spleen and generating blood may also be effective. Future clinical studies should focus on the observation of different types of TCM syndromes and the research on compatibility ratio and dose-dependent relationship of Chinese medicines. Acupuncture has been used during IVF-ET for more than 10 years. Electro-acupuncture can control the expansion of the uterine arteries by inhibiting the sympathetic nerves. However, acupuncture has not been proved to regulate endometrial arteries. To sum up, TCM can be applied to improve endometrial blood flow so as to increase birth rates in IVF-ET. The combination of Chinese and Western medicines and acupuncture application will increase their combined effect, thereby obtaining greater clinical benefits. PMID:22152767

Guo, Jia; Wang, Li-na; Li, Dong

2011-12-01

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Exploring the effects of Chinese medicine in improving uterine endometrial blood flow for increasing the successful rate of in vitro fertilization and embryo transfer  

Directory of Open Access Journals (Sweden)

Full Text Available Endometrial blood flow is directly related to endometrial receptivity thereby affecting in vitro fertilization and embryo transfer (IVF-ET outcomes. In recent years a growing number of studies have shown that traditional Chinese medicine (TCM can play a role to improve endometrial blood flow and embryo transfer. Studies have confirmed that formulas based on reinforcing kidney and activating blood can promote the formation of uterine endometrial blood vessels by adjusting expressions of a variety of vessel growth factors, and regulating nitric oxide level for inhibition of vascular smooth muscle contraction of the uterus. Treatments based on differentiation of syndromes are key to the theory of TCM. Differentiation of syndromes should be combined with biomedical disease diagnosis. It is also necessary to further clarify other endometrial blood flow disorders using TCM diagnostic methods. In these cases, drugs for reinforcing kidney and activating blood are relevant, but other medicines for smoothing liver qi and nourishing blood, as well as tonifying the spleen and generating blood may also be effective. Future clinical studies should focus on the observation of different types of TCM syndromes and the research on compatibility ratio and dose-dependent relationship of Chinese medicines. Acupuncture has been used during IVF-ET for more than 10 years. Electro-acupuncture can control the expansion of the uterine arteries by inhibiting the sympathetic nerves. However, acupuncture has not been proved to regulate endometrial arteries. To sum up, TCM can be applied to improve endometrial blood flow so as to increase birth rates in IVF-ET. The combination of Chinese and Western medicines and acupuncture application will increase their combined effect, thereby obtaining greater clinical benefits.

Jia Guo

2011-12-01

56

Role of MR in diagnosis of uterine leiomyoma  

International Nuclear Information System (INIS)

Uterine myoma is the most common benign uterine neoplasm, and associated with numerous gynecologic and obsteric complication. Preoperative acurrate analysis of the number, location and type of the myoma is important, especially in reproductive women. We analyze the MR findings of uterine myoma for evaluation of the role of MR in diagnosis of uterine myoma. We analyze MR findings of 76 myomas in 40 patients, and 34 myomas in 17 patients of them were confirmed by surgery. With 2.0T Spectro-20000(Gold-star, Korea), T1WI axial images and T2WI axial and sagittal images were obtained. Locations were classified into fundus, anterior body, posterior body, right body, left body, and cervix. Types were classified into submucosal, intramural, and subserosal. Associated findings were analyzed also. The most common location and type were posterior body and intramural type, respectively. Ten myomas were confirmed on surgery only, and the causes were as follows: first, all 10 myomas were less than 2 cm in size; second, 1 subserosal myoma was abutted to a large ovarian mass; third, small myomas were abutted to each other, or small one was adjacent to larger one and considered as one large myoma. Degenerative change was noted in 50% of histologically confirmed cases. High signal halo on T2WI was noted in 14%. MR is excellent in detection and localization of uterine leiomyoma larger than 2cm, and may be a preoperative diagnostic method of choice in patient who need myomectomy for preservation of childbearing function

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Impact of myomas on the results of transcervical resection of the endometrium  

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STUDY OBJECTIVE: To investigate long-term hysterectomy rates after transcervical resection of the endometrium (TCRE) performed by experienced surgeons in the presence and absence of intracavitary myomas. DESIGN: Multicenter case-control study (Canadian Task Force classification II-2). PATIENTS: The study group comprised 456 women with myomas who met the inclusion criteria, and of these, 82 (17.98%) later underwent hysterectomy. The control group comprised 1438 women without myomas, and of these, 284 (19.75%) later underwent hysterectomy. METHODS: From 2001 to 2004, standardized results were extracted from Hyskobase on the basis of a total of 1894 women aged 23 to 59 years. The women were identified as having or not having myomas, and data from both groups were statistically analyzed. Detailed information on myoma size and intramural involvement (type 0, 1, and 2) was collected. MEASUREMENTS AND MAIN RESULTS: After TCRE, women with type 2 myomas, compared with those with type 0 myomas, were found to have asignificantly higher risk of undergoing hysterectomy (p = .04), and women, including controls, with myomas >3.6 cm in greatest diameter were found to have a significantly higher risk of undergoing hysterectomy than were those with smaller myomas (p = .01). There was no statistically significant difference in risk of hysterectomy between type 0 and type 1 myomas or between type 1 and type 2 myomas. When hysterectomy rates between the myoma and control groups were compared, there was an increased risk of hysterectomy in the control group (p = .008). Multiple-step multivariate regression analysis of uterine and procedural characteristics of TCRE demonstrated that factors that were positive predictors of hysterectomy within 66 months after resection were younger age, inaccessible uterine corners, enlarged uterus, and pretreatment using gonadotropin-releasing hormone agonists. CONCLUSION: When performing TCRE in women with intracavitary myomas, the chance of treatment success is worsened if they are of type 2 ortheir diameter is >3.5 cm. In addition, younger age increases the risk of hysterectomy and the need for pretreatment with gonadotropin-releasing hormone agonists, or if the uterus is enlarged or the uterine corners are difficult to access during the procedure.

Christoffersen, Christian; Kahr, Henriette StrØm

2014-01-01

58

Uterine Fibroids  

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... ways to perform endometrial ablation. • Uterine artery embolization (UAE)—In this procedure, tiny particles (about the size ... to the fibroid and cause it to shrink. UAE can be performed as an outpatient procedure in ...

59

Calcified pure uterine lipoma mimicking myoma  

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Full Text Available Pure lipoma of the uterus is a rare entity and only a few cases have been reported in the literature. Clinical symptoms and signs are similar to those found in leiomyoma and create preoperative diagnostic confusion. The histogenesis is still unclear. We report the case of a 70 year-old woman with pure lipoma of the uterus with calcification.

Arghya Bandopadhyay

2010-06-01

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Overcoming paclitaxel resistance in uterine endometrial cancer using a COX-2 inhibitor.  

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Cyclooxygenase (COX)-2 inhibitors have been reported to potentially modulate the resistance of cancer cells to chemotherapeutic drugs by affecting multidrug resistance 1 (MDR1) expression. In the present study, we investigated the association between COX-2 and MDR1 expression in endometrial cancers and evaluated the effects of the COX-2 inhibitor, etodolac, in combination with paclitaxel on paclitaxel-resistant endometrial cancer cells. The relationship between COX-2 and MDR1 mRNA expression was examined by quantitative PCR in 36 endometrial cancer specimens. The paclitaxel-resistant cell line OMC-2P was established from OMC-2 cells. Paclitaxel (1 µg/ml) with or without etodolac (10 µg/ml) was added to OMC-2 and OMC-2P cells, and COX-2 and MDR1 mRNA expression levels were examined. The concentration of prostaglandin E2 (PGE2) in the supernatant of each cell line was examined by enzyme-linked immunosorbent assay. The function of MDR1 was determined by intracellular accumulation of rhodamine 123 using flow cytometry, and the concentration of intracellular paclitaxel was determined by high-performance liquid chromatography. We found a positive relationship between COX-2 and MDR1 mRNA expression in endometrial cancer. Both COX-2 mRNA expression and PGE2 production were elevated in resistant OMC-2P cells when compared to non-resistant OMC-2 cells. Additionally, MDR1 mRNA expression was markedly upregulated in OMC-2P cells. In OMC-2 cells, COX-2 and MDR1 mRNA levels were significantly upregulated by paclitaxel treatment and downregulated by co-administration with etodolac. In OMC-2P cells, COX-2 mRNA expression was also significantly upregulated by paclitaxel treatment and tended to be downregulated by co-administration with etodolac. Moreover, co-administration of paclitaxel and etodolac suppressed the induction of MDR1 mRNA. Rhodamine 123 efflux was increased in OMC-2P cells when compared to the efflux in the OMC-2 cells and was increased in response to paclitaxel treatment. Co-administration of paclitaxel and etodolac in both cell lines resulted in decreased rhodamine 123 efflux. The actual concentration of intracellular paclitaxel in OMC-2P cells was significantly lower than that in OMC-2 cells treated with paclitaxel alone and was significantly increased after co-administration of paclitaxel and etodolac. These findings suggest that paclitaxel resistance may be associated with COX-2 and MDR1 expression in cancer cells. Co-administration of COX-2 inhibitors and paclitaxel may have a key role in modulating or overcoming paclitaxel resistance in endometrial cancers. PMID:24100466

Hasegawa, Kiyoshi; Ishikawa, Kunimi; Kawai, Satoshi; Torii, Yutaka; Kawamura, Kyoko; Kato, Rina; Tsukada, Kazuhiko; Udagawa, Yasuhiro

2013-12-01

 
 
 
 
61

P16(INK4a) protein expression in endocervical, endometrial and metastatic adenocarcinomas of extra-uterine origin: diagnostic and clinical considerations.  

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Determining the primary site of uterine adenocarcinoma (ADC) may be problematic, especially with small specimens. This is particularly important in light of the increase of endocervical and endometrial adenocarcinoma and the decrease in incidence of squamous cell carcinoma. P16(INK4a) , a member of the INK4 family of cell cycle regulatory proteins, plays a critical role. It functions as a negative regulator of cell cycle progression and differentiation by controlling the activity of the tumor-suppressor protein retinoblastoma (pRb), which regulates the cell cycle. Its expression is variable according to the tumoral histotype and in metastasis. The aim of this study was to investigate P16(INK4a) expression in endocervical, endometrial, and metastatic ADCs of extra-uterine origin. Fifty gynaecological biopsies (cervix or endometrium) comprised the study for P16(INK4a) determination. Cases were classified as (1) diffuse positive (P), in intense nuclear immunostaining and/or cytoplasmic in > 30% of neoplastic cells; (2) focal positive (FP), in intense immunostaining in 10% to 30% in isolated cells or small groups; and (3) negative (N), in absence of immunostaining or weak, sporadic immunostaining in < 10% of neoplastic cells. Included in the study were the following: 6 endocervical ADCs, 11 endometrioid-type endometrial ADCs, 5 endometrial serous papillary ADCs, 7 ovarian ADCs, 4 large intestine ADCs, 1 breast ADC, 12 not-otherwise-specified (NOS) ADCs, and 4 endocervical biopsy without atypia (as control). Diffuse, strong positivity with P16(INK4a) suggests an endocervical rather than an endometrial or metastatic ADC. In fact, a P16(INK4a) positive immunostaining pattern was prevalent in endocervical (83%) and serous papillary ADCs of endometrial or ovarian origin, whereas endometrioid ADCs such as metastatic non-ovarian lesions generally presented only focal or negative immunostaining. 10/12 cases of ADC-NOS were reclassified using P16(INK4a) immunostaining: 2 as endocervical ADCs (2 P), 4 as endometrioid-type endometrial ADCs (2 FP, 2 N), 3 as endometrial serous papillary ADCs (3 FP), and 1 as ovarian serous papillary ADC (1 FP). PMID:24878818

Caponio, Maria Angela; Addati, Teresa; Popescu, Ondina; Petroni, Stella; Rubini, Vincenza; Centrone, Marilena; Trojano, Giuseppe; Simone, Giovanni

2014-01-01

62

Endometrial cancer with cervical extension mimicking dual concordant endometrial and cervical malignancy by F18 FDG PET and MRI  

International Nuclear Information System (INIS)

concordant endometrial cancer was found on MRI. Endometrial cancer with cervical extension is sometimes difficult to differentiate from primary cervical cancer. The final histopathologic report showed poorly differentiated endometrial adenocarcinoma with cervical extension, although the FDG PET CT and MRI findings were suggestive of concordant cervical and endometrial cancer. Although histopathologic confirmation is necessary for final diagnosis, MRI and FDG PET CT studies may aid in the differential diagnosis. A metastatic cervical mass from endometrial cancer clinically presenting as cervical myoma is rare. This case suggests that poorly differentiated endometrial cancer may extend into the cervix, presenting as cervical myoma, and the possibility of a metastatic mass should be considered in the differential diagnosis when dealing with cervical myoma

63

Diffuse uterine adenomyosis: Transvaginal US with histopathologic correlation  

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To correlate transvaginal sonographic findings with histopathology in diffuse uterine adenomyosis. We prospectively analyzed the transvaginal sonographic findings of 15 patients undergoing hysterectomy for adenomyosis. Diffuse adenomyosis was diagnosed when an abnormal echotexture (heterogenous echogenicity, decreased echogenicity, increased echogenicity, cystic lesion) was present in myometrium of enlarged uterus. We evaluate the size of the uterus, abnormal echotexture in myometrium and anterior and posterior myometrial wall thickness'. Transvaginal sonographic findings of diffuse adenomyosis are enlarged uterus (n=15), heterogenous and increased echogenicity in myometrium (n=10), heterogenous echogenicity in myometrium (n=4), heterogenous and increased echogenicity with cystic lesion lesion in myometrium (n=1). The posterior myometrial wall is equal to anterior wall (n=7), thicker than anterior wall (n=4), thinner than anterior wall (n=4). The histopathologic findings including ectopic endometrial gland (n=14), muscular hypertrophy (n=15), myoma (n=4). Diffuse adenomyosis was confirmed except one case that proved myoma. Transvaginal sonographic findings of enlarged uterus with heterogenous and increased echotexture in myometrium of adenomyosis is correlated with ectopic endometrial gland with secondary muscular hypertrophy.

Song, Mi Jin; Kim, Hye Sun; Lee, Myung Sook; Cho, Hyeun Cha; Lee, Young Ho [Samsung Cheil Hospital, Sungkyunkwan University College of Medicine, Seoul (Korea, Republic of)

1999-06-15

64

Diffuse uterine adenomyosis: Transvaginal US with histopathologic correlation  

International Nuclear Information System (INIS)

To correlate transvaginal sonographic findings with histopathology in diffuse uterine adenomyosis. We prospectively analyzed the transvaginal sonographic findings of 15 patients undergoing hysterectomy for adenomyosis. Diffuse adenomyosis was diagnosed when an abnormal echotexture (heterogenous echogenicity, decreased echogenicity, increased echogenicity, cystic lesion) was present in myometrium of enlarged uterus. We evaluate the size of the uterus, abnormal echotexture in myometrium and anterior and posterior myometrial wall thickness'. Transvaginal sonographic findings of diffuse adenomyosis are enlarged uterus (n=15), heterogenous and increased echogenicity in myometrium (n=10), heterogenous echogenicity in myometrium (n=4), heterogenous and increased echogenicity with cystic lesion lesion in myometrium (n=1). The posterior myometrial wall is equal to anterior wall (n=7), thicker than anterior wall (n=4), thinner than anterior wall (n=4). The histopathologic findings including ectopic endometrial gland (n=14), muscular hypertrophy (n=15), myoma (n=4). Diffuse adenomyosis was confirmed except one case that proved myoma. Transvaginal sonographic findings of enlarged uterus with heterogenous and increased echotexture in myometrium of adenomyosis is correlated with ectopic endometrial gland with secondary muscular hypertrophy.

65

6 Common Cancers - Gynecologic Cancers Cervical, Endometrial, and Ovarian  

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... 6 Common Cancers - Gynecologic Cancers Cervical, Endometrial, and Ovarian Past Issues / Spring 2007 Table of Contents For ... turn Javascript on. Gynecologic Cancers Cervical, Endometrial, and Ovarian NCI estimates that endometrial, or uterine, cancer will ...

66

A combined ultrasound and histologic approach for analysis of uterine fibroid pseudocapsule thickness.  

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Authors investigated 75 patients with uterine myomas, appraising whether fibroid pseudocapsule (FP) thickness varies depending on fibroid location, by a prospective cohort trial (level of evidence II-2) settled in University-affiliated Hospitals. Uteri were scanned via bidimensional and power Doppler ultrasound (US) to map the fibroids and record the FP thickness, prior to hysterectomy for symptomatic uterine fibroids. After hysterectomy, FP specimens were sampled and analyzed by pathologists. Ultrasound and histology data were matched. Pseudocapsule thickness of 108 fibroids was measured: subserosal fibroids (SSFs), intramural fibroids (IMFs), and fibroids near the endometrial cavity (FEC). The FEC's pseudocapsules were considerably thicker than those of IMF and SSF measured by US and histology (P = .001). A clear cutoff existed between FEC pseudocapsule thickness and all other pseudocapsules, with significant differences observed at 2 mm (P = .001). Similarity between histological and US measurements was observed only with IMF pseudocapsules, whereas FEC or SSF showed significant differences. The pseudocapsule of fibroids is considerably thicker near the endometrial cavity when compared to those of both IMFs and SSFs. Since fibroids closest to the endometrial cavity are the most involved in fertility and infertility and FP is considerably thicker near the endometrial cavity, it is possible to hypothesize an involvement of FP of fibroid near the endometrium since FP contains many neuropeptides and neurotransmitters that are physiologically active, even if these data may take on a broader meaning in a study on a larger number of patients. PMID:24879045

Tinelli, Andrea; Mynbaev, Ospan A; Mettler, Liselotte; Hurst, Brad S; Pellegrino, Marcello; Nicolardi, Giuseppe; Kosmas, Ioannis; Malvasi, Antonio

2014-09-01

67

The utility of MRI for the surgical treatment of women with uterine fibroid tumors.  

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Determination of the reasonable treatment options and the appropriate clinical treatment of women with uterine fibroid tumors often depends on the ability of imaging modalities to accurately detect and localize fibroid tumors. Magnetic resonance imaging (MRI) gives the most complete evaluation (sizes, positions, number) of submucous, intramural, and subserosal myomas and is the most sensitive modality for the detection of small fibroid tumors. MRI allows the evaluation of fibroid tumor proximity to the bladder, rectum, and endometrial cavity, helps define what can be expected at surgery, and may help the gynecologist avoid missing fibroid tumors during surgery. MRI can also make the diagnosis of adenomyosis reliably and may be able to identify uterine sarcoma when present. PMID:21982615

Parker, William H

2012-01-01

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Papel da Histerossonografia no Estudo da Cavidade Uterina em Pacientes com Sangramento Uterino Anormal Role of Sonohysterography in the Evaluation of the Uterine Cavity in Patients with Abnormal Uterine Bleeding  

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Full Text Available Objetivo: determinar o papel da histerossonografia na avaliação das anormalidades da cavidade uterina, em pacientes com sangramento uterino anormal, selecionadas previamente pela ultra-sonografia transvaginal. Métodos: foram selecionadas 48 pacientes na menacme e pós-menopausa, portadoras de sangramento uterino anormal e anormalidades da cavidade uterina, diagnosticadas inicialmente pela ultra-sonografia transvaginal. Todas as pacientes se submeteram à histerossonografia e, posteriormente, aos métodos "padrão ouro", a histeroscopia e/ou histerectomia. As histerossonografias foram avaliadas por dois diferentes médicos e os diagnósticos confrontados. Resultados: a histerossonografia mostrou ter alta sensibilidade e especificidade no diagnóstico das patologias benignas da cavidade uterina. Na presença de pólipo a sensibilidade e a especificidade do método foram, respectivamente, de 100 e 97%, seguido do mioma submucoso cuja sensibilidade e especificidade foram, respectivamente, de 83 e 100%. Já na hiperplasia endometrial e no endométrio normal a sensibilidade e especificidade foram de 100%. Diagnosticamos 33 casos de pólipos, 13 casos de miomas submucosos, quatro casos de hiperplasia endometrial e três casos normais na análise dos métodos "padrão ouro". Houve alta correlação entre os diagnósticos dados pelos dois examinadores. Conclusões: a histerossonografia mostrou ser um exame reprodutível, com alta sensibilidade e especificidade no diagnóstico das patologias benignas da cavidade uterina em pacientes com sangramento uterino anormal.Purpose: to determine the role of sonohysterography in the evaluation of abnormalities in the uterine cavity in patients presenting abnormal uterine bleeding, who had previously been selected by transvaginal ultrasonography. Methods: forty-eight patients presenting abnormal uterine bleeding and changes in the uterine cavity seen by transvaginal ultrasonography were selected, and they were in the menacme or postmenopause period. All patients underwent a sonohysterography, and later a hysteroscopy and/or a hysterectomy. The sonohysterographies were evaluated by two different physicians, and the diagnoses were compared. Results: the sonohysterography method showed high sensitivity and specificity for the diagnosis of benign pathologies in the uterine cavity. First, in the presence of polyps the sensitivity and specificity rates were 100 and 97%, respectively, second, in the presence of submucous myoma, they were 83 and 100%, and finally, concerning endometrial hyperplasia and normal endometrium, they were 100%. We diagnosed thirty-three cases of polyps, thirteen cases of submucous myoma, four cases of endometrial hyperplasia and three normal cases. The correlation between the diagnoses provided by the two physicians was high. Conclusions: sonohysterography is a safe and fast method which is very well tolerated by the patient, and has low levels of complications. Its high sensitivity and specificity allow this method to be used for routine diagnosis concerning benign pathologies in the uterine cavity of patients presenting abnormal uterine bleeding.

Angélica Lemos Debs Diniz

2000-06-01

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Embolization of symptomatic myomas (UAE): technique, indication and results  

International Nuclear Information System (INIS)

Presentation of indication, technique and results of transarterial uterine artery embolization (UAE) for the treatment of symptomatic myomas. Technical requirements are presented like DSA, catheters, superselective catheterisation and the different embolization materials as polyvinylalcohol (PVA) or microspheres, as well as the follow-up after UAE. The technical success rate of UAE is documented to range between 98 to 100% and myomatous symptomatology disappears in 85 to 94% of the cases. A reduction in the size of the myomata after UAE is observed between 48 to 70%. A resolution of the hemorrhage disappears in 80 to 96% of the cases immediately. Particulate embolization of the uterine artery is a new minimally invasive therapy in the management of symptomatic leiomyomas with a high efficiency and low rate of major complications. Further studies may prove the longterm results after UAE, the influence on fertility and possible late complications. (orig.)

70

Screening for uterine tumours.  

Science.gov (United States)

The most prevalent uterine tumours are leiomyomas, which are benign and have a prevalence of about 50% at menopause. The incidence of endometrial cancer and uterine sarcomas is about 25 per 100,000 and 0.7 per 100,000, respectively. Reported risk factors for endometrial cancer are advanced age, unopposed oestrogen stimulation, late menopause, obesity, diabetes mellitus, nulliparity, feminising ovarian tumours, polycystic ovarian syndrome, tamoxifen and belonging to a hereditary non-polyposis colorectal cancer family. Unopposed oestrogen stimulation and tamoxifen have also been confirmed to induce uterine sarcomas. Cervical cytology, endometrial sampling and ultrasound have been proposed in the early diagnosis of endometrial cancer. No pathognomonic ultrasound, magnetic resonance imaging or computed tomography features are able to differentiate between a leiomyoma and a uterine sarcoma, and reliable serum markers for sarcomas are lacking. To date, mass screening for uterine malignancies is not feasible or effective. PMID:22078749

Van den Bosch, Thierry; Coosemans, An; Morina, Memli; Timmerman, Dirk; Amant, Frederic

2012-04-01

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Homeobox gene HOPX is epigenetically silenced in human uterine endometrial cancer and suppresses estrogen-stimulated proliferation of cancer cells by inhibiting serum response factor.  

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HOPX (homeodomain only protein X) is a newly identified homeobox gene whose loss of expression has been reported for several types of neoplasm. Although we found most human uterine endometrial cancers (HEC) defective in HOPX expression, genetic mutations in the HOPX gene were undetectable. As is the case with several tumor suppressor genes, the promoter region of HOPX is densely methylated in HEC tissue samples obtained by laser capture microdissection. HOPX mRNA and protein levels were reduced in the majority of samples, and this correlated with hypermethylation of the HOPX promoter. Forced expression of HOPX resulted in a partial block in cell proliferation, in vivo tumorigenicity and c-fos gene expression in HEC and MCF7 cells in response to 17beta-estradiol (E(2)) stimulation. Analysis of the serum response element (SRE) of c-fos gene promoter showed that the effect of HOPX expression is associated with inhibition of E(2)-induced c-fos activation through the serum response factor (SRF) motif. Knockdown of HOPX in immortalized human endometrial cells resulted in accelerated proliferation. Our study indicates that transcriptional silencing of HOPX results from hypermethylation of the HOPpromoter, which leads to HEC development. PMID:19173292

Yamaguchi, Shinichiro; Asanoma, Kazuo; Takao, Tomoka; Kato, Kiyoko; Wake, Norio

2009-06-01

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Uterine sarcomas.  

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A wide variety of sarcomas occur in the uterus but two subtypes - leiomyosarcoma and endometrial stromal sarcoma - account for a majority of those more routinely encountered. Using the 2003 World Health Organization classification, this review focuses on six uterine sarcomas: endometrial stromal sarcoma, undifferentiated endometrial sarcoma, leiomyosarcoma, rhabomyosarcoma, angiosarcoma and liposarcoma. The epidemiological, clinical, pathological and molecular features are presented along with therapeutic approaches. Familiarity with molecular aspects of these tumors and application of novel technologies in their assessment should be encouraged as they may provide alternate therapies resulting in improved survival for the patient. Clinical information necessary for accurate diagnosis of these lesions is emphasised. A multidisciplinary approach to management of patients with uterine sarcomas is essential for optimal management. PMID:17365823

Moinfar, Farid; Azodi, Masood; Tavassoli, Fattaneh A

2007-02-01

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Uterine lymphatic drainage is unaffected from injection technique and operators: Identical sentinel node detection in two cases of endometrial cancer  

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INTRODUCTION Sentinel node (SN) mapping with cervical injection of 99 m-technetium (99 mTc) albumin nanocolloid in early endometrial cancer has been shown to be feasible and data emerging from recent large series support the incorporation of SN mapping algorithm in endometrial cancer staging. PRESENTATION OF CASE We report two cases of SN mapping which demonstrated identical migration of both radioactive technetium and blue dye in the same patients that were re-injected because surgical intervention was postponed due to transitory cardiac contraindications. DISCUSSION As clearly demonstrated in cervical cancer, SN mapping through intracervical injection of both radioactive technetium and blue dye seems to be effective and easy to perform, providing good results in patients with endometrial cancer. Our report highlights the reproducibility of SN mapping that has been strongly confirmed in both patients, even if re-injections were performed by different operators. Preoperative SPECT/CT imaging seems to enhance accuracy in SN localization and also improves its intraoperative detection in early endometrial cancer. CONCLUSION The anatomically defined bilateral uterus drainage strongly confirms the reproducibility of SN mapping, that seems to be unaffected by after injection technique or operators. PMID:23810917

Buda, Alessandro; Elisei, Federica; Dolci, Carlotta; Cuzzocrea, Marco; Milani, Rodolfo

2013-01-01

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A Histerossonografia na Avaliação da Cavidade Uterina em Pacientes Menopausadas / Sonohysterography in the evaluation of the uterine cavity in postmenopausal women  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Objetivos: avaliar a acuidade diagnóstica da histerossonografia como método de avaliação da cavidade uterina em pacientes menopausadas com cavidade uterina alterada à ultra-sonografia endovaginal convencional. Métodos: este estudo consistiu na avaliação de 99 pacientes menopausadas com cavidade uter [...] ina anormal à ultra-sonografia endovaginal convencional, caracterizada por espessura endometrial maior ou igual a 5 mm em pacientes sem terapia de reposição hormonal, ou espessura endometrial maior ou igual a 8 mm em pacientes em terapia de reposição hormonal, com sangramento irregular. Estas pacientes foram submetidas à histerossonografia e após, foram obtidas amostras para avaliação histopatológica por biópsia dirigida por histeroscopia em 92 pacientes, biópsia endometrial em quatro pacientes e histerectomia em três pacientes. Os resultados da histerossonografia foram comparados com os resultados do exame histopatológico, considerado como "padrão-ouro". Resultados: houve oito casos de cavidade uterina normal e 20 casos de atrofia endometrial e a histerossonografia teve altos níveis de especificidade (97,8 e 97,5%) e baixa sensibilidade (35 e 25%). Houve altos níveis de sensibilidade (92,3 e 75,0%) e especificidade (94,1 e 97,9%) em pólipos (65 casos) e miomas submucosos (quatro casos). Houve três casos de câncer de endométrio e a histerossonografia teve sensibilidade e especificidade de 100%. Conclusões: a histerossonografia mostrou boa acuidade no diagnóstico de doenças focais (pólipos endometriais e miomas submucosos), com altos níveis de sensibilidade e especificidade. Houve três casos de câncer endometrial, e a histerossonografia diagnosticou corretamente todos eles. Mostrou também ser método acurado para excluir anormalidades endometriais. Entretanto, nos casos de espessamento endometrial difuso, a acuidade é baixa, porque endométrios atróficos ou normais freqüentemente aparecem como tendo espessamento difuso à ultra-sonografia endovaginal e à histerossonografia. A histerossonografia não teve complicações durante e após o procedimento. Abstract in english Purpose: to evaluate the diagnostic accuracy of sonohysterography as a diagnostic method for the evaluation of the uterine cavity in postmenopausal women with abnormal uterine cavity at conventional endovaginal sonography. Methods: this study consisted of the evaluation of 99 postmenopausal patients [...] with abnormal uterine cavity on conventional endovaginal sonography, that was defined as endometrial thickness equal to or larger than 5 mm in a postmenopausal patient not on hormone replacement therapy, or endometrial thickness equal to or larger than 8 mm in patients on hormone replacement therapy, with irregular bleeding. These patients were subjected to sonohysterography, and specimens were obtained for pathologic examination by biopsy guided by histeroscopy in 92 patients, endometrial biopsy in four patientes and hysterectomy in three patients. The results of sonohysterography were compared with the pathologic findings, considered "gold standard". Results: there were eight cases of normal uterine cavity and 20 cases of atrophic endometrium and sonohysterography had high levels of specificity (97.8 and 97.5%) and low sensitivity (35 and 25%). There were high levels of sensitivity (92.3 and 75.0%) and specificity (94.1 and 97.9%) for polyps (65 cases) and submucous myomas (four cases). There were three cases of endometrial carcinoma and the sonohysterography had a sensitivity and specificity of 100%. Conclusions: sonohysterography showed to be accurate in the diagnostic of focal diseases (endometrial polyps and submucous myomas). There were three cases of endometrial cancer, and sonohysterography correctly diagnosed all of them. This method was also accurate to exclude endometrial abnormality. However, in the cases of diffusely thickened endometrium, the accuracy was low, because atrophic and normal endometrium on histopathology fre

Benito Pio Vitório, Ceccato Júnior; Victor Hugo de, Melo; José Benedito de, Lira Neto.

75

Quantitative analysis of glucose transporter mRNAs in endometrial stromal cells reveals critical role of GLUT1 in uterine receptivity.  

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Recurrent miscarriages affect about 1-2% of couples trying to conceive; however, mechanisms leading to this complication are largely unknown. Most studies focus on the early embryo, but proper development and implantation of the blastocyst are also dependent on optimal endometrial progression into a receptive state. One of the key steps in the uterine preparation for embryo receptivity, known as decidualization, is the differentiation of endometrial stromal cells (ESCs) into decidual cells. During this transition, the ESCs undergo a drastic change in glucose metabolism. The efficiency of glucose uptake is determined by a family of facilitative glucose transporters (GLUTs), and many have been identified in the stroma. The primary focus of this work was to quantify the absolute amount of GLUT mRNAs in this cell type before and after decidualization. We used primary ESCs isolated from murine and human uteri. We developed and validated cDNA-based calibration curves for each GLUT and used these primers to arrive at absolute mRNA copy numbers. Here, we report all the GLUT mRNAs that are present in the ESCs and their abundance under both conditions, control and decidualized. GLUT1 mRNA is the most abundant and critical transporter in ESCs of both species, because knocking down this GLUT with sort hairpin RNA leads to dramatically reduced decidualization. These findings suggest that GLUT1 mRNA expression is essential for decidualization and we are the first to determine a possible mechanism to explain how maternal conditions of abnormal glucose utilization may impair implantation at the level of the ESCs. PMID:21343253

Frolova, Antonina I; Moley, Kelle H

2011-05-01

76

Uterine Lesions  

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Full Text Available Transvaginal color and pulsed Doppler ultrasound depicts the endometrium in great details. The texture and thicknessof the endometrium are indicators of endometrial development, while blood flow analysis may be used as a bioassay of the uterine receptivity. This method can non-invasively detect uterine anomalies, endometrial polyps,submucous leiomyomas, intrauterine adhesions and other uterine causes that can lead to poor reproductive performance. Vascularization of the uterine tumors, if used together with analysis of morphology and size, can increase our accuracy in differentiation between uterine sarcoma and leiomyoma. It seems that the multiparameter sonographic approach, which includes morphology and size depicted by transvaginal ultrasonography and color flow imaging withpulsed Doppler analysis of neovascular signals,can help in diagnosis of uterine sarcoma in high-risk groups such as postmenopausal patients with a rapidly enlarging uterus. Therefore, serial measurements are recommended for evaluation of the myometrial density, follow-up of the tumoral growth, and detection of the impedance to blood flow.Only such complex observations can lead to proper diagnosis of these rare tumors with unpredictable prognosis. The application of transvaginal color Doppler to the postmenopausal population for screening of endometrial carcinoma may be a viable option if combined with ovarian screening in the same scan. In this way, the capital costs would be shared, and an oncological preventive medicine for women could be created. The use of this technique could also result in a reduction in dilatation and curettage operations with considerable saving of both the potential risks and economic costs of the operation.

A. Kurjak

2005-08-01

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A case of mesodermic mixed tumor of the uterus developing after the treatment of myoma with x-ray irradiation  

International Nuclear Information System (INIS)

A case of mesodermic mixed tumor primarily developing in the endometrium was reported with some discussion. The anamnesis was interesting that the patient had been exposed to the secondary radioactivity of the atomic bomb in Hiroshima and to X-ray for the treatment of myoma. Histological examination revealed adenoma as the epithelial element and fibromyxoma-like tissues, cartilage tissues, vascular tissues, and endometrial interstitium-like tissues as the non-epithelial elements. (Chiba, N.)

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Therapeutic management of uterine fibroid tumors: updated French guidelines.  

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The medical management of symptomatic non-submucosal uterine fibroid tumors (leiomyomas or myomas) is based on the treatment of abnormal uterine bleeding by any of the following: progestogens, a levonorgestrel-releasing intrauterine device, tranexamic acid, nonsteroidal anti-inflammatory drugs, or GnRH analogs. Selective progesterone receptor modulators are currently being evaluated and have recently been approved for fibroid treatment. Neither combined estrogen-progestogen contraception nor hormone treatment of the menopause is contraindicated in women with fibroids. When pregnancy is desired, whether or not infertility is being treated by assisted reproductive technology, hysteroscopic resection in one or two separate procedures of submucosal fibroids less than 4 cm in length is recommended, regardless of whether they are symptomatic. Interstitial, also known as intramural, fibroids have a negative effect on fertility but treating them does not improve fertility. Myomectomy is therefore indicated only for symptomatic fibroids; depending on their size and number, and may be performed by laparoscopy or laparotomy. Physicians must explain to women the potential consequences of myomas and myomectomy on future pregnancy. For perimenopausal women who have been informed of the alternatives and the risks, hysterectomy is the most effective treatment for symptomatic fibroids and is associated with a high rate of patient satisfaction. When possible, the vaginal or laparoscopic routes should be preferred to laparotomy for hysterectomies for fibroids considered typical on imaging. Because uterine artery embolization is an effective treatment with low long-term morbidity, it is an option for symptomatic fibroids in women who do not want to become pregnant, and a validated alternative to myomectomy and hysterectomy that must be offered to patients. Myolysis is under assessment, and research on its use is recommended. Isolated laparoscopic ligation of the uterine arteries is a potential alternative to uterine artery embolization; it also complements myomectomy by reducing intraoperative bleeding. It is possible to use second-generation techniques of endometrial ablation to treat submucosal fibroids in women whose families are complete. Subtotal hysterectomy is a possible alternative to total hysterectomy for fibroid treatment, given that by laparotomy the former has a lower complication rate than the latter, while by laparoscopy, these rates are the same. In each case, the patient is informed about the benefit and risk associated with each therapeutic option. PMID:22939241

Marret, Henri; Fritel, Xavier; Ouldamer, Lobna; Bendifallah, Sofiane; Brun, Jean-Luc; De Jesus, Isabelle; Derrien, Jean; Giraudet, Géraldine; Kahn, Vanessa; Koskas, Martin; Legendre, Guillaume; Lucot, Jean Philippe; Niro, Julien; Panel, Pierre; Pelage, Jean-Pierre; Fernandez, Hervé

2012-12-01

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Evaluation of uterine and fibroid blood supplies before and after uterine artery embolization with dynamic enhanced CT scan  

International Nuclear Information System (INIS)

Objective: To research the blood supply changes of uterine and fibroid before and after UAE for uterine fibroids. Methods: Sixteen patients with symptomatic uterine myoma were treated by Seldinger's bilateral uterine arteries embolization. The same level dynamic enhanced CT scans were undertaken 7 days before and after the procedure with another one 3 months later. The CT values of uterine and fibroid were measured and analyzed. Results: 16 cases finished the same level dynamic CT enhancement scans successfully. The dynamic enhanced curves and the CT values showed no significant difference in uterine but had significant difference in fibroids. The fibroids were in a state of ischemia after the procedure. Conclusions: Selective uterine arterial embolization is a new safety and effective method for treatment of uterine myoma

80

A case of parasitic myoma diagnosed by immunohistochemistry  

Directory of Open Access Journals (Sweden)

Full Text Available A case of parasitic myoma diagnosed by immunohistochemistry is presented . The importance of histopathological and immumohistochemical procedures in the differential diagnosis of parasitic myoma from stromal tumors was discussed.

Kamac?, M.

2004-01-01

 
 
 
 
81

Rare peritoneal tumour presenting as uterine fibroid  

Directory of Open Access Journals (Sweden)

Full Text Available Tumour arising from the uterus in the reproductive age group commonly belongs to benign category, the myoma uterus. Here we present a case report of a 22yr old primiparous mother with uterine metastasis from a rare peritoneal malignancy desmoplastic small round cell tumour who presented as uterine myoma. Desmoplastic small round cell tumour is a rare aggressive neoplasm arising from mesothelial cell, with poor prognosis. This woman presented with excessive bleeding per vaginum in the postpartum period,3months after caesarean section.24weeks enlarged uterine mass found for which uterine artery embolisation was done in vain, later she was planned to undergo myomectomy. But due to widespread uterine mass, hysterectomy was done which led to the diagnosis of this rare neoplasm. [Int J Reprod Contracept Obstet Gynecol 2014; 3(2.000: 450-452

Janu Mangala Kanthi

2014-04-01

82

Endometrial Ablation  

Science.gov (United States)

What is endometrial ablation? Endometrial ablation destroys a thin layer of the lining of the uterus and stops the menstrual flow in many ... or surgery may be required. Why is endometrial ablation done? Endometrial ablation is used to treat many ...

83

Early ultrasonographic findings after a uterine fibroid embolization: the value of differentiate from procedure-related uterine infection  

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To evaluate the early ultrasonographic (US) findings from the uterus and myoma after a uterine fibroid embolization (UFE). From March 2004 to January 2006, eleven patients (27-48 years, mean:37 years) with UFE to treat symptomatic uterine myoma, were retrospectively reviewed. A serial follow up gray-scale and color Doppler US were performed from one day to two weeks following a UFE. The US findings were evaluated for the presence and distribution pattern of air, time of air loss, and presence of fluid collection in the uterine cavity and color Doppler (SD Comment: Doppler is name. Should perhaps be upper case) signal. Numerous high echoes with reverberation artifacts (which suggest air), were observed within the myoma (in all cases), one day after UFE. A branching linear echo pattern was observed in 4 cases (36%), whereas scattered echoes were observed in 7 cases (64%). Progressive loss of air, within 7 days of a UFE, was observed in 9 cases (82%), whereas 2 cases (12%) were observed within 14 days of a UFE. Abnormal fluid collection in the uterine cavity and a color Doppler signal within the myoma was not observed for all cases. Branching or scattered echoes (suggesting air), are normally found within the myoma after a UFE, but these echoes disappeared within 2 weeks. These early US findings can be useful in differentiating from myoma infections after a UFE.

Yang, Seung Boo; Goo, Dong Erk; Chang, Yun Woo [Soonchunhyang University, Gumi Hospital, Gumi (Korea, Republic of); Choi, Jin Soo [School of Medicine, Keimyung University, Daegu (Korea, Republic of)

2008-03-15

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The safety of cesarean myomectomy in women with large myomas  

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Objective To evaluate the safety of cesarean myomectomy in large myomas sized >5 cm. Methods One hundred sixty-five pregnant women with myomas who delivered via cesarean section were identified. Ninety-six women had cesarean section without myomectomy, and 65 women underwent cesarean myomectomy. We compared the maternal characteristics, neonatal weight, myoma types, and operative outcomes between two groups. We further analyzed cesarean myomectomy group according to myoma size. The large myoma was defined as myoma >5 cm in size. The maternal characteristics, neonatal weight, and myoma types were compared between two groups. We also compared the operative outcomes such as preoperative and postoperative hemoglobin, operative time, and hospitalized days between two groups. Results There were no significant differences in the maternal characteristics, myoma types, neonatal weight and operative outcomes between cesarean section without myomectomy and cesarean myomectomy. The subgroup analysis according to myoma size (>5 cm or not) in cesarean myomectomy group revealed that there were no significant differences in the mean hemoglobin change (1.2 vs. 1.3 mg/dL, P=0.6), operative time (90.5 vs. 93.1 minutes, P=0.46), and the length of hospital stay (4.7 vs. 5.2 days, P=0.15) between two groups. The comparison of maternal characteristics, neonatal weight, and myoma types between two groups also showed no statistical significance. Conclusion Cesarean myomectomy in patients with large myomas is a safe and effective procedure. PMID:25264526

Kwon, Dam Hye; Yoon, Kyung Ran; Lee, Keun Young

2014-01-01

85

Defective endometrial receptivity.  

Science.gov (United States)

The endometrium is one of the most fascinating tissues in the human body. Its sole purpose is to enable implantation of an embryo during a relatively short window of opportunity in the menstrual cycle. It is becoming clear that overcoming the current bottleneck in improvements to assisted reproductive techniques will require a closer look at the interface between uterus and embryo. Indeed, embryo implantation requires a cross talk with a receptive endometrium. Using sonography, hysteroscopy and endometrial biopsy we can learn about anatomical and functional markers of endometrial receptivity. This article reviews the factors which might cause defective endometrial receptivity. These include uterine polyps, septa, leiomyomata and adhesions. The effect of thin endometrium, endometriosis and hydrosalpinx is also described. Finally contemporary investigation of molecular markers of endometrial receptivity is described. Improving embryo implantation by a closer look inside the uterus is the key to increasing pregnancy rates in IVF. PMID:22542142

Revel, Ariel

2012-05-01

86

Uterine fibroid embolization  

International Nuclear Information System (INIS)

Full text: Introduction: Today, after numerous lengthy randomized trials embolization of uterine fibroids has become a standard treatment. Percutaneous embolization of myomas is a micro - invasive surgery, which can be regarded as an alternative to traditional surgery. Although these data 2/3 of the patients were not informed about this treatment option. What you will learn: The uterine embolization is minimal invasive non-surgical procedure. It is an alternative treatment to surgery. Under local anesthesia in the femoral artery puncture reaches the internal iliac artery and uterine arteries. Reached selectively by the catheter and chemicals, which causes clogging, are injected into them. In the vessels that feed fibroids occur a process like an attack, the feeding stops, it starts to shrink and it is replaced by fibrous tissue. The blood vessels of the healthy tissue are different in size and have a plurality of collateral connections as opposed to those of the myoma and thus the blood supply to the normal tissue of the uterus is not distorted. Discussion: Nowadays there are more well- calibrated materials for embolization and those with a particle size of about 700µ are proven as the most successful. The procedure is well tolerated, but after a pain occurs, which has to be covered with anesthetics. Usually pain and metrorrhagia disappear immediately. The fibroids themselves shrink to varying degrees. Hospital stay was significantly shorter than that after surgery, and remained fertile power. Complications are few and rare require further treatment. Multiple nodes are problematic and it is difficult to detect the primary one. A three and six months tracking by MRI is desirable. Conclusion: Embolization of uterine myoma is an established method of treatment primarily on clinical symptoms resulting therefrom. In all patients rapidly disappear metrorrhagia symptoms and morbidity, the volume of the assembly decrease, which together with shorter hospital stays and fertility preservation is well accepted by patients and therefore it is a good alternative to surgery

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Uterine Fibroid Embolization Can Still Be Improved: Observations on Post-Procedure Magnetic Resonance Imaging  

International Nuclear Information System (INIS)

PURPOSE: To evaluate the efficacy and completeness of uterine fibroid embolization (UFE) measured by changes in volume and signal intensity at magnetic resonance imaging (MRI), and to compare with clinical outcome. MATERIAL AND METHODS: 40 women with symptomatic uterine fibroids underwent bilateral uterine artery embolization. At MRI studies, including post-contrast sequences before and repeatedly after treatment, the uterus and dominant fibroids were evaluated for volume, location, and contrast enhancement. Prior to treatment, all myomas showed significant contrast enhancement. The mean uterine volume was 929 ml. Clinical examinations with emphasis on menorrhagia, pelvic pain, and urinary dysfunction were performed before and 6 and 12 months after treatment. RESULTS: UFE was bilaterally successful in 38 patients. After UFE, MRI showed no enhancement of myomas in 30 patients. In 8 patients, post-procedural MRI revealed partially remaining vascularization of fibroids despite angiographically complete embolization of the uterine arteries. On average, uterine volume decreased by 46.2% at 12 months. There was significant improvement of symptoms in the majority of patients, but slightly less improvement in patients with partially remaining vascularization of myomas. CONCLUSION: UFE causes significant volume reduction of myomas and clinical improvement. MRI can reveal remaining vascularization in myomas despite angiographically complete embolization of uterine arterieslete embolization of uterine arteries

88

Robotic-Assisted Hysterectomy for Endometrial Cancer  

Medline Plus

Full Text Available ... adenectomy is 163 minutes. That’s always been once concern with minimally invasive surgery is that it takes ... endometrial cancer case and there could be theoretic concerns of exfoliation of cancer cells with uterine manipulation ...

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Transvaginal sonography combined with saline contrast sonohysterography in evaluating the uterine cavity in premenopausal patients with abnormal uterine bleeding  

DEFF Research Database (Denmark)

To evaluate whether saline contrast sonohysterography (SCSH) adds additional information to that obtained by transvaginal sonography (TVS) for predicting endometrial abnormality in premenopausal patients with abnormal uterine bleeding.

Dueholm, M; Forman, Axel

2001-01-01

90

Recurrent endometrial cancer.  

Science.gov (United States)

Endometrial cancer is the most common gynecologic malignancy in the United States. The majority of women are diagnosed with early-stage, low-grade endometrioid tumors that are highly curable with primary surgery. Patients with more advanced and/or higher grade disease require multimodality therapy and have a higher risk for recurrence. Although uterine papillary serous carcinoma and clear cell carcinoma are diagnosed infrequently, they account for almost half of all relapses. As women with recurrent endometrial cancer constitute a heterogeneous group, an individualized approach is required. We review the treatment options of surgery, radiation, hormonal therapy, cytotoxic chemotherapy, and biological agents. PMID:21508696

Del Carmen, Marcela G; Boruta, David M; Schorge, John O

2011-06-01

91

Endometrial cancer  

Science.gov (United States)

... Endometrial biopsy Dilation and curettage ( D and C ) Pap smear (may raise a suspicion for endometrial cancer, but ... for more than 2 years. Frequent pelvic exams, Pap smears and endometrial biopsy may be considered in some ...

92

Uterine Fibroid Embolization Can Still Be Improved: Observations on Post-Procedure Magnetic Resonance Imaging  

Energy Technology Data Exchange (ETDEWEB)

PURPOSE: To evaluate the efficacy and completeness of uterine fibroid embolization (UFE) measured by changes in volume and signal intensity at magnetic resonance imaging (MRI), and to compare with clinical outcome. MATERIAL AND METHODS: 40 women with symptomatic uterine fibroids underwent bilateral uterine artery embolization. At MRI studies, including post-contrast sequences before and repeatedly after treatment, the uterus and dominant fibroids were evaluated for volume, location, and contrast enhancement. Prior to treatment, all myomas showed significant contrast enhancement. The mean uterine volume was 929 ml. Clinical examinations with emphasis on menorrhagia, pelvic pain, and urinary dysfunction were performed before and 6 and 12 months after treatment. RESULTS: UFE was bilaterally successful in 38 patients. After UFE, MRI showed no enhancement of myomas in 30 patients. In 8 patients, post-procedural MRI revealed partially remaining vascularization of fibroids despite angiographically complete embolization of the uterine arteries. On average, uterine volume decreased by 46.2% at 12 months. There was significant improvement of symptoms in the majority of patients, but slightly less improvement in patients with partially remaining vascularization of myomas. CONCLUSION: UFE causes significant volume reduction of myomas and clinical improvement. MRI can reveal remaining vascularization in myomas despite angiographically complete embolization of uterine arteries.

Dorenberg, E.J.; Novakovic, Z.; Smith, H.J.; Hafsahl, G.; Jakobsen, J.Aa. [Rikshospitalet, Oslo (Norway). Dept. of Radiology and Dept. of Gynecology

2005-08-01

93

Dysfunctional Uterine Bleeding  

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Dysfunctional uterine bleeding (DUB) is defined as abnormal uterine bleeding that results from an ovarian endocrinopathy. It may be associated with ovulatory and anovulatory cycles. The diagnosis of DUB depends on a thorough history and physical examination to exclude organic disorders. In older women, endometrial biopsy should be done before starting therapy. The treatment depends on an understanding of the menstrual cycle. In less urgent cases, anovulatory cycles are managed using progester...

Livingstone, Verity H.

1987-01-01

94

Preimplantation embryo-endometrial signalling  

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Recurrent pregnancy loss (RPL) is a common and distressing disorder. Chromosomal errors in the embryo are the single most common cause whereas uterine factors are invariably invoked to explain non-chromosomal miscarriages. These uterine factors are, however, poorly defined. The ability of a conceptus to implant in the endometrium is normally restricted to a few days in the menstrual cycle. A limited ‘window of implantation’ ensures coordinated embryonic and endometrial development, thereb...

Teklenburg, G.

2010-01-01

95

The Effect of Letrozole on Symptomatic Uterine Leiomyomas  

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Full Text Available Background and Objectives: Uterine leiomyomas are the most common benign tumors of the uterine, and several medical treatments have been suggested for these myomas. This study was conducted with the aim of determining the effect of letrozole on symptomatic uterine leiomyomas in patients referring to Naghavi Clinic in Kashan city.Methods: This study is a before and after clinical trial, in which 30 premenopausal women with large symptomatic uterine leiomyoma equal to 3cm received 2.5mg letrozole daily for 90 days continuously. Then, the effect of letrozol on uterine and myoma size, hemoglobin, FSH, LH, and estradiol levels and also accompanied symptoms such as amount and duration of menstrual bleeding and dysmenorrhea were evaluated. Data were analyzed by statistical tests such as paired t-test and test. Levels of p<0.05 were considered as significant.Results: In this study, letrozole had significant effect on decrease in uterine volume (p=0.001 and myoma volume (p<0.001. Also, the means of amount (p<0.001 and duration (p=0.007 of menstrual bleeding decreased and hemoglobin increased by 8% (p<0.001, but have no effect on FSH, LH and, estradiol levels. Conclusion: The results of this study showed that letrozole leads to decrease in leiomyoma and uterine size, amount and duration of menstruation, and increase in hemoglobin level. Therefore, this drug can be used for treatment of symptomatic uterine leiomyomas.

Mansoureh Samimi

2013-02-01

96

Analysis of the factors to affect uterine artery embolization for the treatment of uterine fibroid  

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Objective: To observe the effect of uterine artery embolization for the treatment of uterine fibroids and analyze the influencing factors. Methods: 46 cases with symptomatic uterine myoma were treated by superselective catheterization of the bilateral uterine arteries using PVA particles. All patients were followed up for 6-9 months after uterine artery embolization to observe the improvement about symptoms and the changes of fibroid volume. The different clinical effects and the various factors were analyzed. Results: The clinical symptoms improved significantly, especially the bleeding of uterus. The average volume of fibroids decreased 45.6% in 6 months, 58.4% in 9 months after the proceduce. A lot of factors, including blood vessel anatomy, endocrine secretion, embolization technique and fibroid type can effect the clinical efficacy of uterine artery embolization for the treatment of uterine fibroids. Conclusions: Selective uterine artery embolization is a new safety and effective method for treatment of uterine myoma. Its clinical effect is correlative with a lot of factors, including blood vessel anatomy, endocrine secretion, embolization technique and fibroid type. (authors)

97

[Ulipristal acetate (Esmya): a selective modulator of progesterone receptors, new treatment of uterine fibromatosis].  

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Uterine fibromatosis is a frequent benign gynaecological disease causing heavy menstrual bleeding and in some cases anaemia. Until now, medical treatment aimed to obtain amenorrhea by administration of progestins or Gn-RH agonists. By inducing hypo-oestrogenism, a reduction of myoma size is observed with Gn-RH agonists but after cessation of the treatment, initial myoma size is noted. The impact of progesterone in myoma growth is nowadays demonstrated and use of selective modulators of progesterone receptors represents a new medical approach of this disease. PMID:24923103

Nisolle, M; Closon, F; Firquet, A; Top, M; Pintiaux, A

2014-04-01

98

[Uterine Sarcomas - a review].  

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Uterine sarcomas are a heterogeneous group, which constitutes about 8% of malignant uterine tumors. This heterogeneousness and rare occurrence were the main cause of non-uniform therapeutical management. In previously published papers, there were mainly retrospective assessments of the experience of individual centres. The basis of relevant conclusions of the studies, beside their prospectiveness, is the use of unified classification criteria. Currently, a completely new classification of uterine sarcomas is being used, which consists of leiomyosarcoma, endometrial stromal sarcomas and adenosarcomas. For classification of carcinosarcomas, there are valid new criteria of endometrial cancer classification. The basic therapeutic approach of leiomyosarcoma and endometrial stromal sarcomas is a surgical intervention. The gold standard is hysterectomy and salpingooophorectomy. Justifiability of lymphadenectomy is being discussed. For carcinosarcomas, the same recommendations as for the surgical treatment of prognostically unfavourable endometrial carcinoma are valid - hysterectomy, salpingooophorectomy, pelvic and paraaortal lymph node dissection and omentectomy. It is necessary to implement the new classification into clinical practice, to publish and evaluate existing papers, which take into account their basic thesis. Only then it will be possible to create unified therapies. They should be aimed to improve patients survival. PMID:23102195

Kla?ko, M; Babala, P; Mikloš, P; Zuzák, P; Chorváth, M; Ondrušová, M; Ondruš, D

2012-01-01

99

Angiographic classification of uterine fibroids and its significance to therapeutic embolization strategy  

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Objective: To analyze the vascular manifestations of uterine myoma, to offer a proposal for the angiographic classification of fibroids, and to discuss its practical significance to the strategy of uterine artery embolization. Methods: Fifty patients with fibroids were performed uterine artery embolization with dextran microspheres. After bilateral hypogastric and uterine arteriography, the angiographic manifestations were studied to determine the bilateral uterine arterial blood supply and the feeding proportions to the uterus and myoma respectively. the cross median line anastomoses of bilateral uterine arteries and ovarian parenchymal opacification were also evaluated. Results: According to the different feeding proportions to the uterine leiomyoma by bilateral uterine arteries, the fibroids could be divided into three types: unilateral, predominantly unilateral, and evenly bilateral supplying type. The constitution ratios of these three types were 6%, 84%, and 10% in 50 patients, of which the predominantly unilateral type was the majority occupying 84%. The obvious anastomoses between the bilateral uterine arteries were found in 5, and accessory uterine artery in 2 cases. In addition, the ovarian branches of uterine artery and ovarian opacification were revealed in 15 patients, of which the ipsilateral ovarian artery was retrogradely filled through ovarian anastomoses in 5(10%) cases. Conclusion: The individualized strategy of uterine artery embolization should bey of uterine artery embolization should be advocated according to this angiographic classification of uterine myoma, the distal microsphere embolization have to be reasonably tailored in proportion to the concrete blood feeding ratio to the uterine fibroids by each side. The opacification of ovarian branches of uterine artery or ovarian artery indicates that >350 ?m diameter microspheres should be used for the uterine artery embolization in order to protect the ovarian function. (authors)

100

Preliminary Experience with Locoregional Intraarterial Chemotherapy of Uterine Cervical or Endometrial Cancer Using the Peripheral Implantable Port System (PIPSTM): A Feasibility Study  

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The purpose of this study was to assess the suitability of a percutaneously implantable catheter port system (PIPS)for repeated intraarterial locoregional chemotherapy (ILC) for cervical and endometrial carcinoma. In 30 patients with advanced, recurrent, or high-risk cervical (n 23) or endometrial(n = 7) carcinoma, PIPS for ILC was implanted via a femoral access, the catheter localized in the infrarenal abdominal aorta. Chemotherapy was performed adjuvantly after surgery(n = 14) or neo-adjuvantly to enable surgery, or for palliation (n = 16). Port implantation, catheter placement, and repeated port puncture was uneventful in all patients.Complications included catheter dislocation (n = 1),catheter thrombosis (n = 2), subcutaneous infection(n = 1), port-bed skin atrophy (n = 1),requiring port explantation in 3 patients. At 2 years follow-up,complete remission was observed in 7/14 patients with adjuvant chemotherapy, partial remission in 3/14. Successful down-staging could be achieved in 4/8 patients with neo-adjuvant chemotherapy. The PIPS is suitable for repeated ILC which may be a valuable method for pre- and post-surgical therapy of advanced or high-risk cervical and endometrial cancer, for adjuvant chemotherapy as well as neo-adjuvantly for down-staging, or for palliation

 
 
 
 
101

Giant Intraabdominal Endometrial Cyst  

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Endometriosis is the condition where endometrium gets implanted and flourishes outside the uterine cavity, most commonly in ovary and on the peritoneum which lines the abdominal cavity and viscera. Endometrial cells in areas outside the uterus are influenced by hormonal changes and respond in a way similar to the endometrium inside the uterus. Symptoms often worsen with the menstrual cycle. We present a case of 50 years old female who presented with gross abdominal distension and abdominal pain over years. CT scan showed a huge intraabdominal cyst of unknown origin which was compressing adjacent structures. Patient underwent a high risk operation and whole cyst weighing 214 kg (471 lbs) was removed along with both ovaries and uterus. Histopathologically, it was reported as endometrial cyst. (author)

102

Giant intraabdominal endometrial cyst.  

Science.gov (United States)

Endometriosis is the condition where endometrium gets implanted and flourishes outside the uterine cavity, most commonly in ovary and on the peritoneum which lines the abdominal cavity and viscera. Endometrial cells in areas outside the uterus are influenced by hormonal changes and respond in a way similar to the endometrium inside the uterus. Symptoms often worsen with the menstrual cycle. We present a case of 50 years old female who presented with gross abdominal distension and abdominal pain over years. CT scan showed a huge intraabdominal cyst of unknown origin which was compressing adjacent structures. Patient underwent a high risk operation and whole cyst weighing 214 kg (471 lbs) was removed along with both ovaries and uterus. Histopathologically, it was reported as endometrial cyst. PMID:24953922

Shah, Azhar Ali; Soomro, Niaz Ahmed; Talib, Rabender Kumar; Sadhayo, Asif Nabi; Soomro, Suhail Ahmed

2014-06-01

103

With the advent of selective progesterone receptor modulators, what is the place of myoma surgery in current practice?  

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Uterine fibroids are the most common benign uterine tumors. This review examines the different management strategies, involving mainly surgery, and evaluates them in the light of new developments with selective progesterone receptor modulators. On the one hand, hysteroscopic and laparoscopic (or minilaparotomic) myomectomy is the treatment of choice in women who wish to preserve their uterus, and hysterectomy has long been considered the standard surgical approach in symptomatic women who no longer wish to conceive. On the other hand, recent studies have demonstrated the efficacy of ulipristal acetate in the medical management of myomas. Analyzing the respective advantages of both medical and surgical therapy, we propose new guidelines for the management of fibroids that take into account the most important symptoms (bleeding, infertility) and the age of the patients. PMID:25106762

Donnez, Jacques; Donnez, Olivier; Dolmans, Marie-Madeleine

2014-09-01

104

The endometrial effects of SERMs.  

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The ideal selective oestrogen receptor modulator (SERM) would retain an oestrogen-like effect on the bones, the heart and cardiovascular apparatus, and the central nervous system, while acting as an anti-oestrogen on the breast and the genital tract. It seems, however, that such a compound is not available for clinical use yet. The uterine tissue, and particularly the endometrium, defines an area of special interest in the SERM action, since endometrial hyperplasia and cancer has been linked to agonistic oestrogen effects. Additionally, tamoxifen, the SERM which accumulates most of the clinical experience, has been associated with stimulatory effects on endometrium, including the development of cancer. In contrast, the more recent benzothiophenes, led by raloxifene, seem to operate as endometrial antagonists, thus providing an interesting alternative for clinical use. This review analyses the endometrial action of tamoxifen, including the information gathered from laboratory models, the observed endometrial effects in women using tamoxifen, and the epidemiological and molecular data which link the use of tamoxifen with endometrial cancer. A parallel examination of the raloxifene data presents the available experimental and clinical information, suggesting the endometrial neutrality of this compound. PMID:10874569

Cano, A; Hermenegildo, C

2000-01-01

105

Blastocyst transfer after aseptic vitrification of zygotes: an approach to overcome an impaired uterine environment.  

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In some IVF cycles, no fresh embryo transfer in the stimulated cycle is advisable. The cryopreservation of zygotes and the transfer of blastocysts in a cryo-embryo transfer is an option to circumvent an inadequate uterine environment due to risk of ovarian hyperstimulation syndrome, inappropriate endometrium build up, endometrial polyps or uterine myomas. For this strategy, highly secure and safe cryopreservation protocols are advisable. This study describes a protocol for aseptic vitrification of zygotes that results in high survival rates and minimizes the potential risk of contamination in liquid nitrogen during cooling and long-term storage. In mouse zygotes, there was no difference in efficiency as compared with a conventional open vitrification system. In IVF patients, aseptically vitrified zygotes showed no difference in blastocyst formation rate as compared with sibling zygotes kept in fresh culture. A clinical study comprising 173 cryo-cycles with a transfer of blastocysts originating from vitrified zygotes showed an ongoing pregnancy rate of 40.9%. The live birth rate per patient was 36.8%. A combination of good clinical results and increased safety conditions due to aseptic vitrification encourages the use of cryo-embryo transfer for patients with a suboptimal uterine environment in a fresh cycle. In stimulated IVF cycles, high doses of hormones are given to stimulate multifollicular growth. One drawback of the hormonal substitution is that the uterine environment is not at the same time optimally prepared for embryo implantation. A solution, which is increasingly under discussion, is to cryopreserve the embryos obtained in the stimulated cycle and to transfer them back into the optimal uterine environment in a subsequent cryo-cycle. This procedure requires highly secure and safe cryopreservation protocols in order to ensure benefits for both pregnancy and birth rates. We have established a protocol for the vitrification of zygote-stage embryos in aseptic devices, which minimize the potential risk of contamination during cooling and storage. The vitrified zygotes showed the same blastocyst development as compared with sibling zygotes in fresh culture. A clinical study comprising 173 cryo-cycles with transfer of blastocysts originating from vitrified zygotes shows an ongoing pregnancy rate of 40.9%. The live birth rate per patient was 36.8%. A combination of good clinical results and increased safety conditions due to aseptic vitrification conditions contributes to a change in transfer strategy and encourages us to increase the cryo-embryo transfer rate for an optimal uterine environment. PMID:23069744

Vanderzwalmen, Pierre; Zech, Nicolas H; Ectors, Fabien; Stecher, Astrid; Lejeune, Bernard; Vanderzwalmen, Sabine; Wirleitner, Barbara

2012-12-01

106

Ultrasonographic findings of Myoma, H-mole and Missed abortion  

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Ultrasonography is very important in the diagnosis of various kinds of diseases in Obsterics and Gynecology. It has high diagnostic accuracy in the diagnosis of pelvic masses and widely used for the detection of normal orpathologic pregnancy. But still it is difficult to differentiate degenerated myoma, H-mole and missed abortion by ultrasonography. So the authors analyzed the ultrasonographic findings of 81 patients with myoma(29 cases), H-mole(23 cases), and missed abortion(29 cases) and the results are as follows; 1. Diagnostic accuracy was 8.6% in myoma, 87% in H-mole and 89% in missed abortion. 2. The most typical ultrasonographic finding of myoma was obulated mass contour with nonhomogenous internal echo. 3. The most characteristic finding of H-mole was fine vesicular pattern internal echo with globular enlargement of uterus. 4. The most frequent finding of missed abortion was deformed gestational sac with or without remained fetal echo. 5. Clinical correlation was very important for accurate diagnosis, especially when differential diagnosis was very difficult between myoma with marked cystic degeneration, missed abortion with large distorted gestational sac and H-mole with severe degeneration

Huh, Nam Yoon; You, H. S.; Seong, K. J.; Park, C. Y. [Yonsei University College of Medicine, Yonsei Cancer Center, Seoul (Korea, Republic of)

1982-12-15

107

Ultrasonographic findings of Myoma, H-mole and Missed abortion  

International Nuclear Information System (INIS)

Ultrasonography is very important in the diagnosis of various kinds of diseases in Obsterics and Gynecology. It has high diagnostic accuracy in the diagnosis of pelvic masses and widely used for the detection of normal orpathologic pregnancy. But still it is difficult to differentiate degenerated myoma, H-mole and missed abortion by ultrasonography. So the authors analyzed the ultrasonographic findings of 81 patients with myoma(29 cases), H-mole(23 cases), and missed abortion(29 cases) and the results are as follows; 1. Diagnostic accuracy was 8.6% in myoma, 87% in H-mole and 89% in missed abortion. 2. The most typical ultrasonographic finding of myoma was obulated mass contour with nonhomogenous internal echo. 3. The most characteristic finding of H-mole was fine vesicular pattern internal echo with globular enlargement of uterus. 4. The most frequent finding of missed abortion was deformed gestational sac with or without remained fetal echo. 5. Clinical correlation was very important for accurate diagnosis, especially when differential diagnosis was very difficult between myoma with marked cystic degeneration, missed abortion with large distorted gestational sac and H-mole with severe degeneration

108

Inflammation and endometrial bleeding.  

Science.gov (United States)

Abstract Most of the key physiological processes in the human reproductive tract involve a significant inflammatory component. These processes include follicle development, ovulation, implantation, pregnancy, labor, postpartum, remodeling and menstruation. In this context, the term 'inflammation' usually means an influx of leukocytes ('immune cells'), often of different types, into a reproductive tract tissue. These examples of inflammation are not overtly associated with any infective process. There may also be evidence that these invading leukocytes have altered their functions to take on specific and relevant local regulatory roles. Specific sequential changes in different leukocytes can be demonstrated within human endometrium during the different phases of the normal menstrual cycle. Leukocytes are fairly sparse in numbers through the proliferative phase, but increase substantially into and through the secretory phase, so much so that around 40% of all stromal cells in the premenstrual phase are leukocytes, mainly uterine natural killer cells, a large granulated lymphocyte. Other leukocytes which play key roles in menstruation appear to be macrophages, mast cells, dendritic cells, neutrophils, eosinophils and regulatory T cells. Premenstrual withdrawal of progesterone increases the endometrial expression of inflammatory mediators, including IL-8 and MCP-1, which are believed to drive endometrial leukocyte recruitment at this time. Macrophages and neutrophils are rich sources of defensins and whey acid protein motif proteins, which play important roles in ensuring microbial protection while the epithelial barrier is disrupted. Mast cells are increasingly activated as the menstrual phase approaches, and leukocyte proteases trigger a cascade of matrix metalloproteinases and degradation of extracellular matrix. Dendritic cells and other antigen-presenting cells (e.g. macrophages) almost certainly facilitate clearance of cellular debris from the uterine cavity, and reduce the amount of viable cellular material transiting the Fallopian tubes. All of these processes are influenced or controlled by regulatory T cells. Many of these leukocytes also have the potential to release regulatory molecules which stimulate endometrial repair mechanisms. Increasing recent evidence also implicates disturbances of immune cells and their cytokine mediators in contributing to symptoms of abnormal uterine bleeding and pelvic pain. These recent findings all point towards the importance of the 'inflammatory process' in both normal and abnormal endometrial bleeding. PMID:25247830

Berbic, M; Ng, C H M; Fraser, I S

2014-12-01

109

CA 125 and other tumor markers in uterine leiomyomas and their association with lesion characteristics  

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The aim of this study was to investigate the factors associated with serum levels of several tumor markers in a group of patients operated for uterine myoma. One hundred thirty-seven female patients operated for uterine myoma were included. Serum samples were examined for CA 125, CA 19-9, CA 15-3, carcinoembryonic antigen (CEA) and alpha-fetoprotein (AFP) levels as part of routine workup. Pathological and morphological characteristics of the patients were retrieved from medical records. The mean age was 46.7 ± 8.8 years (range, 22-85 y). Abnormally high levels of CA 125, CA 19-9, CA 15-3, CEA, and AFP were found in 19.7%, 6.6%, 5.1%, 3.7%, and 1.5% of the patients, respectively. Patients with additional adenomyosis and patients with at least one large myoma (? 5 cm diameter) had significantly higher levels of CA 125. Multivariate analysis identified coexistence of adenomyosis (OR 7.7 [95% CI, 2.6-23.0], p < 0.001) and presence of at least one large myoma (OR 5.6 [1.4-22.8], p = 0.016) as independent predictors of abnormally high CA 125 levels. CA 125 levels are affected by the tumor size and coexistence of adenomyosis in uterine leiomyomas. Indirect mechanisms caused by large myoma size such as peritoneal irritation may be responsible for CA 125 elevations. PMID:24955185

Babacan, Ali; Kizilaslan, Cem; Gun, Ismet; Muhcu, Murat; Mungen, Ercument; Atay, Vedat

2014-01-01

110

PET in uterine malignancies  

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Full Text Available Positron Emission Tomography (PET or integrated PET/Computed Tomography (PET/CT with 18F-Fluoro-Deoxy-Glucose (18F-FDG is a functional imaging modality, useful in the characterization of undetermined morphological findings, and in the staging/re-staging of a large number of malignancies. Although its use in uterine malignancies has been poorly investigated, in recent years the employment of this technique has constantly increased. In this review, we evaluate the role of PET (/CT with 18FFDG in uterine malignancies (cervical and endometrial cancers as well as uterine sarcomas, underlying its advantages and discussing its limitations. Metabolic and anatomic information given by PET/CT with 18F-FDG could be useful in the evaluation of local and distant disease involvement at the staging, in the detection of disease recurrence, and in the evaluation of the response after chemotherapy and/or radio-therapy.

Valeria Pirro

2010-07-01

111

Immunoexpression of the relaxin receptor LGR7 in breast and uterine tissues of humans and primates  

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Full Text Available Abstract Background The receptor for the peptide hormone relaxin has recently been identified as the heptahelical G-protein coupled receptor, LGR7. In order to generate molecular tools with which to characterize both in vivo and in vitro expression of this receptor in human and primate tissues, specific monotypic antibodies have been generated and applied to a preliminary analysis of human and primate female reproductive tissues. Methods Three peptide sequences were identified from the proposed open reading frame of the cloned LGR7 receptor gene, representing both extracellular and intracellular domains. Two to three rabbits were immunized for each epitope, and the resulting sera subjected to a systematic validation using cultured cells transiently transfected with a receptor-expressing gene construct, or appropriate control constructs. Results Human and monkey (marmoset, macaque endometrium showed consistent and specific immunostaining in the stromal cells close to glands. Staining appeared to be more intense in the luteal phase of the cycle. Weak immunostaining was also evident in the endometrial epithelial cells of the marmoset. A myoma in one patient exhibited strong immunostaining in the circumscribing connective tissue. Uterine expression was supported by RT-PCR results from cultured primary endometrial and myometrial cells. Human breast tissue (healthy and tumors consistently indicated specific immunostaining in the interstitial connective (stromal tissue within the glands, but not in epithelial or myoepithelial cells, except in some tumors, where a few epithelial and tumor cells also showed weak epitope expression. Conclusions Using validated monotypic antibodies recognizing different epitopes of the LGR7 receptor, and from different immunized animals, and in different primate species, a consistent pattern of LGR7 expression was observed in the stromal (connective tissue cells of the endometrium and breast, consistent also with the known physiology of the relaxin hormone.

Milde-Langosch Karin

2003-11-01

112

The Effect of Different Local Anesthesia Methods on Pain Relief in Outpatient Endometrial Biopsy: Randomized Clinical Trial  

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Introduction: Endometrial biopsy is necessary for diagnosing the reason of abnormal uterine bleeding in perimenopausal women. Currently outpatient endometrial biopsy is used for evaluation of abnormal uterine bleeding which is associated with moderate to severe pain. Using lidocaine is one of the procedures which is used for pain relief while biopsy. This study is aimed at comparing the effect of different local anesthesia procedures on pain relief during endometrial biopsy. Methods: In this ...

Elaheh Olad-Saheb-Madarek; Morteza Ghojazaeh; Fahimeh Behjati; Hossein Alikhah

2013-01-01

113

Endometrial biopsy  

Science.gov (United States)

Biopsy - endometrium ... The biopsy is normal if the cells in the sample are not abnormal. ... Risks of endometrial biopsy include: Infection Causing a hole in (perforating) the uterus or tearing the cervix (rarely occurs) Prolonged bleeding Slight spotting ...

114

Contrast enhancement versus vasculature of uterine tumors  

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The relative contrast enhancement of normal myometrium and small or medium size uterine fibroids and clinical stage I endometrial carcinomas were correlated to their microangiographically demonstrable vascularity. In four cases small uterine fibroids showed contrast enhancement equal to normal myometrium, independent of their vascularity in microangiography. In five, endometrial carcinomas contrast enhancement was always below that of the surrounding myometrium in CT. Intratumour vasculature showed great variability in microangiography. No correlation between the topographic variations in the arrangement or density of tumour blood vessels and the degree of contrast enhancement was found. Contrast enhancement of small uterine fibroids was greater than that of small adenocarcinomas. More contrast material accumulates into the extravascular space of the smooth muscle tissue of the fibroid than into the extravascular space of endometrial carcinoma.

Kormano, M.; Kiilholma, P.; Groenroos, M.

1984-05-01

115

Embolização das artérias uterinas com partículas de PVA-PVAC esférico como preparo para posterior ressecção cirúrgica de miomas / Uterine artery embolization with spherical pva-pvac particles as preparation for surgical resection of miyomas  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: avaliar a utilização de uma nova partícula de polivinil álcool e polivinil acetato (PVA-PVAc) esférica, para embolização das artérias uterinas, em pacientes portadoras de mioma, com indicação cirúrgica. MÉTODOS: doze pacientes foram submetidas à embolização de miomas uterinos com partícula [...] s de PVA-PVAc. Três a nove meses depois, realizou-se uma laparotomia com miomectomia. Analisaram-se os seguintes parâmetros: volume do útero e do maior mioma; concentrações do hormônio folículo estimulante e de hemoglobina; sangramento menstrual (número de dias e de absorventes utilizados), sinais e sintomas antes do tratamento, após a embolização e após a miomectomia. RESULTADOS: a média de idade foi 37 anos e a média do volume uterino, previamente ao tratamento, de 939,3cc. Três anos após a embolização, observou-se diminuição do volume uterino (p=0,0005). Houve melhora na concentração de hemoglobina (p= 0,0004), com elevação após a embolização, sem variação subsequente à miomectomia. Não ocorreu variação significante do hormônio folículo estimulante, (p=0,17). Não foi constatado nenhum caso de falência ovariana, mas uma das pacientes apresentou atrofia de endométrio. Duas pacientes engravidaram, com bons indicadores obstétricos. Quanto aos sinais e sintomas, houve melhora após a embolização, que se manteve após a miomectomia. CONCLUSÃO: a embolização arterial com partículas de PVA-PVAc esférico mostrou-se promissora no preparo para uma intervenção cirúrgica com retirada dos miomas, pois, associou-se à redução do volume uterino, à diminuição do sangramento operatório e tornou possível a utilização de incisões menores, aumentando a chance de preservação do útero. Abstract in english OBJECTIVE: To evaluate the use of a new spherical particle of polyvinyl alcohol and polyvinyl acetate (PVA-PVAc) for uterine artery embolization in patients with myoma with surgical indication. METHODS: twelve patients underwent uterine myoma embolization with PVA-PVAc particles. Three to nine month [...] s later, they were submitted to laparotomy with myomectomy. We analyzed the following parameters: volume of the uterus and of the bigger myoma; concentrations of follicle stimulating hormone and hemoglobin; menstrual bleeding (number of days and used absorbents), signs and symptoms before treatment, after embolization and after myomectomy. RESULTS: The mean age was 37 years and mean uterine volume prior to treatment, 939.3 cc. Three years after embolization, there was reduction in uterine volume (p = 0.0005), increase in hemoglobin concentration after embolization (p = 0.0004), without variation after the myomectomy. There was no significant variation of the follicle stimulating hormone (p = 0.17). There was no case of ovarian failure, but one of the patients had endometrial atrophy. Two patients became pregnant, with good obstetric indicators. Signs and symptoms improved after embolization, and remained after myomectomy. CONCLUSION: Arterial embolization with spherical PVA-PVAc particles is promising in the preparation for myoma surgery, since it was associated with a reduction in uterine volume, decrease in intraoperative bleeding and made possible the use of smaller incisions, increasing the chance of preserving the uterus.

Juraci, Ghiaroni; Gaudencio Espinosa, Lopez; Antonio Carlos, Coutinho Junior; Alberto, Schanaider.

116

Embolização das artérias uterinas com partículas de PVA-PVAC esférico como preparo para posterior ressecção cirúrgica de miomas / Uterine artery embolization with spherical pva-pvac particles as preparation for surgical resection of miyomas  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: avaliar a utilização de uma nova partícula de polivinil álcool e polivinil acetato (PVA-PVAc) esférica, para embolização das artérias uterinas, em pacientes portadoras de mioma, com indicação cirúrgica. MÉTODOS: doze pacientes foram submetidas à embolização de miomas uterinos com partícula [...] s de PVA-PVAc. Três a nove meses depois, realizou-se uma laparotomia com miomectomia. Analisaram-se os seguintes parâmetros: volume do útero e do maior mioma; concentrações do hormônio folículo estimulante e de hemoglobina; sangramento menstrual (número de dias e de absorventes utilizados), sinais e sintomas antes do tratamento, após a embolização e após a miomectomia. RESULTADOS: a média de idade foi 37 anos e a média do volume uterino, previamente ao tratamento, de 939,3cc. Três anos após a embolização, observou-se diminuição do volume uterino (p=0,0005). Houve melhora na concentração de hemoglobina (p= 0,0004), com elevação após a embolização, sem variação subsequente à miomectomia. Não ocorreu variação significante do hormônio folículo estimulante, (p=0,17). Não foi constatado nenhum caso de falência ovariana, mas uma das pacientes apresentou atrofia de endométrio. Duas pacientes engravidaram, com bons indicadores obstétricos. Quanto aos sinais e sintomas, houve melhora após a embolização, que se manteve após a miomectomia. CONCLUSÃO: a embolização arterial com partículas de PVA-PVAc esférico mostrou-se promissora no preparo para uma intervenção cirúrgica com retirada dos miomas, pois, associou-se à redução do volume uterino, à diminuição do sangramento operatório e tornou possível a utilização de incisões menores, aumentando a chance de preservação do útero. Abstract in english OBJECTIVE: To evaluate the use of a new spherical particle of polyvinyl alcohol and polyvinyl acetate (PVA-PVAc) for uterine artery embolization in patients with myoma with surgical indication. METHODS: twelve patients underwent uterine myoma embolization with PVA-PVAc particles. Three to nine month [...] s later, they were submitted to laparotomy with myomectomy. We analyzed the following parameters: volume of the uterus and of the bigger myoma; concentrations of follicle stimulating hormone and hemoglobin; menstrual bleeding (number of days and used absorbents), signs and symptoms before treatment, after embolization and after myomectomy. RESULTS: The mean age was 37 years and mean uterine volume prior to treatment, 939.3 cc. Three years after embolization, there was reduction in uterine volume (p = 0.0005), increase in hemoglobin concentration after embolization (p = 0.0004), without variation after the myomectomy. There was no significant variation of the follicle stimulating hormone (p = 0.17). There was no case of ovarian failure, but one of the patients had endometrial atrophy. Two patients became pregnant, with good obstetric indicators. Signs and symptoms improved after embolization, and remained after myomectomy. CONCLUSION: Arterial embolization with spherical PVA-PVAc particles is promising in the preparation for myoma surgery, since it was associated with a reduction in uterine volume, decrease in intraoperative bleeding and made possible the use of smaller incisions, increasing the chance of preserving the uterus.

Juraci, Ghiaroni; Gaudencio Espinosa, Lopez; Antonio Carlos, Coutinho Junior; Alberto, Schanaider.

2013-10-01

117

Modern review of pathogenesis of urgent uterine bleedings in obstetrical and gynecological practice  

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Full Text Available The article presents modern data concerning mechanisms of uterine bleedings in undeveloped pregnancy, hystero-myoma, and cervical carcinoma. Hemostasis system malfunctions appeared in case of dead foetus in uterus have been considered in the work. They are manifested by consumption coagulopathy and haemorrhagic complications. Uterine bleedings in case of hysteromyoma are caused by dilation of arterial vessels and deprivation of their contractile function and malfunction myometrium contraction. Complications that occur in oncological uterine bleedings arrest have been described. They are caused by individual uterine blood supply and developed network of collateral anastomoses between branches of internal iliac arteries

Rogozhina I.E.

2011-03-01

118

Diffuse uterine leiomyomatosis in patient with successful pregnancy following new surgical management.  

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Diffuse uterine leiomyomatosis is associated with significant infertility and miscarriage complications. Appropriate diagnosis and therapy is essential. A 33-year-old woman was referred to our hospital because of GnRH analogue treatment-resistant multiple myomas and infertility. Following new technical myomectomy, she conceived spontaneously and delivered a 2,470 g healthy baby by cesarean section. New technical myomectomy may become an important conservative treatment option for patients with diffuse uterine leiomyomatosis. PMID:24930118

Otsubo, Yasuo; Nishida, Masato; Arai, Yuko; Ichikawa, Ryota; Sakanaka, Miyako

2014-10-01

119

UTERINE ARTERY EMBOLIZATION FOR THE TREATMENT OF UTERINE FIBROIDS  

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Full Text Available AIM: To determine the outcome of uterine artery embolization in patients with symptomatic uterine fibroids, in order to assess the response of symptoms and fibroid size. METHODS: We analyzed the results of a population study of 112 patients with uterine fibroids made in the period between 2006 and 2010. Main parameters were assessed improvement or disappearance of symptoms and downsizing the adverse effects of the procedure. RESULTS: The predominant age of the patients are in the group of 41-45 years with 80.35%, being the most common symptom of menorrhagia 66.07%, myoma volume ranged between 35cm3 and 523cm3, and procedure duration ranged from 1 hour to 2.5 hours. The most common symptoms after embolization was mild pain 44.64%, not having symptoms in 43.75%. Also it was associated nausea in 8.03% and vomiting in 3.57% as other adverse effects. After three months of treatment 47.32% had oligomenorrhea and amenorrhea was 17.85%. Fibroid size at 6 months was reduced significantly dominate the volume between 36 and 113cm3. CONCLUSION: Uterine artery embolization is an effective treatment for symptomatic fibroids, considered an alternative to surgical treatment

González- Perez Santiago

2013-01-01

120

Failed transarterial embolization of subserosal uterine arteriovenous malformation.  

Science.gov (United States)

Uterine arteriovenous malformation (AVM) is rare but potentially life-threatening from excessive vaginal bleeding. All uterine AVMs reported to date have been found in the endometrial or myometrial layers. Here we present a patient with a subserosal type AVM on the fundus of uterus, which spontaneously ruptured. PMID:24328024

Seo, Kyung Jin; Kim, Jin; Sohn, In Sook; Kwon, Han Sung; Park, Sang Woo; Hwang, Han Sung

2013-09-01

 
 
 
 
121

Superoxide dismutase and lipid hydroperoxides in blood and endometrial tissue of patients with benign, hyperplastic and malignant endometrium  

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Full Text Available SciELO Brazil | Language: English Abstract in portuguese Resultados epidemiológicos e experimentais apontam para o envolvimento dos radicais derivados do oxigênio na patogênese das moléstias ginecológicas, assim como no desenvolvimento do câncer. O objetivo do presente estudo foi o de examinar as alterações nas atividades e níveis de Cu/Zn superóxido dism [...] utase (CuZnSOD) e hidroperóxidos lipídicos (LOOH)no sangue e tecido endometrial de pacientes diagnosticados com mioma uterino, pólipo endometrial, hiperplasia simplex, hiperplasia complex e adenocarcinoma do endométrio. Os resultados de nosso estudo mostraram atividades de SOD diminuídas e nível de SOD proteína inalterado no sangue de todos os pacientes examinados em comparação a indivíduos saudáveis. Diminuição de ambos, atividade de SOD e nível protéico, foram encontrados no endométrio de pacientes com hiperplasia simplex, hiperplasia complex e adenocarcinoma em comparação às mulheres com pólipos e/ou mioma. O nível de LOOH estava elevado em ambos os tecidos de pacientes com hyperplasia e adenocarcinoma em comparação a indivíduos saudáveis ou pacientes com diagnóstico benigno. Nossos resultados sugerem que um decréscimo na atividade e nível protéico de SOD, assim como um incremento no nível de LOOH, em pacientes com desordens ginecológicas, tornam esses pacientes mais susceptíveis ao dano oxidativo causado pelas espécies reativas de oxigênio (ROS). Um desequilíbrio na formação de ROS e no nível de SOD pode ser importante na patogênese e/ou perpetuação do dano tecidual em pacientes ginecológicos. Desde que existe evidência de que SOD pode ser um alvo para terapia de câncer, nossos resultados fornecem uma base para futura pesquisa e opções para aplicações clínicas. Abstract in english Epidemiological and experimental data point to involvement of oxygen derived radicals in the pathogenesis of gynecological disorders, as well as in cancer development. The objective of the present study was to examine changes in activities and levels of copper/zinc superoxide dismutase (CuZnSOD) and [...] lipid hydroperoxides (LOOH) in blood and endometrial tissue of patients diagnosed with uterine myoma, endometrial polypus, hyperplasia simplex, hyperplasia complex and adenocarcinoma endometrii. The results of our study have shown decreased SOD activities and unchanged SOD protein level in blood of all examined patients in comparison to healthy subjects. Decrease of both SOD activity and level was found in endometrium of patients with hyperplasia simplex, hyperplasia complex and adenocarcinoma in comparison to women with polypus or myoma. LOOH level was elevated in both tissues of patients with hyperplasiaor adenocarcinoma in comparison to healthy subjects or patients with benign diagnosis. Our findings suggest that the decrease in SOD activity and level, as well as the increase in LOOH level, in patients with gynecological disorders, render these patients more susceptible to oxidative damage caused by reactive oxygen species (ROS). An imbalance in ROS formation and SOD level may be important in the pathogenesis and/or perpetuation of tissue damage in gynecological patients. Since evidence suggests that SOD may be a therapy target for cancer treatment, our findings provide a basis for further research and options for clinical applications.

Snežana, Peji& #263; ; Ana, Todorovi& #263; ; Vesna, Stojiljkovi& #263; ; Dragana, Cvetkovi& #263; ; Nenad, Lu& #269; i& #263; ; Ratko M., Radoji& #269; i& #263; ; Zorica S., Sai& #269; i& #263; ; Snežana B., Pajovic.

122

Superoxide dismutase and lipid hydroperoxides in blood and endometrial tissue of patients with benign, hyperplastic and malignant endometrium  

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Full Text Available Epidemiological and experimental data point to involvement of oxygen derived radicals in the pathogenesis of gynecological disorders, as well as in cancer development. The objective of the present study was to examine changes in activities and levels of copper/zinc superoxide dismutase (CuZnSOD and lipid hydroperoxides (LOOH in blood and endometrial tissue of patients diagnosed with uterine myoma, endometrial polypus, hyperplasia simplex, hyperplasia complex and adenocarcinoma endometrii. The results of our study have shown decreased SOD activities and unchanged SOD protein level in blood of all examined patients in comparison to healthy subjects. Decrease of both SOD activity and level was found in endometrium of patients with hyperplasia simplex, hyperplasia complex and adenocarcinoma in comparison to women with polypus or myoma. LOOH level was elevated in both tissues of patients with hyperplasiaor adenocarcinoma in comparison to healthy subjects or patients with benign diagnosis. Our findings suggest that the decrease in SOD activity and level, as well as the increase in LOOH level, in patients with gynecological disorders, render these patients more susceptible to oxidative damage caused by reactive oxygen species (ROS. An imbalance in ROS formation and SOD level may be important in the pathogenesis and/or perpetuation of tissue damage in gynecological patients. Since evidence suggests that SOD may be a therapy target for cancer treatment, our findings provide a basis for further research and options for clinical applications.Resultados epidemiológicos e experimentais apontam para o envolvimento dos radicais derivados do oxigênio na patogênese das moléstias ginecológicas, assim como no desenvolvimento do câncer. O objetivo do presente estudo foi o de examinar as alterações nas atividades e níveis de Cu/Zn superóxido dismutase (CuZnSOD e hidroperóxidos lipídicos (LOOHno sangue e tecido endometrial de pacientes diagnosticados com mioma uterino, pólipo endometrial, hiperplasia simplex, hiperplasia complex e adenocarcinoma do endométrio. Os resultados de nosso estudo mostraram atividades de SOD diminuídas e nível de SOD proteína inalterado no sangue de todos os pacientes examinados em comparação a indivíduos saudáveis. Diminuição de ambos, atividade de SOD e nível protéico, foram encontrados no endométrio de pacientes com hiperplasia simplex, hiperplasia complex e adenocarcinoma em comparação às mulheres com pólipos e/ou mioma. O nível de LOOH estava elevado em ambos os tecidos de pacientes com hyperplasia e adenocarcinoma em comparação a indivíduos saudáveis ou pacientes com diagnóstico benigno. Nossos resultados sugerem que um decréscimo na atividade e nível protéico de SOD, assim como um incremento no nível de LOOH, em pacientes com desordens ginecológicas, tornam esses pacientes mais susceptíveis ao dano oxidativo causado pelas espécies reativas de oxigênio (ROS. Um desequilíbrio na formação de ROS e no nível de SOD pode ser importante na patogênese e/ou perpetuação do dano tecidual em pacientes ginecológicos. Desde que existe evidência de que SOD pode ser um alvo para terapia de câncer, nossos resultados fornecem uma base para futura pesquisa e opções para aplicações clínicas.

Snežana Peji?

2008-09-01

123

Superoxide dismutase and lipid hydroperoxides in blood and endometrial tissue of patients with benign, hyperplastic and malignant endometrium  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in portuguese Resultados epidemiológicos e experimentais apontam para o envolvimento dos radicais derivados do oxigênio na patogênese das moléstias ginecológicas, assim como no desenvolvimento do câncer. O objetivo do presente estudo foi o de examinar as alterações nas atividades e níveis de Cu/Zn superóxido dism [...] utase (CuZnSOD) e hidroperóxidos lipídicos (LOOH)no sangue e tecido endometrial de pacientes diagnosticados com mioma uterino, pólipo endometrial, hiperplasia simplex, hiperplasia complex e adenocarcinoma do endométrio. Os resultados de nosso estudo mostraram atividades de SOD diminuídas e nível de SOD proteína inalterado no sangue de todos os pacientes examinados em comparação a indivíduos saudáveis. Diminuição de ambos, atividade de SOD e nível protéico, foram encontrados no endométrio de pacientes com hiperplasia simplex, hiperplasia complex e adenocarcinoma em comparação às mulheres com pólipos e/ou mioma. O nível de LOOH estava elevado em ambos os tecidos de pacientes com hyperplasia e adenocarcinoma em comparação a indivíduos saudáveis ou pacientes com diagnóstico benigno. Nossos resultados sugerem que um decréscimo na atividade e nível protéico de SOD, assim como um incremento no nível de LOOH, em pacientes com desordens ginecológicas, tornam esses pacientes mais susceptíveis ao dano oxidativo causado pelas espécies reativas de oxigênio (ROS). Um desequilíbrio na formação de ROS e no nível de SOD pode ser importante na patogênese e/ou perpetuação do dano tecidual em pacientes ginecológicos. Desde que existe evidência de que SOD pode ser um alvo para terapia de câncer, nossos resultados fornecem uma base para futura pesquisa e opções para aplicações clínicas. Abstract in english Epidemiological and experimental data point to involvement of oxygen derived radicals in the pathogenesis of gynecological disorders, as well as in cancer development. The objective of the present study was to examine changes in activities and levels of copper/zinc superoxide dismutase (CuZnSOD) and [...] lipid hydroperoxides (LOOH) in blood and endometrial tissue of patients diagnosed with uterine myoma, endometrial polypus, hyperplasia simplex, hyperplasia complex and adenocarcinoma endometrii. The results of our study have shown decreased SOD activities and unchanged SOD protein level in blood of all examined patients in comparison to healthy subjects. Decrease of both SOD activity and level was found in endometrium of patients with hyperplasia simplex, hyperplasia complex and adenocarcinoma in comparison to women with polypus or myoma. LOOH level was elevated in both tissues of patients with hyperplasiaor adenocarcinoma in comparison to healthy subjects or patients with benign diagnosis. Our findings suggest that the decrease in SOD activity and level, as well as the increase in LOOH level, in patients with gynecological disorders, render these patients more susceptible to oxidative damage caused by reactive oxygen species (ROS). An imbalance in ROS formation and SOD level may be important in the pathogenesis and/or perpetuation of tissue damage in gynecological patients. Since evidence suggests that SOD may be a therapy target for cancer treatment, our findings provide a basis for further research and options for clinical applications.

Snežana, Peji& #263; ; Ana, Todorovi& #263; ; Vesna, Stojiljkovi& #263; ; Dragana, Cvetkovi& #263; ; Nenad, Lu& #269; i& #263; ; Ratko M., Radoji& #269; i& #263; ; Zorica S., Sai& #269; i& #263; ; Snežana B., Pajovic.

2008-09-01

124

Uterine restoration after repeated sloughing of fibroids or vaginal expulsion following uterine artery embolization  

International Nuclear Information System (INIS)

The aim of our study is to present our experience with uterine restoration after repeated sloughing of uterine fibroids or transvaginal expulsion following uterine artery embolization (UAE) and to determine its safety and outcome. One hundred and twenty-four women (mean age, 40.3 years; age range, 29-52 years) with symptomatic uterine fibroids were included in this retrospective study. We performed arterial embolization with poly(vinyl alcohol) particles (250-710 ?m). Clinical symptoms and follow-up information for each patient were obtained through medical records. At an average of 3.5 months (range, 1-8 months) after embolization, magnetic resonance imaging examinations with T1- and T2-weighted and gadolinium-enhanced T1-weighted images were obtained for all patients. The mean follow-up duration was 120 days (90-240 days). Eight (6.5%) patients experienced uterine restoration after repeated sloughing of uterine fibroids or spontaneous transvaginal expulsion. The locations of the leiomyomas were submucosal (n=5), intramural (n=2) and transmural (n=1). The maximum diameter of the fibroids ranged from 3.5 to 18.0 cm, with a mean of 8.4 cm. The time interval from embolization to the uterine restoration was 7-150 days (mean 70.5 days). The clinical symptoms before and during vaginal sloughing or expulsion were lower abdominal pain (n=4), vaginal discharges (n=3), infection of necrotic myomas (n=2) and cramping abdominal pain (n=1). Gentle abdominal compression (n=1) and). Gentle abdominal compression (n=1) and hysteroscopic assistance (n=1) were required to remove the whole fibroid. No other clinical sequelae, either early or delayed, were documented. Magnetic resonance images revealed the disappearance of leiomyomas, intracavitary rupture resulting in transformation of intramural or transmural myomas into submucosal myomas and localized uterine wall defects. Although the small size of this study precludes a strict conclusion, there appear to be few serious complications directly related to vaginal expulsion. Vaginal expulsion or fibroid sloughing is a possible course following UAE that is manageable, and the patients should be informed about this possibility. (orig.)

125

Uterine restoration after repeated sloughing of fibroids or vaginal expulsion following uterine artery embolization  

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The aim of our study is to present our experience with uterine restoration after repeated sloughing of uterine fibroids or transvaginal expulsion following uterine artery embolization (UAE) and to determine its safety and outcome. One hundred and twenty-four women (mean age, 40.3 years; age range, 29-52 years) with symptomatic uterine fibroids were included in this retrospective study. We performed arterial embolization with poly(vinyl alcohol) particles (250-710 {mu}m). Clinical symptoms and follow-up information for each patient were obtained through medical records. At an average of 3.5 months (range, 1-8 months) after embolization, magnetic resonance imaging examinations with T1- and T2-weighted and gadolinium-enhanced T1-weighted images were obtained for all patients. The mean follow-up duration was 120 days (90-240 days). Eight (6.5%) patients experienced uterine restoration after repeated sloughing of uterine fibroids or spontaneous transvaginal expulsion. The locations of the leiomyomas were submucosal (n=5), intramural (n=2) and transmural (n=1). The maximum diameter of the fibroids ranged from 3.5 to 18.0 cm, with a mean of 8.4 cm. The time interval from embolization to the uterine restoration was 7-150 days (mean 70.5 days). The clinical symptoms before and during vaginal sloughing or expulsion were lower abdominal pain (n=4), vaginal discharges (n=3), infection of necrotic myomas (n=2) and cramping abdominal pain (n=1). Gentle abdominal compression (n=1) and hysteroscopic assistance (n=1) were required to remove the whole fibroid. No other clinical sequelae, either early or delayed, were documented. Magnetic resonance images revealed the disappearance of leiomyomas, intracavitary rupture resulting in transformation of intramural or transmural myomas into submucosal myomas and localized uterine wall defects. Although the small size of this study precludes a strict conclusion, there appear to be few serious complications directly related to vaginal expulsion. Vaginal expulsion or fibroid sloughing is a possible course following UAE that is manageable, and the patients should be informed about this possibility. (orig.)

Park, Hye Ri; Kim, Nack Keun; Lee, Mee Hwa [Pochon CHA University, Department of Obstetrics and Gynecology, Bundang CHA General Hospital, Sungnam-si, Kyonggi-do (Korea); Kim, Man Deuk; Kim, Hee Jin; Yoon, Sang-Wook [Pochon CHA University, Department of Diagnostic Radiology, Bundang CHA General Hospital, Sungnam-si, Kyonggi-do (Korea); Park, Won Kyu [Yeungnam University, Department of Diagnostic Radiology, Kyongson, Dyongbuk (Korea)

2005-09-01

126

Effects of postparturient uterine lavage on uterine involution in the mare.  

Science.gov (United States)

Eighteen postparturient mares were used to evaluate effects of uterine lavage on uterine involution. Mares were randomly assigned to one of three treatment groups: Group 1 (seven mares), no lavage; Group 2 (five mares), lavage on Day 3 post partum; and Group 3 (six mares), lavage on Days 3, 4, and 5 post partum. Five liters sterile physiologic saline, prewarmed to 42 degrees C, were used for each lavage. Transrectal ultrasound examination of the reproductive tract was performed on Day 11 post partum to detect the presence of free fluid in the uterine lumen, to estimate the cross-sectional diameter of the uterine horns and body, and to determine if ovulation had occurred. Endometrial biopsies were also taken on Day 11 post partum to evaluate endometrial histologic characteristics. Lavage had no effect (P>0.05) on diameter of the uterine body or previously gravid uterine horn, presence of fluid in the uterine lumen, or number of mares which had ovulated by Day 11 post partum. Histologic characteristics of the endometrium (height of luminal epithelium, gland depth, relative gland vclume, and inflammatory-cell score) were not affected by treatment (P>0.05). Postpartum uterine lavage did not significantly affect uterine involution by the parameters measured in normal-foaling mares at Day 11 post partum. PMID:16726700

Blanchard, T L; Varner, D D; Brinsko, S P; Meyers, S A; Johnson, L

1989-10-01

127

Gestação de termo após ablação endometrial Full-term pregnancy after endometrial ablation  

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Full Text Available A ablação endometrial por via histeroscópica é uma técnica utilizada em casos de sangramento uterino anormal com resposta desfavorável ao tratamento clínico. Mesmo com destruição ou ressecção das camadas funcional e basal do endométrio é possível ocorrer uma gravidez posterior à intervenção. No entanto essas gestações freqüentemente terminam em abortamento ou se apresentam com complicações. Relata-se o caso de uma paciente que desenvolveu gravidez a termo sem intercorrências após ter realizado ablação endometrial por sangramento uterino anormal resistente ao tratamento clínico.Endometrial ablation is a useful technique in patientes with abnormal uterine bleeding without response to clinical measures. Pregnancy is possible even after the destruction or resection of the endometrium. The case reported is a normal term pregnancy after endometrial ablation because ot menorrhagia without successful prior clinical treatment.

Rievane S. Damião

1999-06-01

128

The Value of Tumor Markers in Endometrial Carcinoma: Review of Literature  

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Endometrial cancer is the most common gynecologic malignancy in more developed countries. Most endometrial carcinomas cases are diagnosed at an early stage with a tumor confined to the uterine corpus. Although most patients are cured by surgery alone, about 15% - 20% with no signs of locally advanced or metastatic disease at primary treatment recurs, with limited r...

Cenk Yasa; Ozguc Takmaz; Ozlem Dural; Suleyman Engin Akhan

2013-01-01

129

Ultrasound detection of endometrial fluid in postmenopausal women  

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Full Text Available Introduction. The aim of this prospective study was to estimate whether the presence of endometrial fluid detected by transvaginal ultrasound investigation was a marker for the pathological changes of the endometrium in postmenopausal women. Material and methods. 128 postmenopausal women with uterine bleeding and 29 asymptomatic postmenopausal women underwent transvaginal ultrasound investigation, curettage and histopathological investigation of the curettage specimens. Results. There were significantly more asymptomatic women with endometrial fluid collection was found (41,4% than those with uterine bleeding (7,8% (p<0,001. We found 4 cases of carcinoma of the endometrium, 4 with hyperplasia and 1 with polyp of the endometrium in women with uterine bleeding and endometrial fluid collection. In the asymptomatic group of women we found 1 case with polyp and 1 with carcinoma of the endometrium. In the presence of endometrial fluid collection the least thickness of the endometrium measured by transvaginal ultrasound was 12 mm in postmenopausal women with carcinoma of the endometrium, 7 mm in women with hyperplasia and 5 mm with polyp. No pathological changes were found below the above values. Conclusion. The presence of endometrial fluid detected by transvaginal ultrasonography is a good marker for pathological changes of the endometrium in postmenopausal women if the endometrial thickness is greater than 4 mm. If the endometrial thickness is 4 mm or less, the presence of endometrial fluid is not an indication for further invasive investigation of endometrial cavity, but we must eliminate possible presence of ednexal or cervical malignant disease in some patients.

?ur?i? Aleksandar

2009-01-01

130

Hounsfield number measurement after a uterine fibroid embolization: significance as a predictive factor of embolization success  

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To assess the usefulness of the Hounsfield number, measured by a non-contrast enhanced pelvic CT, after a uterine artery embolization as an index of the successful outcome of a uterine fibroid embolization (UFE). The study subjects included 15 women (age range: 28-49 years, mean age: 36.4 years) diagnosed with symptomatic uterine myomas and seen from March 2003 to August 2005. A non-contrast enhanced pelvic CT scan was performed six hours after a uterine artery embolization. The global and maximal CT numbers were measured for each myoma. In addition, a pelvic MRI was performed to measure the volume of each myoma prior to and 6 months after the UFE. The relationship between fibroid volume reduction and the global CT number were prospectively analysed. The mean global CT number was 91.25 HU in Group I and 40.8 HU in Group II. Further, the mean fibroid volume reduction rate was 73% in Group I and 10% in Group II ({rho} < 0.05). The global CT number measured by a non-contrast enhanced pelvic CT is a useful predictive factor of a successful uterine fibroid embolization.

Yang, Seung Boo; Lee, San Jin; Choi, Gyo Chang [Soonchunhyang University, Gumi Hospital, Gumi (Korea, Republic of)] (and others)

2008-07-15

131

Hounsfield number measurement after a uterine fibroid embolization: significance as a predictive factor of embolization success  

International Nuclear Information System (INIS)

To assess the usefulness of the Hounsfield number, measured by a non-contrast enhanced pelvic CT, after a uterine artery embolization as an index of the successful outcome of a uterine fibroid embolization (UFE). The study subjects included 15 women (age range: 28-49 years, mean age: 36.4 years) diagnosed with symptomatic uterine myomas and seen from March 2003 to August 2005. A non-contrast enhanced pelvic CT scan was performed six hours after a uterine artery embolization. The global and maximal CT numbers were measured for each myoma. In addition, a pelvic MRI was performed to measure the volume of each myoma prior to and 6 months after the UFE. The relationship between fibroid volume reduction and the global CT number were prospectively analysed. The mean global CT number was 91.25 HU in Group I and 40.8 HU in Group II. Further, the mean fibroid volume reduction rate was 73% in Group I and 10% in Group II (? < 0.05). The global CT number measured by a non-contrast enhanced pelvic CT is a useful predictive factor of a successful uterine fibroid embolization

132

Achados histeroscópicos na cavidade endometrial após ablação endometrial / Hysteroscopic appearance of the endometrial cavity after endometrial ablation  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Verificar o aspecto da cavidade uterina após a ablação endometrial histeroscópica, a prevalência de sinéquias após o procedimento e, com isso, avaliar a importância da histeroscopia realizada no pós-operatório dessas pacientes. MÉTODOS: Foram avaliados, retrospectivamente, os laudos [...] dos exames de 153 pacientes que haviam sido submetidas à histeroscopia ambulatorial após ablação do endométrio devido a sangramento uterino anormal de causa benigna, no período entre janeiro de 2006 e julho de 2011. As pacientes foram divididas em dois grupos: HIST?60 (n=90), com pacientes submetidas ao exame no período de 40 a 60 dias após o procedimento, e grupo HIST>60 (n=63), das que foram examinadas entre 61 dias e 12 meses. RESULTADOS: No grupo HIST?60, 30% das pacientes apresentavam algum grau de sinéquia; aderências grau I foram descritas em 4,4%; grau II em 6,7%; grau IIa em 4,4%; grau III em 7,8%; e 2,2% apresentavam grau IV. No HIST>60, sinéquias foram descritas em 53,9% dos casos, 3,2% tinham sinéquias grau I; 11,1%, grau II; 7,9%, grau IIa; 15,9%, grau III; e 4,8%, grau IV. Hematometra foi descrito em 2,2% dos casos do HIST?60 e em 6,3% no HIST>60. CONCLUSÕES: A cavidade uterina de pacientes submetidas à histeroscopia ambulatorial até 60 dias após a ablação endometrial mostrou menor número de sinéquias quando comparada com as cavidades uterinas de pacientes que foram submetidas ao exame após 60 dias. Acompanhamento em longo prazo é necessário para avaliar plenamente o impacto da histeroscopia ambulatorial após a ablação endometrial. Abstract in english PURPOSE: To examine the aspect of the uterine cavity after hysteroscopic endometrial ablation, to determine the prevalence of synechiae after the procedure, and to analyze the importance of hysteroscopy during the postoperative period. METHODS: The results of the hysteroscopic exams of 153 pat [...] ients who underwent outpatient hysteroscopy after endometrial ablation due to abnormal uterine bleeding of benign etiology during the period from January 2006 to July 2011 were retrospectively reviewed. The patients were divided into two groups: HIST?60 (n=90) consisting of patients undergoing the exam 40-60 days after the ablation procedure, and the group HIST>60 (n=63) consisting of patients undergoing the exam between 61 days and 12 months after the procedure. RESULTS: In the HIST?60 group, 30% of the patients presented some degree of synechiae: synechiae grade I in 4.4% of patients, grade II in 6.7% , grade IIa in 4.4%, grade III in 7.8%, and grade IV in 2.2%. In the HIST>60 group, 53.9% of all cases had synechiae, 3.2% were grade I, 11.1% grade II, 7.9% grade IIa, 15.9% grade III, and 4.8% grade IV. Hematometra was detected in 2.2 % of all cases in group HIST?60 and in 6.3% of all cases in group HIST>60. CONCLUSIONS: The uterine cavity of the patients submitted to diagnostic hysteroscopy up to 60 days after endometrial ablation showed significantly fewer synechiae compared to the uterine cavity of patients who underwent the exam after 60 days. Long-term follow-up is necessary to fully evaluate the importance of outpatient hysteroscopy after endometrial ablation regarding menstrual patterns, risk of cancer and prevalence of treatment failure.

Aline Rocha, Guerin; Reginaldo Guedes Coelho, Lopes; Daniella de Batista, Depes; João Alfredo, Martins.

2014-05-20

133

Postpartum Prolapsed Leiomyoma with Uterine Inversion Managed by Vaginal Hysterectomy  

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Background. Uterine inversion is a rare, but life threatening, obstetrical emergency which occurs when the uterine fundus collapses into the endometrial cavity. Various conservative and surgical therapies have been outlined in the literature for the management of uterine inversions. Case. We present a case of a chronic, recurrent uterine inversion, which was diagnosed following spontaneous vaginal delivery and recurred seven weeks later. The uterine inversion was likely due to a leiomyoma. This late-presenting, chronic, recurring uterine inversion was treated with a vaginal hysterectomy. Conclusion. Uterine inversions can occur in both acute and chronic phases. Persistent vaginal bleeding with the appearance of a prolapsing fibroid should prompt further investigation for uterine inversion and may require surgical therapy. A vaginal hysterectomy may be an appropriate management option in select populations and may be considered in women who do not desire to maintain reproductive function. PMID:25379314

Pieh-Holder, Kelly L.; DeVente, James E.

2014-01-01

134

Ossifying luteinized thecoma of the ovary with endometrial adenocarcinoma  

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Full Text Available Luteinized thecomas are one of the sex cord stromal tumors of the ovary rarely undergoing ossification. We report a case of a 66-year-old post-menopausal female with the chief complaint of uterine bleeding of 7 months duration. Endometrial curettage performed showed features of endometrial adenocarcinoma. Follow-up total abdominal hysterectomy revealed bilateral luteinized thecomas of the ovary, one of which had undergone massive ossification converting the ovary into a bone. True bone formation in ovarian tumors is rare. This case is the second in the literature of osseous metaplasia in an ovarian luteinized thecoma, with the association of endometrial adenocarcinoma suggesting its functional status.

Pervatikar S

2009-04-01

135

RESECCION ENDOMETRIAL TRANSCERVICAL: UNA ALTERNATIVA A LA HISTERECTOMIA  

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Full Text Available Siendo la metrorragia una causa frecuente de morbilidad ginecológica, se plantea la resección endometrial como una buena alternativa de tratamiento en casos seleccionados. Se analizan 102 resecciones endometriales realizadas en mujeres que cumplían requisitos definidos de inclusión y exclusión. Los resultados consideran la edad, el tiempo operatorio, las complicaciones, los resultados anatomopatológicos, los controles histeroscópicos y el seguimiento. Se concluye que la resección endometrial tiene éxito en un 87% de los casos, posee pocas complicaciones y las cavidades uterinas permanecen permeables para futuras evaluaciones.Metrorraghia is one of the most common cause of gynecological morbidity. Transcervical endometrial resection is a good alternative treatment for specific cases. 102 endometrial resections are analysed including age, operating time, complications, pathological results, hysteroscopic controls and follow up. We conclud that the transcervical endometrial resection has 87% of good results, has few complications and the uterine cavity stays permeable for future evaluations.

Carmen Luz Alvarado S

2002-01-01

136

Endometrial carcinoma  

International Nuclear Information System (INIS)

From June 1974 to June 1984, 347 women with endometrial carcinoma were referred to the radiotherapy department of the Catharina Hospital, Eindhoven, The Netherlands. Of this total number, 327 patients were considered eligible for analysis; 36 being referred for recurrences of previous surgically treated endometrial carcinoma, and 291 bein referred for radiotherapy as part of the initial treatment. The 28% 5-year relapse-free survival (RFS) of the group of 36 patients demonstrated that endometrial carcinoma may behave as a radiosensitive tumour. The remaining 291 had all undergone surgery, except 10. Radiotherapy consisted of high dose-rate brachytherapy applied to the vaginal vault for pathological stage I tumours, well differentiated, and with superficial myometrial invasion. All other patients received external beam irradiation to a pelvic dose of 40 Gy in 4 weeks, followed by brachytherapy (4 fractions of 5 Gy each). The 5-year RFS for pathologically staged patients was: stage I (232 patients) 88%, stage II (27 patients) 68%, stage III and IV (22 patients) 50%. Treatment-related complications were minimal. In-field recurrences were rare: 5% locoregional, 2.2 both loco-regional and distant, versus 9.3% distant failures. Multivariate RFS analysis demonstrated age, stage and tumour differentiation as independent prognostic factors, tumour differentiation being the most important factor. (author). 16 refs.; 3 figs.; 4 tabs

137

Uterine Fibroids  

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Full Text Available Uterine Fibroids Introduction Fibroids are common, benign tumors of the uterus. They can cause significant pain, as well as ... located above and behind the vagina and uterus. Fibroids Uterine fibroids are benign tumors in the middle ...

138

Pólipos endometriais Endometrial polyps  

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Full Text Available Os pólipos endometriais são lesões benignas, com baixo potencial de malignização. No período reprodutivo seu diagnóstico é obtido nas pacientes sintomáticas, com sangramento uterino anormal ou infertilidade. Na pós-menopausa em sua maioria são assintomáticos, podendo estar associados a sangramento anormal em torno de um terço dos casos. São mais freqüentes na pós-menopausa e os fatores de risco para câncer de endométrio não têm sido associados da mesma maneira, como de risco para pólipos endometriais, embora sejam hormônio-dependentes, como nas pacientes usuárias do tamoxifeno, por exemplo. Seu diagnóstico definitivo é realizado pelo exame histológico com amostra obtida de maneira mais eficiente por biópsia dirigida por meio da histeroscopia, assim como seu tratamento mais efetivo é a ressecção histeroscópica. Pólipos podem apresentar recorrência após tratamento. A polipectomia é altamente satisfatória na pós-menopausa, tem menor taxa de sucesso em mulheres sintomáticas no período reprodutivo e melhora as taxas de fertilidade em mulheres inférteis.Endometrial polyps are benign lesions, with a low potential of malignancy. In the reproductive period their diagnosis is established in symptomatic patients with abnormal uterine bleeding or infertility. Postmenopausal women are mostly asymptomatic but in approximately one third of the cases there is an association with abnormal bleeding. They are more frequent after the menopause and risk factors of cancer of the endometrium have not been associated in the same way as risk for endometrial polyps, although they are hormone-dependent as in patients in use of tamoxifen, for instance. Their definitive diagnosis is established by hysteroscopy-guided biopsy and their most effective treatment is hysteroscopic resection. Polyps may recur after treatment. Polypectomy is highly satisfactory after the menopause, is less successful in symptomatic women in the reproductive period and improves fertility rates in infertile women.

Antonio Alberto Nogueira

2005-05-01

139

Uterine factors.  

Science.gov (United States)

Uterine anomalies are one of the most common parental causes of recurrent pregnancy loss, occurring in about 19% of patients. Congenital uterine anomalies are most likely caused by HOX gene mutations, although the mechanism is probably polygenic. There are no known environmental causes other than estrogenic endocrine disruptors such as diethylstilbestrol. Acquired uterine anomalies may result from uterine trauma (adhesions) or benign growths of the myometrium (fibroids) or endometrium (polyps). Although randomized controlled trials are lacking, surgical treatment is recommended for repair of uterine septa, and for removal of severe adhesions and submucosal fibroids, especially if no other causes are identified. PMID:24491984

Jaslow, Carolyn R

2014-03-01

140

Investigation of amyloid deposition in uterine leiomyoma patients  

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Full Text Available Objects: To investigate the pathogenesis of amyloid presented in uterine leiomyoma. Methods: 36 uterine leiomyoma patients were recruited and divided into two groups according to Congo red staining results. 6 cases are Congo red staining-positive, and 30 cases Congo red staining-negative which represented amyloid positive and amyloid negative respectively. All patients’ serum total protein (TP, albumin (Alb and prealbumin (PA levels were measured as well as blood hemoglobin (Hb, cell counts of white blood cell (WBC, neutrophils (NEU and lymphocyte (LYM. Glycogen in tissue was compared between amyloid accumulated and amyloid negative sections with periodic acid schiff staining (PAS in leiomyoma patients. Results: All of blood Hb concentration, WBC, NEU and LYM have not been found significant differences between two groups. Also no obvious infiltration of inflammatory cells was observed in tissue with amyloid deposition in uterine leiomyoma patients. And levels of TP, Alb and prealbumin have not been found significant differences between two groups. The amyloid was negative in leiomyoma entity cells range by Congo red staining, while small blood vessels in myoma tissues were positively detected with high rate. Amyloid was found in normal tissue around myoma as well as in blood vessel of pseudo-capsule. Increased PAS-positive material induced by leiomyoma was not correlated with amyloid deposition. Conclusions: Metabolic changes in the setting of functional alterations of cell in local microenvironment with uterine leiomyoma, may be related to the amyloid deposition.

Jinping Liu

2012-08-01

 
 
 
 
141

Area detection of uterine peristalsis using cine-MR images  

International Nuclear Information System (INIS)

In this paper, a technique for evaluating uterine peristalsis obtained by magnetic resonance images is proposed. Uterine peristalsis is the wavelike movement of uterine muscle contractions with rhythm and direction. Correlation between direction of uterine peristalsis and menstrual cycle has been reported, which is supposed to help sperm transpotation and implantation. While evaluation of uterine peristalsis has been done, they are very subjective and no quantitative evaluation has been established. In the proposed method the peristalsis area and their contraction intensity were calculated. The points of uterine peristalsis was estimated by the spatio-temporal map, which reflect the time series behavior of the intensities around points set on uterine endometrial boundaries. Then peristalsis area was decided as the estimated points. The contraction intensity was defined as the ratio of the signal intensity change in the peristalsis area. (author)

142

Endometrial aspiration biopsy: a non-invasive method of obtaining functional lymphoid progenitor cells and mature natural killer cells.  

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The aim of this study was to compare the efficacy of endometrial aspiration biopsy (EAB) with the more traditional dilatation and curettage (D&C) for the procurement of lymphoid progenitor cells and uterine natural killer (NK) populations in endometrial tissue. This prospective observational study conducted in a tertiary referral university hospital examined endometrium obtained from 32 women admitted for laparoscopic gynaecological procedures. Each participant had endometrium sampled using both EAB and D&C. Both methods were assessed as a source of uterine NK and lymphoid progenitor cells. Similar proportions of mature CD45+CD56+ NK cells (range 25.4-36.2%) and CD45+CD34+ lymphoid progenitors (range 1.2-2.0%) were found in tissue obtained using both EAB and D&C. These cells were adequate for flow cytometric analysis, magnetic bead separation and culture. Colony formation by the CD34+ population demonstrated maturational potential. Tissues obtained via endometrial biopsy and D&C are equivalent, by analysis of uterine NK and lymphoid progenitor cells. The aim of this study was to compare two methods of endometrial sampling - endometrial aspiration biopsy and traditional dilatation and curettage - for the procurement of haematopoietic stem cells and uterine natural killer (NK) populations in endometrial tissue. Thirty-two women who had gynaecological procedures in a tertiary referral hospital participated in this study and had endometrial tissue collected via both methods. Similar populations of mature NK cells and haematopoietic stem cells were found in tissue obtained using both endometrial aspiration biopsy and dilatation and curettage. Tissue obtained via endometrial aspiration biopsy was adequate for the culture and growth of haematopoietic stem cells. We conclude that tissue obtained via endometrial biopsy and dilatation and curettage is equivalent, by analysis of uterine NK and haematopoietic stem cells using flow cytometry. This has implications for further more extensive study of endometrial haematopoietic stem cell populations, as these samples can be collected in a clinical setting without a requirement for general anaesthesia.

McMenamin, Moya

2012-09-01

143

Endometrial surveillance in tamoxifen users: role, timing and accuracy of hysteroscopic investigation: observational longitudinal cohort study.  

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To determine the role, timing and indications for endometrial hysteroscopic investigation in relation to the clinical, ultrasound and histological features of the endometrium during tamoxifen (TAM) use. We performed an observational longitudinal cohort study (years 2007-2012) that investigated the endometria of 151 TAM users with hysteroscopy and histology. For all patients, gynaecological history, years of adjuvant treatment, ultrasound endometrial thickness measurement and indications for hysteroscopy were recorded. Hysteroscopic findings showed that 100% of patients referred for simple follow-up had no evidence of endometrial disease. We found a strong correlation between previous history of abnormal uterine bleeding (with or without endometrial thickening) and hysteroscopic suspicion of endometrial atypia that was confirmed by histology. Hysteroscopy had 83.3% sensitivity, 99% specificity, 83.3% positive predictive value (PPV) and 99% negative predictive value (NPV) in detecting endometrial atypia. No significant correlation was found between endometrial thickening to >5?mm without bleeding and histological atypia. Similarly, the duration of treatment was not related to endometrial thickening and histological atypia. Endometrial stromal hyperplasia was detected by histology in 70.5% of patients with endometrial thickness measurements ranging from 5 to 10?mm. In contrast, no atypia was detected when endometrial thickness was <5?mm. Ultrasound performed using a 5-mm cut-off threshold for endometrial thickness resulted in 100% sensitivity, 15% specificity, 4% PPV and 100% NPV in detecting endometrial atypia, while a 10-mm cut-off threshold resulted in 84% sensitivity, 69% specificity, 10% PPV and 99% NPV. Low-risk TAM users do not require different endometrial surveillance than the general population. Hysteroscopy could play a fundamental role in determining the endometrial status of patients before the initiation of TAM treatment and in assessing the endometrial status of patients when bleeding occurs. PMID:23629476

Saccardi, Carlo; Gizzo, Salvatore; Patrelli, Tito Silvio; Ancona, Emanuele; Anis, Omar; Di Gangi, Stefania; Vacilotto, Antonio; D'Antona, Donato; Nardelli, Giovanni Battista

2013-08-01

144

Adenovirus Mediated Homozyogous Endometrial Epithelial Pten Deletion Results in Aggressive Endometrial Carcinoma  

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PTEN is the most frequently mutated gene in uterine endometriod carcinoma (UEC) and its precursor complex atypical hyperplasia (CAH). Because the mutation frequency is similar in CAH and UEC, PTEN mutations are thought to occur relatively early in endometrial tumorigenesis. Previous work from our laboratory using the Pten+/? mouse model has demonstrated somatic inactivaton of the wild type allele of Pten in both CAH and UEC. In the present study, we injected adenoviruses expressing Cre into...

Joshi, Ayesha; Ellenson, Lora Hedrick

2011-01-01

145

Uterine fluid from bitches with mating-induced endometritis reduces the attachment of spermatozoa to the uterine epithelium.  

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Persistence of free fluid in the uterine lumen of bitches with endometrial hyperplasia appears to be diagnostic for mating-induced endometritis and is associated with reduced chances of pregnancy. This study investigated the possibility that reduced fertility might be associated with an effect of uterine fluid on sperm. Uterine lavage fluid was collected pre- and post-insemination from normal bitches without ultrasonographically-detectable luminal fluid (n=4), and previously non-pregnant bitches with endometrial hyperplasia and luminal fluid (n=4). Concentrations of polymorphonuclear neutrophils (PMNs) were measured and the effect of the fluid on the attachment of spermatozoa to the uterine epithelium was studied using medium (M) 199 as a control. To elucidate whether any effect was accounted for by the presence of PMNs, attachment was also measured in M199 with PMNs added at the concentration found in lavage fluid. Pre-insemination lavage fluid from both groups contained low concentrations of PMNs which increased post-insemination; the increase was larger for bitches with uterine fluid. Compared with M199 controls, lavage fluid reduced the attachment of spermatozoa; fluid from bitches with endometrial hyperplasia and uterine fluid had a greater effect than normal bitches, and post-insemination fluid had a greater effect than pre-insemination fluid. Spermatozoal attachment was reduced by a similar magnitude for M199 with added PMNs, although post-insemination fluid from bitches with endometrial hyperplasia reduced attachment more than M199 with added PMNs. Poor fertility in bitches with uterine luminal fluid might be partially associated with impaired attachment of spermatozoa to uterine epithelium, mediated principally, but not solely, by PMN influx into the uterine lumen. PMID:23981353

Freeman, S L; Green, M J; England, G C W

2013-10-01

146

Review literature on uterine carcinosarcoma.  

Science.gov (United States)

Carcinosarcoma of the uterus is a rare gynaecological neoplasm, which is also known as malignant mixed mesodermal tumor. Traditionally this tumour has been regarded as a subtype of uterine sarcoma, and its origin remains controversial. The exact nature and prognosis was not clear in the past. It is believed that uterine carcinosarcoma have a Mullerian duct origin and have a capacity to differentiate into various mesenchymal and epithelial components. Regarding the histogensis, various theories have been given; of which 'conversion theory' was broadly accepted. Carcinosarcoma are mostly of monoclonal origin with the carcinomatous component being the driving force. This type of tumor is broadly divided into two groups, homologous and heterologous, depending on the characteristics of the stroma or mesenchymal components of endometrial tissue. It is more frequent in black women and postmenopausal women. Radiation is a possible etiological factor but the exact etiology is not known yet. However, tamoxifen may induce carcinogenesis in some patients. Its clinical feature is very similar to endometrial carcinoma i.e. postmenopausal vaginal bleeding, have a very aggressive behavior and a poor prognosis. This pelvic malignancy is treated by multimodality therapy including surgery, chemotherapy and radiotherapy. Here we are reviewing old concepts about the disease and modern understandings of the origin, classification, pathogenesis and recent advances in the treatment of the uterine carcinosarcoma. PMID:25313723

Singh, Rajendra

2014-01-01

147

Endometrial cancer  

International Nuclear Information System (INIS)

Endometrial cancers are frequent and affect mainly postmenopausal women. They are mostly diagnosed at an early stage with an excellent prognosis. Surgery is the reference for a precise FIGO staging who guide adjuvant treatment. Tumor extension, grade, myometrium invasion and involved lymph nodes will be discriminating in therapeutic strategy. The management of stages I and II has been recently amended by ESMO, who proposed surveillance, brachytherapy, and radiation therapy followed by brachytherapy for respectively low, intermediate and high risk groups. These recommendations are controversial and must be confirmed. Locally advanced stages represent a heterogeneous population in which surgery should be proposed if it is feasible then followed by radiotherapy and/or chemotherapy. Based on an illustrated clinical case, indications, delineation, dosimetry and complications expected with radiotherapy are demonstrated. (authors)

148

Global endometrial ablation in the presence of essure® microinserts.  

Science.gov (United States)

Abnormal uterine bleeding (AUB) affects 30% of women at some time during their reproductive years and is one of the most common reasons a woman sees a gynecologist. Many women are turning to endometrial ablation to manage their AUB. This article reviews the data relating to the available endometrial ablation techniques performed with hysteroscopic sterilization, and focuses on data from patients who had Essure® (Conceptus, San Carlos, CA) coils placed prior to performance of endometrial ablation. Reviewed specifically are data regarding safety and efficacy of these two procedures when combined. Data submitted to the US Food and Drug Administration for the three devices currently approved are reviewed, as well as all published case series. Articles included were selected based on a PubMed search for endometrial ablation (also using the brand names of the different techniques currently available), hysteroscopic sterilization, and Essure. PMID:24358407

Aldape, Diana; Chudnoff, Scott G; Levie, Mark D

2013-01-01

149

Uterine morphology and peristalsis in women with polycystic ovary syndrome  

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Background. Polycystic ovary syndrome (PCOS) is associated with chronic oligo-anovulation and high circulating sex hormone levels. Women with PCOS have an increased risk of developing endometrial cancer. In anovulatory women with PCOS a positive relationship between endometrial thickness and endometrial hyperplasia has been observed. Uterine peristalsis, which has been suggested to be of importance for female fertility, has not previously been studied in PCOS. Purpose. To assess whether women with PCOS have altered endometrial thickness, uterine wall morphology, and peristalsis. Material and Methods. In this prospective case-control study 55 women with PCOS (mean age, 29.5 years {+-} 4.5 SD) and 28 controls (27.6 {+-} 3.2) were examined using magnetic resonance imaging (MRI), assessing thickness of endometrium, junctional zone (JZ), and myometrium, and evaluating the occurrence, frequency (waves/min), strength (amplitude), pattern, and direction of peristalsis. Uterine morphology was also assessed by transvaginal ultrasonography (TVUS). Results. The endometrium was thinner in PCOS with oligo-amenorrhea compared to controls, also after adjustments for age and BMI (adjusted P = 0.043). There was no difference in thickness of the JZ or the myometrium in cases versus controls. Uterine peristalsis was less commonly observed in women with PCOS than in controls (adjusted P = 0.014). Conclusion. There were no differences in myometrial morphology between PCOS and controls, but the endometrium was thinner in PCOS with oligo-amenorrhea. Based on cine MRI, uterine peristalsis was less common in PCOS than in controls.

Leonhardt, Henrik; Hellstroem, Mikael [Department of Radiology, Institute of Clinical Sciences, Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden)], E-mail: henrik.leonhardt@vgregion.se; Gull, Berit; Nilsson, Lars; Janson, Per O. [Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg, Gothenburg (Sweden); Kishimoto, Keiko [Department of Radiology, St Marianna University School of Medicine, Kanagawa (Japan); Kataoka, Masako [Department of Radiology, Kyoto University Hospital, Kyoto (Japan); Stener-Victorin, Elisabet [Institute of Neuroscience and Physiology, Department of Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg (Sweden)

2012-12-15

150

Potential role of endometrial stem/progenitor cells in the pathogenesis of early-onset endometriosis.  

Science.gov (United States)

The pathogenesis of early-onset endometriosis has recently been revisited, sparked by the discovery of endometrial stem/progenitor cells and their possible role in endometriosis, and because maternal pregnancy hormone withdrawal following delivery induces uterine bleeding in the neonate. The neonatal uterus has a large cervix to corpus ratio which is functionally blocked with mucous, supporting the concept of retrograde shedding of neonatal endometrium. Only 5% show overt bleeding. Furthermore, the presence of endometriosis in pre-menarcheal girls and even in severe stage in adolescents supports the theory that early-onset endometriosis may originate from retrograde uterine bleeding soon after birth. Endometrial stem/progenitor cells have been identified in menstrual blood suggesting that they may also be shed during neonatal uterine bleeding. Thus, we hypothesized that stem/progenitor cells present in shedding endometrium may have a role in the pathogenesis of early-onset endometriosis through retrograde neonatal uterine bleeding. During the neonatal and pre-pubertal period, shed endometrial stem/progenitor cells are postulated to survive in the pelvic cavity in the absence of circulating estrogens supported by niche cells also shed during neonatal uterine bleeding. According to this hypothesis, during thelarche, under the influence of rising estrogen levels, endometrial stem/progenitor cells proliferate and establish ectopic endometrial lesions characteristic of endometriosis. This New Research Horizon review builds on recent discussions on the pathogenesis of early-onset endometriosis and raises new avenues for research into this costly condition. PMID:24674992

Gargett, C E; Schwab, K E; Brosens, J J; Puttemans, P; Benagiano, G; Brosens, I

2014-07-01

151

Saline infusion sonohysterography versus hysteroscopy for uterine cavity evaluation  

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Background and Objectives: The most frequent procedures performed on women with abnormal uterine bleeding are 2D and 3D ultrasound. The most common accepted approach for the management of abnormal uterine bleeding is 2D TV scan followed by therapeutic hysteroscopy. The purpose of this prospective study was to assess whether 3D saline infusion sonohysterography (3D SIS) could replace diagnostic hysteroscopy (DH) for the diagnosis of endometrial pathology, in patients with abnormal uteri...

Khan Faryal; Jamaat Sadia; Al-Jaroudi Dania

2011-01-01

152

Loss of Lkb1 provokes highly invasive endometrial adenocarcinomas.  

Science.gov (United States)

Mutations in the LKB1 tumor suppressor gene result in the Peutz-Jeghers syndrome, an autosomal dominant condition characterized by hamartomatous polyps of the gastrointestinal tract and a dramatically increased risk of epithelial malignancies at other sites, including the female reproductive tract. Here we show that female mice heterozygous for a null Lkb1 allele spontaneously develop highly invasive endometrial adenocarcinomas. To prove that these lesions were indeed due to Lkb1 inactivation, we introduced an adenoviral Cre vector into the uterine lumen of mice harboring a conditional allele of Lkb1. This endometrial-specific deletion of the Lkb1 gene provoked highly invasive and sometimes metastatic endometrial adenocarcinomas closely resembling those observed in Lkb1 heterozygotes. Tumors were extremely well differentiated and histopathologically distinctive and exhibited alterations in AMP-dependent kinase signaling. Although Lkb1 has been implicated in the establishment of cell polarity, and loss of polarity defines most endometrial cancers, Lkb1-driven endometrial cancers paradoxically exhibit (given their highly invasive phenotype) normal cell polarity and apical differentiation. In human endometrial cancers, Lkb1 expression was inversely correlated with tumor grade and stage, arguing that Lkb1 inactivation or down-regulation also contributes to endometrial cancer progression in women. This study shows that Lkb1 plays an important role in the malignant transformation of endometrium and that Lkb1 loss promotes a highly invasive phenotype. PMID:18245476

Contreras, Cristina M; Gurumurthy, Sushma; Haynie, J Marshall; Shirley, Lane J; Akbay, Esra A; Wingo, Shana N; Schorge, John O; Broaddus, Russell R; Wong, Kwok-Kin; Bardeesy, Nabeel; Castrillon, Diego H

2008-02-01

153

Uterine Cancer  

Science.gov (United States)

... sheet about uterine cancer is part of the Centers for Disease Control and Prevention’s (CDC) Inside Knowledge: Get the Facts About Gynecologic ... more information about uterine and other gynecologic cancers? Centers for Disease Control and Prevention: 1-800-CDC-INFO or www.cdc.gov/ ...

154

Abnormal uterine bleeding: a clinicohistopathological analysis  

Directory of Open Access Journals (Sweden)

Methods: In our prospective study of 359 Patients of the age between 46 and 73 years, clinical characteristics and the pattern of endometrial histopathology and their association in women, who present with abnormal uterine bleeding, are categorised into six groups. Results: In our study, a significant correlation of histopathology and BMI was observed with endometrial hyperplasia and malignancy in obese patient i.e. 37 out 96 and 13 out of 23 respectively. The incidence of malignancy has been increasing with the age being 1.6% in 46-50 years to 60% in 70-75 years. In our study 116 (32.3% had hypertension, 33 patients (9.2% had diabetes mellitus, 40 patients (11.1% had hypothyroidism. Conclusions: We found a maximum incidence of AUB in multiparous women. Clinicohistopathological analysis of AUB revealed endometrial hyperplasia in majority of patients. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 656-661

Anupamasuresh Y

2014-06-01

155

Ultrastaging of lymph node in uterine cancers  

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Full Text Available Abstract Background Lymph node status is an important prognostic factor and a criterion for adjuvant therapy in uterine cancers. While detection of micrometastases by ultrastaging techniques is correlated to prognosis in several other cancers, this remains a matter of debate for uterine cancers. The objective of this review on sentinel nodes (SN in uterine cancers was to determine the contribution of ultrastaging to detect micrometastases. Methods Review of the English literature on SN procedure in cervical and endometrial cancers and histological techniques including hematoxylin and eosin (H&E staining, serial sectioning, immunohistochemistry (IHC and molecular techniques to detect micrometastases. Results In both cervical and endometrial cancers, H&E and IHC appeared insufficient to detect micrometastases. In cervical cancer, using H&E, serial sectioning and IHC, the rate of macrometastases varied between 7.1% and 36.3% with a mean value of 25.8%. The percentage of women with micrometastases ranged from 0% and 47.4% with a mean value of 28.3%. In endometrial cancer, the rate of macrometastases varied from 0% to 22%. Using H&E, serial sectioning and IHC, the rate of micrometastases varied from 0% to 15% with a mean value of 5.8%. In both cervical and endometrial cancers, data on the contribution of molecular techniques to detect micrometastases are insufficient to clarify their role in SN ultrastaging. Conclusion In uterine cancers, H&E, serial sectioning and IHC appears the best histological combined technique to detect micrometastases. Although accumulating data have proved the relation between the risk of recurrence and the presence of micrometastases, their clinical implications on indications for adjuvant therapy has to be clarified.

Uzan Serge

2010-01-01

156

Application of saline infusion sonography in the diagnosis of endometrial polyps  

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Full Text Available Endometrial polyps represent benign focused growths of endometrium with the prevalnece of 5-10 in 100 patients older than 30 years of age. The most frequent symptom is irregular uterine bleeding. Saline Infusion Sonography (SIS is the least invasive and the simplest method for detection of an abnormality of the uterine cavity. In this paper we have presented a case of a65- year old patient with endometrial polypus, irregular uterine bleeding referred to hyperplasia endometria as a working diagnosis. Using the Saline Infusion Sonography check-up the diagnosis of endometrial polypus was established including its localization, diameter and other diagnostic parameters. The results of this study have shown that the Saline Infusion Sonography provides more information about the state of uterocervical cavity as compared to the standard transvaginal sonography.

K. Drljevi?

2006-08-01

157

Evaluation and management of abnormal uterine bleeding in premenopausal women.  

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Up to 14 percent of women experience irregular or excessively heavy menstrual bleeding. This abnormal uterine bleeding generally can be divided into anovulatory and ovulatory patterns. Chronic anovulation can lead to irregular bleeding, prolonged unopposed estrogen stimulation of the endometrium, and increased risk of endometrial cancer. Causes include polycystic ovary syndrome, uncontrolled diabetes mellitus, thyroid dysfunction, hyperprolactinemia, and use of antipsychotics or antiepileptics. Women 35 years or older with recurrent anovulation, women younger than 35 years with risk factors for endometrial cancer, and women with excessive bleeding unresponsive to medical therapy should undergo endometrial biopsy. Treatment with combination oral contraceptives or progestins may regulate menstrual cycles. Histologic findings of hyperplasia without atypia may be treated with cyclic or continuous progestin. Women who have hyperplasia with atypia or adenocarcinoma should be referred to a gynecologist or gynecologic oncologist, respectively. Ovulatory abnormal uterine bleeding, or menorrhagia, may be caused by thyroid dysfunction, coagulation defects (most commonly von Willebrand disease), endometrial polyps, and submucosal fibroids. Transvaginal ultrasonography or saline infusion sonohysterography may be used to evaluate menorrhagia. The levonorgestrel-releasing intrauterine system is an effective treatment for menorrhagia. Oral progesterone for 21 days per month and nonsteroidal anti-inflammatory drugs are also effective. Tranexamic acid is approved by the U.S. Food and Drug Administration for the treatment of ovulatory bleeding, but is expensive. When clear structural causes are identified or medical management is ineffective, polypectomy, fibroidectomy, uterine artery embolization, and endometrial ablation may be considered. Hysterectomy is the most definitive treatment. PMID:22230306

Sweet, Mary Gayle; Schmidt-Dalton, Tarin A; Weiss, Patrice M; Madsen, Keith P

2012-01-01

158

Comparison of efficacy of oral drotaverine plus mefenamic acid with paracervical block and with intravenous sedation for pain relief during hysteroscopy and endometrial biopsy  

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Background : Office hysteroscopy with endometrial biopsy is usually the first investigation for abnormal uterine bleeding and other uterine diseases. Aims: To evaluate the effect of oral drotaverine with mefenamic acid on pain perception during hysteroscopy and endometrial biopsy and to compare it with that of paracervical block using 1% lignocaine and with that of intravenous sedation using diazepam with pentazocine. Settings and Design : Outpatient gynecological...

Sharma J; Aruna J; Kumar Praveen; Roy Kallol; Malhotra Neena; Kumar Sunesh

2009-01-01

159

Uterine Fibroids  

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Full Text Available ... and do not require treatment other than regular observation by a doctor. For women who experience occasional ... surgery. It is an alternative to leiomyomectomy, hysterectomy, watchful waiting, hormone therapy, or uterine fibroid embolization. FUA uses ...

160

Uterine Fibroids  

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Full Text Available ... well as abnormal bleeding. About 30% of all women may have fibroids. Most of them do not ... may be discovered during a routine examination. Some women who have uterine fibroids may experience symptoms, such ...

 
 
 
 
161

Uterine Fibroids  

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Full Text Available ... periods • A feeling of fullness in the lower abdomen Other symptoms of uterine fibroids include: • Frequent urination ... the uterus through a small incision in the abdomen to destroy the blood vessels feeding the fibroids. ...

162

Uterine Fibroids  

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Full Text Available ... Uterine fibroids are made of nodules of smooth muscle cells and fibrous tissue that develop in the ... may experience symptoms, such as: • Excessive or painful bleeding during menstruation • Bleeding between periods • A feeling of ...

163

Uterine Fibroids  

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Full Text Available ... intend to become pregnant. FUA is a non-invasive surgery. It is an alternative to leiomyomectomy, hysterectomy, watchful waiting, hormone therapy, or uterine fibroid embolization. ...

164

Uterine Fibroids  

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Full Text Available ... Myolysis • Uterine Fibroid Embolization or UFE • Focused Ultrasound Ablation Myolysis Myolysis is a procedure in which an ... Last reviewed: 09/20/2013 5 Focused Ultrasound Ablation or FUA Focused Ultrasound Ablation uses focused ultrasounds ...

165

Uterine Fibroids  

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Uterine fibroids are the most common benign tumors in women of childbearing age. Fibroids are made of muscle cells and other tissues ... of the uterus, or womb. The cause of fibroids is unknown. Risk factors include being African American ...

166

Uterine Fibroids  

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Full Text Available ... focused ultrasounds that are guided by magnetic resonance images to target and destroy uterine fibroids. The procedure is intended to treat women who have completed child bearing or do not ...

167

Uterine Fibroids  

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Full Text Available ... uses focused ultrasounds that are guided by magnetic resonance images to target and destroy uterine fibroids. The ... a device that combines two systems – a magnetic resonance imaging (MRI) machine to visualize patient anatomy, map ...

168

Uterine Fibroids  

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Full Text Available ... cells and fibrous tissue that develop in the wall of the uterus. Fibroids may grow as a ... in diameter. Uterine fibroids may grow in the wall of the uterus, or they may project into ...

169

Uterine Fibroids  

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Full Text Available ... Ablation uses focused ultrasounds that are guided by magnetic resonance images to target and destroy uterine fibroids. ... uses a device that combines two systems – a magnetic resonance imaging (MRI) machine to visualize patient anatomy, ...

170

Uterine contractions evaluated on cine MR imaging in patients with uterine leiomyomas  

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Purpose: Submucosal leiomyoma is one of the most recognized causes of infertility and habitual abortion. The purpose of this study is to evaluate uterine peristalsis, a cycle-related inherent contractility of uterus probably responsible for sperm transport and conservation of pregnancy, in patients with uterine leiomyomas using cine magnetic resonance (MR) imaging. Materials and methods: Study population consisted of 26 female patients (age range: 19-51 years, mean: 41 years), in which 16 patients had submucosal leiomyomas and 10 patients had intramural or subserosal leiomyomas. We prospectively performed MR imaging of the midsagittal plane of uterus using 1.5 T magnet (Symphony, Siemens Medical Systems) with a body array coil, and obtained 60 half-Fourier acquisition single shot turbo spin echo (HASTE) images (Echo time=80 ms, FOV=300 mm, slice thickness 5 mm, matrix 256x256) within 2 min, and displayed them on cine mode at 12x faster than real speed. Evaluated were peristaltic movements at the endometral-myometrial junction and focal myometrial movements, adjacent to leiomyomas, regarding presence, direction, frequency, and conduction. Results: The peristaltic movements were identified in 12/16 patients with submucosal lesions and 10/10 with other leiomyomas. The frequency and direction were cycle-related. Loss of peristalsis was noted adjacent to submucosal myomas in 4/12 patients, but was not in others. Focal myometrial movements were noted in 9/16 patients with submucosal myomas, but not in others. Conclusions: Uterine peristaltic movements were partly interrupted by submucosal leiomoymas, but not by myometrial or subserosal leiomyomas. Loss of peristalsis and focal myometrial movements was noted only adjacent to submucosal leiomyomas. These findings are considered to represent dysfunctional contractility, and may be related with pregnancy loss.

Nishino, Mizuki E-mail: mizuki@mbox.kyoto-inet.or.jpnishinomizuki@hotmail.com; Togashi, Kaori; Nakai, Asako; Hayakawa, Katsumi; Kanao, Shotarou; Iwasaku, Kazuhiro; Fujii, Shingo

2005-01-01

171

Uterine contractions evaluated on cine MR imaging in patients with uterine leiomyomas  

International Nuclear Information System (INIS)

Purpose: Submucosal leiomyoma is one of the most recognized causes of infertility and habitual abortion. The purpose of this study is to evaluate uterine peristalsis, a cycle-related inherent contractility of uterus probably responsible for sperm transport and conservation of pregnancy, in patients with uterine leiomyomas using cine magnetic resonance (MR) imaging. Materials and methods: Study population consisted of 26 female patients (age range: 19-51 years, mean: 41 years), in which 16 patients had submucosal leiomyomas and 10 patients had intramural or subserosal leiomyomas. We prospectively performed MR imaging of the midsagittal plane of uterus using 1.5 T magnet (Symphony, Siemens Medical Systems) with a body array coil, and obtained 60 half-Fourier acquisition single shot turbo spin echo (HASTE) images (Echo time=80 ms, FOV=300 mm, slice thickness 5 mm, matrix 256x256) within 2 min, and displayed them on cine mode at 12x faster than real speed. Evaluated were peristaltic movements at the endometral-myometrial junction and focal myometrial movements, adjacent to leiomyomas, regarding presence, direction, frequency, and conduction. Results: The peristaltic movements were identified in 12/16 patients with submucosal lesions and 10/10 with other leiomyomas. The frequency and direction were cycle-related. Loss of peristalsis was noted adjacent to submucosal myomas in 4/12 patients, but was not in others. Focal myometrial movements were noted in 9/16 patients with submucosal myomas, but not in others. Conclusions: Uterine peristaltic movements were partly interrupted by submucosal leiomoymas, but not by myometrial or subserosal leiomyomas. Loss of peristalsis and focal myometrial movements was noted only adjacent to submucosal leiomyomas. These findings are considered to represent dysfunctional contractility, and may be related with pregnancy loss

172

Role of Local Anesthetics on Pain Relief in Endometrial Biopsy: Randomized Clinical Trial  

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Full Text Available Objectives: Endometrial biopsy is necessary for diagnosing the reason of abnormal uterine bleeding in perimenopausal women. Currently outpatient endometrial biopsy is used for evaluation of abnormal uterine bleeding which is associated with moderate to severe pain. Using lidocaine is one of the procedures which is used for pain relief while biopsy. This study is aimed at comparing the effect of different local anesthesia procedures on pain relief during endometrial biopsy. Materials and Methods: In this randomized clinical trial, 160 multiparous 40-55 years old women with AUB (Abnormal Uterine Bleeding, candidates for endometrial biopsy, were randomly assigned into four equal groups, to receive: 1-intrauterine lidocaine; 2-cervical spray lidocaine; 3- intrauterine lidocaine plus cervical spray lidocaine; or 4-intrauterine distilled water. Pain relief was measured at 3 different times: during endometrial biopsy, just after and 15 minutes after biopsy. Results: Pain intensity was reduced significantly at different times in intrauterine lidocaine and intrauterine lidocaine with cervical spray lidocaine receivers in compare with the groups which received cervical spray lidocaine and distilled water. The mean of difference pain relief during biopsy and 15 minutes after that was reduced significantly in the group which received intrauterine lidocaine and intrauterine lidocaine with cervical spray lidocaine in comparison with the other two groups. Conclusion: Intrauterine lidocaine was effective during endometrial biopsy, and using it with cervical spray lidocaine had no more beneficial effect.

Elaheh Ouladsahebmadarek

2014-01-01

173

Prevalence and effect of uterine luminal free fluid on pregnancy and litter size in bitches.  

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Free fluid within the uterine lumen has been identified ultrasonographically as a transient finding in normal bitches in the period immediately after mating, and delayed clearance of the fluid has been documented in bitches with endometrial hyperplasia. This study used B-mode ultrasonography to investigate the prevalence of free fluid in the uterine lumen in normal bitches (n = 53) and bitches with endometrial hyperplasia (n = 10) on Days -7, 0, +5, and +14 in relation to estimated ovulation. For normal bitches without endometrial hyperplasia, 47 (86.6%) bitches become pregnant, whereas for bitches with endometrial hyperplasia, 3 (30%) become pregnant. In both the groups, the presence of uterine fluid on Days -7 and 0 was not associated with the probability of a bitch becoming pregnant, whereas the presence of uterine fluid on either Day +5 or +14 was significantly associated with a reduced likelihood of pregnancy. In pregnant bitches, uterine luminal fluid present on Day 0 was associated with a smaller litter size. This is the first study to establish the prevalence and effect of uterine luminal free fluid in bitches. We postulate that as the uterine luminal free fluid may be detected in normal bitches before mating and has no effect on the pregnancy rate or litter size in either group, this fluid is "physiological." However, it seems that the later in estrus the uterine fluid is present, the more likely it is to have an adverse effect on fertility. In some cases, this is manifest as a reduced litter size, while, importantly, the presence of fluid 5 to 14 days after ovulation is strongly associated with an absence of pregnancy, both in bitches with and without endometrial hyperplasia. We propose that ultrasonographic detection of uterine luminal free fluid after mating may be a useful prognostic indicator for pregnancy outcome, which may allow the targeting of treatments specifically to a population of animals that presumably develop mating-induced endometritis. PMID:23622942

Freeman, S L; Green, M J; England, G C W

2013-07-15

174

Persistence of endometrial activity after radiation therapy for cervical carcinoma  

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Radiation therapy is a proved treatment for cervical carcinoma; however, it destroys ovarian function and has been thought to ablate the endometrium. Estrogen replacement therapy is often prescribed for patients with cervical carcinoma after radiation therapy. A review of records of six teaching hospitals revealed 16 patients who had endometrial sampling for uterine bleeding after standard radiation therapy for cervical carcinoma. Fifteen patients underwent dilatation and curettage, and one patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy when a dilatation and curettage was unsuccessful. Six patients had fibrosis and inflammation of the endometrial cavity, seven had proliferative endometrium, one had cystic hyperplasia, one had atypical adenomatous hyperplasia, and one had adenocarcinoma. Although the number of patients who have an active endometrium after radiation therapy for cervical carcinoma is not known, this report demonstrates that proliferative endometrium may persist, and these patients may develop endometrial hyperplasia or adenocarcinoma. Studies have indicated that patients with normal endometrial glands have an increased risk of developing endometrial adenocarcinoma if they are treated with unopposed estrogen. Patients who have had radiation therapy for cervical carcinoma should be treated with estrogen and a progestational agent to avoid endometrial stimulation from unopposed estrogen therapy

175

Persistence of endometrial activity after radiation therapy for cervical carcinoma  

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Radiation therapy is a proved treatment for cervical carcinoma; however, it destroys ovarian function and has been thought to ablate the endometrium. Estrogen replacement therapy is often prescribed for patients with cervical carcinoma after radiation therapy. A review of records of six teaching hospitals revealed 16 patients who had endometrial sampling for uterine bleeding after standard radiation therapy for cervical carcinoma. Fifteen patients underwent dilatation and curettage, and one patient underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy when a dilatation and curettage was unsuccessful. Six patients had fibrosis and inflammation of the endometrial cavity, seven had proliferative endometrium, one had cystic hyperplasia, one had atypical adenomatous hyperplasia, and one had adenocarcinoma. Although the number of patients who have an active endometrium after radiation therapy for cervical carcinoma is not known, this report demonstrates that proliferative endometrium may persist, and these patients may develop endometrial hyperplasia or adenocarcinoma. Studies have indicated that patients with normal endometrial glands have an increased risk of developing endometrial adenocarcinoma if they are treated with unopposed estrogen. Patients who have had radiation therapy for cervical carcinoma should be treated with estrogen and a progestational agent to avoid endometrial stimulation from unopposed estrogen therapy.

Barnhill, D.; Heller, P.; Dames, J.; Hoskins, W.; Gallup, D.; Park, R.

1985-12-01

176

A case of malignant low grade endometrial stromal sarcoma and review of the literature  

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Full Text Available Low grade endometrial stromal sarcoma is a rare pelvic malignancy that arises from the endometrium. This article describes the morphological features of one such tumour discovered as finding in a hysterectomy specimen of a 32 year lady with a clinical diagnosis of dysfunctional uterine bleeding with multiple fibroids. Morphological and immunohistochemical evaluations were performed and a final diagnosis of low grade endometrial stromal sarcoma was given. This report is aimed to present a case of endometrial stromal tumor because of its rare existence and difficulties in establishing histological diagnosis.

Amrish N Pandya, Arpita Nishal, Hemali Tailor

2011-01-01

177

The Value of Tumor Markers in Endometrial Carcinoma: Review of Literature  

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Full Text Available Endometrial cancer is the most common gynecologic malignancy in more developed countries. Most endometrial carcinomas cases are diagnosed at an early stage with a tumor confined to the uterine corpus. Although most patients are cured by surgery alone, about 15% - 20% with no signs of locally advanced or metastatic disease at primary treatment recurs, with limited responsiveness to systemic therapy. Although it has a comparatively low mortality rate compared with other gynaecological cancers, it is capable of aggressive behaviour. Diagnosis at an early stage is the most important determinant of survival. Discovery of new diagnostic biomarkers/panels for early diagnosis of endometrial cancer is one of the main challenges of modern medicine. For endometrial cancers, there are no established serum markers. We will review the present knowledge regarding tumor markers, assessing how such markers could be applied to address in screening, diagnosis and monitoring of endometrial carcinoma.

Cenk Yasa

2013-06-01

178

Recidual carcinoma after intracavitary irradiation of endometrial carcinoma, stage I  

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Surgical specimens from 87 patients with endometrial carcinoma, stage I, preoperatively treated by intracavitary irradiation were investigated by a whole-organ sectioning technique. Re-examination of the curettage material showed cancer stage 0 in 8 (9 percent) and carcinoma stage I in 79 cases (91 percent). In the stage I cases 57 percent showed residual carcinoma localized mainly to the myometrium of the uterine body and cornuae. Histological changes in the carcinoma were unevenly distributed, but tumors growing close to the external uterine surface were well preserved. In 40.5 percent, no carcinoma was present, and in 2.5 percent the changes found could not be classified. Correlated to disparity in irradiation technique, no significant difference could be demonstrated in the incidence or localization of residual carcinoma. The findings indicate that it is unlikely that endometrial carcinoma stage I with myometrial invasion will be eradicated by intracavitary irradiation. (Authors)

179

Redução Endometrial por Vídeo-Histeroscopia: experiência em um Hospital de Ensino Endometrial Resection by Video-Hysteroscopy: experience in a Teaching Hospital  

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Full Text Available Objetivo: demonstrar a efetividade da redução endometrial vídeo-histeroscópica no tratamento do sangramento uterino anormal. Métodos: foram analisados os prontuários de 60 pacientes com sangramento uterino anormal não-controlado clinicamente. Resultados: oitenta e oito por cento das pacientes tiveram resposta adequada ao tratamento (53,3% oligomenorréia e 35% amenorréia. Foi encontrado um índice de 8,3% de complicações (5 perfurações uterinas. Conclusão: a redução endometrial vídeo-histeroscópica é uma técnica eficaz no tratamento do sangramento uterino anormal não-controlado clinicamente, com baixos índices de complicações intra e pós-operatórias.Objective: to demonstrate the effectiveness of video-hysteroscopic endometrial resection in the treatment of abnormal uterine bleeding. Patients and method: The authors studied 60 records of patients with abnormal uterine bleeding who did not respond to clinical treatment. Results: eighty-eight percent of the patients had adequate response to the treatment (53% oligomenorrhea and 35% amenorrhea. The complication rate was 8.3% (5 uterine perforations. Conclusion: video-hysteroscopic endometrial resection is an effective technique to treat abnormal uterine bleeding which failed to respond to clinical management. The intra and postoperative complication rates are low.

Caio Parente Barbosa

1998-08-01

180

Tumor misto de células musculares lisas e do estroma endometrial uterino: relato de caso / Mixed endometrial stromal and smooth muscle tumor of the uterus: case report  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Os tumores mistos de células musculares lisas e do estroma endometrial uterino, caracterizados pela presença de componentes de ambas as linhagens, coexistindo em proporções quase equivalentes, são neoplasmas raros. Possuem potencial biológico incerto e se comportam de acordo com o componente estroma [...] l. A imuno-histoquímica é uma grande aliada no diagnóstico microscópico, pois a clínica e os exames de imagem não ajudam a diferenciá-los de outras doenças uterinas. Descrevemos o caso de uma paciente cuja hipótese diagnóstica era de leiomioma uterino e que, após cirurgia, foi diagnosticada pelo estudo anatomopatológico como tumor misto de células musculares lisas e do estroma endometrial uterino. Abstract in english Mixed tumors of uterine smooth muscle and endometrial stromal cells, which are characterized by the presence of components from both cell lineages with similar proportions, are rare neoplasms. Their biological potential is uncertain, and they behave according to the stromal component. Immunohistoche [...] mistry is an important ally in microscopic diagnosis, because symptoms and imaging exams do not help in the differentiation from other uterine diseases. We describe a case of a patient who had been previously diagnosed with uterine leiomyoma, and after surgery, the anatomopathological study revealed a mixed tumor of uterine smooth muscle and endometrial stromal cells.

Luiz Gustavo Oliveira, Brito; Heitor Leandro Paiva, Rodrigues; Francisco José Candido dos, Reis; Francesca Maia, Faria; Maurício Mesquita Sabino de, Freitas.

2012-12-01

 
 
 
 
181

Effectiveness of Hysteroscopic Repair of Uterine Lesions in Reproductive Outcome  

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Full Text Available Background: Small intrauterine lesions such as septum, adhesion, polyp, and submucous myoma may be of greater significance in causing implantation failure, poor reproductive performance and abnormal uterine bleeding. We studied effectiveness of therapeutic intervention through operative hysteroscopy in improvement of pregnancy outcome and cessation of abnormal uterine bleeding (AUB in women with pregnancy and fertility problems. Materials and Methods: This prospective cohort study was performed between 2003- 2009 on 65 patients with primary or secondary infertility, recurrent abortion and structural uterine lesions reported in sonography or hysterosalpingography. After hysteroscopic metroplasty, myomectomy, adhesiolysis and polypectomy under laparoscopic guide, we evaluated reproductive outcome, early and late complications, one year after surgery. Results: Among all patients with recurrent abortion, 6 patients (75% complete their pregnancy successfully. Our results showed that pregnancy rate after metroplasty was 58%. Reproductive outcome was poor after myomectomy and adhesiolysis. Abnormal uterine bleeding was improved in 62% of patients. Conclusion: Structural uterine lesions has been assumed to cause infertility, while several studies have shown very poor reproductive performance with high miscarriage and low term delivery rates when malformation is not treated. We show improvement in conceptional outcome and in patient’s chief complaints after hysteroscopy surgery of these anomalies.

Atta Allah Ghahiry

2014-07-01

182

Uterine arterial embolization for hysteromyomas: report of 45 cases  

International Nuclear Information System (INIS)

Objective: To assess the effectiveness of uterine arterial embolization for the treatment of hysteromyomas and to discuss the factors related to the clinical results. Methods: Super-selective uterine arterial embolization was performed in forty-five patients with hysteromyomas. Of 45 patients, multiple hysteromyomas were seen in 36 and solitary lesion in 9. The lesion was located at the myometrium in 41 cases, among them coexisted endometrioma was found in 5 cases and coexisted submucosal myoma in 2. The lesion was located submucous layer in the remaining 4 cases. The diagnosis was confirmed by imaging study and gynecological examination. After the operation, ultrasonography and laboratory tests were carried out in all patients to observe the tumor size, hormone levels and hemoglobin concentration. Results: A total of 91 uterine arteries were found in 45 patients, including double left uterine arteries in one case. Successful catheterization was obtained in 87 arteries (95.6%). All forty-five patients were followed up for 6-36 months. Six months after the procedure the mean reduction of the tumor size was 69.3%, and the lesion completely disappeared in two cases. In the anemic patients the hemoglobin concentration returned to normal level. The main side-effects included low fever and pain at lower abdomen. Conclusion: Uterine arterial embolization is a safe and effective treatment for hysteromyomas. (authors)

183

Effectiveness of Hysteroscopic Repair of Uterine Lesions in Reproductive Outcome  

Science.gov (United States)

Background Small intrauterine lesions such as septum, adhesion, polyp, and submucous myoma may be of greater significance in causing implantation failure, poor reproductive performance and abnormal uterine bleeding. We studied effectiveness of therapeutic intervention through operative hysteroscopy in improvement of pregnancy outcome and cessation of abnormal uterine bleeding (AUB) in women with pregnancy and fertility problems. Materials and Methods This prospective cohort study was performed between 2003- 2009 on 65 patients with primary or secondary infertility, recurrent abortion and structural uterine lesions reported in sonography or hysterosalpingography. After hysteroscopic metroplasty, myomectomy, adhesiolysis and polypectomy under laparoscopic guide, we evaluated reproductive outcome, early and late complications, one year after surgery. Results Among all patients with recurrent abortion, 6 patients (75%) complete their pregnancy successfully. Our results showed that pregnancy rate after metroplasty was 58%. Reproductive outcome was poor after myomectomy and adhesiolysis. Abnormal uterine bleeding was improved in 62% of patients. Conclusion Structural uterine lesions has been assumed to cause infertility, while several studies have shown very poor reproductive performance with high miscarriage and low term delivery rates when malformation is not treated. We show improvement in conceptional outcome and in patient’s chief complaints after hysteroscopy surgery of these anomalies. PMID:25083176

Ghahiry, Atta Allah; Refaei Aliabadi, Elahe; Taherian, Ali Akbar; Najafian, Aida; Ghasemi, Mojdeh

2014-01-01

184

HIPERPLASIA ENDOMETRIAL: ANÁLISIS DE SERIE DE CASOS DIAGNOSTICADOS EN BIOPSIA ENDOMETRIAL  

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Full Text Available Antecedentes: La hiperplasia endometrial es una entidad en la que existe una proliferación de glándulas endometriales de tamaño y forma irregular, con mayor proporción de glándulas sobre el estroma, a consecuencia de una excesiva exposición a los estrógenos. Aproximadamente, en el 15% de legrados/biopsias endometriales de mujeres postmenopausicas con cuadro clínico de hemorragia uterina anormal, se diagnostica esta entidad. Objetivo: Describir la incidencia y hallazgos histopatológicos en legrado/biopsia endometrial en pacientes de un hospital público de tercer nivel. Métodos: Se revisaron 22.048 procedimientos realizados en el Hospital Universitario de Santander, procesados en el Departamento de Patología de la Universidad Industrial de Santander, en el periodo comprendido entre 1 de enero de 2005 y 31 de diciembre 2008, de los cuales 1.750 correspondieron a legrados/biopsias de endometrio y en 168 de estos se realizó el diagnóstico histopatológico de hiperplasia endometrial. Resultados: Se encontró que el promedio de edad de presentación de está entidad fue de 44,8 años y que el mayor porcentaje de pacientes (68,5% estuvieron en el grupo de la hiperplasia simple sin atipia. En el 19,7% de los casos hubo evidencia de atipia. Conclusiones: El promedio de edad encontrado y los porcentajes por subgrupos de hiperplasia estuvieron en relación a otros estudios. Se destaca una menor proporción de casos con atipia.Background: Endometrial hyperplasia is an entity in which there is a proliferation of endometrial glands of irregular size and shape, with the highest proportion of glands on the stroma, resulting from excessive exposure to estrogen. Approximately 15% of curettages/endometrial biopsies of postmenopausal women with clinical symptoms of abnormal uterine bleeding is diagnosed this entity. Objective: To describe the incidence and pathological findings in curettage/endometrial biopsy in patients of a tertiary public hospital. Methods: A retrospective review of 22,048 surgical procedures performed in the University Hospital of Santander, processed in the Pathology Department of Industrial University of Santander in the period from 1 January 2005 and 31 December 2008, of which 1,750 corresponded to curettage/biopsy of the endometrium and in 168 of these histopathological diagnosis was made of endometrial hyperplasia. Results: We found that the average age of presentation in this institution was 44.8 years and that the greater percentage of patients (68.5% were in the group of simple hyperplasia without atypia. In 19.7% of the cases had evidence of atypia. Conclusions: The mean age and percentages found by hyperplasia subgroups were relatively within limits with regard to other studies, although broadly outlined in a lower proportion of cases with atypia.

Ernesto García Ayala

2010-01-01

185

Uterine Fibroids  

Medline Plus

Full Text Available ... periods • A feeling of fullness in the lower abdomen Other symptoms of uterine fibroids include: • Frequent urination resulting from a fibroid that presses on the bladder • Pain during sexual intercourse • Low back pain Complications In rare cases, a fibroid may press on ...

186

Uterine Fibroids  

Medline Plus

Full Text Available ... to have them at an earlier age. Athletic women seem to have a lower prevalence of uterine fibroids than women who do not ... you to go into early menopause. Too few women have gotten pregnant after UFE for researchers to know if there ...

187

Uterine Fibroids  

Medline Plus

Full Text Available ... focused ultrasounds that are guided by magnetic resonance images to target and destroy uterine fibroids. The procedure is intended to treat women who have completed child bearing or do not intend to become pregnant. FUA is a non-invasive surgery. It is ...

188

Photodynamic therapy for endometrial ablation: a study of treatment parameters and effects  

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The use of PDT for endometrial ablation has been the focus of much recent research. However, the mechanism of action, optimal treatment parameters, and long-term clinical effect are still poorly understood. This study was undertaken to further the understanding of the endometrial response to this drug/light- induced damage. Postpartum rat (Charles River) uterine horns were used as the animal model for fluorescence and treatment studies. Aminolevulinic acid was administered topically (intrauterine), and following a 0.5- to 3-hour drug incubation time, the endometrium was either removed and processed for fluorescence microscopy to assess drug localization or exposed to 150-200 J/cm2 of 630-nm laser light via a 1-cm cylindrical diffusing tip. The light=treated uterine horns were removed and histologically examine 7 to 10 days following treatment. The extent and character of uterine and endometrial damage (gross and histological analysis) were recorded for the varying light doses and incubation times. With topical (intrauterine) application of photosensitizer, incubation time and penetration ability of drug were found to be crucial factors. The use of a drug penetration enhancing vehicle produced greater tissue effects (endometrial ablation). These preliminary studies also showed that tissue effect is drug and light dose related and that the most profound effects may be vascular mediated. The study provided preliminary information for the use of PDT in gynecological applications such as endometrial ablation and female sterilization through Fallopian tube occlusion.

Jerath, Maya R.; Hoopes, P. Jack; Manganiello, Paul D.

1995-05-01

189

Endometrial receptivity defects and impaired implantation in diabetic NOD mice.  

Science.gov (United States)

Implantation failure is a major hurdle to a successful pregnancy. The high rate of postimplantation fetal loss in nonobese diabetic (NOD) mice is believed to be related to an abnormal decidual production of interferon (IFN)gamma. To address whether diabetes alters the natural events associated with successful implantation, certain morphological and molecular features of uterine receptivity in diabetic NOD (dNOD) mice were examined in normally mated pregnancy and in concanavalin A (ConA)-induced pseudopregnancy. As opposed to normoglycemic NOD (cNOD) mice, dNOD mice expressed retarded maturation of their uterine pinopodes and overexpressed MUC1 mucin at implantation sites (P < 0.001). Uterine production of leukemia inhibitory factor (LIF) and phosphorylation of uterine NFkappaBp65 and STAT3-Ty705 were found to be low (P < 0.01) during Day 4.5 postcoitum, whereas IFNgamma was aberrantly overexpressed. Loss of temporal regulation of progesterone receptor A (PR A) and PR B, together with aberrantly increased expression of the protein inhibitor of activated STAT-y (PIASy) (P < 0.01) and reduced recruitment (P < 0.01) of the latter to nuclear progesterone receptor sites were prominent features of decidualization failure occurring at peri-implantation in dNOD mice. In conclusion, the aberrant expression of endometrial IFNgamma in dNOD mice is associated with a nonreceptive endometrial milieu contributing to peri-implantation embryo loss in type 1 diabetes. PMID:22539679

Albaghdadi, Ahmad J H; Kan, Frederick W K

2012-08-01

190

Endometrial response to IVF hormonal manipulation: Comparative analysis of menopausal, down regulated and natural cycles  

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Abstract Background Uterine luminal epithelial cell response to different hormonal strategies was examined to determine commonality when an endometrium attains a receptive, stimulated, morphological profile that may lead to successful implantation. Methods Endometrial biopsies from 3 cohorts of patients were compared. The tissue samples taken from these patients were categorized into 8 different groups according to their baseline and the hormone regime used....

Gayer Nalini; Hosie Margot J; Terry Vera; Adams Susan M; Murphy Christopher R

2004-01-01

191

A case of endometrial cancer presenting with malignant spinal cord compression  

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Malignant spinal cord compression (MSCC) rarely presents in patients with endometrial cancer. It usually occurs months or years after the diagnosis of the primary tumor. A 65-year-old woman presented with a huge uterine tumor suspecting leiomyosarcoma. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Histopathological examination revealed mixed carcinoma (small cell carcinoma and endometrioid adenocarcinoma) of the endometrium...

Ryoji Hayase; Dan Yamamoto; Aya Nagai; Mari Sawada; Shigeki Taga

2013-01-01

192

The value of diagnostic hysteroscopy with biopsy in the preoperative of endometrial ablation  

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Full Text Available Objective: To assess the value of diagnostic hysteroscopy with biopsy in the preoperative preparation for endometrial ablation. Methods: It was a prospective non-randomized study conducted at the division of Gynecologic Endoscopy of Hospital do Servidor Público Estadual “Francisco Morato de Oliveira” from March 2007 to May 2009. A total of 45 patients with abnormal uterine bleeding, and referred to endometrial ablation were included. All women underwent a diagnostic hysteroscopy, and were treated with a GnRH analogous – goserelin – 10.8 mg before surgery. The endometrial ablation was performed with a surgical resectoscope. Patients were submitted to one directed endometrial biopsy, one guided endometrial biopsy with Novak curette, and to endometrial ablation, which was considered as reference for pathological examination with samples from the biopsies. Data were analyze using the SPSS-v16 software, and considered significance at p = 0.05. Results: The mean age of women was 44.20 years (33-56, parity of 2.67 (0-9, uterus size of 139.99 calculated in cc (42-278, and the mean duration of symptoms was 3.68 years (0.5-15. The guided endometrial biopsy showed sensitivity of 80% for endometrium without atypia, and the directed endometrial biopsy had sensitivity of 60%. For proliferative endometrium the directed endometrial biopsy showed sensitivity of 76 and 100% for secretory endometrium, which was higher than the guided endometrial biopsy with 53 and 50%, respectively. Conclusion: The directed biopsy before endometrial ablation had lower sensitivity than guided biopsy for endometrium without atypia, however it was higher for proliferative and secretory endometrium.

Salete Yatabe

2011-12-01

193

Endometrial Cancer Prevention  

Science.gov (United States)

What is prevention? Cancer prevention is action taken to lower the chance of getting cancer. By preventing cancer, the number of ... black women each year since 1998. Endometrial Cancer Prevention Avoiding risk factors and increasing protective factors may ...

194

T2-weighted sequences in the MR study of endometrial carcinoma and their histological correlation  

International Nuclear Information System (INIS)

The degree of myometrial involvement is one of the factors that most markedly affect the prognosis and mode of treatment of endometrial carcinoma in its early stages. Our objective is to assess the value of MR in detecting the degree of myometrial invasion in patients with low-grade endometrial carcinoma and correlated some features of the MR images with the histological findings. We performed a prospective study in 25 postmenopausal patients diagnosed as having endometrial carcinoma on the basis of Pap smear. Using a 0.5 Tesla MR, T1-weighted, T2-weigheted and PD axial, coronal and sagittal prohections were done in the uterus. Shortly afterwards, radical hysterectomy and pelvic lymphadenectomy were carried out and the MR findings were compared with the results of the histological study of the resected tissue. The following parameters were recorded at MR for the evaluation of the endometrial carcinoma: size of the uterus, endometrial thickness, presence or absence of a mas, cervical involvement, lymph node involvement and degree of myometrial invasion (more or less than 50% of the tickness): in the latter case, the junction was assessed when visible and the tumor-myometrium interface when it was not. The overall validity of MR in the detection of deep invasion was 80%, with a sensitivity of 80% and a specificity of 80%. The major errors invlved four cases of overstimation of the depth of the invasion. In two of them, the surgical specimens presented polypoid masses thcal specimens presented polypoid masses that distended the uterus, stretching out the myometrium, in another, the histological study disclosed a myoma accompanied by sites of adenomyomatosis; and the fourth case presented senile myometrial atrophy. MR is useful in the preoperative staging of endometrial carcinoma as it is capable of predicting the degree of myometrial invasion, upon which the lymphatic dissemination depends directly. This information is the basis for chroosing a more or less aggressive surgical approach and for deciding on the need for postoperative radiotherapy. (Author) 9 refs

195

RESECCIÓN ENDOMETRIAL HISTEROSCÓPICA MÁS INSERCIÓN DE DIU-LNG EN EL SANGRADO UTERINO ANORMAL REFRACTARIO A TRATAMIENTO MÉDICO  

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Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Objetivo: Evaluar los resultados del tratamiento del sangrado uterino anormal (SUA) refractario a tratamiento médico, con resección endometrial histeroscópica asociado a la inserción de un sistema intrauterino de liberación de levonorgestrel. Método: Estudio prospectivo de 24 pacientes con SUA trata [...] das con resección endometrial histeroscópica seguida de inserción de un dispositivo intrauterino que libera 20 microgramos diarios de levonorgestrel. Resultados: En 23 de las 24 pacientes tratadas se obtuvo un resultado favorable en término de control del SUA, con un período de seguimiento promedio de 18,3 meses. Una paciente requirió histerectomía por persistencia de dolor pélvico. Conclusión: Asociar a la resección endometrial histeroscópica la inserción de un sistema intrauterino de liberación de levonorgestrel mejora los resultados de la cirugía conservadora pudiendo evitar la histerectomía en el 95,9% de las mujeres con SUA de causa benigna Abstract in english Objective: To evaluate hysteroscopic endometrial resection associated to levonorgestrel intrauterine device insertion as a treatment of abnormal uterine bleeding of benign cause. Method: 24 patients with abnormal uterine bleeding, were treated with hysteroscopic endometrial resection followed by the [...] insertion of a intrauterine levonorgestrel device. Results: 23 of 24 patients no report symptoms after 18.3 months follow up. One hysterectomy was performed for persistent chronic pelvic pain. Conclusions: Endometrial ablations with diathermic loop followed by the insertion of intrauterine levonorgestrel device improve the results of the conservative surgeries, avoiding 95.9% of hysterectomies in patients with abnormal uterine bleeding

Juan Carlos, Carvajal V; Juan, Rodríguez C; Tamara, Briceño C; Julio, Veas P.

196

Uterine horn aplasia with complications in two mixed-breed bitches : case report  

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Full Text Available Unilateral segmental uterine horn aplasia was found in 2 mixed-breed bitches. The 1st bitch was presented with clinical signs of acute abdominal pain, and pyometra was suspected. Pyometra was confirmed surgically with rupture of a blind-ending cranial portion of the anomalous right uterine horn, which had resulted in peritonitis. The 2nd bitch was presented for routine ovariohysterectomy. The right uterine horn was affected by segmental aplasia, with mucometra of the cranial portion of the affected horn. Histopathology demonstrated both uteri to have diffuse cystic endometrial hyperplasia. It is postulated that cystic endometrial hyperplasia, together with the congenital anomaly, resulted in pyometra in one case and in mucometra in the other case. This is believed to be the 1st report of uterine horn aplasia in the bitch in association with clinical signs and lesions other than infertility.

M.L. Schulman

2012-07-01

197

Citología endometrial en pacientes posmenopáusicas con terapia hormonal  

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Full Text Available Objetivo: Demostrar la utilidad de la toma de muestra con Uterobrush® y compararlo con la biopsia endometrial, en pacientes posmenopáusicas con terapia hormonal. Método: Estudio prospectivo durante un lapso de seis meses, en el cual se incluyeron 30 pacientes, de las cuales 15 referían sangrado genital anormal y 15 no referían sintomatología. A cada paciente se le realizó citología endometrial con Uterobrush® y posteriormente se le realizó biopsia de endometrio con cureta de Novak. El diagnóstico citológico se comparó con el diagnóstico biópsico, para obtener la sensibilidad y especificidad de la técnica con Uterobrush®. Ambiente: Consulta externa del Servicio de Ginecología del Instituto Autónomo Hospital Universitario de Los Andes (IAHULA Mérida. Resultados: El procedimiento fue fácil en un 73,3 % de las pacientes, no refiriendo dolor. No se presentó sangrado posterior a la introducción del Uterobrush® en un 53,3 %. Las muestras fueron adecuadas en el 70 % de los casos. La principal causa de limitación fue la mala preservación de las células. Al comparar los diagnósticos citológicos con la biopsia encontramos una sensibilidad del 71 % y una especificidad del 75 %. Conclusión: La citología endometrial con Uterobrush® es un procedimiento aceptable, fácil de usar, económico, y bien tolerado por las pacientes; siendo útil para la valoración endometrial en mujeres posmenopáusicas y en aquellas que así lo ameriten, pero no se pretende desplazar a la biopsia endometrial sino sugerir estudios más extensos.Objective: To demonstrate the efficacy of endometrial cytology with the Uterobrush® sampler and compare it with endometrial biopsy, in postmenopausal women under hormonal replacement therapy. Method: Prospective study with 30 patients during a lapse of six months, fifteen of them refered abnormal uterine bleeding and the other fifteen did not. Endometrial cytology sampling was done with Uterobrush® and biopsy with Novak´s currette to all patients. Difficulty, pain, bleeding, cervical characteristics, celularity and adequacy of the sampling where assessed, cytology was compared with biopsy diagnosis. Setting: Gynecology service of the University Hospital of Los Andes, Results: 73.3 % of the patients did not refer pain. No bleeding was present after the introduction of Uterobrush ® in 53.3 %. The samples were adequate in 70 % of cases. Principal cause of limitation was poor fixation of cells. When comparing cytologic diagnosis with biopsy we found a sensitivity of 71 % and 75 % specificity. Conclusions: The endometrial cytology with Uterobrush® is a procedure easy to use, economic, and well tolerated by the patients; being useful to evaluate the endometrium in post menopausal women, but not pretending to overtake endometrial biopsy.

Belkys Chacín Peña

2008-06-01

198

Sentinel node mapping in high risk endometrial cancer after laparoscopic supracervical hysterectomy with morcellation?  

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INTRODUCTION Occult endometrial cancer after supracervical hysterectomy is very uncommon. Even if optimal management of those rare cases is still unproven, to guide the need for further therapies, restaging should be recommended in this situation. PRESENTATION OF CASE We report of a 60-year old woman with occult high risk endometrial cancer after supracervical hysterectomy with morcellation. We describe the feasibility of laparoscopic intraoperative sentinel node identification with cervical stump removing to restage the suspicious early stage high risk endometrial cancer. DISCUSSION In high risk endometrial cancer surgical restaging is important, considering that 10–35% of cases can present pelvic nodal metastasis. To reduce the treatment related morbidity maintaining the benefit of surgical staging, with a negative preoperative PET/CT, we performed a laparoscopic SN mapping with cervical stump removing. CONCLUSION This report highlight the fact that SN mapping with cervical injection is a feasible and safe technique also without the uterine corpus after supracervical hysterectomy with morcellation. PMID:23959405

Buda, Alessandro; Marco, Cuzzocrea; Dolci, Carlotta; Elisei, Federica; Baldo, Romina; Locatelli, Luca; Milani, Rodolfo; Messa, Cristina

2013-01-01

199

Global Endometrial Ablation in the Presence of Essure(R) Microinserts  

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Abnormal uterine bleeding (AUB) affects 30% of women at some time during their reproductive years and is one of the most common reasons a woman sees a gynecologist. Many women are turning to endometrial ablation to manage their AUB. This article reviews the data relating to the available endometrial ablation techniques performed with hysteroscopic sterilization, and focuses on data from patients who had Essure® (Conceptus, San Carlos, CA) coils placed prior to performance of endometrial ablation. Reviewed specifically are data regarding safety and efficacy of these two procedures when combined. Data submitted to the US Food and Drug Administration for the three devices currently approved are reviewed, as well as all published case series. Articles included were selected based on a PubMed search for endometrial ablation (also using the brand names of the different techniques currently available), hysteroscopic sterilization, and Essure. PMID:24358407

Aldape, Diana; Chudnoff, Scott G; Levie, Mark D

2013-01-01

200

Does gestrinone antagonize the effects of estrogen on endometrial implants upon the peritoneum of rats?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: English Abstract in english OBJECTIVE: To evaluate the effects of estrogen treatment in combination with gestrinone on an experimental rat model of endometriosis. METHODS: Uterine transplants were attached to the peritoneum of female Wistar rats via a surgical autotransplantation technique. The implanted area was measured duri [...] ng the proestrus phase and after hormonal treatment. We performed morphometric analysis and examined the macroscopic and morphometric alterations of endometrial implants after hormonal treatment in ovariectomized rats. RESULTS: The high dose of estrogen caused macroscopic increases in the endometrial implant group compared with other groups, which were similar to increases in the proestrus phase. The low dose showed morphometric development of implants, such as an increase in number of endometrial glands, leukocyte infiltration and mitosis. Gestrinone antagonized both doses of estrogen. CONCLUSION: Our findings suggest that gestrinone antagonizes estrogen's effects on rat peritoneal endometrial implants.

Vera Lúcia Rodrigues, Lobo; José Maria, Soares Júnior; Manuel de Jesus, Simões; Ricardo dos Santos, Simões; Geraldo Rodrigues de, Lima; Edmund C, Baracat.

 
 
 
 
201

Balão Térmico para Ablação Endometrial: Resultados Preliminares / Endometrial Ablation Using a Thermal Balloon: Preliminary Results  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Objetivos: os autores mostram a experiência preliminar com o uso do balão térmico para ablação do endométrio em pacientes com queixas de menorragia. Pacientes e Métodos: foram submetidas a este procedimento 20 pacientes. Após exame pélvico completo e ultra-sonografia endovaginal, todas as pacientes [...] foram submetidas à histeroscopia diagnóstica com biópsia de endométrio para excluir causas de malignidade. Das 20 pacientes que se submeteram ao tratamento com balão térmico, 16 foram submetidas em regime ambulatorial com anestesia local. O procedimento teve duração de 8 minutos e 30 segundos. Resultados: duas das 20 pacientes mostraram-se insatisfeitas, mantendo o quadro hemorrágico inalterado, e 18 pacientes referiram melhora da sintomatologia. Não houve complicações do procedimento. Conclusões: o uso do balão térmico para ablação endometrial mostrou-se seguro e eficaz para o tratamento da menorragia de causa benigna. Abstract in english Purpose: to evaluate thermal balloon endometrial ablation in the management of menorrhagia. Study design: twenty patients were submitted to endometrial ablation using the thermal balloon device, between June 1996 and June 1997. Local anesthesia was used in 16 patients. The device was introduced into [...] the uterine cavity. The duration of the procedure was 8 minutes and 30 seconds. Results: two patients (10%) did not show improvement of the symptons. Eighteen patients (90%) referred improvement of symptoms. There was no complication during and after the procedure. Conclusions: The thermal balloon seems to be safe and efficient in the management of menorrhagia.

Francesco, Viscomi; João Alfredo, Martins; Marilice, Pastore; Rogério, Dias; Laurival, DeLuca.

202

Endometrial Stem Cells and Reproduction  

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Abnormal endometrial function remains a significant cause of implantation failure, recurrent pregnancy loss, and other pathologies responsible for female infertility. The development of novel therapies to treat infertility due to endometrial dysfunction requires an understanding of the latest advancements in endometrial cell biology, such as the role of endometrial stem cells. The remarkable regenerative capacity of the human endometrium is absolutely essential for successful reproduction an...

Morelli, Sara S.; Pauline Yi; Goldsmith, Laura T.

2012-01-01

203

[Uterine eosinophils and infertility in the rat].  

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Uterine horn and adnexa structure have been studied with morphologic and morphometric methods in rats on the 10th day after infection of Staphylococcus aureus culture and in rats who became sterile after inflammatory survival. The even-aged intact female rats were used as control. The study demonstrates that nonbearing rats served the fertilization ability, but in genitals the signs of different degree indolent chronic inflammatory process have been observed. Endometrial inability to incorporate the embryonated egg may be determined by complex disturbances, the main of them being the dense eosinophilic infiltration of uterine wall and pathological cell interrelations in endometrium. The insufficient tissue drainage impaired the situation and caused the accumulation of toxic and antigenic substances. PMID:20432721

Kurganov, S A

2010-02-01

204

Granulocyte colony-stimulating factor (G-CSF): a mediator in endometrial receptivity for a patient with polycystic ovary (PCO) undergoing in vitro maturation (IVM).  

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Proliferative and secretory changes at the endometrial lining are the result of a complex intrauterine environment where sex steroid hormones and different local factors play an important role for endometrial thickening. Optimal endometrial thickness reflects an adequate maturation which is a key factor for embryo implantation. Here, we present a case of a woman with polycystic ovary who was treated using in vitro maturation (IVM) techniques. In addition, this patient showed a dyssynchrony between the endometrial phase characterised by endometrial thinning and the embryo development which had a negative impact for embryo implantation. A protocol using uterine perfusion of granulocyte colony-stimulating factor (G-CSF) was performed as an alternative treatment for the unresponsive endometrium. We found that uterine infusion of G-CSF quickly increased endometrial thickness resulting in a successful pregnancy and healthy born baby. These results suggest that G-CSF is a factor that participates during endometrial remodelling enhancing the synchronisation between uterine environment and embryo development. PMID:23605819

Lucena, Elkin; Moreno-Ortiz, Harold

2013-01-01

205

Ultrastructural assessment of leiomyoma tissue and different layers of myometrium in patients with uterine leiomyoma during hypo- and hyperestrogenic states after different schemes of gonadotroping relising hormone agonists use  

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Full Text Available In study conducted ultrastructural analysis of cells and extracellular matrix of myoma tissue and different layers of myometrium in 35 patients with uterine leyomioma in long-term and short-term corre ction of hormonal status before surgery gosereline acetate. Study of ultrastructural characteristics we re performed on ultrathin sectio ns for transmission electron microscope. Studies have shown that the ultrastructural characteristics of uterine le yomioma were similar to those of unchanged myometrium. The most characteristic feature of uterine fibroids is excessive extracellular matrix elements, arranged randomly. Under the action of a-GnRH there were atrophic changes in myocytes, which in most cases do not lead to cell death and is reversible: reducing the size of myocytes in both myomatous tissue and in normal myometrium, two-fold reduction in myofilaments amount in unchanged myometrium and in uterine myoma. Under the influence of hyperestrogenemy, along with increasing size of the nucleus, endoplasmic reticulum elements and number of ribosom es the size of myocytes was likely to increase in both myoma tissue and myometrium; increased the ratio of condensed chromatin to uncondensed one (in simple fibroids – 1.7 times, in cellular fibroids – 2.1 times; increase in 1.5 times the number of myofilaments both in unchanged myometrium and in uterine myoma; increase in number of mitochondria and increase of their size in myomatous tissue only caused mainly by by intracellular edema. Elements of extracellu lar matrix do not depend on short-term action of hyperestrogeny and mid-term action of hypoestrogeny, bu t the synthesis of new fibers is reduc ed under action of artificial menopause.

Medvedev M.V.

2011-01-01

206

Paclitaxel and Carboplatin With or Without Metformin Hydrochloride in Treating Patients With Stage III, IV, or Recurrent Endometrial Cancer  

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Endometrial Adenocarcinoma; Endometrial Clear Cell Carcinoma; Endometrial Papillary Serous Carcinoma; Recurrent Endometrial Carcinoma; Stage IIIA Endometrial Carcinoma; Stage IIIB Endometrial Carcinoma; Stage IIIC Endometrial Carcinoma; Stage IVA Endometrial Carcinoma; Stage IVB Endometrial Carcinoma

2014-09-29

207

Thermal balloon endometrial ablation: safety aspects evaluated by serosal temperature, light microscopy and electron microscopy.  

DEFF Research Database (Denmark)

OBJECTIVES: Thermal balloon endometrial ablation is a new method for treating menorrhagia. The technique appears to be less difficult compared to standard hysteroscopic ablation techniques and to be significantly safer. The influence into the uterine wall of the thermal balloon ablation procedure was investigated with special reference to the ability of total destruction of the endometrium and the thermal action on the myometrium and the serosa. STUDY DESIGN: Temperatures were measured at the uterine serosal surface during thermal balloon endometrial ablation for 8-16 min in eight patients. After subsequent hysterectomy the extent of thermal damage into the myometrium was assessed by light and electron microscopy. RESULTS: The highest temperature measured on the uterine serosa was 39.1 degrees C. Coagulation of the myometrium adjacent to the endometrium could be demonstrated by light microscopy in all patients, with a maximum depth of 11.5 mm. By electron microscopy no influence of heat could be demonstrated beyond 15 mm from the endometrial surface. CONCLUSION: Up to 16 min of thermal balloon endometrial ablation therapy can destroy the endometrium and the submucosal layers. The myometrium is only coagulated to a depth where full thickness necrosis or injury is unlikely.

Andersen, L F; Meinert, L

1998-01-01

208

Thermal Balloon Endometrial Ablation: Safety Aspects Evaluated by Serosal Temperature, Light Microscopy and Electron Microscopy  

DEFF Research Database (Denmark)

OBJECTIVES: Thermal balloon endometrial ablation is a new method for treating menorrhagia. The technique appears to be less difficult compared to standard hysteroscopic ablation techniques and to be significantly safer. The influence into the uterine wall of the thermal balloon ablation procedure was investigated with special reference to the ability of total destruction of the endometrium and the thermal action on the myometrium and the serosa. STUDY DESIGN: Temperatures were measured at the uterine serosal surface during thermal balloon endometrial ablation for 8-16 min in eight patients. After subsequent hysterectomy the extent of thermal damage into the myometrium was assessed by light and electron microscopy. RESULTS: The highest temperature measured on the uterine serosa was 39.1 degrees C. Coagulation of the myometrium adjacent to the endometrium could be demonstrated by light microscopy in all patients, with a maximum depth of 11.5 mm. By electron microscopy no influence of heat could be demonstrated beyond 15 mm from the endometrial surface. CONCLUSION: Up to 16 min of thermal balloon endometrial ablation therapy can destroy the endometrium and the submucosal layers. The myometrium is only coagulated to a depth where full thickness necrosis or injury is unlikely.

Andersen, L F; Meinert, L

1998-01-01

209

Primary pulmonary carcinoid tumor with metastasis to endometrial polyp  

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INTRODUCTION A carcinoid tumor occurring in the endometrium has been documented in the literature, but there is no report in regard to carcinoid tumor metastasis to endometrium. PRESENTATION OF CASE We report a case of a malignant carcinoid metastasis to an endometrial polyp. Patient underwent hysteroscopy, and polypectomy. The pathology demonstrated an endometrial polyp containing a 4 mm x 5 mm nodule of metastatic carcinoid tumor, consistent with metastasis from patient's known pulmonary carcinoid. The tumor was morphologically similar to the tumors of the right lung, with similar immune-profile. DISCUSSION This patient presented with a suspicious pelvic ultrasound. Due to her age, the first priority was to exclude uterine cancer. The endometrial polyp, which was found, had a small focus of metastatic carcinoid tumor. To the best of our knowledge, this finding has not been previously recorded in the literature. Our patient also had a history of metastatic carcinoid tumor to breast. This finding is also very uncommon. CONCLUSION This is the first case in the literature described a malignant carcinoid metastasis to an endometrial polyp. PMID:23127865

Momeni, Mazdak; Kolev, Valentin; Costin, Dan; Mizrachi, Howard H.; Chuang, Linus; Warner, Richard R.P.; Gretz, Herbert F.

2012-01-01

210

Minimal uterine serous carcinoma with extrauterine tumor of identical morphology: an immunohistochemical study of 13 cases.  

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Minimal uterine serous carcinoma includes endometrial intraepithelial serous carcinoma and superficial invasive serous carcinoma. Although they represent in situ and early invasive serous carcinomas, more than 50% of them present with extrauterine tumors of identical morphology. It has not been completely clear whether the extrauterine involvement represents a synchronous tumor arising independently or a metastatic lesion from the endometrial primary. To investigate the relationship between the extrauterine tumor and minimal uterine serous carcinoma, 13 cases of such condition were studied by histologic examination and immunohistochemical staining of 5 related protein markers: estrogen receptor, progestin receptor, p53, WT1, and Ki-67. Morphologic assessment of all extrauterine tumors showed similar histologic features to their corresponding endometrial minimal serous carcinomas. Immunostaining revealed almost identical patterns of 5 protein markers with similar intensities between the endometrial tumors and their corresponding extrauterine lesions. WT1 nuclear staining was observed in most of our cases indicating WT1 expression is not a specific marker in distinguishing ovarian serous carcinoma from uterine serous carcinoma. In conclusion, our findings support the hypothesis that a transtubal metastatic process is responsible for the extrauterine involvement by minimal endometrial serous carcinoma. PMID:19956063

Yan, Zhijie; Hui, Pei

2010-01-01

211

MR imaging of endometrial cancer that occurs after radiation therapy for cervix cancer  

International Nuclear Information System (INIS)

We wanted to describe the MR imaging findings of endometrial cancer in patients with a history of prior radiation therapy for cervical cancer (ECRT) and we compare them to the MR imaging findings of patients with spontaneously occurring endometrial cancer (SEC). Twenty-two patients with endometrial cancer that was diagnosed by operation or endometrial biopsy were included in the study. The patients were divided into two groups according to the presence of past RT for cervical cancer: ECRT (n = 4) and SEC (n = 18). The MR images were retrospectively analyzed by consensus of two experienced radiologists. The MR imaging findings were analyzed by the size, shape and signal intensity of the mass, distension of the uterine cavity, the presence of cervical stenosis and the nature of the fluid collection. For the mass shape, all the ECRT lesions were polypoid masses. However, the SEC patients had 5 polypoid masses and 13 wall thickenings. The maximal diameter, signal intensity and enhancement pattern of the masses were not different between the ECRT and SEC patients. The width of the endometrial cavity varied between 3.9 cm in the ECRT patients and 0.4 cm in the SEC patients (? = 0.002). All the ECRT patients had cervical stenosis. However, none of the SEC patients had cervical stenosis. MR imaging of ECRT patients demonstrated prominent distension of their uterine cavity and cervical stenosis, which may be the result of radiation fibrosis in the uterus

212

Clinical outcomes of patients with insufficient sample from endometrial biopsy or curettage.  

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Endometrial biopsy and curettage are widely used uterine sampling procedures. Occasionally, the amount of tissue obtained is so minimal that diagnosis cannot be reached. In published studies, insufficient samples comprise 2% to 60% of endometrial samples and are influenced by multiple contributory factors. To date, specific quantitative criteria for an adequate endometrial sample have not been established in the pathology community. The decision to classify a sample as nondiagnostic is subject to great interobserver variability, especially where elderly patients are concerned. Meanwhile, whether or not to repeat the procedure is the dilemma for clinical management. Herein we studied the clinicopathologic features of 1120 endometrial samples designated as insufficient for diagnosis. Such samples were more commonly encountered in elderly patients than younger ones (14.6% vs. 5.8%). Our pathologists generally required one intact tissue fragment containing both glands and stroma for premenopausal patients and 5 to 10 strips of atrophic endometrial epithelium for postmenopausal patients. By the 12-mo follow-up, 38% of patients with nondiagnostic samples had second sampling procedures and 7% underwent hysterectomy. The second sample was adequate in 75% of patients, 10% of which showed malignant tumor. If any worrisome histologic findings were present in the initial nondiagnostic sample, a high percentage of these patients were found to have uterine malignancy on second procedures (43%). Aims of this study are to bring awareness to this commonly overlooked topic, to validate our diagnostic criteria, and to outline important clinical implications. PMID:25083966

Kandil, Dina; Yang, Xiaofang; Stockl, Thomas; Liu, Yuxin

2014-09-01

213

Uterine lipoma.  

Directory of Open Access Journals (Sweden)

Pure lipoma of the uterus is a rare entity and few cases have been reported. They usually develop in postmenopausal women. Clinical symptoms and physical signs are similar to those found in leiomyomas. The histogenesis of these lesions is still unclear. The diagnosis is easily made at the time of surgery or at autopsy, but before this, they may lead to many problems in the differential diagnosis with another uterine tumors. Recent papers suggest the possibility of a preoperative diagnosis made by computed tomography and magnetic resonance imaging. We report a case of a 67-year-old postmenopausal women presented with pelvic pressure and urinary symptoms. Pathological evaluation revealed pure intramural lipoma of the uterus illustrating characteristic morphological and histological findings with no evidence of sarcomata's component.

Jaudah A. Al-Maghrabi

2004-10-01

214

Pinopodes as markers of endometrial receptivity in clinical practice.  

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Clinical evidence indicates the existence in the human of a narrow window of uterine receptivity which opens during the mid-luteal phase. At the same time, formation of pinopodes on the apical membranes of the endometrial epithelial cells occurs. To develop a specific marker for receptivity in clinical practice, the kinetics of pinopode formation has been investigated through sequential endometrial biopsying in natural, hormone replacement and stimulated cycles. The results show that pinopodes last pinopodes form earlier in stimulated cycles and later in hormone replacement cycles, compared with natural cycles. Pinopode expression is strongly correlated with implantation following embryo transfer and furthermore, detection of pinopodes in assessment cycles may be extremely useful for the assessment of receptivity on an individual basis to optimize embryo transfer, resulting in increased implantation rates. Finally, pinopodes seem to be correlated well with other cellular and molecular events occurring in the mid-luteal endometrium. PMID:10690805

Nikas, G

1999-12-01

215

Endometrial modifications during early pregnancy in bonnet monkeys (Macaca radiata).  

Science.gov (United States)

The present study was undertaken to investigate endometrial modifications that occur before embryo invasion in bonnet monkeys (Macaca radiata). These changes were analysed in luminal epithelium, glandular epithelium and stroma of endometrial functionalis on Day 6 post ovulation from pregnant and non-pregnant animals (n = 4 each) by transmission electron microscopy. Distinct features (i.e. loss of columnar shape by epithelial cells, changes in mitochondrial size and diffused apicolateral gap junctions) were observed in the luminal and glandular epithelium in pregnant animals. Stromal compaction was also observed in pregnant animals. Further, immunogold localisation studies demonstrated significantly higher expression (P alpha, an oestrogen-regulated gene, in the glandular epithelium and stroma of the endometrium in pregnant animals compared with non-pregnant animals. Expression of two other genes known to be regulated by oestradiol, namely beta-actin and cyclo-oxygenase-1, were also significantly higher (P activity in the uterine milieu before embryo invasion. PMID:18255018

Rosario, Gracy X; D'Souza, Serena J; Manjramkar, Dhananjay D; Parmar, Vipul; Puri, Chander P; Sachdeva, Geetanjali

2008-01-01

216

Late solitary metastasis of cutaneous malignant melanoma presenting as abnormal uterine bleeding.  

Science.gov (United States)

We present the case of a 52-year-old woman with a history of excised cutaneous malignant melanoma complaining of abnormal uterine bleeding 11 years after initial diagnosis. Hysteroscopic examination showed an endometrial lesion with polypoid shape and endometrial biopsy was suggestive for melanoma. After a complete clinical work-up ruling out other metastatic sites, the patient underwent total abdominal hysterectomy with bilateral salpingo-oophorectomy and pelvic lymphadenectomy. Final histopathological and immunohistochemical analysis confirmed the diagnosis of endometrial melanoma with initial myometrial invasion. After a 6-month follow-up period, the patient was disease free. Even after many years of negative follow up, gynecologists should be aware of the possibility that abnormal uterine bleeding could represent the clinical expression of metastatic melanoma in order to offer a prompt diagnosis and a personalized strategy of treatment. PMID:18840192

Fambrini, Massimiliano; Andersson, Karin Louise; Buccoliero, Anna Maria; Pieralli, Annalisa; Livi, Lorenzo; Marchionni, Mauro

2008-08-01

217

Successful robot-assisted surgery for treating endometrial cancer affecting bicornuate-bicollis or didelphic uterus  

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Full Text Available Uterine anomalies are mainly associated with improper development of Mullerian ducts. To our knowledge, reports describing the use of a da Vinci Robot System for treating an endometrial cancer in a woman with an abnormal uterus are lacking. Here, we reported the description of two extremely obese women, affected by endometrial cancer and presenting bicornuate-bicollis and didelphic uterus have been treated by Robot System-assisted surgery. No operative and postoperative complications were recorded. Both women are disease-free to follow-up. A robot-assisted surgery could represent an effective treatment option for complex hysterectomies and in complicated patients, as those showing an extreme obesity.

Francesco Petruzzelli

2013-07-01

218

Role of the Soluble Differentiated Molecule Structural and Functional Forms in Differential Diagnosis of the Uterus Myoma and Endometrium Cancer  

Directory of Open Access Journals (Sweden)

Full Text Available Aim of investigation is a comparative assessment of the peripheral blood soluble differentiated molecule pull structural and functional state of patients with the endometrium cancer and uterus myoma.Materials and methods. A serous level of the soluble differentiated molecules CD8, CD25, CD38, CD50, CD54, CD18, oligomeric fractions of the soluble molecules CD8, CD25, CD38, CD50 and CD54, soluble associates CD8—HLA-I, CD18—CD50 and CD18—CD54 was detected in patients with the endometrium cancer and uterus myoma.Results. The differences in content of the peripheral blood soluble differentiated molecule structural and functional form in patients with the uterus myoma and endometrium cancer are revealed. An increase of the soluble molecule CD38 and CD50 total fraction serous content, as well as the soluble complexes CD8—HLA-I, was observed at the uterus myoma. Besides, a content of the soluble molecule CD50 total fraction correlated with a serous level of the soluble complexes CD18—CD50. A serous content of the soluble molecule CD8 total and oligomeric fractions, oligomeric form of the molecules CD50 and total fraction of the soluble molecules CD54 was increased both at the uterus myoma and endometrium cancer. However, a serous content of the soluble associates CD18—CD54 was increased only at the endometrium cancer.

K.A. Korovushkina

2010-05-01

219

Metastatic endometrial stromal sarcoma: a case report  

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Full Text Available Endometrial Stromal Sarcoma (ESS is a rare slow growing tumour of mesodermal origin arising from the stroma of the endometrium and accounting for less than 1% of all uterine cancers. It is characterized by late recurrences and distant metastases. This report presents a case of ESS in a 40 year old nulliparous woman who had a myomectomy for a clinically suspected Leiomyoma uterus in a local hospital. The histopathological examination of the specimen revealed ESS and the patient was referred to our tertiary institute. Here after investigations including a CT scan which also revealed pulmonary metastases, patient underwent Modified Radical Hysterectomy with Bilateral Salpingo-oophorectomy with pelvic lymph node sampling. Histopathological Examination of the uterine specimen confirmed the diagnosis. The patient was given the option of referral to a thoracic surgeon for resection of the isolated lung metastasis, but she refused this and opted instead for hormone therapy which she is presently undergoing. ESS is a very rare tumour often presenting with clinical and examination findings suggestive of leiomyoma of the uterus and hence misdiagnosed. In cases of rapidly growing tumours and suspicious radiological features, suspect sarcoma and initiate timely diagnosis and proper treatment. Recommended long-term follow up in view of late recurrences. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 812-815

Shobha S. Pillai

2014-06-01

220

BIOPSIA ENDOMETRIAL AMBULATORIA: EXPERIENCIA PRELIMINAR  

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Full Text Available Objetivo: Presentar la experiencia inicial en el diagnóstico histológico con biopsia endometrial ambulatoria obtenida con pipelle de Cornier. Material y método: Se efectuó biopsia endometrial ambulatoria con pipelle de Cornier en 144 pacientes con sospecha clínica y/o ecográfica de patología endometrial difusa. Resultados: Se logró realizar el procedimiento a 131 pacientes (91%, obteniéndose diagnóstico histológico satisfactorio en 110 casos (76,4%. De las 110 muestras analizadas, se diagnosticó cáncer de endometrio en 3 pacientes (2,7% e hiperplasia con atipias en 1 paciente (0,9%. Conclusiones: La biopsia endometrial ambulatoria es un procedimiento sensible, específico, eficiente, seguro y económico, que permite aumentar la cobertura del diagnóstico precoz del cáncer de endometrioObjective: To present our initial experience with the ambulatory endometrial biopsy obtained with Cornier pipelle. Material and method: We used the device to obtain the endometrial sampling in 144 women with suspicious pathology of endometrium. Results: We obtained 131 endometrial specimens (91%, 110 were appropriate for histological diagnosis (76.4%. We met 3 women with endometrial carcinoma (2.7% and 1 with hyperplastic atypia. Conclusion: Endometrial ambulatory biopsy is a sensitive, specific, efficient, safe and cheap procedure. This method improves the early diagnosis of endometrial carcinoma

Claudio Domínguez C

2006-01-01

 
 
 
 
221

Concomitance of primary insular carcinoid developing in mature cystic teratoma of the ovary and endometrial papillary serous carcinoma  

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Full Text Available The primary ovarian carcinoid tumor is rare and must be differentiated from metastatic carcinoid tumors. Uterine serous papillary carcinoma is a highly aggressive type of endometrial carcinoma. A 70 year old patient referred to the clinic with the complaint of postmenapousal bleeding. Endometrial biopsy was performed and papillary serous carcinoma was diagnosed. Total hysterectomy and bilateral salpingoopherectomy was performed. Beside the tumor in the uterine cavity, the left ovary was 6x4,5x4 cm in size and had a multiloculated cystic appearance with a mural nodule 1,5 cm in diameter. With histopathologic examination, concomitance of insular carcinoid tumor developing in ovarian mature cystic teratoma and endometrial papillary serous carcinoma was found to be interesting and presented.

Ayten L?VAO?LU

2006-09-01

222

Immature Uterine Teratoma Associated with Uterine Inversion  

Science.gov (United States)

Teratomas are the most commonly diagnosed germ cell tumors and occur primarily in testes and ovaries. Platinum-based therapy followed by surgical resection of the residual lesion is generally the recommended treatment. In contrast, immature uterine teratomas are rare, with few cases reported in the literature. Moreover, there is no standard treatment for these tumors. Non-puerperal uterine inversion is also rare in women younger than 45 years of age, and neoplastic lesions are responsible for this condition. Here, we report a case of an immature uterine teratoma associated with uterine inversion. The patient underwent surgery followed by adjuvant chemotherapy and continues to be monitored. PMID:25276328

Souza, Karla Teixeira; Negrao, Marcelo Vailati; da Silva Rocha, Lucila Soares; Di Favero, Giovanni; da Costa, Samantha Cabral Severino; Diz, Maria Del Pilar Estevez

2014-01-01

223

Immature uterine teratoma associated with uterine inversion  

Directory of Open Access Journals (Sweden)

Full Text Available Teratomas are the most commonly diagnosed germ cell tumors and occur primarily in testes and ovaries. Platinum-based therapy followed by surgical resection of the residual lesion is generally the recommended treatment. In contrast, immature uterine teratomas are rare, with few cases reported in the literature. Moreover, there is no standard treatment for these tumors. Non-puerperal uterine inversion is also rare in women younger than 45 years of age, and neoplastic lesions are responsible for this condition. Here, we report a case of an immature uterine teratoma associated with uterine inversion. The patient underwent surgery followed by adjuvant chemotherapy and continues to be monitored.

Karla Teixeira Souza

2014-07-01

224

Clinical and cytological definition of endometrial cancer during radiotherapy  

International Nuclear Information System (INIS)

The state of primary tumor in 45 patients with adenocarcinoma of the endometrium, stage 1-3, during concomitant radical radio-and hormonotherapy according to the data of hysterocervicography, hysterometry and cytohistology have been studied. Contact irradiation was performed in single fractions of 9.5-10.0 Gy per week. The time course of primary uterine tumor regression was observed with regard to various radiation dose levels in accordance with cytological data. The cytological method is regarded as an important quantitative criterion in the evaluation of radio- and hormonotherapeutic efficacy of inoperable endometrial cancer

225

The Effect of Different Local Anesthesia Methods on Pain Relief in Outpatient Endometrial Biopsy: Randomized Clinical Trial  

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Full Text Available Introduction: Endometrial biopsy is necessary for diagnosing the reason of abnormal uterine bleeding in perimenopausal women. Currently outpatient endometrial biopsy is used for evaluation of abnormal uterine bleeding which is associated with moderate to severe pain. Using lidocaine is one of the procedures which is used for pain relief while biopsy. This study is aimed at comparing the effect of different local anesthesia procedures on pain relief during endometrial biopsy. Methods: In this randomized clinical trial, 160 multiparous 40-55 years old women with AUB, candidates for endometrial biopsy, were randomly assigned into four equal groups, to receive: 1-intrauterine lidocaine; 2-cervical spray lidocaine; 3- intrauterine lidocaine plus cervical spray lidocaine; or 4-intrauterine distilled water. Pain relief was measured at 3 different times: during endometrial biopsy, just after and 15 minutes after biopsy. Results: Pain intensity was reduced significantly at different times in intrauterine lidocaine and intrauterine lidocaine with cervical spray lidocaine receivers in compare with the groups which received cervical spray lidocaine and distilled water. The mean of difference pain relief during biopsy and 15 minutes after that was reduced significantly in the group which received intrauterine lidocaine and intrauterine lidocaine with cervical spray lidocaine in comparison with the other two groups. Conclusion: Intrauterine lidocaine was effective during endometrial biopsy, and using it with cervical spray lidocaine had no more beneficial effect.

Elaheh Olad-Saheb-Madarek

2013-08-01

226

Hydrothermal Endometrial Ablation Can Reduce the Need for Hysterectomy and Transfusion  

Science.gov (United States)

Women seeking emergency care for severe uterine hemorrhage with profound anemia often undergo transfusion dilatation curettage and ultimately hysterectomy. The purpose of this article is to describe a modern conservative approach to treating persistent uterine hemorrhage unresponsive to medical therapy, avoiding transfusion and allowing for nonemergent future therapy without the potential complications of transfusion. Six patients with unremitting uterine bleeding were included in the study performed in the Department of Gynecology at an academically affiliated general hospital. Patients underwent successful hydrothermal endometrial ablation after failed medical therapy. This procedure is effective in controlling severe uterine bleeding in patients with large intrauterine fibroids; thus, the number of women being transfused can be significantly reduced. PMID:20932367

Hanes, Michelle; Nabizadeh, Farzaneh

2010-01-01

227

Uterine Artery Embolization Versus Laparoscopic Uterine Artery Occlusion: The Outcomes of a Prospective, Nonrandomized Clinical Trial  

International Nuclear Information System (INIS)

Purpose: To compare outcomes of two different types of occlusive therapy of uterine fibroids. Methods: Women with fibroid(s) unsuitable for laparoscopic myomectomy (LM) were treated with uterine artery embolization (UAE) or laparoscopic uterine artery occlusion (LUAO). Results: Before the procedure, patients treated with UAE (n = 100) had a dominant fibroid greater in size (68 vs. 48 mm) and a mean age lower (33.1 vs. 34.9 years) than surgically treated patients (n = 100). After 6 months, mean shrinkage of fibroid volume was 53 % after UAE and 39 % after LUAO (p = 0.063); 82 % of women after UAE, but only 23 % after LUAO, had complete myoma infarction (p = 0.001). Women treated with UAE had more complications (31 vs. 11 cases, p = 0.006) and greater incidence of hysteroscopically verified intrauterine necrosis (31 vs. 3 %, p = 0.001). Both groups were comparable in markers of ovarian functions and number of nonelective reinterventions. The groups did not differ in pregnancy (69 % after UAE vs. 67 % after LUAO), delivery (50 vs. 46 %), or abortion (34 vs. 33 %) rates. The mean birth weight of neonates was greater (3270 vs. 2768 g, p = 0.013) and the incidence of intrauterine growth restriction lower (13 vs. 38 %, p = 0.046) in post-UAE patients. Conclusion: Both methods are effective in the treatment of women with future reproductive plans and fibroids not suitable for LM. UAE is more effective in causing complete ischemia of fibroids, but it is associated with greateribroids, but it is associated with greater risk of intrauterine necrosis. Both methods have low rate of serious complications (except for a high abortion rate).

228

Uterine Artery Embolization Versus Laparoscopic Uterine Artery Occlusion: The Outcomes of a Prospective, Nonrandomized Clinical Trial  

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Purpose: To compare outcomes of two different types of occlusive therapy of uterine fibroids. Methods: Women with fibroid(s) unsuitable for laparoscopic myomectomy (LM) were treated with uterine artery embolization (UAE) or laparoscopic uterine artery occlusion (LUAO). Results: Before the procedure, patients treated with UAE (n = 100) had a dominant fibroid greater in size (68 vs. 48 mm) and a mean age lower (33.1 vs. 34.9 years) than surgically treated patients (n = 100). After 6 months, mean shrinkage of fibroid volume was 53 % after UAE and 39 % after LUAO (p = 0.063); 82 % of women after UAE, but only 23 % after LUAO, had complete myoma infarction (p = 0.001). Women treated with UAE had more complications (31 vs. 11 cases, p = 0.006) and greater incidence of hysteroscopically verified intrauterine necrosis (31 vs. 3 %, p = 0.001). Both groups were comparable in markers of ovarian functions and number of nonelective reinterventions. The groups did not differ in pregnancy (69 % after UAE vs. 67 % after LUAO), delivery (50 vs. 46 %), or abortion (34 vs. 33 %) rates. The mean birth weight of neonates was greater (3270 vs. 2768 g, p = 0.013) and the incidence of intrauterine growth restriction lower (13 vs. 38 %, p = 0.046) in post-UAE patients. Conclusion: Both methods are effective in the treatment of women with future reproductive plans and fibroids not suitable for LM. UAE is more effective in causing complete ischemia of fibroids, but it is associated with greater risk of intrauterine necrosis. Both methods have low rate of serious complications (except for a high abortion rate).

Mara, Michal; Kubinova, Kristyna, E-mail: kristyna.kubinova@gmail.com [General Faculty Hospital and 1st Medical Faculty of Charles University, Department of Obstetrics and Gynecology (Czech Republic); Maskova, Jana [Aberdeen Royal Infirmary, Department of Radiology (United Kingdom); Horak, Petr [General Faculty Hospital and 1st Medical Faculty of Charles University, Department of Obstetrics and Gynecology (Czech Republic); Belsan, Tomas [Central Military Hospital, Department of Radiology (Czech Republic); Kuzel, David [General Faculty Hospital and 1st Medical Faculty of Charles University, Department of Obstetrics and Gynecology (Czech Republic)

2012-10-15

229

Relationships between endometrial cytology and interval to first ovulation, and pregnancy in postpartum dairy cows in a single herd.  

Science.gov (United States)

The objectives were to investigate the relationships between endometrial cytology (EC) and interval from calving to first ovulation, and pregnancy in dairy cows, and that between uterine fluid and EC. On day 25 postpartum, 39 dairy cows were grouped based on EC, as having low (?8%) or high (>8%) polymorphonuclear cells (PMN), and the quantity of uterine fluid was assessed by ultrasound. The interval from calving to first ovulation was shorter in low, than in high PMN cows (32 vs. 45 d). A greater proportion of cows with uterine fluid had high PMN (64% vs. 21%), and the PMN increased from 14% to 34% as the quantity of uterine fluid increased. The mean interval from calving to ovulation was longer in primiparous cows with high PMN (49 d) compared to that of primiparous and multiparous cows with low PMN (28 and 29 d, respectively). Although the conception rate to first service at 92 d postpartum was not different between PMN groups, the cumulative pregnancy at 270 d tended to be higher in low than in high PMN (80% vs. 58%) multiparous cows. Also, cows that had uterine fluid on day 25 postpartum had a shorter interval from calving to pregnancy than those with no uterine fluid (161 vs. 208 d). In conclusion, combining transrectal ultrasonography with endometrial cytology on day 25 postpartum has diagnostic value in the assessment of uterine inflammation. PMID:21176928

Dourey, Antoine; Colazo, Marcos G; Barajas, Patricio Ponce; Ambrose, Divakar J

2011-12-01

230

Evaluation of endometrium in peri-menopausal abnormal uterine bleeding.  

Science.gov (United States)

Abnormal Uterine Bleeding (AUB) is one of the most common health problems encountered by women. It affects about 20% women of reproductive age, and accounts for almost two thirds of all hysterectomies. Gynaecologists are often unable to identify the cause of abnormal bleeding even after a thorough history and physical examination. Diagnostic evaluations and treatment modalities have been evolving over time. The onus in AUB management is to exclude complex endometrial hyperplasia and endometrial cancer. From D and C + EUA under general anesthesia the shift to more accurate procedures like hysteroscopy and vision directed biopsy was welcome. But the current minimally invasive procedures like sonohysterography, office vacuum aspiration (Pipelle) and the use of office hysteroscopy have revolutionized the management of AUB. We have tried to review the current literature and guidelines for evaluation of endometrium with the twin goals of finding an accurate reason causing the AUB and to rule out endometrial cancer or a potential for the cancer in future. We have also attempted to compare the current procedures and their present perspective vis-à-vis each other. Histological assessment is the final word, but obtaining a sample for histology makes it more accurate, and we have reviewed these techniques to enhance accuracy in diagnosis. Hysteroscopy and directed biopsy is the 'gold standard' approach for most accurate evaluation of endometrium to rule out focal endometrial Ca. Blind endometrial biopsies should no longer be performed as the sole diagnostic strategy in perimenopausal as well as in postmenopausal women with AUB. A single-stop approach, especially in high risk women (Obesity, diabetes, family history of endometrial, ovarian or breast cancer) as well as in women with endometrial hyperplasia of combining the office hysteroscopy, directed biopsy in presence of a focal lesion, and vacuum sampling of endometrium in normal looking endometrium, all without anesthesia is the most minimally invasive and yet accurate approach in current practice. PMID:23833528

Kotdawala, Parul; Kotdawala, Sonal; Nagar, Nidhi

2013-01-01

231

Accuracy of doppler ultrasound in diagnosis of endometrial carcinoma  

International Nuclear Information System (INIS)

Objective: To determine the accuracy of Doppler ultrasound in the diagnosis of endometrial carcinoma in patients presenting with post-menopausal bleeding while taking histopathological findings as the gold standard. Methods: The cross-sectional study was done at the Department of Radiology, Bahawal Victoria Hospital, Bahawalpur, from April 1 to September 30, 2009, and comprised 128 patients above 50 years of age having history of post-menopausal bleeding and who were referred to the department. Name, age and hospital registration number were recorded on a proforma. Doppler ultrasound was performed and endometrial thickness and uterine artery resistive index were recorded on transabdominal ultrasonography. Patients with endometrial thickness of more than 5mm and uterine artery resistive index of less than 0.7 were considered to be having endometrial carcinoma. Histopathology findings were also recorded using the hospital registration number of the patient. The findings of Doppler ultrasound scan were validated with the findings of histopathology. Results: Of the 128 patients, 48 (37.5%) were between the ages of 51 and 55 years; 46 (35.93%) were in the 56-60 age group; and 34 (26.57%) were over 65 years. On the basis of Doppler ultrasound findings, 106 (82.8%) patients were diagnosed as having endometrial carcinoma, while 22 (17.19%) were declared negative. Ultrasonography results were compared with histopathology findings. The percentages of true positive, true negative, false positive and false negative were calculated. There were 103 (80.47%) true positive; 12 (9.37%) false positive; 10 (7.81%) true negative; and 3 (2.35%) false negative. Specificity, sensitivity, positive predictive value and negative predictive value were found to be 97.16%, 76%, 89.56% and 76.92% respectively. Conclusion: The use of Doppler ultrasonography in non-invasive diagnosis of endometrial carcinoma in patients presenting with post-menopausal bleeding was quite useful with good sensitivity, specificity, as well as positive and negative predictive values. There were no procedural complications. (author)

232

Uterine Fibroid Embolization  

Medline Plus

Full Text Available ... is for uterine fibroids. Over the past 15 years, we've developed some new procedures that allow ... us. This is a young woman. She's 31 years old. She has very symptomatic uterine fibroids, very ...

233

Uterine Fibroid Embolization  

Medline Plus

Full Text Available Uterine Fibroid Embolization Baptist Health South Florida Miami, FL March 25, 2010 Good afternoon, and welcome to the Baptist ... is going to be an embolization of uterine fibroids. So we're going to show you the ...

234

Uterine artery embolization - discharge  

Science.gov (United States)

Uterine fibroid embolization - discharge; UFE - discharge; UAE - discharge ... You had uterine artery embolization (UAE). UAE is a procedure to treat fibroids using radiology instead of surgery. During the procedure, the blood supply of the fibroids ...

235

Uterine Fibroid Embolization  

Medline Plus

Full Text Available ... old. She has very symptomatic uterine fibroids, very heavy menstrual periods. Her periods last on the order ... we see in women with uterine fibroids is heavy bleeding. In fact, some of our patients have ...

236

Uterine Cancer Statistics  

Science.gov (United States)

... and Badges About the Campaign Buttons and Badges Statistics for Other Types of Cancer Breast Cervical Colorectal ( ... Skin Vaginal and Vulvar Cancer Home Uterine Cancer Statistics Uterine cancer is the fourth most common cancer ...

237

Tamoxifeno e Espessamento Endometrial Assintomático  

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Tamoxifen is a first-line agent for adjuvant treatment of estrogen-receptor positive breast cancer, and is used to reduce the risk of this condition in high-risk individuals. Retrospective studies established an association between tamoxifen use, endometrial thickness and endometrial cancer. There have been many attempts to identify an effective screening program for tamoxifen-related endometrial cancer, which have led to the use of transvaginal ultrasound and invasive procedures. The use of ...

Amaral, N.; Robalo, R.; Fatela, A.

2008-01-01

238

Preoperative staging of endometrial cancer using TVS, MRI, and hysteroscopy  

DEFF Research Database (Denmark)

OBJECTIVES: To evaluate the accuracy of different preoperative modalities for staging of endometrial cancer to restrict extensive surgery to patients at high risk of metastatic disease. SETTING: Aarhus University Hospital. POPULATION: 156 women referred in 2006-2011 because of atypical endometrial hyperplasia (G0) or endometrial cancer. METHODS: Patients were offered preoperative transvaginal ultrasonography (TVS), magnetic resonance imaging (MRI), and hysteroscopic-directed biopsies from the uterine tumor and cervix. Final pathology of the removed uterus was the reference standard. Patients were divided into low risk (<50% myometrial invasion, and grades 0, 1, 2, and no cervical invasion) or high risk (all others). MAIN OUTCOME MEASURES: Accuracy, sensitivity, specificity, positive/negative predictive value. RESULTS: Patients were aged 32-88 years, with a mean body mass index of 29. At final pathology 81% had cancer and 19% G0 or no residual tumor; 54% were high risk. Hysteroscopy-directed biopsies had a higher accuracy (92%) than endometrial biopsy (58%) for differentiating G0 from cancer (p < 0.001); grade 3 tumor identification had similar accuracy (93 vs. 92%). Deep myometrial invasion was estimated with higher accuracy by MRI (82%) than TVS (74%) (p < 0.02). For cervical involvement, hysteroscopy-directed biopsies had higher accuracy (94%) than MRI (84%,) and TVS (80%) (p < 0.02). Accuracy for identifying high-risk women was highest (83%) using a combination of MRI and hysteroscopic-directed biopsies, compared with TVS and endometrial biopsy (72%) (p < 0.05). CONCLUSION: Preoperative staging with MRI and hysteroscopy-directed biopsy can identify eight of 10 women with high risk of lymph node metastases and spare eight of 10 low-risk women extended surgery.

Ørtoft, Gitte; Dueholm, Margit

2013-01-01

239

Effect of Isopropanolic Cimicifuga racemosa Extract on Uterine Fibroids in Comparison with Tibolone among Patients of a Recent Randomized, Double Blind, Parallel-Controlled Study in Chinese Women with Menopausal Symptoms.  

Science.gov (United States)

Objective. Effect of isopropanolic Cimicifuga racemosa extract (iCR) on uterine fibroid size compared with tibolone. Method. The randomized, double-blind, controlled study in China enrolled 244 patients aged 40-60 years with menopausal symptoms (Kupperman Menopause Index ? 15). The participants were treated with either iCR of 40 mg crude drug/day (N = 122) or tibolone 2.5?mg/day (N = 122) orally for 3 months in 2004. Now, we investigated the subset of all women (N = 62) with at least one uterine fibroid at onset of treatment for the effect of iCR (N = 34) on fibroid size compared with tibolone (N = 28) by transvaginal ultrasonography. Results. The median myoma volume decreased upon iCR by as much as -30% (P = 0.016) but increased upon tibolone by +4.7%. The percentage of volume change, mean diameter change and geometric mean diameter change of the iCR group compared to tibolone were statistically significant (P = 0.016, 0.021, 0.016 respectively). Conclusion. Our results suggest that iCR (Remifemin) is a valid herbal medicinal product in patients with uterine myomas as it provides adequate relief from menopausal symptoms and inhibits growth of the myomas in contrast to tibolone. PMID:24719645

Xi, Sisi; Liske, Eckehard; Wang, Shuyu; Liu, Jianli; Zhang, Zhonglan; Geng, Li; Hu, Lina; Jiao, Chunfeng; Zheng, Shurong; Zepelin, Hans-Heinrich Henneicke-von; Bai, Wenpei

2014-01-01

240

The opioid neuropeptides in uterine fibroid pseudocapsules: a putative association with cervical integrity in human reproduction.  

Science.gov (United States)

The myoma pseudocapsule (MP) is a fibro-vascular network rich of neurotransmitters, as a neurovascular bundle, surrounding fibroid and separating myoma from myometrium. We investigated the distribution of the opioid neuropeptides, as enkephalin (ENK) and oxytocin (OXT), in the nerve fibers within MP and their possible influence in human reproduction in 57 women. An histological and immunofluorescent staining of OXT and ENK was performed on nerve fibers of MP samples from the fundus, corpus and isthmian-cervical regions, with a successive morphometric quantification of OXT and ENK. None of the nerve fibers in the uterine fundus and corpus MPs contained ENK and the nerve fibers in the isthmian-cervical region demonstrated an ENK value of up to 94?±?0.7?CU. A comparatively lower number of OXT-positive nerve fibers were found in the fundal MP (6.3?±?0.8?CU). OXT-positive nerve fibers with OXT were marginally increased in corporal MP (15.0?±?1.4?CU) and were substantially higher in the isthmian-cervical region MP (72.1?±?5.1?CU) (p?uterine corpus, while are highly present into the cervico-isthmic area, with influence on reproductive system and sexual disorders manifesting after surgical procedures on the cervix. PMID:23937196

Malvasi, Antonio; Cavallotti, Carlo; Nicolardi, Giuseppe; Pellegrino, Marcello; Vergara, Daniele; Greco, Marilena; Kosmas, Ioannis; Mynbaev, Ospan A; Kumakiri, Jun; Tinelli, Andrea

2013-11-01

 
 
 
 
241

HIPERPLASIA ENDOMETRIAL: ANÁLISIS DE SERIE DE CASOS DIAGNOSTICADOS EN BIOPSIA ENDOMETRIAL  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Antecedentes: La hiperplasia endometrial es una entidad en la que existe una proliferación de glándulas endometriales de tamaño y forma irregular, con mayor proporción de glándulas sobre el estroma, a consecuencia de una excesiva exposición a los estrógenos. Aproximadamente, en el 15% de legrados/bi [...] opsias endometriales de mujeres postmenopausicas con cuadro clínico de hemorragia uterina anormal, se diagnostica esta entidad. Objetivo: Describir la incidencia y hallazgos histopatológicos en legrado/biopsia endometrial en pacientes de un hospital público de tercer nivel. Métodos: Se revisaron 22.048 procedimientos realizados en el Hospital Universitario de Santander, procesados en el Departamento de Patología de la Universidad Industrial de Santander, en el periodo comprendido entre 1 de enero de 2005 y 31 de diciembre 2008, de los cuales 1.750 correspondieron a legrados/biopsias de endometrio y en 168 de estos se realizó el diagnóstico histopatológico de hiperplasia endometrial. Resultados: Se encontró que el promedio de edad de presentación de está entidad fue de 44,8 años y que el mayor porcentaje de pacientes (68,5%) estuvieron en el grupo de la hiperplasia simple sin atipia. En el 19,7% de los casos hubo evidencia de atipia. Conclusiones: El promedio de edad encontrado y los porcentajes por subgrupos de hiperplasia estuvieron en relación a otros estudios. Se destaca una menor proporción de casos con atipia. Abstract in english Background: Endometrial hyperplasia is an entity in which there is a proliferation of endometrial glands of irregular size and shape, with the highest proportion of glands on the stroma, resulting from excessive exposure to estrogen. Approximately 15% of curettages/endometrial biopsies of postmenopa [...] usal women with clinical symptoms of abnormal uterine bleeding is diagnosed this entity. Objective: To describe the incidence and pathological findings in curettage/endometrial biopsy in patients of a tertiary public hospital. Methods: A retrospective review of 22,048 surgical procedures performed in the University Hospital of Santander, processed in the Pathology Department of Industrial University of Santander in the period from 1 January 2005 and 31 December 2008, of which 1,750 corresponded to curettage/biopsy of the endometrium and in 168 of these histopathological diagnosis was made of endometrial hyperplasia. Results: We found that the average age of presentation in this institution was 44.8 years and that the greater percentage of patients (68.5%) were in the group of simple hyperplasia without atypia. In 19.7% of the cases had evidence of atypia. Conclusions: The mean age and percentages found by hyperplasia subgroups were relatively within limits with regard to other studies, although broadly outlined in a lower proportion of cases with atypia.

Ernesto, García Ayala; Laura, Cárdenas Mastrascusa; Diana, Sandoval Martínez; Henry, Mayorga Anaya.

242

Analysis of TSG101 tumour susceptibility gene transcripts in cervical and endometrial cancers  

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Carcinoma of the uterine cervix is a common malignancy among women that has been found to show loss of heterozygosity in the chromosome 11p. Recent studies have localized the TSG101 gene in this region, and also demonstrated a high frequency of abnormalities of this gene in human breast cancer. To determine the role of the TSG101 gene in the carcinogenesis of cervical and uterine carcinoma, 19 cases of cervical carcinoma and five cases of endometrial carcinoma, as well as nearby non-cancerous...

Chang, J-g; Su, T-h; Wei, H-j; Wang, J-c; Chen, Y-j; Chang, C-p; Jeng, C-j

1999-01-01

243

Role of Hysteroscopy and Laparoscopy in Evaluation of Abnormal Uterine Bleeding.  

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Full Text Available Abnormal uterine bleeding poses a real challenge for the gynecologists Dilatation and curettagehas been the gold standard for differentiating benign from malignant endometrium. Hysteroscopyand laparoscopy are the recent addition to the armamentarium of investigations for abnormaluterine bleeding. This study was done to evaluate the role of hysteroscopy and laparoscopy in75 women with abnormal uterine bleeding. Hysteroscopy findings were compared withhistopathology in the diagnosis and etiology of abnormal uterine bleeding. Majority of the patientspresented with menorrhagia (40% and metrorrhagia (20%. Hysteroscopy showed abnormalitydetection rate of 66% as compared to 26.6% with traditional curettage. Diagnostic accuracy ofhysteroscopy was higher in patients with polyps and myoma. Hysteroscopy allows the exclusionof intra uterine pathology with greater precision. Hysteroscopy is superior to curettage, thoughnot a substitute for tissue diagnosis. Laparoscopy was performed in 50 cases including 16 of coexistentinfertility, 25 cases with normal hysteroscopy findings and in 9 patients symptoms andsigns indicative of pelvic inflammatory diseases were present. An abnormaliity was detected in40% of these cases in the form of adhesions, leiomyomas, ovarian cysts, misplaced IUCDs andendometriosis. Thus laparoscopy can be complimentary to hysteroscopy in evaluation andmanagement of patients with abnormal uterine bleeding.

Jyotsana, Kamlesh Manhas, Sudha Sharma.

2004-01-01

244

Endometrial stromal sarcoma  

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Full Text Available Endometrial stromal sarcoma (ESS is a rare malignant tumor of the endometrium, occurring in the age group of 40-50 years. This is a case of low-grade ESS presenting as rapid enlargement of a fibroid uterus. Because of her secondary infertility, she was planned for myomectomy. However, due to the high degree of suspicion of a sarcomatous change in the fibroid, in view of rapid enlargement of uterus within the last 4 months, we planned for a preoperative endometrial aspiration. It showed low-grade ESS, which was later confirmed by histopathology examination of total hysterectomy specimen. As surgery was the main treatment for ESS, because of the proper preoperative diagnosis, we could plan the treatment accordingly. Despite the rarity of the tumor, one has to consider the possibility of ESS in cases with presentation of rapid enlargement of a fibroid uterus.

Puliyath Geetha

2010-03-01

245

Radiotherapy of endometrial cancers  

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The surgery treatment of endometrial cancer is not enough and the role of a further radiotherapy, important. In this article, the authors try to determine this role and successively look into the curietherapy-radiotherapy-surgery association, the exclusive irradiations with indications, the abdomen irradiation, the recurrent treatment according to the first treatment and finally, the high dose rate curietherapy. Actually, this last method gives interesting results

246

Comparison of Transvaginal Ultrasonography with Hysterosonography as a Screening Method in Patients with Abnormal Uterine Bleeding  

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Objective To assess the utility of hysterosonography (HS) as a screening method in patients with abnormal uterine bleeding. Materials and Methods We retrospectively reviewed transvaginal ultrasonography (TVS) and HS for 105 patients whose diagnosis was confirmed pathologically. All 105 patients were initially evaluated on the same day with both TVS and HS. On TVS and HS examination, endometrial cavitary lesions were classified as diffuse hyperplasia, endometrial polyp, endometrial cancer, uterine synechia and submucosal leiomyoma. Hysteroscopy with biopsy (n=35), curettage (n=60) or hysterectomy (n=10) was performed, and the results of TVS and HS examination were correlated with the pathological findings. Results The sensitivity and specificity were 79.0% and 45.8% for TVS, and 95.1% and 83.3% for HS, respectively. The positive and negative predictive values were 83.0% and 39.3% for TVS, and 95.1% and 83.3% for HS, respectively. Twenty-seven showed a discrepancy between the TVS and HS, and eight cases showed a discrepancy between HS and the pathologic diagnosis. Conclusion TVS is a sensitive method to evaluate the endometrial cavitary lesions, but it often does not provide the physician with sufficient diagnostic information. With its higher sensitivities, specificities and positive and negative predictive values, HS can be better used than TVS in evaluating those patients with abnormal uterine bleeding. PMID:15064558

Ryu, Jeong-ah; Lee, Jongmee; Kim, Sooah; Lee, Sang Hoon

2004-01-01

247

Comparison of transvagianl ultrasonography with hysterosonography as a screening method in patients with abnormal uterine bleeding  

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To assess the utility of hysterosonography (HS) as a screening method in patients with abnormal uterine bleeding. We retrospectively reviewed transvaginal ultrasonography (TVS) and HS for 105 patients whose diagnosis was confirmed pathologically. All 105 patients were initially evaluated on the same day with both TVS and HS. On TVS and HS examination. endometrial cavitary lesions were classified as diffuse hyperplasis, endometrial polyp, endometrial cancer, uterine synechia and submucosal leiomyoma. Hysteroscopy with biopsy (n=35), curettage (n=60) or hysterectomy (n=10) was performed, and the results of TVS and HS examination were correlated with the pathological findings. The sensitivity and specificity were 79.0% and 45.8% for TVS, and 95.1% and 83.3% for HS, respectively. The positive and negative predictive values were 83.0% and 39.3% for TVS, and 95.1% and 83.3% for HS, respectively. Twenty-seven showed a discrepancy between the TVS and HS, and eight cases showed a discrepancy between HS and the pathologic diagnosis. TVS is a sensitive method to evaluate the endometrial cavitary lesions, but it often does not provide the physician with sufficient diagnostic information. With its higher sensitivities, specificities and positive and negative predictive values, HS can be better used than TVS in evaluating those patients with abnormal uterine bleeding.

Ryu, Jeong Ah; Kim, Bo Hyun; Lee, Jong Mee; Kim, Soo Ah [Sungkyunkwan University, Seoul (Korea, Republic of); Lee, Sang Hoon [University of Ulsan College of Medicine, Seoul (Korea, Republic of)

2004-03-15

248

Immunohistochemical survey of mismatch repair protein expression in uterine sarcomas and carcinosarcomas.  

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Uterine sarcomas and carcinosarcomas are an aggressive group of uterine malignancies. The frequency of mismatch repair (MMR) protein loss by immunohistochemical evaluation has not been comprehensively characterized in this group of tumors; hence, the appropriateness of applying an immunohistochemical panel to screen for Lynch syndrome in these tumors remains unclear. We examined for the immunohistochemical loss of 4 MMR proteins (MLH1, MSH2, MSH6, and PMS2) in a series of 67 uterine carcinosarcomas and 51 uterine sarcomas (20 leiomyosarcomas, 11 adenosarcomas, 9 low-grade endometrial stromal sarcomas, 8 high-grade endometrial stromal sarcomas/undifferentiated endometrial sarcomas, and 3 rhabdomyosarcomas) at our institution. Four of the 67 (6.0%) carcinosarcomas demonstrated abnormal MMR protein expression. Two tumors showed concurrent loss of MLH1 and PMS2 in both the carcinomatous and sarcomatous components. One tumor showed the loss of only PMS2 in both components. The remaining tumor showed an isolated loss of MLH1 and PMS2 in only the small cell carcinoma component, whereas the non-small-cell carcinoma and sarcoma components demonstrated normal staining patterns for MMR proteins. Two of 20 leiomyosarcomas (10%) showed the loss of MMR proteins: one with loss of PMS2 and the other with loss of MSH2 and MSH6. All other uterine sarcoma types examined showed intact MMR protein expression. These observations provide a basis for MMR protein screening in uterine carcinosarcomas and leiomyosarcomas but not in other types of uterine mesenchymal or mixed epithelial/mesenchymal malignancies. PMID:25083964

Hoang, Lien N; Ali, Rola H; Lau, Sherman; Gilks, C Blake; Lee, Cheng-Han

2014-09-01

249

Surgical Treatment of Endometrial Cancer  

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Full Text Available Each year endometrial cancer is diagnosed in approximately 11.700 women in Germany. Operation is the therapy of choice in the primary treatment of patients with endometrial cancer. The traditional abdominal approach, vaginal, laparoscopic and robotic-assisted methods are available for the surgical treatment of EC today. This article compares and evaluates these different treatment options. With rising incidence of obesity, number of patients with endometrial cancer will also increase. However, operations in obese patients are more challenging. Laparotomy as standard therapy in endometrial cancer patients stage I and II should be replaced by laparoscopic approaches. Laparoscopy is oncologically adequate to open procedures and offers many advantages to patients. Robotic surgery in the treatment of endometrial cancer is still under evaluation. Most controversial points of treatment today are indication and extention of lymphadenectomy in different stages. In advanced tumor stages, optimal debulking should be performed in order to improve effectiveness of adjuvant chemotherapeutic and/or radiation therapy.

Lanowska Malgorzata

2010-12-01

250

Carcinoma of the Lower Uterine Segment (LUS): Clinicopathological Characteristics and Association with Lynch Syndrome.  

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Endometrial cancer arises from the uterine body and fundus in many cases, but can also originate from the lower region of the uterine body through the upper region of the cervix. Such tumors are referred to as carcinoma of the lower uterine segment (LUS) or isthmus, and account for 3-6.3% of all cases of endometrial cancer. This relatively low incidence has permitted performance of only small-scale studies, but the clinical and pathological characteristics of carcinoma of the LUS in all these reports have differed from those of other endometrial cancers. Generally, endometrial cancer is classified into estrogen-dependent endometrioid adenocarcinoma (designated as type I), and non-endometrioid types that are less associated with estrogen and include poorly differentiated adenocarcinoma (type II). In some reports, carcinoma of the LUS has been found to have type II characteristics. Carcinoma of the LUS has also been associated with Lynch syndrome, a hereditary disease with frequent development of colorectal, endometrial, and ovarian cancers. Lynch syndrome is thought to be induced by mismatch repair gene mutation. The frequency of Lynch syndrome in cases of general endometrial cancer is 1-2%. In contrast, the frequency in patients with carcinoma of the LUS is much higher, with up to 29% of cases diagnosable with Lynch syndrome and a high frequency of hMSH2 mutation found in one study. This suggests that further investigation of the clinical and pathological characteristics of carcinoma of the LUS and the association with Lynch syndrome is required through performance of a large-scale survey. PMID:21886452

Masuda, Kenta; Banno, Kouji; Yanokura, Megumi; Kobayashi, Yusuke; Kisu, Iori; Ueki, Arisa; Ono, Asuka; Nomura, Hiroyuki; Hirasawa, Akira; Susumu, Nobuyuki; Aoki, Daisuke

2011-03-01

251

Sarcoma del estroma endometrial de grado alto: presentación de un caso / High degree endometrial stromal sarcoma: case report  

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Full Text Available SciELO Peru | Language: Spanish Abstract in spanish El sarcoma del estroma endometrial (SEE) es un tumor infrecuente, que comprende menos del 1% de los tumores malignos ginecológicos. Presentamos el caso de una mujer de 24 años con hemorragia uterina anormal a la que se le realizó histerectomía con anexectomía bilateral por tumor pélvico. Microscópic [...] amente, la neoplasia estaba constituida por una proliferación maligna de células estromales del endometrio. El estudio inmunohistoquimico mostró positividad para vimentina y desmina. Se presenta el estudio clínico patológico, la nueva clasificación de la OMS y las opciones terapéuticas. Abstract in english Endometrial stromal sarcoma (ESS) is a rare tumor comprising less than 1% of gynecological malignancies. We report the case of a 24 year old woman with abnormal uterine bleeding who underwent hysterectomy and bilateral oophorectomy for pelvic tumor. At microscopy the neoplasm was composed of maligna [...] nt proliferation of endometrial stromal cells. Immunohistochemical studies were positive for vimentin and desmin. Clinical and pathologic findings are presented, as well as a review of the new WHO classification and treatment options.

Ernesto, Molina-Loza; Carlos, Altez-Navarro.

252

Uterine artery embolization to treat uterine fibroids  

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The first reported application of uterine artery embolization, in 1979, was to treat life-threatening hemorrhage after a failed hysterectomy. Since then, uterine artery embolization has been used very successfully to control acute or delayed post-partum hemorrhage, post-surgical hemorrhage and hemorrhage from ectopic pregnancy, to treat uterine arteriovenous malformations and as prophylaxis before high-risk surgery, such as cesarean delivery in women with placenta previa. In contrast to these proven but underutilized applications, uterine embolization for fibroids has, in a short time, achieved significant notice in the lay press and is being widely offered. Ravina and colleagues, first reported uterine fibroid shrinkage after embolization for the treatment of acute bleeding. Since then, his group has performed over 100 procedures with up to a 6-year follow-up. The cumulative clinical success rate for the treatment of abnormal uterine bleeding due to fibroids is reported to be approximately 85% and for treatment of pain or pressure symptoms, about 75%. Six-month follow-up sonography reveals an average reduction of fibroid size of approximately 40%. However, to date, no studies have compared patients who undergo embolization with a nontreatment cohort or with surgical intervention. (author)

Machan, L.; Martin, M. [Univ. of British Columbia Hospital, Dept. of Radiology, Vancouver, BC (Canada)

2001-06-01

253

Uterine artery embolization to treat uterine fibroids  

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The first reported application of uterine artery embolization, in 1979, was to treat life-threatening hemorrhage after a failed hysterectomy. Since then, uterine artery embolization has been used very successfully to control acute or delayed post-partum hemorrhage, post-surgical hemorrhage and hemorrhage from ectopic pregnancy, to treat uterine arteriovenous malformations and as prophylaxis before high-risk surgery, such as cesarean delivery in women with placenta previa. In contrast to these proven but underutilized applications, uterine embolization for fibroids has, in a short time, achieved significant notice in the lay press and is being widely offered. Ravina and colleagues, first reported uterine fibroid shrinkage after embolization for the treatment of acute bleeding. Since then, his group has performed over 100 procedures with up to a 6-year follow-up. The cumulative clinical success rate for the treatment of abnormal uterine bleeding due to fibroids is reported to be approximately 85% and for treatment of pain or pressure symptoms, about 75%. Six-month follow-up sonography reveals an average reduction of fibroid size of approximately 40%. However, to date, no studies have compared patients who undergo embolization with a nontreatment cohort or with surgical intervention. (author)

254

Uterine pinopodes in peri-implantation human endometrium. Clinical relevance.  

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Current clinical studies indicate the existence in the human of an "implantation/nidation window," similar to that observed in animal models. During this short period of uterine receptivity, the formation of pinopodes on the apical cell membrane of the endometrial epithelium is a consistent morphological event, observed in a number of species studies including the human. In order to develop a specific marker of the implantation window in clinical practice, we have investigated the kinetics of pinopode formation through sequential endometrial sampling under various hormonal conditions. Our results show that the implantation window in humans, according to this marker, lasts less than 48 hours, and the timing of its opening is dependent on the hormonal treatment applied, occurring earlier in cycles following ovarian stimulation and later in cycles induced by hormone replacement treatment. Furthermore, the timing varies among different individuals under the same treatment. These findings suggest that examination for pinopodes in endometrial samples can be highly useful in infertility treatment and research for the assessment of the nidation window on an individual basis. Our preliminary data strongly support the value of this assessment for better timing of ovum transfer, leading to an increase in implantation rates. Studies are now in progress on the expression of other endometrial signals present in relation to the pinopodes. PMID:9238262

Nikas, G; Psychoyos, A

1997-06-17

255

What's New in Endometrial Cancer Research and Treatment?  

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... resources for endometrial cancer What`s new in endometrial cancer research and treatment? Molecular pathology of endometrial cancer Recent ... Your Doctor After Treatment What`s New in Endometrial Cancer Research? Other Resources and References Cancer Information Cancer Basics ...

256

Metabolic vulnerabilities in endometrial cancer.  

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Women with metabolic disorders, including obesity and diabetes, have an increased risk of developing endometrial cancer. However, the metabolism of endometrial tumors themselves has been largely understudied. Comparing human endometrial tumors and cells with their nonmalignant counterparts, we found that upregulation of the glucose transporter GLUT6 was more closely associated with the cancer phenotype than other hallmark cancer genes, including hexokinase 2 and pyruvate kinase M2. Importantly, suppression of GLUT6 expression inhibited glycolysis and survival of endometrial cancer cells. Glycolysis and lipogenesis were also highly coupled with the cancer phenotype in patient samples and cells. To test whether targeting endometrial cancer metabolism could be exploited as a therapeutic strategy, we screened a panel of compounds known to target diverse metabolic pathways in endometrial cells. We identified that the glycolytic inhibitor, 3-bromopyruvate, is a powerful antagonist of lipogenesis through pyruvylation of CoA. We also provide evidence that 3-bromopyruvate promotes cell death via a necrotic mechanism that does not involve reactive oxygen species and that 3-bromopyruvate impaired the growth of endometrial cancer xenografts Cancer Res; 74(20); 5832-45. ©2014 AACR. PMID:25205105

Byrne, Frances L; Poon, Ivan K H; Modesitt, Susan C; Tomsig, Jose L; Chow, Jenny D Y; Healy, Marin E; Baker, William D; Atkins, Kristen A; Lancaster, Johnathan M; Marchion, Douglas C; Moley, Kelle H; Ravichandran, Kodi S; Slack-Davis, Jill K; Hoehn, Kyle L

2014-10-15

257

Endometrial Receptivity Defects and Impaired Implantation in Diabetic NOD Mice1  

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Implantation failure is a major hurdle to a successful pregnancy. The high rate of postimplantation fetal loss in nonobese diabetic (NOD) mice is believed to be related to an abnormal decidual production of interferon (IFN)gamma. To address whether diabetes alters the natural events associated with successful implantation, certain morphological and molecular features of uterine receptivity in diabetic NOD (dNOD) mice were examined in normally mated pregnancy and in concanavalin A (ConA)-induced pseudopregnancy. As opposed to normoglycemic NOD (cNOD) mice, dNOD mice expressed retarded maturation of their uterine pinopodes and overexpressed MUC1 mucin at implantation sites (P < 0.001). Uterine production of leukemia inhibitory factor (LIF) and phosphorylation of uterine NFkappaBp65 and STAT3-Ty705 were found to be low (P < 0.01) during Day 4.5 postcoitum, whereas IFNgamma was aberrantly overexpressed. Loss of temporal regulation of progesterone receptor A (PR A) and PR B, together with aberrantly increased expression of the protein inhibitor of activated STAT-y (PIASy) (P < 0.01) and reduced recruitment (P < 0.01) of the latter to nuclear progesterone receptor sites were prominent features of decidualization failure occurring at peri-implantation in dNOD mice. In conclusion, the aberrant expression of endometrial IFNgamma in dNOD mice is associated with a nonreceptive endometrial milieu contributing to peri-implantation embryo loss in type 1 diabetes. PMID:22539679

Albaghdadi, Ahmad J.H.; Kan, Frederick W.K.

2013-01-01

258

Sonohysterography-Guided Biopsy of Focal Endometrial Abnormalities: Technical Feasibility and Diagnostic Accuracy  

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To assess the feasibility and diagnostic accuracy of a sononohysterography-guided biopsy in an evaluation of focal endometrial lesions. Sixty-five consecutive patients with focal endometrial lesions detected on baseline sonohysterography were enrolled prospectively. The biopsy was performed under real-time sonohysterography guidance, using a 3.1 mm Pipelle endometrial sampler as the primary biopsy device. The feasibility was evaluated from the technical success rates and the number of 'diagnostic' specimen for the histological diagnosis. The diagnostic accuracy was assessed by comparing the biopsy results with the final pathological diagnosis obtained by the surgical procedure. Sonohysterography-guided biopsy was performed successfully in 59(90.8%) out of 65 patients. The reasons for failure in 6 patients were a failure to pass through the cervix (n=3): failure to target a focal lesion (n=2): and inadequate uterine distension (n=1). The biopsy specimen was 'diagnostic' in 49 (83.1%) out of 50 patients, and 'non-diagnostic' in 10 patients with insufficient tissue (n=6) and indeterminate cellular features for a histological diagnosis (n=4). The cytology results of the sonohysterographically-guided biopsy correlated well with the pathological diagnosis in 35 (92.1%) out of 38 patients who underwent subsequent surgical procedures. Sonohysterography-guided biopsy is technically feasible and can be an accurate method for diagnosing focal endometrial lesions. It could be considered to be a reliable office triage as an alternative to hysteroscopic biopsy in patients with focal endometrial abnormalities

259

Endometrial Histology of Depomedroxyprogesterone Acetate Users: A Pilot Study  

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Full Text Available Objective. To obtain pilot data on the endometrial histology of Depomedroxyprogesterone acetate (Depo-Provera, DMPA users experiencing breakthrough bleeding (BTB versus users with amenorrhea. To compare the endometrial histology of patients who used DMPA continuously for 3–12 months versus those who used it for 13 months or more. Methods. Cross-sectional study. Endometrial biopsy was obtained from all consenting patients who used DMPA for at least 3 months. Patients were divided into those with BTB in the last 3 months versus those with amenorrhea for at least 3 months. Histology results and duration of therapy were compared. Results. The proportion of women with chronic endometritis, uterine polyps, atrophic, proliferative, or progesterone-dominant endometrium did not differ between those DMPA users with BTB versus those with amenorrhea. Duration of therapy did not correlate with symptoms of BTB or endometrial histology. Chronic endometritis was the most common histologic finding (10/40, 25% and occurred more often in women experiencing BTB (35% versus 15% (RR 1.62 CI 0.91–2.87. Moreover, 45% of women with BTB had received DMPA for more than 12 months. Conclusions. BTB was more common than previously reported in women using DMPA for more than 12 months. Chronic endometritis, which may indicate an underlying infectious or intracavitary anatomic etiology, has not been previously reported as a frequent finding in DMPA users, and may be related to ethnic or other sociodemographic characteristics of our patient population. Further study to elucidate the etiology of chronic endometritis in these patients is warranted.

David E. Soper

2006-02-01

260

Endometrial Histology of Depomedroxyprogesterone Acetate Users: A Pilot Study  

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Full Text Available Objective. To obtain pilot data on the endometrial histology of Depomedroxyprogesterone acetate (Depo-Provera, DMPA users experiencing breakthrough bleeding (BTB versus users with amenorrhea. To compare the endometrial histology of patients who used DMPA continuously for 3–12 months versus those who used it for 13 months or more. Methods. Cross-sectional study. Endometrial biopsy was obtained from all consenting patients who used DMPA for at least 3 months. Patients were divided into those with BTB in the last 3 months versus those with amenorrhea for at least 3 months. Histology results and duration of therapy were compared. Results. The proportion of women with chronic endometritis, uterine polyps, atrophic, proliferative, or progesterone-dominant endometrium did not differ between those DMPA users with BTB versus those with amenorrhea. Duration of therapy did not correlate with symptoms of BTB or endometrial histology. Chronic endometritis was the most common histologic finding (10/40, 25% and occurred more often in women experiencing BTB (35% versus 15% (RR 1.62 CI 0.91–2.87. Moreover, 45% of women with BTB had received DMPA for more than 12 months. Conclusions. BTB was more common than previously reported in women using DMPA for more than 12 months. Chronic endometritis, which may indicate an underlying infectious or intracavitary anatomic etiology, has not been previously reported as a frequent finding in DMPA users, and may be related to ethnic or other sociodemographic characteristics of our patient population. Further study to elucidate the etiology of chronic endometritis in these patients is warranted.

2006-01-01

 
 
 
 
261

Pharmacological therapy for abnormal uterine bleeding.  

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Pharmacological therapies for the treatment of abnormal uterine bleeding are effective and generally well tolerated. This review presents an evidence-based approach to medical therapy. Selection depends on the etiology and amount of bleeding, need for contraception or preservation of fertility, perimenopause status, and medication efficacy and adverse effects.Available nonhormonal agents include nonsteroidal anti-inflammatory agents, which reduce bleeding by 25% to 35% and improve dysmenorrhea through reduced prostaglandin levels; tranexamic acid, which inhibits plasminogen activator with a 40% to 60% reduction in menstrual blood loss; and intranasal desmopressin, which is an antifibrinolytic for women with an underlying bleeding disorder (eg, von Willebrand disease).Hormonal regimens cause the inhibition of endometrial growth. Cyclic progestogen therapy for 21 days results in a significant reduction in menstrual blood loss. Limited data suggest that oral contraceptives reduce menstrual blood loss by 40% to 50% with decreased breast tenderness and dysmenorrhea and a reduction in risk of uterine and ovarian cancer. The progestin-releasing intrauterine devices are effective up to 97% by 6 months and provide relief of dysmenorrhea and contraception. Long-acting progestogen injections produce amenorrhea and provide contraception but are associated with irregular spotting and reversible bone loss. Danazol leads to endometrial atrophy with a reduced menstrual loss; androgenic adverse effects may be lessened with lower doses or vaginal use. Gonadotrophin agonists lead to ovarian suppression and are used to shrink fibroids or the endometrium preoperatively but are limited by hypoestrogenic adverse events. Emergency use of parenteral conjugated estrogens has a 70% chance of stopping abnormal bleeding but an increased risk of thrombosis. PMID:21701432

Pinkerton, JoAnn V

2011-04-01

262

[Endometrial biopsy in the evaluation of endometrial receptivity].  

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The histological changes underwent by endometrium during a natural menstrual cycle were described more than 50 years ago. Dating yields several methodological flaws, with intra- and inter-observer variability and shows questionable relationship to endometrial receptivity. The best studied endometrial factors involved in implantation include the formation of luminal epithelial "pinopodes", expression of adhesion molecules and of cytokines. Ovarian stimulation for IVF is known to affect luteal phase function. Factors influencing the endometrial receptivity in such cycles are poorly understood. Studies comparing the endometrium in IVF cycles with natural cycle controls have shown premature secretory changes in the postovulatory and early luteal phase of IVF cycles. These findings suggest a profound modification of luteal endometrial development in stimulated cycles. Studies exploring the endometrium within the cycle of embryo transfer have shown a deleterious effect of severe periovulatory maturation advancement exceeding 3 days, as no clinical pregnancies were observed in this condition. PMID:14968038

Bourgain, C

2004-02-01

263

Resveratrol interferes with AKT activity and triggers apoptosis in human uterine cancer cells  

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Full Text Available Abstract Background Endometrial cancer is the fourth most prominent cancer among all feminine cancers in the Western world. Resveratrol, a natural anti-oxidant found in red wine emerging as a novel anticancer agent, exerts antiproliferative and pro-apoptotic activity in various cancer cell types, but its effect on uterine cancer cells is poorly understood. At the molecular level, resveratrol has been reported to inhibit cyclooxygenase (COX expression and/or activity; in endometrial cancer cells, COX-2 is overexpressed and confers cellular resistance to apoptosis. The aim of the present study was to determine if resveratrol could exert anti-proliferative and pro-apoptotic activity over uterine cancer cells upon inhibition of COX-2 expression and/or activity. Six different human uterine cancer cell lines were used as a model (HeLa, Hec-1A, KLE, RL95-2, Ishikawa and EN-1078D. Results and discussion High-dose of resveratrol triggered apoptosis in five out of six uterine cancer cell lines, as judged from Hoechst nuclear staining and effector caspase cleavage. In accordance, uterine cancer cell proliferation was decreased. Resveratrol also reduced cellular levels of the phosphorylated/active form of anti-apoptotic kinase AKT. Endogenous COX-2 protein levels were decreased, concomitant with a decrease in production of COX metabolites PGE2 and PGF2?, in each uterine cancer cell line expressing detectable levels of COX-1 and/or COX-2 in presence of resveratrol. Although COX expression was identified as a target of resveratrol in uterine cancer cells, inhibition of COX activity or exogenously added PGE2 did not modulate the effect of resveratrol on cellular proliferation. Conclusion High-dose of resveratrol exerts tumoricidal activity over uterine cancer cells and regulates COX expression. In these cells, resveratrol would not directly target COX activity, but possibly other enzymes involved in prostaglandin synthesis that act downstream of the COXs.

Asselin Eric

2006-10-01

264

Risks of Endometrial Cancer Screening  

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... birth. Beginning menstruation at an early age. Reaching menopause at an older age. Having the gene for hereditary non-polyposis colon cancer (HNPCC). Being white. Endometrial Cancer Screening Tests are used to screen for different types of ...

265

Abnormal Uterine Bleeding  

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... uterine lining. It's done by putting a thin plastic tube (called a catheter) into your uterus. A tiny piece of the uterine lining is taken out and sent to a lab for testing. The test will show if you have cancer or a change in the cells. A biopsy ...

266

Ten-year literature review of global endometrial ablation with the NovaSure® device  

Directory of Open Access Journals (Sweden)

Full Text Available Richard J Gimpelson Mercy Clinic, Minimally Invasive Gynecology, Department of Obstetrics and Gynecology, Mercy Hospital St Louis, St Louis, MO, USA Abstract: This review examines the peer-reviewed literature describing prospective studies that report amenorrhea rates, patient satisfaction, and surgical reintervention rates following the NovaSure® endometrial ablation procedure. A search of the English-language literature published from 2000 to 2011 was conducted using PubMed. Ten prospective studies, six single-arm NovaSure trials, and four randomized controlled trials comparing the NovaSure procedure with other global endometrial ablation modalities met the inclusion criteria and were reviewed. The follow-up periods ranged from 6 to 60 months. Amenorrhea rates for the NovaSure procedure ranged from 30.0% to 75.0%. Patients who reported being satisfied with the NovaSure procedure ranged from 85.0% to 94.0%. In randomized controlled trials with other global endometrial ablation modalities, amenorrhea rates at 12 months with the NovaSure procedure ranged from 43.0% to 56.0%, while other modalities ranged from 8% to 24%. In addition, this manuscript reviews the following: the NovaSure technology; use of the NovaSure procedure in the office setting; intraoperative and postoperative pain; effects on premenstrual syndrome (PMS; dysmenorrhea; special circumstances, including presence of uterine disease, history of cesarean delivery, coagulopathy, or use of anticoagulant medication; post-procedure uterine cavity assessment and cancer risk; contraception and pregnancy; and safety. Keywords: abnormal uterine bleeding, menorrhagia, endometrial ablation, NovaSure®

Gimpelson RJ

2014-03-01

267

Biomarkers of endometrial receptivity--a review.  

Science.gov (United States)

Implantation is a phenomenon that involves an interaction between the embryo and maternal endometrium. There is, in the menstrual cycle, a short and precise period of time in which the maternal-embryonic interaction is optimal and culminates with adhesion and invasion of the blastocyst into the progesterone-induced secretory endometrium. This period is called nidation or implantation window. In the implantation window changes occur in endometrial epithelial morphology, characterized by the appearance of membrane projections called pinopodes. Pinopodes are progesterone-dependent organelles, that look like apical cellular protrusions appearing between days 20 and 21 of the natural menstrual cycle. There are many factors that regulate the changes typical of the implantation window and the appearance of the pinopodes. The embryonic and maternal expression of growth factors and cytokines, calcitonin, HOX genes and cell adhesion molecules might all play a major role in the phenomenon of implantation. The cytokines function as chemical messengers and can serve as biomarkers of uterine receptivity. Understanding the function of these biomarkers and their role in determining the implantation window in women, will help us to diagnose and treat infertile couples more efficiently. PMID:14559029

Cavagna, M; Mantese, J C

2003-10-01

268

High-dose atorvastatin ameliorates the uterine microenvironment in streptozotocin-induced diabetic rats.  

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Abstract The aim of this study was to investigate whether atorvastatin can ameliorate the uterine microenvironment in diabetes mellitus. Six non-diabetic (control) and 12 diabetic mature female Sprague-Dawley albino rats were used in this study. Diabetes was induced by intraperitoneal injections of 60?mg/kg streptozotocin, and 10?mg/kg/day of oral atorvastatin was administered for 4?weeks via orogastric tubes. The animals were euthanized, and blood samples were collected via cardiac puncture for biochemical analysis. Bilateral hysterectomy was performed for the histopathologic examination. Endometrial gland degeneration and stromal fibrosis scores concomitant with epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) immunoexpressions were analyzed. The endometrial gland degeneration scores, stromal fibrosis scores and VEGF immunoexpression was significantly lower, and the EGFR immunoexpression was significantly higher in the atorvastatin-treated diabetic rats when compared to the non-treated diabetic group, suggesting that atorvastatin ameliorates the uterine microenvironment in diabetes mellitus. PMID:24989632

Zeybek, Burak; Ergenoglu, Mete; Erbas, Oytun; Yildirim, Nuri; Akdemir, Ali; Yavasoglu, Altug; Aktug, Huseyin; Taskiran, Dilek

2014-11-01

269

[Malignant non-epithelial neoplasms of the uterine body--clinical analysis].  

Science.gov (United States)

Twenty six cases of primary uterine sarcomas treated between 1980-1990 are analyzed. There were 16 cases (62%) of endometrial stromal sarcoma, 8 cases (31%) of leiomyosarcoma and 2 cases (7%) of botryoid rhabdomyosarcoma. Symptoms of uterine sarcoma are presented. In 19 patients (73%) pathological diagnosis was obtained by endometrial curettage before surgery. Stage of disease was classified according to intraoperative scale of Lewis. Median survival for the whole group treated surgically, by radiotherapy and chemotherapy was 22.2 months. Five patients (19%) in whom the disease was limited to the endometrium survived more than 5 years. Recurrences of the neoplasm and their treatment by secondary cytoreductive surgery are described. PMID:9686471

Emerich, J; Konefka, T; Dudziak, M

1997-12-01

270

Diagnosis of the early endometrial cancer used MRI CO2-VIBE (volume interpolated breath-hold examination) method  

International Nuclear Information System (INIS)

To evaluate the myometrial infiltration of the endometrial cancer prior to aggressive treatment, dynamic MRI (magnetic resonance imaging) has attracted attention. However, it has also been found that in many cases, MRI exhibits inconsistent results with regard to the extent of invasion into this component of the uterine body. To overcome this limitation, the authors designed a method to delineate the tumor morphology more clearly by injecting CO2 gas into the uterine cavity. This procedure was combined with VIBE (volumetric interpolated breath-hold examination) to determine more precisely the depth of the tumor invasion. From our clinical results, the efficacy of the method was evaluated. In 53 patients with endometrial cancers (stage Ia-IIb), CO2 was injected to dilate the intra-uterine space through a catheter equipped with a balloon that had been introduced into the uterine cavity, after which VIBE was conducted. The images were interpreted by MPR (multi-planar reconstruction) and the findings from these images were compared with the histopathological findings. By using this method, it was possible to clearly delineate the tumorous lesion in the uterine body, and three-dimensional images of the tumor invasion were acquired. The site and extent of tumor invasion in the myometrium were generally consistent with the histopathological findings. (author)

271

The prevalence of endometrial hyperplasia and endometrial cancer in women with polycystic ovary syndrome or hyperandrogenism  

DEFF Research Database (Denmark)

Polycystic ovary syndrome may be associated with an increased risk of endometrial hyperplasia and endometrial cancer, but substantial evidence for this remains to be established. We investigated the prevalence of endometrial hyperplasia and endometrial cancer in a well characterized group of women with polycystic ovary syndrome and/or clinical/biochemical hyperandrogenism.

Holm, Nina Sofie Lillegaard; Glintborg, Dorte

2012-01-01

272

Uterine Fibroid Embolization  

Directory of Open Access Journals (Sweden)

Full Text Available Uterine fibroids are commonly asymptomatic. They often cause pelvic pain, abnormal and increased vaginal bleeding, etc. Traditional treatment of symptomatic uterine fibroids was trans-abdominal hysterectomy. Nowadays, uterine artery embolization (UAE, also called uterine fibroid embolization, is considered as a safe and highly-effective nonsurgical treatment for women with symptomatic uterine fibroid tumors. Advantages of UAE over conventional hormonal suppression and surgical procedures include avoidance of the side effects of drug therapy and surgery-related physical and psychological trauma. These patients commonly resume their normal activities within a week after the procedure; weeks earlier than that for trans-abdominal hysterectomy. Over the past 30 years, interventional radiologists have done UAE for treatment of emergency uterine bleeding. Since 1995, interventional radiologists have turned their attention to treatment of uterine fibroids with a similar procedure. The first fibroid embolization in Iran was done approximately three years ago. So far, more than 100 cases have been treated by this method and it is going to be quickly accepted as a safe alternate for surgery.

"R. Malek

2003-06-01

273

Uterine fibroids: current perspectives.  

Science.gov (United States)

Uterine fibroids are a major cause of morbidity in women of a reproductive age (and sometimes even after menopause). There are several factors that are attributed to underlie the development and incidence of these common tumors, but this further corroborates their relatively unknown etiology. The most likely presentation of fibroids is by their effect on the woman's menstrual cycle or pelvic pressure symptoms. Leiomyosarcoma is a very rare entity that should be suspected in postmenopausal women with fibroid growth (and no concurrent hormone replacement therapy). The gold standard diagnostic modality for uterine fibroids appears to be gray-scale ultrasonography, with magnetic resonance imaging being a close second option in complex clinical circumstances. The management of uterine fibroids can be approached medically, surgically, and even by minimal access techniques. The recent introduction of selective progesterone receptor modulators (SPRMs) and aromatase inhibitors has added more armamentarium to the medical options of treatment. Uterine artery embolization (UAE) has now been well-recognized as a uterine-sparing (fertility-preserving) method of treating fibroids. More recently, the introduction of ultrasound waves (MRgFUS) or radiofrequency (VizAblate™ and Acessa™) for uterine fibroid ablation has added to the options of minimal access treatment. More definite surgery in the form of myomectomy or hysterectomy can be performed via the minimal access or open route methods. Our article seeks to review the already established information on uterine fibroids with added emphasis on contemporary knowledge. PMID:24511243

Khan, Aamir T; Shehmar, Manjeet; Gupta, Janesh K

2014-01-01

274

Somatic MED12 mutations in uterine leiomyosarcoma and colorectal cancer  

DEFF Research Database (Denmark)

Background:Mediator complex participates in transcriptional regulation by connecting regulatory DNA sequences to the RNA polymerase II initiation complex. Recently, we discovered through exome sequencing that as many as 70% of uterine leiomyomas harbour specific mutations in exon 2 of mediator complex subunit 12 (MED12). In this work, we examined the role of MED12 exon 2 mutations in other tumour types.Methods:The frequency of MED12 exon 2 mutations was analysed in altogether 1158 tumours by direct sequencing. The tumour spectrum included mesenchymal tumours (extrauterine leiomyomas, endometrial polyps, lipomas, uterine leiomyosarcomas, other sarcomas, gastro-intestinal stromal tumours), hormone-dependent tumours (breast and ovarian cancers), haematological malignancies (acute myeloid leukaemias, acute lymphoid leukaemias, myeloproliferative neoplasms), and tumours associated with abnormal Wnt-signalling (colorectal cancers (CRC)).Results:Five somatic alterations were observed: three in uterine leiomyosarcomas (3/41, 7%; Gly44Ser, Ala38_Leu39ins7, Glu35_Leu36delinsVal), and two in CRC (2/392, 0.5%; Gly44Cys, Ala67Val).Conclusion:Somatic MED12 exon 2 mutations were observed in uterine leiomyosarcomas, suggesting that a subgroup of these malignant tumours may develop from a leiomyoma precursor. Mutations in CRC samples indicate that MED12 may, albeit rarely, contribute to CRC tumorigenesis.

Kämpjärvi, K; Mäkinen, N

2012-01-01

275

Myometrial hyperplasia mimics the clinical presentation of uterine fibroids: a report of 3 cases.  

Science.gov (United States)

The clinical diagnosis of fibroid uterus is based on physical examination findings and/or ultrasound. However, it is not uncommon for routine pathology examination to report no significant fibroids in such cases. Myometrial hyperplasia (MMH) is a structural variation with irregular zones of hypercellularity and increased nucleus/cell ratio that appears in adolescence, can progress during the childbearing years, and can sometimes cause grossly detectable bulges on pathologic examination. MMH can be inframucosal, intramural (microscopic), or subserosal. Three premenopausal women with a preoperative diagnosis of fibroids on pelvic examination, and/or sonograms, underwent hysterectomies. In all the 3 cases, the Myoma Index (number of fibroids×size of largest fibroid) indicated insignificant fibroids. The pathology simulating fibroids was firm, bulging inframucosal MMH. Firm, bulging MMH can mimic uterine fibroids on ultrasound and physical examination. In hysterectomies for fibroid uterus with a Myoma Index <3.7, it is recommended that pathologists evaluate for MMH as the possible explanation for the findings on physical examination and/or ultrasound. PMID:24071875

Newcomb, Patricia M; Cramer, Stewart F; Leppert, Phyllis C

2013-11-01

276

Uterine Leiomyoma: Hysterosalpingographic Appearances  

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Full Text Available Uterine leiomyoma is the most common benign tumor of genital tract. The etiology of myomasis unknown. Leiomyoma shows a broad spectrum of radiographic appearances depending on thenumber, size, and location of the tumor. The diagnostic method for uterine leiomyomas is basedprimarily on the clinical situation. Despite of the varied diagnostic options such as; transvaginalsonography, sonohysterography, hysteroscopy, laparoscopy and MRI; hysterosalpingography isstill one of the valuable imaging methods for identification of uterine leiomyoma.The various features of the proved leiomyoma are illustrated in this pictorial review. The incidence,risk factors and clinical features will also be discussed briefly.

Firoozeh Ahmadi

2008-01-01

277

Hormone-regulated expression and distribution of versican in mouse uterine tissues  

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Full Text Available Abstract Background Remodeling of the extracellular matrix is one of the most striking features observed in the uterus during the estrous cycle and after hormone replacement. Versican (VER is a hyaluronan-binding proteoglycan that undergoes RNA alternative splicing, generating four distinct isoforms. This study analyzed the synthesis and distribution of VER in mouse uterine tissues during the estrous cycle, in ovariectomized (OVX animals and after 17beta-estradiol (E2 and medroxyprogesterone (MPA treatments, either alone or in combination. Methods Uteri from mice in all phases of the estrous cycle, and animals subjected to ovariectomy and hormone replacement were collected for immunoperoxidase staining for versican, as well as PCR and quantitative Real Time PCR. Results In diestrus and proestrus, VER was exclusively expressed in the endometrial stroma. In estrus and metaestrus, VER was present in both endometrial stroma and myometrium. In OVX mice, VER immunoreaction was abolished in all uterine tissues. VER expression was restored by E2, MPA and E2+MPA treatments. Real Time PCR analysis showed that VER expression increases considerably in the MPA-treated group. Analysis of mRNA identified isoforms V0, V1 and V3 in the mouse uterus. Conclusion These results show that the expression of versican in uterine tissues is modulated by ovarian steroid hormones, in a tissue-specific manner. VER is induced in the myometrium exclusively by E2, whereas MPA induces VER deposition only in the endometrial stroma.

Aplin John D

2009-06-01

278

Regulation of S100G Expression in the Uterine Endometrium during Early Pregnancy in Pigs.  

Science.gov (United States)

Calcium ions play an important role in the establishment and maintenance of pregnancy, but molecular and cellular regulatory mechanisms of calcium ion action in the uterine endometrium are not fully understood in pigs. Previously, we have shown that calcium regulatory molecules, transient receptor potential vanilloid type 5 (TRPV6) and calbindin-D9k (S100G), are expressed in the uterine endometrium during the estrous cycle and pregnancy in a pregnancy status- and stage-specific manner, and that estrogen of conceptus origin increases endometrial TRPV6 expression. However, regulation of S100G expression in the uterine endometrium and conceptus expression of S100G has been not determined during early pregnancy. Thus, we investigated regulation of S100G expression by estrogen and interleukin-1? (IL1B) in the uterine endometrium and conceptus expression of S100G during early pregnancy in pigs. We obtained uterine endometrial tissues from day (D) 12 of the estrous cycle and treated with combinations of steroid hormones, estradiol-17? (E2) and progesterone (P4), and increasing doses of IL1B. Real-time RT-PCR analysis showed that E2 and IL1B increased S100G mRNA levels in the uterine endometrium, and conceptuses expressed S100G mRNA during early pregnancy, as determined by RT-PCR analysis. To determine if endometrial expression of S100G mRNA during the implantation period was affected by the somatic cell nuclear transfer (SCNT) procedure, we compared S100G mRNA levels in the uterine endometrium from gilts with SCNT-derived conceptuses with those from gilts with conceptuses derived from natural mating on D12 of pregnancy. Real-time RT-PCR analysis showed that levels of S100G mRNA in the uterine endometrium from gilts carrying SCNT-derived conceptuses was significantly lower than those from gilts carrying conceptuses derived from natural mating. These results showed that S100G expression in the uterine endometrium was regulated by estrogen and IL1B of conceptus origin, and affected by the SCNT procedure during early pregnancy. These suggest that conceptus signals regulate S100G, an intracellular calcium transport protein, for the establishment of pregnancy in pigs. PMID:25049477

Choi, Yohan; Seo, Heewon; Shim, Jangsoo; Kim, Mingoo; Ka, Hakhyun

2012-01-01

279

Derivation of Insulin Producing Cells From Human Endometrial Stromal Stem Cells and Use in the Treatment of Murine Diabetes  

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Pancreatic islet cell transplantation is an effective approach to treat type 1 diabetes, however the shortage of cadaveric donors and limitations due to rejection require alternative solutions. Multipotent cells derived from the uterine endometrium have the ability to differentiate into mesodermal and ectodermal cellular lineages, suggesting the existence of mesenchymal stem cells in this tissue. We differentiated human endometrial stromal stem cells (ESSC) into insulin secreting cells using ...

Santamaria, Xavier; Massasa, Efi E.; Feng, Yuzhe; Wolff, Erin; Taylor, Hugh S.

2011-01-01

280

[Uterine contractile activity at embryo transfer--as a new pharmacotherapeutic target in assisted reproduction].  

Science.gov (United States)

Uterine contractile activity plays an important role in the reproduction of mammals, influencing sperm transport in the genital tract and positioning of the implanting embryo within the uterine cavity In humans, apart from the time of menses, the activity of a non-pregnant uterus is usually not perceived, and it is also not a subject of any routine clinical testing. Major contractile factors in non-gravid uteri are oxytocin and prostaglandins, locally produced within the endometrium. Oxytocin synthesis and expression of its receptors is gradually increasing in the follicular phase, following an increase in estrogen levels, and reaches its peak in the periovulatory period. In stimulated cycles, where supraphysiological estradiol concentrations are present, uterine contractile activity can be elevated. Exaggerated uterine contractions before embryo transfer are observed in one third of women undergoing controlled ovarian stimulation. Detection of such patients could enable their qualification for pharmacologic treatment. Evaluation of uterine contractions in such cases should be done non-invasively in order to avoid any endometrial trauma. Ultrasound evaluation of the movements of endometrial interface can be applied. Pharmacologic treatment of elevated uterine contractility before embryo transfer could improve the success rates of fertility treatments. So far application of beta mimetics or non-steroid anti-inflammatory drugs has not been associated with any progress. Oxytocin receptor system in the myometrium and the endometrium is a potential target for new class of medications aiming to improve implantation rates. This review summarizes up-to-date knowledge on the significance of uterine contractile activity in embryo implantation and describes the emerging new treatment targets in assisted reproduction. PMID:25219142

Pierzy?ski, Piotr; Zbucka-Kretowska, Monika

2014-08-01

 
 
 
 
281

Uterine Fibroid Embolization  

Medline Plus

Full Text Available ... a young woman. She's 31 years old. She has very symptomatic uterine fibroids, very heavy menstrual periods. ... is a catheter, very similar to what he has in the vessel. And if I show you, ...

282

Uterine Fibroid Embolization  

Medline Plus

Full Text Available ... a little background. Hysterectomies are the commonest performed surgery in the United States. And the commonest reason that that surgery occurs is for uterine fibroids. Over the past ...

283

Uterine ruptures in Yemen.  

Directory of Open Access Journals (Sweden)

This study confirms high incidence of such serious preventable obstetrical problem. Poor antenatal and intranatal care, poor provision of health service and low socio-economic standard are the main factors contributing to uterine rupture.

Abdalla E. Diab

2005-02-01

284

Lynch syndrome screening should be considered for all patients with newly diagnosed endometrial cancer.  

Science.gov (United States)

Lynch syndrome (LS) is an autosomal dominant inherited disorder caused by germline mutations in DNA mismatch repair (MMR) genes. Mutation carriers are at substantially increased risk of developing cancers of the colorectum and endometrium, among others. Given recent recommendations for universal, cost-effective screening of all patients with newly diagnosed colorectal cancer using MMR protein immunohistochemistry, we evaluated MMR protein expression in a series of endometrial cancers in the general population. A total of 605 consecutive cases of primary endometrial cancer at a single institution (1997 to 2013) were evaluated regardless of age, family history, or histologic features. Evaluation methods consisted of immunohistochemistry for the MMR proteins MLH1, MSH2, MSH6, and PMS2, followed by DNA methylation analysis for cases with MLH1/PMS2 deficiency. Germline mutation testing was performed on a subset of cases. Forty MMR-deficient, nonmethylated endometrial cancers were identified: 3 MLH1/PMS2 and 37 MSH6/MSH2 protein deficiencies. Only 25% occurred in women below 50 years of age (range, 39 to 88 y), 1 of which was in a risk-reducing hysterectomy specimen. Only 15% of patients had a prior history of carcinoma, including only 2 patients with prior colorectal carcinoma. Most (80%) of the endometrial cancers were purely endometrioid; there were 2 mixed endometrioid/mucinous, 1 mucinous, 1 serous, 2 clear cell, and 2 carcinosarcoma cases. When grading was applicable, 40% of the endometrial malignancies were FIGO grade 1, 34% grade 2, and 26% grade 3. Thirteen percent arose in the lower uterine segment, and 23% had tumor-infiltrating lymphocytes. Of the tumors with known germline testing, 41% with a LS-associated germline mutation were not associated with any of the traditional indicators that have been recommended for LS screening (ie, age 50 y or younger, personal/family cancer pedigree that meets Bethesda guideline criteria, presence of MMR-associated tumor morphology, or location in the lower uterine segment). These data suggest that a significant number of LS-associated endometrial carcinomas are missed using clinical, histologic, and locational screening parameters and provide support for universal screening of all newly diagnosed endometrial cancers. PMID:25229768

Mills, Anne M; Liou, Sofia; Ford, James M; Berek, Jonathan S; Pai, Reetesh K; Longacre, Teri A

2014-11-01

285

Uterine fibroids: current perspectives  

Directory of Open Access Journals (Sweden)

Full Text Available Aamir T Khan,1 Manjeet Shehmar,1 Janesh K Gupta21Birmingham Women's Hospital, Edgbaston, Birmingham, UK; 2Academic Department of Obstetrics and Gynaecology, University of Birmingham, Birmingham, UKAbstract: Uterine fibroids are a major cause of morbidity in women of a reproductive age (and sometimes even after menopause. There are several factors that are attributed to underlie the development and incidence of these common tumors, but this further corroborates their relatively unknown etiology. The most likely presentation of fibroids is by their effect on the woman's menstrual cycle or pelvic pressure symptoms. Leiomyosarcoma is a very rare entity that should be suspected in postmenopausal women with fibroid growth (and no concurrent hormone replacement therapy. The gold standard diagnostic modality for uterine fibroids appears to be gray-scale ultrasonography, with magnetic resonance imaging being a close second option in complex clinical circumstances. The management of uterine fibroids can be approached medically, surgically, and even by minimal access techniques. The recent introduction of selective progesterone receptor modulators (SPRMs and aromatase inhibitors has added more armamentarium to the medical options of treatment. Uterine artery embolization (UAE has now been well-recognized as a uterine-sparing (fertility-preserving method of treating fibroids. More recently, the introduction of ultrasound waves (MRgFUS or radiofrequency (VizAblate™ and Acessa™ for uterine fibroid ablation has added to the options of minimal access treatment. More definite surgery in the form of myomectomy or hysterectomy can be performed via the minimal access or open route methods. Our article seeks to review the already established information on uterine fibroids with added emphasis on contemporary knowledge.Keywords: leiomyoma, menorrhagia, ultrasonography, selective progesterone receptor modulators, uterine artery embolization, myomectomy

Khan AT

2014-01-01

286

Diagnostic utility of hepatocyte nuclear factor 1-beta immunoreactivity in endometrial carcinomas: lack of specificity for endometrial clear cell carcinoma.  

Science.gov (United States)

Hepatocyte nuclear factor 1-beta (HNF1?) has recently emerged as a relatively sensitive and specific marker for ovarian clear cell carcinoma. The purpose of this study is to assess the diagnostic utility of this marker for endometrial clear cell carcinoma. Immunohistochemical analysis was performed on 75 endometrial tissues using a goat polyclonal antibody raised against a peptide mapping at the C-terminus of human HNF1? protein. The 75 cases included 15 clear cell carcinomas, 20 endometrioid carcinomas, 15 endometrial serous carcinomas/uterine papillary serous carcinomas, 20 cases of normal endometrium, 2 cases of clear cell metaplasia, and 3 cases of Arias Stella reaction. Staining interpretations were based on a semiquantitative scoring system, a 0 to 12+ continuous numerical scale that was derived by multiplying the extent of staining (0 to 4+ scale) by the intensity of staining (0 to 3+ scale) for each case. HNF1? expression was found to be present in a wide spectrum of tissues. Twenty-seven (54%) of the 50 carcinomas displayed at least focal nuclear HNF1? expression, including 11 (73%) of 15, 9 (60%) of 15, and 7 (35%) of 20 clear cell, serous, and endometrioid carcinomas, respectively. The average nuclear staining scores for clear cell carcinomas, endometrioid carcinomas, and serous carcinomas were 5.2, 1.4, and 4.1, respectively. Clear cell carcinomas and endometrioid carcinomas displayed statistically significant differences regarding their nuclear staining scores (P = 0.0027), but clear cell carcinomas and endometrial serous carcinomas did not (P = 0.45). The calculated sensitivity of any nuclear HNF1? expression in classifying a carcinoma as being of the clear cell histotype was 73%, whereas the specificity was 54%. Nineteen of 20 normal endometrium samples displayed at least focal nuclear expression of HNF1?, and this expression was often diffuse. The 5 cases of benign histologic mimics of clear cell carcinomas (Arias Stella reaction and clear cell metaplasia) displayed some degree of HNF1? immunoreactivity, with an average nuclear staining score of 7.3. We conclude that although HNF1? is frequently expressed in clear cell carcinomas, it should be used with caution as a diagnostic marker because of its lack of specificity. It neither distinguishes endometrial serous carcinomas from clear cell carcinomas nor clear cell carcinomas from its benign mimics. The greatest diagnostic utility of HNF1? expression may be in a supportive evidentiary role favoring clear cell carcinoma when the principal differential diagnostic consideration is endometrioid carcinoma. PMID:22495362

Fadare, Oluwole; Liang, Sharon X

2012-12-01

287

False contouring effect of the uterine wall during hysteroscopy a lesson from immediate hydrosonography  

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Full Text Available A 42 years old woman suffering from repeated events of intensive vaginal bleeding during the week off birth control pills was referred for diagnostic hysteroscopy. The patient underwent hysterohy drosonoscopy, a 3-step procedure, including a transvaginal ultrasound scan, a diagnostic hysteroscopy and immediate hydrosonography. A3 cmintramural myoma was detected by the ultrasound scan without impinging onto the uterine cavity as visualized by diagnostic hysteroscopy. However, continuous hydrosonographic evaluation of the uterus, performed immediately afterwards, unveiled a fibroid with a significant intracavitary portion. A falsely normal cavity could be appreciated by high pressured hysteroscopy, while during the gradual fall of the intracavitary pressure a significant lesion could be revealed encroaching into the lumen. In the absence of an agreed distention pressure range during hysteroscopy, an immediate hydrosonography may serve as an auxiliary tool to follow the uterine wall contour as distention pressure declines during the eventual escape of the distention fluid from the lumen. Uterine wall contour is heavily dependent on the distension pressure and guidelines for intrcavitary pressure during hysteroscopy are evidently needed.

Ronit Haimov-Kochman

2013-07-01

288

Endometrial carcinoma in a young subfertile woman with polycystic ovarian syndrome  

Directory of Open Access Journals (Sweden)

Full Text Available Adenocarcinoma of the endometrium is a morbid condition in women under 40 years of age with an incidence of 25%. However, patients with anovulatory polycystic ovarian syndrome are at risk of developing endometrial carcinoma. The disease is often advanced when diagnosed, thereby depriving the woman of the option for fertility sparing conservative approach. In young women with menstrual abnormalities and polycystic ovarian disease and/or infertility, an endometrial evaluation should be performed. Carcinoma endometrium should be kept in mind while evaluating young women with polycystic ovary syndrome for abnormal uterine bleeding. Only strictly selected patients should, therefore, be indicated for long-term progestogen treatment and careful evaluation before and after treatment should be performed.

Jayakrishnan K

2010-01-01

289

Endometrial polyps in the bitch: a retrospective study of 21 cases.  

Science.gov (United States)

Endometrial polyps (EPs) are tumour-like lesions reported frequently in domestic carnivores. The present report describes the clinical and pathological features of EPs in 21 bitches. Most affected bitches had a regular reproductive history. Five bitches had no clinical signs and eleven showed clinical signs of pyometra. Four bitches had a large EP which resulted in compression of the abdominal viscera. One bitch had an acute uterine torsion. A clinical diagnosis of EPs was only made when the lesions were large and identified by abdominal palpation or ultrasound. Grossly, the EPs were 5-25 cm in diameter and were single, sessile or pedunculated. They were often associated with cystic endometrial hyperplasia. Microscopically, the EPs were fibroglandular with the stroma sometimes being haemorrhagic and infiltrated by inflammatory cells. In one case, there were areas of stromal smooth muscle and epithelial squamous metaplasia, which may have been consistent with preneoplastic change. PMID:23651692

Marino, G; Barna, A; Rizzo, S; Zanghì, A; Catone, G

2013-11-01

290

Involvement of VCAM1 in the bovine conceptus adhesion to the uterine endometrium.  

Science.gov (United States)

Following bidirectional communication, the conceptus and the uterine epithelium must establish a proper cell-cell interaction, resulting in the progression of implantation processes. To clarify the mechanism of conceptus attachment to the uterine endometrium, we studied whether vascular cell adhesion molecule (VCAM1) was expressed in bovine conceptuses or endometrium during the peri-attachment period. Uterine VCAM1 expression was minimal in day 17 (day 0=day of estrus) cyclic and pregnant animals, but increased between days 20 and 22 of pregnancy. In the intercaruncular regions, VCAM1 protein was localized to the luminal and glandular epithelia, whereas in the caruncular regions, VCAM1 protein was detected in the stroma and endothelia of the uterine endometrium. In cultured endometrial epithelial cells (EECs), VCAM1 expression was up-regulated when treated with uterine flushings or growth factor and further increased when EECs were cocultured with bovine trophoblast CT1 cells. VCAM1 expression in CT1 cells was also up-regulated with the use of uterine flushings, and further increased when these cells were cocultured with EECs. Expression of VCAM1 receptor, integrin ? 4 (ITGA4) mRNA, increased significantly in day 22 conceptuses. In day 22 pregnant uteri, VCAM1 protein was found in both EECs and conceptuses, but ITGA4 was localized only to trophoblasts. These observations indicate that cell-cell interactions between conceptuses and uterine epithelial cells are required for sufficient VCAM1 and ITGA4 expression in the bovine species and suggest that uterine VCAM1 and conceptus ITGA4 play a role in the establishment of conceptus adhesion to the uterine endometrium. PMID:24803492

Bai, Rulan; Bai, Hanako; Kuse, Mariko; Ideta, Atsushi; Aoyagi, Yoshito; Fujiwara, Hiroshi; Okuda, Kiyoshi; Imakawa, Kazuhiko; Sakurai, Toshihiro

2014-08-01

291

How Are Uterine Fibroids Diagnosed?  

Science.gov (United States)

... Resources and Publications En Español How are uterine fibroids diagnosed? Skip sharing on social media links Share ... probably won’t know that you have uterine fibroids. Sometimes, health care providers find fibroids during a ...

292

Conservative management of a recurrent puerperal uterine inversion with bakri® balloon tamponade  

Directory of Open Access Journals (Sweden)

Full Text Available Puerperal Uterine Inversion (PUI is a rare but potentially life-threatening delivery complication in which the uterine fundus collapses within the endometrial cavity. This “glove-finger” introflexion of uterine walls generally occurs as an immediate postpartum complication and is responsible of different degrees of vaginal bleeding, shock and hypogastric pain that can cause serious maternal complications, including death. There are few reports of recurrent postpartum uterine inversion like the one we present here, and its causes remain unclear. Early diagnosis of this complication is crucial as it is the only one measure that can allow a successful and conservative treatment: an inverse relationship between the time that uterus keeps inverted and the probability of repositioning has been firmly established. This case report describes the exceptional and innovative use of the SOS Bakri® balloon (Cook Medical Incorporated in the management of a recurrent puerperal uterine inversion. To our knowledge it is one of the first reports in the world of this procedure, perhaps the second one after Soleymani’s et al description; and the first one in a third degree recurrent puerperal uterine inversion.

Jesús Joaquín Hijona Elósegui

2011-12-01

293

Detection of congenital uterine malformation by using transvaginal three-dimensional ultrasound.  

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This study assessed the clinical application of transvaginal three-dimensional ultrasound (3D TVUS) in the diagnosis of congenital uterine malformation. A retrospective study was performed on 62 patients with congenital uterine malformation confirmed hysteroscopically and/or laparoscopically. The patients were subjected to transvaginal two-dimensional ultrasound (2D TVUS) and 3D TVUS. The accuracy rate was compared between the two methods. The accuracy rate of 3D TVUS was (98.38%, 61/62), higher than that of 2D TVUS (80.65%, 50/62). 3D TVUS coronal plane imaging could demonstrate the internal shape of the endometrial cavity and the external contour of the uterine fundus. It allowed accurate measurement on the coronary plane, and could three-dimensionally show the image of cervical tube, thereby providing information for the diagnosis of some complex uterine malformation. 3D TVUS imaging can obtain comprehensive information of the uterus malformation, and it is superior to 2D TVUS for the diagnosis of congenital uterine malformations, especially complex uterine anomaly. PMID:25318893

Yu, Li-Li; Zhang, Xuan; Zhang, Ting; Chen, Han-Rong; Wang, Ze-Hua

2014-10-01

294

Acute puerperal uterine inversion  

International Nuclear Information System (INIS)

Objective: To determine the frequency, causes, clinical presentations, management and maternal mortality associated with acute puerperal inversion of the uterus. Materials and Methods: All the patients who developed acute puerperal inversion of the uterus either in or outside the JPMC were included in the study. Patients of chronic uterine inversion were not included in the present study. Abdominal and vaginal examination was done to confirm and classify inversion into first, second or third degrees. Results: 57036 deliveries and 36 acute uterine inversions occurred during the study period, so the frequency of uterine inversion was 1 in 1584 deliveries. Mismanagement of third stage of labour was responsible for uterine inversion in 75% of patients. Majority of the patients presented with shock, either hypovolemic (69%) or neurogenic (13%) in origin. Manual replacement of the uterus under general anaesthesia with 2% halothane was successfully done in 35 patients (97.5%). Abdominal hysterectomy was done in only one patient. There were three maternal deaths due to inversion. Conclusion: Proper education and training regarding placental delivery, diagnosis and management of uterine inversion must be imparted to the maternity care providers especially to traditional birth attendants and family physicians to prevent this potentially life-threatening condition. (author)

295

Ultrasound in screening of endometrial carcinoma in asymptomatic postmenopausal women  

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Full Text Available Introduction The aim of this prospective study was to investigate whether there was a significant difference in ultrasound detection of pathologic states of endometrium between asymptomatic postmenopausal women and postmenopausal women with uterine bleeding in whom the thickness of endometrium was greater than 3 mm at ultrasound examination. Material and methods The study included 128 postmenopausal women with uterine bleeding and 29 asymptomatic posmenopausal women who underwent gynecological examination, transvaginal ultrasound examination, fractional explorative curettage and histopathological examination of the endometrium. Results The results showed no statistically significant difference between the examined groups of women in relation to the detection of pathologic states of the endometrium (polyps, hyperplasias and carcinomas as well as between individual pathologic states, although the research showed that the asymptomatic women were more frequently presented with well-differentiated carcinoma versus the medium-differentiated carcinoma in the symptomatic group of women. Conclusion It can be concluded that the transvaginal ultrasound examination in postmenopausal women could be an adequate screening method for detection of endometrial carcinoma in early asymptomatic stage of the disease, whereas in the women with ultrasound finding of the thickened endometrium, the final diagnosis should be established by histopathological examination of the endometrium samples obtained by hysteroscopy, instead of previously used explorative curettage.

?ur?i? Aleksandar

2009-01-01

296

Effect of immunomodulatory therapy on the endometrial inflammatory response to induced infectious endometritis in susceptible mares  

DEFF Research Database (Denmark)

The objective of the present study was to evaluate the effect of immunomodulatory therapy (glucocorticoids (GC) and mycobacterium cell wall extract (MCWE)) on the endometrial gene expression of inflammatory cytokines in susceptible mares with induced infectious endometritis. Endometrial gene expression of pro- and anti-inflammatory cytokines; interleukin (IL)-1ß, IL-6, IL-8, IL-10, tumor necrosis factor (TNF)-a, IL-1 receptor antagonist (ra), acute phase protein (APP) serum amyloid A (SAA) and clinical parameters were evaluated. Five mares were classified as susceptible to persistent endometritis based on their endometrial histopathology and ability to clear an induced uterine inflammation. To investigate the effect of immunomodulatory therapy, the mares were inoculated with 10(5) colony forming units (CFU) Escherichia coli in three consecutive estrus cycles in a modified cross-over study design. Thus, each mare served as its own control and the treatment type was performed in randomized order. The effect of treatment with MCWE (1.5 mg Settle IV), dexamethasone (0.1 mg per kg IV) or no treatment was investigated. All mares were free from uterine inflammation before each E. coli inoculation. Endometrial biopsies were recovered 3, 24 and 72 h post inoculation. Relative gene-expression analyses were performed by quantitative reverse transcriptase PCR (qRT-PCR). Endometrial gene expression of inflammatory cytokines was modulated by administration of GC. Expression of proinflammatory cytokines (IL-1ß, IL-6, IL-8) and SAA was significantly lower in the GC treated group late in the study period (72 h) compared to "no treatment" and MCWE treatment. Increased expression of the anti-inflammatory cytokine IL-10 was observed 3 and 24 h after E. coli infusion and GC treatment. A significant decrease of SAA expression was observed after MCWE treatment compared to "no treatment". MCWE and GC treatment had a significant effect on the clearance of uterine pathogens and number of mares retaining fluid after E. coli infusion. The results of the current investigation suggest that GC is capable of effectively modulating the innate immune response to induced infectious endometritis in susceptible mares.

Christoffersen, Mette; Woodward, E. M.

2012-01-01

297

Gynecologic Cancer InterGroup (GCIG) Consensus Review for Clear Cell Carcinoma of the Uterine Corpus and Cervix.  

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Clear cell carcinomas of the uterine corpus and cervix are rare gynecological cancers with limited information regarding the pathogenesis and biology. At present, the approach to management is the same as for patients with the more common histological subtypes of endometrioid endometrial cancer and adenocarcinoma of the cervix. Surgical resection is the standard treatment for patients with early-stage disease, but there is no evidence-based approach to direct the management of patients with more advanced-stage disease at presentation or with recurrent disease. We review the epidemiology, pathology, and what is known about both uterine corpus and cervical clear cell cancers and make management recommendations. PMID:25341588

Hasegawa, Kosei; Nagao, Shoji; Yasuda, Masanori; Millan, David; Viswanathan, Akila N; Glasspool, Rosalind M; Devouassoux-Shisheboran, Mojgan; Covens, Alan; Lorusso, Domenica; Kurzeder, Christian; Kim, Jae-Weon; Gladieff, Laurence; Bryce, Jane; Friedlander, Michael; Fujiwara, Keiichi

2014-11-01

298

Pure uterine lipoma.  

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Lipomatous tumors of the uterus are unusual, benign neoplasms seen in postmenopausal women. Although many of the mixed-type cases such as lipoleiomyoma and fibrolipoma have been reported, pure uterine lipomas are extremely rare. In the literature, a few cases with pure uterine lipoma have been reported. We first present the advanced magnetic resonance findings of pure uterine lipoma, followed by those of ultrasonography (US) and computed tomography (CT). We markedly detected lipid peaks on the magnetic resonance spectroscopy (MRS) and the apparent diffusion coefficient value to be 0.00 due to chemical-shift effects with diffusion-weighted imaging (DWI). Although pelvic lipomatous tumors can be diagnosed with US and CT, in some cases, further workup may be required to localize the lesion. MRI may yield more valuable data for differential diagnosis. MRS and DWI findings provide additional clues on the nature of the lesion. PMID:17905250

Erdem, Gulnur; Celik, Onder; Karakas, Hakki Muammer; Alkan, Alpay; Hascalik, Seyma

2007-10-01

299

Uterine arteriovenous malformation.  

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Uterine arteriovenous malformation (AVM) is a rare condition, with fewer than 100 cases reported in the literature. Despite it being rare, it is a potentially life-threatening condition. This case report describes a 33-year-old woman who presented with secondary post-partum hemorrhage. Transabdominal ultrasound (US) of the pelvis showed increased vascularity with multidirectional flow of the uterus and a prominent vessel, located on the left lateral wall. She also had retained product of conception, which complicated the diagnosis. A uterine artery angiogram confirmed an AVM in the fundal region with an early draining vein. Embolisation of the AVM was performed successfully. PMID:23983582

Hashim, Hilwati; Nawawi, Ouzreiah

2013-03-01

300

Case Report: Uterine Adenocarcinoma Metastasis to the Skull Base and Cervical Spine Presenting with Pathological Fracture and Myelopathy  

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Full Text Available Objective: The authors report a rare case of uterine adenocarcinoma metastasis to both the skull base and cervical spine presenting with pathological fracture and myelopathy. Methods: We report the case of a 43-year-old Asian female with widely metastatic uterine adenocarcinoma who over the course of 3 years was diagnosed with a large clival mass and more recently a cervical spine pathological fracture presenting with myelopathy. Results: This patient underwent multiple procedures over a three-year period, including total hysterectomy with tumor debulking, endonasal biopsy of clival mass and most recently cervical corpectomy and fusion. She has received chemotherapy and radiation therapy for treatment of the unresectable clival mass and has done quite well despite having this pathology. Conclusion: This is the first documented case of clival involvement of endometrial adenocarcinoma. Additionally, this is a unique case of spinal metastatic endometrial adenocarcinoma presenting with pathological fracture and myelopathy.

Paul E. Kaloostian

2013-07-01

 
 
 
 
301

PGRMC1 and PGRMC2 in uterine physiology and disease.  

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It is clear from studies using progesterone receptor (PGR) mutant mice that not all of the actions of progesterone (P4) are mediated by this receptor. Indeed, many rapid, non-classical P4 actions have been reported throughout the female reproductive tract. Progesterone treatment of Pgr null mice results in behavioral changes and in differential regulation of genes in the endometrium. Progesterone receptor membrane component (PGRMC) 1 and PGRMC2 belong to the heme-binding protein family and may serve as P4 receptors. Evidence to support this derives chiefly from in vitro culture work using primary or transformed cell lines that lack the classical PGR. Endometrial expression of PGRMC1 in menstrual cycling mammals is most abundant during the proliferative phase of the cycle. Because PGRMC2 expression shows the most consistent cross-species expression, with highest levels during the secretory phase, PGRMC2 may serve as a universal non-classical P4 receptor in the uterus. While the functional importance of PGRMC1/2 in the uterus remains to be fully explored, accumulating evidence suggests that disruption in PGRMC1/2 expression correlates with uterine disease. In this review we will summarize what is known about PGRMC1/2 in uterine physiology and we will provide examples of disrupted expression of these genes in uterine disease states. PMID:24065879

Pru, James K; Clark, Nicole C

2013-01-01

302

PGRMC1 and PGRMC2 in Uterine Physiology and Disease  

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Full Text Available It is clear from studies using progesterone receptor (PGR mutant mice that not all of the actions of progesterone (P4 are mediated by this receptor. Indeed, many rapid, non-classical P4 actions have been reported throughout the female reproductive tract. Progesterone treatment of Pgr null mice results in behavioral changes and in differential regulation of genes in the endometrium. Progesterone receptor membrane component (PGRMC 1 and PGRMC2 belong to the heme-binding protein family and may serve as P4 receptors. Evidence to support this derives chiefly from in vitro culture work using primary or transformed cell lines that lack the classical PGR. Endometrial expression of PGRMC1 in menstrual cycling mammals is most abundant during the proliferative phase of the cycle. Because PGRMC2 expression shows the most consistent cross-species expression, with highest levels during the secretory phase, PGRMC2 may serve as a universal non-classical P4 receptor in the uterus. While the functional importance of PGRMC1/2 in the uterus remains to be fully explored, accumulating evidence suggests that disruption in PGRMC1/2 expression correlates with uterine disease. In this review we will summarize what is known about PGRMC1/2 in uterine physiology and we will provide examples of disrupted expression of these genes in uterine disease states.

JamesKeithPru

2013-09-01

303

Endometrial pinopodes indicate a shift in the window of receptivity in IVF cycles.  

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The formation of endometrial pinopodes detected by scanning electron microscopy may be a specific marker for uterine receptivity. Aiming to assess the effects of ovarian stimulation on pinopode formation, we examined sequential endometrial biopsies from 17 oocyte donors. Seven normally menstruating women served as controls. Up to four samples were taken from each woman at 24-72 h intervals between days 14 and 24, giving a total of 69 samples. The day of oocyte retrieval was designated day 14 in ovarian stimulation cycles and the day of luteinizing hormone surge was designated day 13 in natural cycles. Endometrial morphology and pinopode numbers were similar in both groups. Fully developed pinopodes appeared in only one sample per cycle, indicating their short life span. However, the cycle day these structures appeared varied up to 5 days between women and the distribution was as follows: day 18 (n = 2), day 19 (n = 7), day 20 (n = 4), day 21 (n = 3), day 22 (n = 1) in ovarian stimulation cycles, and day 20 (n = 2), day 21 (n = 2), day 22 (n = 3) in natural cycles. Furthermore, accelerated pinopode formation in ovarian stimulation cycles was positively correlated with day 13 progesterone. Our findings show that ovarian stimulation does not affect endometrial pinopode formation in terms of quantity and life span. The cycle days when pinopodes form are specific to the individual, being on average 1-2 days earlier in ovarian stimulation than in natural cycles. These changes in pinopode expression may reflect shifts in the window of receptivity, resulting in ovo-endometrial asynchrony and limiting implantation success in in-vitro fertilization. PMID:10221715

Nikas, G; Develioglu, O H; Toner, J P; Jones, H W

1999-03-01

304

Endometrial stromal sarcomas with sex cord differentiation are associated with PHF1 rearrangement.  

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Endometrial stromal tumors may pose diagnostic challenges particularly when they exhibit variant histologic appearances, involve extrauterine sites, or present as metastatic disease. In such cases, use of immunohistochemical markers and identification of specific nonrandom chromosomal rearrangements may be helpful. Over the last decade, fluorescence in situ hybridization (FISH) has been progressively incorporated as a diagnostic tool for the evaluation of endometrial stromal tumors. The purpose of this study was to review a series of these tumors and compare the results of FISH analysis with the clinicopathologic characteristics. Three endometrial stromal nodules (ESNs), 13 endometrial stromal sarcomas (ESSs), and 7 undifferentiated endometrial sarcomas (UESs) were reviewed. Three metastases from 1 of the ESS cases were also analyzed. Nine of these tumors (1 ESN, 8 ESSs, and 1 UES) exhibited unusual histologic features, including smooth muscle (3), sex cord (7), epithelioid (1), fibromyxoid (1), and skeletal muscle (2) differentiation. A tissue microarray was prepared, and FISH analysis was performed using break-apart and fusion probes for JAZF1, SUZ12, EPC1, and PHF1 genes. FISH was successful in 22 cases, and rearrangements involving JAZF1, SUZ12, EPC1, and PHF1 genes were detected in 10 of the 22 (45%) uterine tumors, including 2 of the 3 ESNs and 8 of 12 ESSs. Genetic rearrangements were found neither in the 3 metastases of the ESS nor in any of the UESs. It is noteworthy that a correlation between sex cord differentiation and PHF1 rearrangement was encountered in ESSs (P=0.008). In our series, all ESSs showing sex cords had PHF1 genetic rearrangement, suggesting that such rearrangements may induce sex cord differentiation. PMID:23211293

D'Angelo, Emanuela; Ali, Rola H; Espinosa, Inigo; Lee, Cheng-Han; Huntsman, David G; Gilks, Blake; Prat, Jaime

2013-04-01

305

Flexible hysteroscopy with narrow band imaging (NBI) for endoscopic diagnosis of malignant endometrial lesions.  

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Narrow band imaging (NBI) for detection of blood vessels and microstructures on the mucosal surface is used in gastrointestinal endoscopy since it can improve qualitative diagnosis and detection of lesion. However, there are no studies on flexible hysteroscopy using NBI. We performed flexible hysteroscopy with NBI for outpatients to investigate the sensitivity and specificity of endoscopic diagnosis of malignant endometrial lesions. Of patients who attended our hospital for suspected lesions in the uterine cavity between April 2009 and May 2010, 104 subjects underwent hysteroscopy with NBI, in addition to white light. Using the pathological diagnosis as the gold-standard, we evaluated the sensitivity and specificity of NBI hysteroscopy for detecting atypical endometrial hyperplasia (AEH) or carcinoma. The results were also compared with historical data (n=209) for conventional hysteroscopy using white light only in 2008. The sensitivities were 97.2% [95% confidence interval (95% CI): 90.3-99.7%] and 82.6% (95% CI: 74.4-89.0%) for NBI hysteroscopy and conventional hysteroscopy, respectively. The 95% CIs for the two methods did not overlap and the sensitivity of lesion detection was higher with NBI hysteroscopy. Specificities were comparable, 90.6% (95% CI: 75.0-98.0%) and 85.1% (95% CI: 76.3-91.6%) between the methods. NBI hysteroscopy has increased sensitivity for detection of atypical endometrial hyperplasia (AEH) or carcinoma. A comparison with historical data suggested that NBI may be useful for diagnosis of malignant endometrial lesions. As far as we are aware, this is the first evaluation of flexible hysteroscopy with NBI for diagnosis of malignant endometrial lesions. PMID:21240458

Kisu, Iori; Banno, Kouji; Kobayashi, Yusuke; Ono, Asuka; Masuda, Kenta; Ueki, Arisa; Nomura, Hiroyuki; Hirasawa, Akira; Abe, Takayuki; Kouyama, Keisuke; Susumu, Nobuyuki; Aoki, Daisuke

2011-03-01

306

Effects of estrogen and/or progesterone on the changes occuring in the uterine luminal epithelium of ovariectomized rats  

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Full Text Available This study examined the histological changes that occurred in the uterine luminal epithelium after ovariectomy and subsequent administration of ovarian hormones. Female Wistar-albino rats that were 6 weeks of age were used. The rats were subject to bilateral ovariectomy and then estrogen and progesterone (2,5 mg/kg were given alone or together. Effects of ovarian hormones on the uterine luminal epithelium were examined under the light microscope. In the ovariectomized and progesterone injected animals, the uterine epithelium atrophied and the luminal epithelial cell height decreased. In the estrogen injected animals the uterine tissue was more hyperemic and filled with more luminal fluid than in the other groups. Estrogen treatment induced a significant increase in the epithelial cell height and a marked thickening in the basement membrane of epithelial cells. No histologically identifiable changes were observed in the uterine luminal epithelial cells after estrogen + progesterone treatment, except for well-developed endometrial glands. This study suggests that the uterine luminal epithelial cell height increases with estrogen treatment, while the uterine tissue atrophies after ovariectomy and progesterone treatment.

Oner H.

2002-01-01

307

Quantitative light microscopic autoradiographic study on [3H]leukotriene C4 binding to nonpregnant bovine uterine tissue  

International Nuclear Information System (INIS)

Mammalian uteri contain both lipoxygenase and cyclooxygenase pathways of arachidonic acid metabolism. Sulfidopeptidyl leukotrienes formed by the lipoxygenase pathway can stimulate uterine contractions and play a role in uterine preparation for implantation. These actions of leukotrienes are perhaps mediated by binding to specific receptors. To understand the cellular basis of leukotriene C4 action, the present quantitative light microscopic autoradiographic study was undertaken on nonpregnant bovine uterine tissue. The results demonstrated that the circular and elongated myometrial smooth muscle, uterine vascular smooth muscle, stromal cells of endometrium, and fibroblasts of perimetrium, but not the endometrial glands, vascular endothelium, and erythrocytes in lumen of arterioles, contained specific silver grains after incubation with [3H]leukotriene C4. The number of grains per 100-micron2 areas were similar in circular and elongated myometrial smooth muscle (P greater than 0.05), which was higher than in other uterine cells (P less than 0.05-0.01). The grains in all cells were greatly reduced after coincubation with excess unlabeled leukotriene C4, but not with leukotriene A4, leukotriene B4, leukotriene D4, leukotriene E4, prostaglandin E2, prostaglandin F2 alpha, or prostacyclin. In conclusion, leukotriene C4 may regulate both uterine cells and uterine vasculature and exert contractile and noncontractile actions via the specific leukotriene C4-binding sites present in different cell types

308

Endometrial carcinoma arising in a bicornuate uterus  

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Endometrial carcinomas arising in a bicornuate uterus are rare, only five case of which have been previously reported. We present a case of endometrial cancer arising in a bicornuate uterus, occurring in a 65-year-old woman. Unlike previously reported cases, our case showed mixed endometrial adenocarcinoma and undifferentiated carcinoma in one horn and focal adenocarcinoma in the other. Adequate tissue sampling of both horns is necessary for accurate diagnosis of malignancy in patients with a bicornuate uterus. Physicians should be aware of the possibility of this abnormality in cases when endometrial cancer is suspected but histology fails to confirm. PMID:25264532

Munkhdelger, Jijgee; Mia-Jan, Khalilullah; Cha, Dong Soo

2014-01-01

309

Uterine Fibroid Embolization  

Medline Plus

Full Text Available ... a big fibroid. And here is this catheter coming inside the artery, coming all the way down inside the uterine artery. ... if you look up here, there's a vessel coming way up here, outside the uterus. And this, ...

310

Uterine Fibroid Embolization  

Medline Plus

Full Text Available ... to steer our way into the artery that supplies the uterus and supplies the fibroids. And we have a couple of ... very abnormal uterine artery, the very rich blood supply. And that is typical of a woman with ...

311

Breakages at YWHAE, FAM22A, and FAM22B loci in uterine angiosarcoma: a case report with immunohistochemical and genetic analysis.  

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Described herein is the first reported case of a uterine angiosarcoma with breakages at three loci, YWHAE (17p13), FAM22A (10q23) and FAM22B (10q22). A 62-year-old postmenopausal woman was found to have endometrial thickening of her uterus. An endometrial biopsy indicated a malignant, spindle cell neoplasm. A total hysterectomy with bilateral salpingooophorectomy was performed. Histologic examination of the uterine specimen showed a malignant tumor consisting of irregular rudimentary vascular channels and solid small nests diffusely infiltrating to the middle of the myometrial wall. The tumor cells were epithelioid, and displayed eosinophilic cytoplasm and vesicular nuclei in some areas of the tumor. Immunohistochemically, the tumor cells showed vascular differentiation; they were diffusely positive for CD31 and D2-40 but were negative for factor VIII and CD34. In the course of the procedure of differential diagnoses, we included fluorescence in situ hybridization analysis for detection of a FAM22B-YWHAE fusion gene resulting from t(10;17)(q22;p13), recently reported in a series of endometrial stromal sarcoma, and unexpectedly identified breakages at three loci, i.e. YWHAE (17p13), FAM22A (10q23) and FAM22B (10q22). Collectively, these findings suggest that abnormality in the loci of YWHAE, FAM22A and FAM22B, which are known to be associated with oncogenesis of endometrial stromal sarcoma, may contribute to the development of uterine angiosarcoma. PMID:24125656

Suzuki, Shioto; Tanioka, Fumihiko; Minato, Hiroshi; Ayhan, Ayse; Kasami, Masako; Sugimura, Haruhiko

2014-02-01

312

Persisting cyclical uterine bleeding in patients treated with radical radiation therapy and hormonal replacement for carcinoma of the cervix  

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Radical radiation therapy used for carcinoma of the cervix will ablate ovarian function. Since January 1986, our policy has been to administer oral combination oestrogen-progesterone replacement hormonal therapy to all premenopausal patients undergoing radical radiation with or without synchronous chemotherapy, for invasive cervix cancer. Five out of 22 (23%) such patients unexpectedly experienced between one and four episodes of cyclical per vaginal bleeding after the completion of radiation therapy. Bleeding episodes occurred in the absence of persistent tumor or radiation reaction, and suggest persisting endometrial response to exogenous hormonal stimulation. Uterine activity was temporarily retained in these five patients despite a minimal endometrial surface dose of between 4800 and 6490 cGy. The limited number of cycles before bleeding spontaneously ceased may represent the slow death of endometrial cells subsequent to radiation or radiochemotherapy treatment, and has not previously been described. In view of the paucity of data on the radiosensitivity of normal endometrium, we have carefully examined these patients who appear to have retained endometrial sensitivity to hormonal stimuli after radical radiation-chemotherapy for uterine cervix cancer

313

Persisting cyclical uterine bleeding in patients treated with radical radiation therapy and hormonal replacement for carcinoma of the cervix  

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Radical radiation therapy used for carcinoma of the cervix will ablate ovarian function. Since January 1986, our policy has been to administer oral combination oestrogen-progesterone replacement hormonal therapy to all premenopausal patients undergoing radical radiation with or without synchronous chemotherapy, for invasive cervix cancer. Five out of 22 (23%) such patients unexpectedly experienced between one and four episodes of cyclical per vaginal bleeding after the completion of radiation therapy. Bleeding episodes occurred in the absence of persistent tumor or radiation reaction, and suggest persisting endometrial response to exogenous hormonal stimulation. Uterine activity was temporarily retained in these five patients despite a minimal endometrial surface dose of between 4800 and 6490 cGy. The limited number of cycles before bleeding spontaneously ceased may represent the slow death of endometrial cells subsequent to radiation or radiochemotherapy treatment, and has not previously been described. In view of the paucity of data on the radiosensitivity of normal endometrium, we have carefully examined these patients who appear to have retained endometrial sensitivity to hormonal stimuli after radical radiation-chemotherapy for uterine cervix cancer.

McKay, M.J.; Bull, C.A.; Houghton, C.R.; Langlands, A.O. (Westmead Hospital, Sydney (Australia))

1990-04-01

314

Immunohistochemical localization of the progesterone and oestrogen alpha receptors in the uterine horns of the African giant rat (Cricetomys gambianus).  

Science.gov (United States)

The present study investigated the immunolocalization of the progesterone and oestrogen alpha receptors in the uterine horns of the African giant rat during the oestrous cycle. The progesterone and oestrogen alpha receptors were demonstrated in various cellular constituents of the endometrium, myometrium and perimetrium. The intensity of progesterone and oestrogen alpha receptor immunostaining in the endometrial and myometrial layers of the uterine horns varied during the oestrous cycle. The intensity of oestrogen alpha receptor immunoreactivity in the luminal epithelium was high during pro-oestrus, oestrus and dioestrus. Progesterone and oestrogen alpha receptor immunoreactivity in the endometrial epithelia was absent during metoestrus. Moderate to strong immunostaining for the progesterone and oestrogen alpha receptors was demonstrated in the myometrial smooth muscle cells during pro-oestrus, oestrus and dioestrus. The intensity of progesterone and oestrogen alpha receptor immunostaining in the myometrial smooth muscle cells was low during metoestrus. Stromal cells in the perimetrium consistently expressed progesterone and oestrogen alpha receptor immunoreactivity throughout the oestrous cycle. The findings of the study indicate that in the giant rat the immunolocalization of the progesterone and oestrogen alpha receptors, in endometrial and myometrial regions of the uterine horns, varies during the oestrous cycle. PMID:19694646

Madekurozwa, M-C; Oke, B O; Akinloye, A K

2009-11-01

315

Assessment of uterine cavity size and shape: a systematic review addressing relevance to intrauterine procedures and events.  

Science.gov (United States)

Uterine cavity measurement began with evaluation of post-mortem and surgical specimens. It has been extended in vivo by use of mechanical instruments and visualization techniques. This is a systematic review of the range of values for the uterine cavity and the practical implications of these measurements, Following a review of multiple data bases & a QUORUM analysis. Only articles with clearly defined quantitative measurements were included. Mechanical cavity measurements with a variety of instruments gave a mean endometrial cavity length (ECL) of 33.73 mm (18-22.1) and a mean endometrial cavity width (ECW) of 25.1 mm (17.8-32.2) for nulliparae. The values for multiparae were mean ECL 38.6mm(20.61-40.3) and mean ECW 34.9 mm (23.4-53). Imaging measurements for the uterine cavity by hysterography and ultrasound were mean ECL 44.3 mm (29-64) for multiparae and ECL 37 mm for nulliparae. Mean ECW was 28.2 mm (21-33) for nulliparae and 32.1 mm (26-38) for multiparae. There were wide variations due to parity, ethnicity and gestational states. Accurate measurement of intrauterine parameters is valuable for improving and enhancing many intrauterine procedures including IUD insertion, endometrial ablation, embryo placement in IVF and management of spontaneous and therapeutic abortion. PMID:23437507

Goldstuck, Norman

2012-09-01

316

Management of Recurrent Endometrial Carcinoma.  

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Management of recurrent endometrial carcinoma has traditionally focused on providingtargeted adjuvant therapy in select groups of patients based on their risk factors. Majorprogress has been made over the last two decades in identifying these clinical-pathologicalrisk factors, which has led to the classification of patients into different risk groups. Patientswith high-risk factors are generally treated with adjunctive radiation therapy immediatelyfollowing surgery to minimize the incidence o...

Ming-Shian Kao

2004-01-01

317

Diagnostic criteria for distinguishing endometrial adenocarcinoma from complex atypical endometrial hyperplasia.  

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Morphologic criteria for distinguishing endometrial adenocarcinoma from complex atypical endometrial hyperplasia have been described previously, but they have not been examined extensively for their individual ability for predicting endometrial adenocarcinoma as determined by subsequent hysterectomy. We examined endometrial biopsies diagnosed in the spectrum of complex atypical endometrial hyperplasia to well-differentiated endometrial adenocarcinoma for various morphologic features that may be predictive for the presence of myoinvasive endometrial adenocarcinoma in subsequent hysterectomy. Cases diagnosed as FIGO grade I endometrial adenocarcinoma or complex atypical endometrial hyperplasia in endometrial biopsies seen at New York University Medical Center from 2003 to 2006 were analyzed for the presence of various morphologic features without the knowledge of hysterectomy findings. Only those cases with subsequent hysterectomy were included in the study. The data were analyzed to identify features with high specificity for a finding of myoinvasive endometrial adenocarcinoma in subsequent hysterectomy. Extreme glandular crowding (95% or greater area with glands, aggregate size 3 mm or greater) and cribriform foci of any size were found to have high sensitivity and specificity for the finding of myoinvasive carcinoma in subsequent hysterectomy (P < .0001). PMID:24182562

Mittal, Khush; Salem, Amira; Lo, Andy

2014-01-01

318

Maspin expression, subcellular localization and clinicopathological correlation in endometrial hyperplasia and endometrial adenocarcinoma.  

Science.gov (United States)

Maspin expression in endometrial hyperplasia and endometrial endometrioid adenocarcinomas was assessed and its correlation with p53 and Ki67 expressions and clinical outcome, as well as its potential to distinguish typical from atypical endometrial hyperplasia, were assessed in this study. Histological sections from 114 cases of endometrial endometrioid adenocarcinoma, 75 cases of endometrial hyperplasia (typical and atypical), and 23 normal endometrial tissue samples were examined. The most representative hematoxylin-eosin slides were selected and 2-3 micron-thick sections were cut for immunohistochemical staining with maspin, p53, and Ki67 antibodies. While there was no maspin expression in normal endometrial cells, it was present in 14.5% of the patients with endometrial hyperplasia without atypia. Staining for maspin was positive in atypical hyperplasia and endometrial adenocarcinoma in, respectively, 45% and 49.1% of the cases studied. No statistically significant correlations were found between maspin and Ki-67 antibodies or p53 expression. Our findings showed that maspin expression, which generally correlates with a less aggressive behavior, is significantly higher in atypical hyperplasia and in endometrial endometrioid adenocarcinoma. Maspin positivity in endometrial hyperplasia could be used to identify pseudo-atypical hyperplasia and could be considered a potentially useful prognostic parameter in those cases in which adenocarcinomas are well differentiated. PMID:24346847

Blandamura, Stella; Alessandrini, Lara; Saccardi, Carlo; Giacomelli, Luciano; Fabris, Alberta; Borghero, Angela; Litta, Pietro

2014-06-01

319

Frequency of primary uterine malignancy in hystrectomy specimens of postmenopausal women - a study of 255 cases at combined military hospital peshawar  

International Nuclear Information System (INIS)

Objective: To determine the frequency of primary uterine malignancy in hysterectomy specimens in women with postmenopausal bleeding. Study Design: A descriptive cross-sectional study. Place and Duration of study: It was conducted in the department of histopathology at Combined Military Hospital, Peshawar from 1st September 2010 to 31st May 2011. Material and Methods: A total of 255 hysterectomy specimens of postmenopausal women were examined grossly and microscopically to analyse the underlying pathology. Results: The mean age of patients with malignant diseases was 56.4 years and with benign diseases 49.3 years. Out of 255 patients 215 (95.6%) were found to have benign pathologies and 10 (4.4%) had malignant lesions. The frequency and histological pattern of primary uterine malignancy was; endometrial carcinoma 3.1%, cervical carcinoma 0.9% and leiomyosarcoma 0.4%. The benign pathologies included leiomyoma 35.6%, atrophic endometritis 16.4%, endometrial hyperplasia 15.1%, adenomysis 11.1%, endometrial polyp 10.2%, adenomyoma 6.7% and endometrial stromal nodule 0.4%. Conclusion: This study shows that frequency of malignancy in postmenopausal women is low in our set up and most of the underlying pathologies are benign. The most frequent malignancy found in postmenopausal women is endometrial carcinoma followed by cervical carcinoma. (author)

320

Quantitation of human choriocarcinoma spheroid attachment to uterine epithelial cell monolayers.  

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Adhesive interactions of trophoblast cells with endometrium are essential for embryo implantation in the uterus. Choriocarcinoma cells, the malignant counterpart of trophoblast, show pronounced invasiveness and are of interest for model studies. We describe here an in vitro model system for the study of adhesion of human JAR choriocarcinoma multicellular spheroids to different human endometrial epithelial cell lines (RL95-2, HEC-1A, KLE, AN3-CA) grown as monolayers. Cell characterization showed JAR spheroids to s++ecrete the placental hormones human chorionic gonadotropin and progesterone into the culture medium; distinct patterns of keratin, vimentin, and uvomorulin expression were seen in the endometrial cell lines. Spheroid attachment to endometrial monolayers was quantified using a centrifugal force-based adhesion assay, and morphology was examined by light and electron microscopy. Results showed the JAR spheroids to attach to three of the endometrial monolayers (RL95-2, HEC-1A, KLE) progressively over a 24-h period (by which time > or = 80% of the spheroids attached). Significant differences in spheroid attachment were most pronounced at 5 h (RL95-2 > HEC-1A > KLE and poly-D-lysine control, i.e. 90:45:17:17% attached). JAR spheroids did not attach to the endometrial cell line AN3-CA. Morphology revealed choriocarcinoma cells to begin to intrude between the uterine RL95-2 epithelial cells at 5 h. At 24 h, this intrusive type of penetration continued to be seen only with the RL95-2 monolayer. The assay system thus identifies differences in attachment properties between choriocarcinoma cells and various endometrial cell lines and forms the basis for further studies on the molecular interactions involved. PMID:8331030

John, N J; Linke, M; Denker, H W

1993-06-01

 
 
 
 
321

Diagnostic Features and Therapeutic Consequences of Hysteroscopy in Women with Abnormal Uterine Bleeding and Abortion  

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Full Text Available Problem statement: Hysteroscopy is a procedure in which the endometrial cavity is observable and subject of manipulation via transcervical route. Hysteroscopy is a minimally invasive process in diagnosis and treatment of many intrauterine and endocervical conditions. Polypectomy, myomectomy and endometrial ablation could be easily manageable by this procedure. According to safety and high efficiency of hysteroscopy, this method is changing to a widespread procedure in dealing with many gynecologic and obstetrical conditions. This study aimed at evaluating the diagnostic and therapeutical efficiency of hysteroscopy in managing of common conditions including abnormal uterine bleeding and abortion. Approach: In a descriptive cross-sectional setting, 243 women underwent hysteroscopy were evaluated in two groups: with uterine bleeding 236 cases and with recurrent abortions 7 cases. This study was conducted in Tabriz Alzahra Educational Center during a 15-month period. The main causes of the complaints were determined in each group. Six months after treatment, the overall success rate was recorded. Results: Hysteroscopy was the sole diagnostic procedure in 16.5 and 14.3% of the patients in groups with abnormal uterine bleeding and abortion, respectively. In the group with abnormal uterine bleeding, curettage, myomectomy, polypectomy, hysterectomy, laparoscopy and laparotomy were the main diagnostic-therapeutical approaches along with the hysteroscopy in descending order. In the group with recurrent abortion, laparoscopy, curettage and myomectomy were the main diagnostic-therapeutical approaches along with the hysteroscopy in descending. There was not any major complication. The diagnostic-therapeutical measures accompanying with the laparoscopy were successful in 73.5% of the bleeding group in follow-up period. Conclusion: Based on our results, hysteroscopy is a safe, accurate and highly-efficient procedure in managing women with abnormal uterine bleeding and recurrent abortion.

Sedigheh A. Fard

2012-01-01

322

A comparative study of the effects of an estradiol-releasing vaginal ring combined with an oral gestagen versus transdermal estrogen combined with a levonorgestrel-releasing IUD: clinical findings and endometrial response.  

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At the outpatient obstetric-gynecologic clinic of Areteion Hospital in Athens, Greece, 56 postmenopausal women, 48-76 years old and with signs and symptoms of estrogen deficiency-induced atrophic vaginitis, were randomly assigned to either the group using a silicon vaginal ring containing 2 mg micronized 17-beta- estradiol and oral medroxyprogesterone acetate for 7 days at the beginning of each month (group A) or the group using a combination of 50 mcg estradiol via a transdermal patch and a levonorgestrel-releasing IUD (group B). The women were using these regimens for 12 months. The purpose of the study was to compare the clinical and endometrial effects of the new vaginal ring with an oral progestin with those of the established hormone replacement regimen of transdermal estrogen and a levonorgestrel-releasing IUD. Vaginal ultrasound and pathologic examination of uterine curettage samples were used to determine endometrial effects. The urogenital complaints of all 56 women disappeared. The mean endometrial thickness before treatment was similar for both groups (2.9 mm for group A and 3 mm for group B) and was not significantly different than endometrial thickness after treatment (2.6 and 2.8 mm, respectively). Endometrial proliferation was not observed. The mean endometrial thickness at baseline predicted normal endometrium. After 3 months of treatment, vaginal bleeding patterns were similar in both groups. These findings confirm that both regimens effectively treat estrogen deficiency-induced urogenital disorders and do not increase the risk of endometrial proliferation. PMID:9010746

Kalogirou, D; Antoniou, G; Karakitsos, P; Kalogirou, O; Antoniou, D; Giannikos, L

1996-01-01

323

Can Endometrial Cancer Be Found Early?  

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... finding early endometrial cancers. The Pap test (or Pap smear), which screens for cervical cancer , can occasionally find some early endometrial cancers, but it is not a good test for this type of cancer. The Pap test is very effective in finding early cancers ...

324

Magnetic resonance imaging of cancer of uterine cervix and body. Preliminary study in 9 cases of body cancer and 20 of cervical cancer  

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We studied nine cases of endometrial carcinoma and twenty of cervix carcinoma. Correlation with histology is made after curietherapy in 8 cases of endometrial carcinoma. Tumor is not always seen and particularly when there is no mass effect on macroscopic examination. Myometral invasion is not seen with accuracy: the interruption of junctional zone is not a good sign. The cervix tumors are well seen on T2 sequences before any treatment. There extra uterine extension is difficult to appreciate. The best results of RMI were in the follow-up after radiotherapy. Therefore it appears actually to us the best indication of RMI

325

Polipectomia endometrial histeroscópica: tratamento ambulatorial versus convencional / Hysteroscopic endometrial polypectomy: outpatient versus conventional treatment  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Comparar resultados da polipectomia histeroscópica endometrial efetuada ambulatorialmente, sem anestesia, com polipectomia histeroscópica convencional sob anestesia, em centro cirúrgico, avaliando taxa de sucesso, tempo de procedimento e complicações. Mensurar dor aferida pela paciente nos [...] dois grupos. MÉTODOS: Estudo transversal observacional de 60 pacientes com diagnóstico histeroscópico de pólipo endometrial divididas em dois grupos: Grupo Ambulatorial, composto por pacientes submetidas à polipectomia histeroscópica ambulatorial, utilizando-se pinça endoscópica em histeroscópio operatório ambulatorial de fluxo contínuo, por meio de vaginoscopia sem anestesia, e Grupo Convencional com pacientes submetidas à polipectomia histeroscópica em centro cirúrgico, utilizando-se ressectoscópio monopolar sob anestesia. RESULTADOS: Os grupos foram similares quanto a idade, paridade, tipo de parto e presença ou não de menopausa. Ambos os grupos apresentaram 100% de eficácia na exérese dos pólipos. O tempo médio de procedimento foi de 7 minutos no Grupo Ambulatorial e 35,16 minutos no Grupo Convencional. No Grupo Ambulatorial, as pacientes após a menopausa (p=0,04) e aquelas com pólipos >1cm (p=0,01) apresentaram tempo de procedimento maior. Durante o procedimento,a média de dor referida pelas pacientes, segundo a Escala Analógica Verbal de Dor, no Grupo Ambulatorial, foi de 2,93 e, após efeito anestésico do procedimento no Grupo Convencional, foi de 1,42 pontos. Não houve complicações no Grupo Ambulatorial. No Grupo Convencional, registraram-se um caso de perfuração uterina e um de falso trajeto. CONCLUSÃO: A polipectomia histeroscópica realizada em regime ambulatorial, sem anestesia, é um procedimento bem tolerado. Quando comparada ao tratamento convencional, apresenta a mesma eficácia, porém com menor tempo gasto no procedimento e menor índice de complicações. Abstract in english OBJECTIVE: To compare results of hysteroscopic polypectomy of the endometrium performed in an outpatient clinic, under no anesthesia, to conventional hysteroscopic polypectomy under anesthesia in the operating theatre, assessing success rate, procedure time and complications; and to measure pain ref [...] erred by patients in both groups. METHODS: An observational cross-sectional study of 60 patients with hysteroscopic diagnosis of endometrial polyps, divided into two groups: the Outpatient Group, comprising patients submitted to outpatient´s hysteroscopic polypectomy by continuous flow vaginoscopy using endoscopic forceps under no anesthesia, and the Conventional Group with patients submitted to hysteroscopic polypectomy in the operating theater, using a monopolar resectoscope under anesthesia. RESULTS: The groups were similar as to age, parity, mode of delivery and menopausal status. Both groups presented 100% efficacy in exeresis of polyps. The mean time of procedure was 7 minutes in the Outpatient Group and 35.16 minutes in the Conventional Group. In the Outpatient Group, menopausal patients (p=0.04) and those with polyps >1cm (p=0.01) had longer procedures. Using the Verbal Analog Scale of Pain, the mean score of pain referred by patients during the procedure was 2.93 in the Outpatient Group and, after anesthetic effect, 1.42 in the Conventional Group. There were no complications in the Outpatient Group. There was one case of uterine perforation and one case of false passage in the Conventional Group. CONCLUSION: Hysteroscopic polypectomy performed in an outpatient setting under no anesthesia is a well-tolerated procedure. As compared to conventional treatment, it displays the same efficacy, but the procedure time is shorter and the complication rate is lower.

Angela Mendes, Bergamo; Daniella de Batista, Depes; Ana Maria Gomes, Pereira; Taciana Cristina Duarte de, Santana; Umberto Gazi, Lippi; Reginaldo Guedes Coelho, Lopes.

326

Polipectomia endometrial histeroscópica: tratamento ambulatorial versus convencional / Hysteroscopic endometrial polypectomy: outpatient versus conventional treatment  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Comparar resultados da polipectomia histeroscópica endometrial efetuada ambulatorialmente, sem anestesia, com polipectomia histeroscópica convencional sob anestesia, em centro cirúrgico, avaliando taxa de sucesso, tempo de procedimento e complicações. Mensurar dor aferida pela paciente nos [...] dois grupos. MÉTODOS: Estudo transversal observacional de 60 pacientes com diagnóstico histeroscópico de pólipo endometrial divididas em dois grupos: Grupo Ambulatorial, composto por pacientes submetidas à polipectomia histeroscópica ambulatorial, utilizando-se pinça endoscópica em histeroscópio operatório ambulatorial de fluxo contínuo, por meio de vaginoscopia sem anestesia, e Grupo Convencional com pacientes submetidas à polipectomia histeroscópica em centro cirúrgico, utilizando-se ressectoscópio monopolar sob anestesia. RESULTADOS: Os grupos foram similares quanto a idade, paridade, tipo de parto e presença ou não de menopausa. Ambos os grupos apresentaram 100% de eficácia na exérese dos pólipos. O tempo médio de procedimento foi de 7 minutos no Grupo Ambulatorial e 35,16 minutos no Grupo Convencional. No Grupo Ambulatorial, as pacientes após a menopausa (p=0,04) e aquelas com pólipos >1cm (p=0,01) apresentaram tempo de procedimento maior. Durante o procedimento,a média de dor referida pelas pacientes, segundo a Escala Analógica Verbal de Dor, no Grupo Ambulatorial, foi de 2,93 e, após efeito anestésico do procedimento no Grupo Convencional, foi de 1,42 pontos. Não houve complicações no Grupo Ambulatorial. No Grupo Convencional, registraram-se um caso de perfuração uterina e um de falso trajeto. CONCLUSÃO: A polipectomia histeroscópica realizada em regime ambulatorial, sem anestesia, é um procedimento bem tolerado. Quando comparada ao tratamento convencional, apresenta a mesma eficácia, porém com menor tempo gasto no procedimento e menor índice de complicações. Abstract in english OBJECTIVE: To compare results of hysteroscopic polypectomy of the endometrium performed in an outpatient clinic, under no anesthesia, to conventional hysteroscopic polypectomy under anesthesia in the operating theatre, assessing success rate, procedure time and complications; and to measure pain ref [...] erred by patients in both groups. METHODS: An observational cross-sectional study of 60 patients with hysteroscopic diagnosis of endometrial polyps, divided into two groups: the Outpatient Group, comprising patients submitted to outpatient´s hysteroscopic polypectomy by continuous flow vaginoscopy using endoscopic forceps under no anesthesia, and the Conventional Group with patients submitted to hysteroscopic polypectomy in the operating theater, using a monopolar resectoscope under anesthesia. RESULTS: The groups were similar as to age, parity, mode of delivery and menopausal status. Both groups presented 100% efficacy in exeresis of polyps. The mean time of procedure was 7 minutes in the Outpatient Group and 35.16 minutes in the Conventional Group. In the Outpatient Group, menopausal patients (p=0.04) and those with polyps >1cm (p=0.01) had longer procedures. Using the Verbal Analog Scale of Pain, the mean score of pain referred by patients during the procedure was 2.93 in the Outpatient Group and, after anesthetic effect, 1.42 in the Conventional Group. There were no complications in the Outpatient Group. There was one case of uterine perforation and one case of false passage in the Conventional Group. CONCLUSION: Hysteroscopic polypectomy performed in an outpatient setting under no anesthesia is a well-tolerated procedure. As compared to conventional treatment, it displays the same efficacy, but the procedure time is shorter and the complication rate is lower.

Angela Mendes, Bergamo; Daniella de Batista, Depes; Ana Maria Gomes, Pereira; Taciana Cristina Duarte de, Santana; Umberto Gazi, Lippi; Reginaldo Guedes Coelho, Lopes.

2012-09-01

327

Two different embolic agents in the treatment of uterine arterial embolization for symptomatic fibroids  

International Nuclear Information System (INIS)

Objective: To compare the efficacy and safety of dextran microspheres and polyvinyl alcohol particles in the uterine arterial embolization (UAE)for symptomatic uterine leiomyomata. Methods: Forty women (mean aged 38.5 years, ranged 28-44 years)with symptomatic myomas were randomly divided into two groups with 20 patients in each, PVA (polyvinyl alcohol particles, 355-500 ?m)was used as embolic agents in group A and dextran microspheres(Sephadex G-50, 100-300 ?m)in group B. The mean diameter of fibroids was 6.5 cm (range, 3-12 cm)with symptoms of menorrahgia, bulk-related symptoms, dysmenorrhea and infertility. Analgesics, anti-infection and rehydration treatments were used after the procedure. The hospital stay, post-embolization syndromes, follow-up materials were reviewed and compared. Results: The hospital stay and the post embolization pain showed no obvious difference between the two groups, simultaneously with no serious complications. The average follow-up duration was 9 months (range, 6-24 months). The average volumes of uterus and fibroid in group A and B decreased gradually during follow-up: 53.4%, 55% and 48.6%, 40.9%, respectively. Conclusion: Dextran microspheres is as the same effective and safe as PVA particles for UAE, but rather cheaper than latter. Further prospective study is warranted. (authors)

328

The hysterosonography in the study of the bled  

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Hysterosonography (HS) is the sterile saline infusion on the endometrium under sonographic control, to localize any uterine abnormalities to the endocavitary space, and determine endometrial or submucosal origin. Forty patients had HS, with hysteroscopic correlation on 23 patients. Fourteen patients were on reproductive age (Group I) and 9 were peri menopausal (Group II), all of them with abnormal uterine bleeding. Diagnostic accuracy of HSG on Group I was of 92.8%, and 100% on Group II patients. For Group I patients, the main abnormalities were endometrial polyps, submucosal myomas, septae and adherences. For Group II patients, the most frequent findings were polyps and submucosal myomas. We conclude that HS increases the specificity of trans vaginal ultrasound in the characterization of abnormalities of the endometrial cavity, and can establish which require hysteroscopy or other diagnostic or therapeutic methods

329

Effects of BST on oviductal and uterine genes encoding components of the IGF system in lactating dairy cows.  

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Lactating Holstein cows, averaging 80 d in milk, were used to examine effects of exogenous bovine somatotropin (bST) on oviductal and uterine genes encoding components of the insulin-like growth factor (IGF) system. About 12 h before expected ovulation in an Ovsynch protocol, cows were assigned randomly to receive bST (500 mg; n = 11) or serve as untreated controls (n = 10). Cows that ovulated (n = 9 bST, 8 control) were divided within treatment to be sacrificed on d 3 or 7 postovulation. Samples of oviductal and intercaruncular endometrial tissue from oviducts and uterine horns ipsilateral to the corpus luteum (CL) were collected and immediately frozen at -80 degrees C for subsequent mRNA analyses. Northern blots revealed mRNAs for IGF-II, IGF-binding protein-2 (IGFBP-2), and IGFBP-3 in all oviductal and endometrial tissues. Significant amounts of IGF-I and growth hormone receptor-1A (GHR-1A) mRNAs were detected in uteri but not in oviducts. The bST treatment had no effect on amount of IGF-I mRNA transcript in uterine endometrium. The mRNA encoding IGF-II was induced by bST in oviducts collected on both d 3 and 7 but was down-regulated in endometrium on d 7. Transcript of IGFBP-2 mRNA was greater in endometrial than oviductal tissues and did not differ between treatments. Both oviductal and endometrial IGFBP-3 mRNA concentrations increased between d 3 and 7 postovulation, with a tendency for greater endometrial IGFBP-3 mRNA in bST-treated cows on d 7. On d 7, concentrations of endometrial GHR-1A mRNA were 30% lower in bST-treated cows. Results indicate complex and tissue-specific regulation of the uterine IGF system components by exogenous bST. Some of those biological responses to bST may be important in early development of bovine embryos. PMID:12512599

Pershing, R A; Lucy, M C; Thatcher, W W; Badinga, L

2002-12-01

330

Management of Uterine Sarcomas  

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Full Text Available Uterine sarcomas are rare malignant tumors characterized by a great clinical and histopathological diversity. The aim of this work is to analyze the difficulties of diagnosis, therapeutic and prognosis posed by these tumors. Thirty-seven patients with uterine sarcoma, collected in the service Radiotherapy and Oncology, University Ibn Rochd of Casablanca between January 2000 and December 2007 were included in this study retrospective. The average patient age was 50 years (17-76. The bleeding was present in all patients, isolated in 54% of cases associated with pelvic pain in 24.6% and a mass abdomino-pelvic in seven patients. The average time of evolution was 10 months. The main histological type was found leiomyosarcoma. Twenty four patients in our series underwent total hysterectomy without annexial conservation. The surgery R0 was obtained in 43% of cases. The sarcomas were classified as stage IV in 51.4%. Adjuvant radiotherapy was indicated in 13 patients. After a mean of 20 months, half of patients evaluable presented a local relapse and/or metastatic, the third of cases were tumor progression while complete remission was maintained in 18.5% of cases. Uterine sarcomas are rare malignant mesenchymal tumor, which often occur in women after menopause. The main prognostic factors are hormonal status of the patient, stage clinical, histological type, histological grade and quality surgical excision. The management of uterine sarcomas is multidisciplinary, based mainly on surgery remains the only means of cure. Adjuvant radiotherapy allows decreased risk of local recurrence, with no impact on survival achieved at best 30% at 5 years. The role of chemotherapy remains confirm.

Asmaa Naim

2012-10-01

331

Endometrial carcinomas: a review emphasizing overlapping and distinctive morphological and immunohistochemical features.  

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This review focuses on the most common diagnostic pitfalls and helpful morphologic and immunohistochemical markers in the differential diagnosis between the different subtypes of endometrial carcinomas, including: (1) endometrioid versus serous glandular carcinoma, (2) papillary endometrioid (not otherwise specified, villoglandular and nonvillous variants) versus serous carcinoma, (3) endometrioid carcinoma with spindle cells, hyalinization, and heterologous components versus malignant mixed müllerian tumor, (4) high-grade endometrioid versus serous carcinoma, (5) high-grade endometrioid carcinoma versus dedifferentiated or undifferentiated carcinoma, (6) endometrioid carcinoma with clear cells versus clear cell carcinoma, (7) clear cell versus serous carcinoma, (8) undifferentiated versus neuroendocrine carcinoma, (9) carcinoma of mixed cell types versus carcinoma with ambiguous features or variant morphology, (10) Lynch syndrome-related endometrial carcinomas, (11) high-grade or undifferentiated carcinoma versus nonepithelial uterine tumors. As carcinomas in the endometrium are not always primary, this review also discusses the differential diagnosis between endometrial carcinomas and other gynecological malignancies such as endocervical (glandular) and ovarian/peritoneal serous carcinoma, as well as with extra-gynecologic metastases (mainly breast and colon). PMID:21993268

Bartosch, Carla; Manuel Lopes, José; Oliva, Esther

2011-11-01

332

Staging of endometrial cancer with MRI: Guidelines of the European Society of Urogenital Imaging  

International Nuclear Information System (INIS)

The purpose of this study was to define guidelines for endometrial cancer staging with MRI. The technique included critical review and expert consensus of MRI protocols by the female imaging subcommittee of the European Society of Urogenital Radiology, from ten European institutions, and published literature between 1999 and 2008. The results indicated that high field MRI should include at least two T2-weighted sequences in sagittal, axial oblique or coronal oblique orientation (short and long axis of the uterine body) of the pelvic content. High-resolution post-contrast images acquired at 2 min ± 30 s after intravenous contrast injection are suggested to be optimal for the diagnosis of myometrial invasion. If cervical invasion is suspected, additional slice orientation perpendicular to the axis of the endocervical channel is recommended. Due to the limited sensitivity of MRI to detect lymph node metastasis without lymph node-specific contrast agents, retroperitoneal lymph node screening with pre-contrast sequences up to the level of the kidneys is optional. The likelihood of lymph node invasion and the need for staging lymphadenectomy are also indicated by high-grade histology at endometrial tissue sampling and by deep myometrial or cervical invasion detected by MRI. In conclusion, expert consensus and literature review lead to an optimized MRI protocol to stage endometrial cancer. (orig.)

333

Staging of endometrial cancer with MRI: Guidelines of the European Society of Urogenital Imaging  

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The purpose of this study was to define guidelines for endometrial cancer staging with MRI. The technique included critical review and expert consensus of MRI protocols by the female imaging subcommittee of the European Society of Urogenital Radiology, from ten European institutions, and published literature between 1999 and 2008. The results indicated that high field MRI should include at least two T2-weighted sequences in sagittal, axial oblique or coronal oblique orientation (short and long axis of the uterine body) of the pelvic content. High-resolution post-contrast images acquired at 2 min {+-} 30 s after intravenous contrast injection are suggested to be optimal for the diagnosis of myometrial invasion. If cervical invasion is suspected, additional slice orientation perpendicular to the axis of the endocervical channel is recommended. Due to the limited sensitivity of MRI to detect lymph node metastasis without lymph node-specific contrast agents, retroperitoneal lymph node screening with pre-contrast sequences up to the level of the kidneys is optional. The likelihood of lymph node invasion and the need for staging lymphadenectomy are also indicated by high-grade histology at endometrial tissue sampling and by deep myometrial or cervical invasion detected by MRI. In conclusion, expert consensus and literature review lead to an optimized MRI protocol to stage endometrial cancer. (orig.)

Kinkel, K. [Geneva University Hospital and Institut de Radiologie, Clinique des Grangettes, Chene-Bougeries/Geneva (Switzerland); Clinique des Grangettes, Institut de radiologie, Chene-Bougerie/Geneva (Switzerland); Forstner, R. [LandesklinikenSalzburg, Zentralroentgeninstitut, Salzburg (Austria); Danza, F.M. [Universita Cattolica del S. Cuore, Dipartimento di Bioimmagini e scienze radiologiche, Rome (Italy); Oleaga, L. [Hospital Clinic, Radiology Department, Barcelona (Spain); Cunha, T.M. [Instituto Portugues de Oncologia de Lisboa Francisco Gentil, Department of Radiology, Lisboa Codex (Portugal); Bergman, A. [Uppsala University Hospital, Department of Radiology, Uppsala (Sweden); Barentsz, J.O. [Radboud University Nijmegen Medical Center, Department of Radiology, Nijmegen (Netherlands); Balleyguier, C. [Institut de Cancerologie Gustave Roussy, Department of Radiology, Villejuif Cedex (France); Brkljacic, B. [University Hospital ' ' Dubrava' ' , Department of Diagnostic and Interventional Radiology, Zagreb (Croatia); University of Zagreb, Medical School, Zagreb (Croatia); Spencer, J.A. [St James' s Institute of Oncology, Department of Clinical Radiology, Leeds (United Kingdom)

2009-07-15

334

Cyclic remodeling of the nonhuman primate endometrium: a model for understanding endometrial receptivity.  

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Old World monkeys display physiological responses to steroid hormones that are similar to those of women. In this review, we describe cyclic morphological changes that take place within the uterus of Old World primates during the menstrual cycle. In primates, estrogen stimulates endometrial growth in the follicular phase of the menstrual cycle. Progesterone secreted in the luteal phase acts to induce secretory differentiation, which is required for successful embryo implantation. During the differentiation process, endometrial estrogen receptor-1 (ESR-1) is suppressed, and reduced staining for ESR-1 is a definitive marker of the onset of uterine receptivity. Downregulation of ESR-1 is topographically limited to the functionalis (upper) zones of the endometrium, the zones in which embryo implantation occurs, indicating that zone-specific factors play a role in the differentiation process. Future genomic and proteomic studies are expected to reveal additional markers for diagnosing endometrial receptivity. Due to the distinct zonal response of the endometrium to ovarian steroids, accurate histological characterization will remain necessary to interpret novel targets in the assessment of fertility. PMID:24959820

Slayden, Ov Daniel

2014-09-01

335

Gynecologic Cancer InterGroup (GCIG) Consensus Review for Endometrial Stromal Sarcoma.  

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Endometrial stromal sarcoma (ESS) accounts for approximately 20% of all uterine sarcomas and presents, at a mean age, around 50 years of age. Half of the patients are premenopausal. ESS often manifests as an endometrial polyp and 60% of cases present with FIGO stage I disease. The natural history is one of slow growing indolent disease. Typical microscopic findings include a uniform population of endometrial stromal-type cells invading the myometrium and myometrial vessels. Imaging studies cannot reliably diagnose ESS preoperatively, so surgical resection for a presumed fibroid is a common scenario. Hysterectomy is the cornerstone of treatment for localized ESS, but morcellation should be avoided. Systematic lymphadenectomy in ESS does not improve the outcome. Leaving the ovaries in situ does not worsen survival and this is of importance especially for young women. The data support the current practice to administer adjuvant hormonal treatment, although several questions remain, such as optimal doses, regimens (progestins or aromatase inhibitors) and duration of therapy. Repeat surgery for recurrent disease that is indolent and hormone sensitive appears to be an acceptable approach. Systemic treatment for recurrent disease is mainly hormonal. PMID:25033257

Amant, Frédéric; Floquet, Anne; Friedlander, Michael; Kristensen, Gunnar; Mahner, Sven; Nam, Eun Ji; Powell, Matthew A; Ray-Coquard, Isabelle; Siddiqui, Nadeem; Sykes, Peter; Westermann, Anneke M; Seddon, Beatrice

2014-11-01

336

Impact of middle and lower jugular neck dissection on supraclavicular lymph node metastasis from endometrial carcinoma  

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Full Text Available Abstract Supraclavicular lymph node metastasis from endometrial carcinoma is considerably rarer than metastasis from uterine cervical cancer. To date, there have been no reported cases regarding systematic neck dissection as a salvage treatment. In this report, we describe the neck dissection procedure carried out on a 74-year-old woman with supraclavicular lymph node metastasis. Our objective was to histologically determine the origin of the metastasis while simultaneously providing appropriate treatment. The patient’s past medical history included two prior cases of cancer: rectal cancer 7?years earlier and endometrial adenocarcinoma 4?years earlier. We determined that middle and lower jugular neck dissection was appropriate in treating this case based on the results of our preoperative FDG-PET and tumor markers. This surgery provided histological evidence that metastasis occurred from endometrial carcinoma. Middle and lower jugular neck dissection was expected to improve the patient’s prognosis without impacting the patient’s active daily life. We have continued to monitor the patient closely over an extended period.

Kojima Masataka

2012-07-01

337

Significance of negative hysteroscopic view in abnormal uterine bleeding.  

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Full Text Available Ninety six cases of abnormal uterine bleeding were evaluated by both panoramic hysteroscopy and dilatation and curettage. The indications for hysteroscopy included postmenopausal bleeding, infertility with abnormal bleeding, abnormal bleeding and suspected leiomyoma with bleeding. Twenty three patients had abnormal hysteroscopy findings. Hysteroscopy diagnosed endometrial polyp and submucus leiomyoma with 100% accuracy. In 17 cases, the results of hysteroscopy and curettage were in agreement and hysteroscopy revealed more information than curettage in 6 cases. Among the remaining 73 cases with ?negative? hysteroscopic view, an abnormality was detected by tissue sampling in only 2 patients. The specificity and positive predictive value of hysteroscopy is 100%. The sensitivity of hysteroscopy was greater (92% than that of curettage (76% and the negative predictive value of hysteroscopy was 2.8%. Thus, panoramic hysteroscopy may prove to be superior to curettage in making an accurate diagnosis of intrauterine pathology.

Parasnis H

1992-04-01

338

Local activation of uterine Toll-like receptor 2 and 2/6 decreases embryo implantation and affects uterine receptivity in mice.  

Science.gov (United States)

Embryo implantation is a complex interaction between maternal endometrium and embryonic structures. Failure to implant is highly recurrent and impossible to diagnose. Inflammation and infections in the female reproductive tract are common causes of infertility, embryo loss, and preterm labor. The current work describes how the activation of endometrial Toll-like receptor (TLR) 2 and 2/6 reduces embryo implantation chances. We developed a morphometric index to evaluate the effects of the TLR 2/6 activation along the uterine horn (UH). TLR 2/6 ligation reduced the endometrial myometrial and glandular indexes and increased the luminal index. Furthermore, TLR 2/6 activation increased the proinflammatory cytokines such as interleukin (IL)-1beta and monocyte chemotactic protein (MCP)-1 in UH lavages in the preimplantation day and IL-1 receptor antagonist in the implantation day. The engagement of TLR 2/6 with its ligand in the UH during embryo transfer severely affected the rate of embryonic implantation (45.00% ± 6.49% vs. 16.69% ± 5.01%, P < 0.05, control vs. test, respectively). Furthermore, this interference with the embryo implantation process was verified using an in vitro model of human embryo implantation where trophoblast spheroids failed to adhere to a monolayer of TLR 2- and TLR 2/6-activated endometrial cells. The inhibition of TLR receptors 2 and 6 in the presence of their specific ligands restored the ability of the spheroids to bind to the endometrial cells. In conclusion, the activation of the innate immune system in the uterus at the time of implantation interfered with the endometrial receptivity and reduced the chances of implantation success. PMID:24621922

Sanchez-Lopez, Javier Arturo; Caballero, Ignacio; Montazeri, Mehrnaz; Maslehat, Nasim; Elliott, Sarah; Fernandez-Gonzalez, Raul; Calle, Alexandra; Gutierrez-Adan, Alfonso; Fazeli, Alireza

2014-04-01

339

Differential diagnostics of mesenhymal tumors of uterine corpus founded on immunophenotypes of neoplasms.  

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Full Text Available Morphological diagnostics of mesenhymal uterine neoplasms is complex due to polymorphism of benign and malignant processes. The purpose of our research was to devise the complex differential diagnostics criterions for foregoing tumors founded on expression's indexes of biological tissue's properties markers studying. We determined, that for smooth muscle tumors with unknown malignant potential diagnostics, it will be an expedient to use as main markers p53, Ki-67, ER, PGR and as auxiliary p21, bax, VEGF, TSP-1, CD34. For differential diagnosis of leiomyomas and endometrial stromal tumors it is ne?essary to use ?D10, desmin, ?-SMA, h-caldesmon, Ki-67. For definition of atypia's level in the tumors of endometrial stroma, the most informative will be diagnostical panel from Ki-67, p53, ER, PGR, and cyclin D1. To solve the issue of histogenesis will help the complex consists of CD10, ?-SMA, desmin, ?? h-caldesmon.

Shponka I.S.

2011-01-01

340

Two case reports: Carcinoma of the cervix and carcinoma of the endometrium treated with radiotherapy after previous irradiation for benign uterine bleeding  

International Nuclear Information System (INIS)

In the 1940s, 1950s and 1960s, low doses of radiotherapy were used to treat benign uterine bleeding. The cases of two women who received this form of therapy and later developed gynaecological malignancies and had high-dose pelvic radiotherapy are presented. A 76-year-old woman with an International Federation of Gynecology and Obstetrics (FIGO) stage-II B squamous cell carcinoma of the cervix received external beam radiotherapy and intra-uterine brachytherapy and a 77-year-old woman with a FIGO stage-I B endometrial adenocarcinoma received adjuvant postoperative pelvic radiotherapy. Both women had a significant past history of low-dose-rate intra-uterine irradiation for dysfunctional uterine bleeding. Therefore the theoretical question of carcinogenesis was raised, and also the practical questions of what dose had previously been given and what further dose could be safely given with regard to normal tissue tolerance. Copyright (1998) Blackwell Science Pty Ltd

 
 
 
 
341

The Content of Soluble HLA Class I and HLA-DR Molecules in Serum in Patients with Uterine Cervix and Body Pathology  

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Full Text Available The aim of the investigation was to assess the correlation of the content of soluble HLA (sHLAI class I and HLA-DR (sHLA-DR molecules in blood serum of patients with uterine cervix and body pathologies, and their pathology type, tumor grade, the number and localization of myomatous nodes. Materials and Methods. 142 women with uterine cervix and body pathology aged 31–79 years (median — 52 years were under study. Serum level of sHLAI and sHLA-DR molecules was determined by enzyme immunoassay using monoclonal antibodies. Blood samples were drawn from cubital vein. All tests were performed before and after the treatment course. For enzyme immunoassay we used mouse monoclonal antibodies to reveal soluble differentiated molecules. Results. Malignant pathologies of uterine cervix and body and myomas were found to be accompanied by an increased serum level of sHLAI ? sHLA-DR molecules, its degree depending on the type of pathology diagnosed in patients with cervical cancer and hysterocarcinomas, and differentiation degree of adenocarcinoma in hysterocarcinoma patients, the number and localization of myomatous nodes. Initial concentration of soluble HLA class I and HLA-DR molecules in a preoperative period can serve as an additional diagnostic test in patients with uterine tumors for their further selection for surgery.

?.?. Mamaeva

2014-06-01

342

Comparison of endometrial biopsy by PIPELLE with diagnostic curretage in patients with abnormal utrine bleeding, Imam Khomeini Hospital  

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Full Text Available It this prospective cross sectional study out-patient endometrial biopsy by PIPELLE was compared with diagnostic curretage (D&C in patients suffering of Abnormal Uterine bleeding (AUB. Diagnostic accuracy, sufficient tissue sampling, intensity of pain and effective factors in biopsy results were the evaluated parameters in this study. In 70 patients with complaint of AUB (20 of them were post-menoupsal age admitted in hospital for D&C endometrial biopsy was conducted by PIPELLE before operation and the results were compared. 96% of total patients (67 and 91% of patients with post menopause age had tolerance of undergoing out-patient PIPELLE biopsy of endometrium. 79% of these individuals complained of mild pain and 21% of moderate pain. Endometrium biopsy by PIPELLE in 77% of patients had similar accurate diagnostic results as compared to D&C. PIPELLE in 34% of patients (24 could not be conducted with the same accuracy of D&C patients, although in 14 (20% of them, notissue samples could be collected by D&C. In none of these methods endometrial hyperplasia or endometrial cancer were detected. This study showed that in 77% of the total patients, the extra cost and general anesthetical risk of D&C could have been eliminated, by utilization of out-patient biopsy with PIPELLE

Ghaemmaghami F

1999-06-01

343

Metaplasia óssea endometrial: quadro clínico e seguimento após tratamento / Endometrial osseous metaplasia: clinical presentation and follow-up  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: apresentar o quadro clínico das pacientes com metaplasia óssea e avaliar os fatores de risco, as mudanças dos sinais e sintomas após a retirada do fragmento ósseo. MÉTODOS: foi realizado um estudo transversal com 16 pacientes diagnosticadas com fragmentos ósseos na cavidade uterina no perí [...] odo de julho de 2006 a janeiro de 2009. O critério de inclusão foi o achado de fragmento ósseo retirado da cavidade uterina. Todas as pacientes tiveram confirmação histológica de presença de tecido ósseo na cavidade endometrial. Obtivemos os dados de todas as pacientes antes e depois da retirada por meio de um questionário para avaliar o efeito da retirada sobre a sintomatologia das pacientes, além da pesquisa de possíveis fatores relacionados ao aparecimento da doença. RESULTADOS: metade das pacientes (8/16) tinha sintomas hemorrágicos e um terço (6/16) apresentava infertilidade. A retirada dos fragmentos foi efetiva na melhora das queixas, havendo desaparecimento dos sintomas em todos os casos de menorragia e dor pélvica. CONCLUSÃO: A retirada do fragmento ósseo pode restaurar a fertilidade em pacientes selecionadas e que tenham como causa a metaplasia óssea, além de ser bastante efetiva em proporcionar melhora nos casos que cursam com dor pélvica e menorragia. Abstract in english PURPOSE: to describe the clinical signs and symptoms of patients with bone metaplasia and to assess the risk factors for changes in these symptoms after removal of the bone fragment. METHODS: a cross-sectional study was conducted on 16 patients with a diagnosis of bone fragments in the uterine cavit [...] y during the period comprising July 2006 to January 2009. The inclusion criterion was the detection of a bone fragment removed from the uterine cavity. The presence of bone tissue in the endometrial cavity was histologically confirmed in all patients. The data of all patients were obtained before and after removal by means of a questionnaire for the evaluation of the effect of removal on the symptoms and for the search of possible factors related to the onset of the disease. RESULTS: half the patients (8/16) had hemorrhagic symptoms and one third (6/16) were infertile. Removal of the fragments was quite effective in improving the complaints, with the disappearance of symptoms in all cases of hemorrhage and of pelvic pain. CONCLUSION: removal of bone fragments can restore the fertility of selected patients whose infertility is caused by bone metaplasia and is quite effective in leading to improvement in patients with pelvic pain and menorrhage.

Raphael Câmara Medeiros, Parente; Vilmon de, Freitas; Rodrigo Soares de, Moura Neto; Marco Aurélio Pinho de, Oliveira; Ricardo Bassil, Lasmar; Marisa Teresinha, Patriarca; Felipe Simões, Canavez.

2010-01-01

344

Epigenetic Regulation of Uterine Biology by Transcription Factor KLF11 via Posttranslational Histone Deacetylation of Cytochrome p450 Metabolic Enzymes.  

Science.gov (United States)

Endocrine regulation of uterine biology is critical for embryo receptivity and human reproduction. Uterine endometrium depends on extrinsic sex steroid input and hence likely has mechanisms that enable adaptation to hormonal variation. Emerging evidence suggests that sex steroid bioavailability in the endometrium is determined by adjusting their metabolic rate and fate via regulation of cytochrome (CYP) p450 enzymes. The CYP enzymes are targeted by ubiquitously expressed Sp/Krüppel-like (Sp/KLF) transcription factors. Specifically, KLF11 is highly expressed in reproductive tissues, regulates an array of endocrine/metabolic pathways via epigenetic histone-based mechanisms and, when aberrantly expressed, is associated with diabetes and reproductive tract diseases, such as leiomyoma and endometriosis. Using KLF11 as a model to investigate epigenetic regulation of endometrial first-pass metabolism, we evaluated the expression of a comprehensive array of metabolic enzymes in Ishikawa cells. KLF11 repressed most endometrial CYP enzymes. To characterize KLF11-recruited epigenetic regulatory mechanisms, we focused on the estrogen-metabolizing enzyme CYP3A4. KLF11 expression declined in secretory phase endometrial epithelium associated with increased CYP3A4 expression. Additionally, KLF11 bound to CYP3A4 promoter GC elements and thereby repressed promoter, message, protein as well as enzymatic function. This repression was epigenetically mediated, because KLF11 colocalized with and recruited the corepressor SIN3A/histone deacetylase resulting in selective deacetylation of the CYP3A4 promoter. Repression was reversed by a mutation in KLF11 that abrogated cofactor recruitment and binding. This repression was also pharmacologically reversible with an histone deacetylase inhibitor. Pharmacological alteration of endometrial metabolism could have long-term translational implications on human reproduction and uterine disease. PMID:25076120

Zheng, Ye; Tabbaa, Zaid M; Khan, Zaraq; Schoolmeester, John K; El-Nashar, Sherif; Famuyide, Abimbola; Keeney, Gary L; Daftary, Gaurang S

2014-11-01

345

Correlation between Endometrial Parameters in Doppler Sonography and Success Rate of Implantation in Assisted Reproductive Programs  

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Full Text Available Background: A good blood supply towards the endometrium is usually considered to be an essential requirement for implantation. Evaluating the role of endometrial and sub-endometrial blood flows detected by color Doppler sonography at the day of embryo transfer, as a predictor of pregnancy rate during IVF/ICSI programs was our main goal in this study.Materials and Methods: Seventy three infertile patients aged <38 years with basal serum FSH level<12 mIU/ml who had less than two failed attempts of ART cycles were prospectively evaluated. The cases with more than two failed IVF cycle and uterine disorders were excluded. All procedures were performed by one expert and two good quality embryos were transferred. Vaginal power color Doppler sonography was performed at the day of embryo transfer and endometrial characteristics including endometrial vascularization, area of vascularization distribution and pulsatility index were registered. Then pregnant and non-pregnant groups were compared for ultrasonographic parameters of endometrium.Results: Pregnancy occurred in 28 patients. Mean age, duration and etiology of infertility, baseline mean FSH and estradiol level at the day of Human chorionic gonadotropin (HCG injection, amount of drug administered, number of retrieved oocytes and embryos, also number and quality of transferred embryos in the pregnant and non-pregnant groups showed no statistically significant difference .On the other hand, none of the sonographic parameters reported in two groups indicated a statistically significant difference.Conclusion: Doppler ultrasonographic indices at the day of embryo transfer are not considered appropriate criteria for prediction of success rate or failure of embryo implantation.

Firoozeh Ahmadi

2007-01-01

346

Genistein promotes DNA demethylation of the steroidogenic factor 1 (SF-1) promoter in endometrial stromal cells  

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Highlights: {yields} Genistein (GEN) is a phytoestrogen found in soy products. {yields} GEN demethylated/unsilenced the steroidogenic factor 1 gene in endometrial tissue. {yields} GEN thus altered mRNA expression in uteri of ovariectomized (OVX) mice. {yields} A high-resolution melting assay was used to screen for epigenetic change. {yields} We isolated an endometrial cell clone that was epigenetically modulated by GEN. -- Abstract: It has recently been demonstrated that genistein (GEN), a phytoestrogen in soy products, is an epigenetic modulator in various types of cells; but its effect on endometrium has not yet been determined. We investigated the effects of GEN on mouse uterine cells, in vivo and in vitro. Oral administration of GEN for 1 week induced mild proliferation of the endometrium in ovariectomized (OVX) mice, which was accompanied by the induction of steroidogenic factor 1 (SF-1) gene expression. GEN administration induced demethylation of multiple CpG sites in the SF-1 promoter; these sites are extensively methylated and thus silenced in normal endometrium. The GEN-mediated promoter demethylation occurred predominantly on the luminal side, as opposed to myometrium side, indicating that the epigenetic change was mainly shown in regenerated cells. Primary cultures of endometrial stromal cell colonies were screened for GEN-mediated alterations of DNA methylation by a high-resolution melting (HRM) method. One out of 20 colony-forming cell clones showed GEN-induced demethylation of SF-1. This clone exhibited a high proliferation capacity with continuous colony formation activity through multiple serial clonings. We propose that only a portion of endometrial cells are capable of receiving epigenetic modulation by GEN.

Matsukura, Hiroshi, E-mail: hmatsukura.epi@mri.tmd.ac.jp [Department of Molecular Epidemiology, Medical Research Institute, Tokyo Medical and Dental University, 2-3-10 Kanda-surugadai, Chiyoda-ku, Tokyo 101-0062 (Japan); Aisaki, Ken-ichi; Igarashi, Katsuhide; Matsushima, Yuko; Kanno, Jun [Division of Cellular and Molecular Toxicology, National Institute of Health Sciences, 1-18-1 Kamiyoga, Setagaya-ku, Tokyo 158-8501 (Japan); Muramatsu, Masaaki [Department of Molecular Epidemiology, Medical Research Institute, Tokyo Medical and Dental University, 2-3-10 Kanda-surugadai, Chiyoda-ku, Tokyo 101-0062 (Japan); Sudo, Katsuko [Department of Molecular Epidemiology, Medical Research Institute, Tokyo Medical and Dental University, 2-3-10 Kanda-surugadai, Chiyoda-ku, Tokyo 101-0062 (Japan); Animal Research Center, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402 (Japan); Sato, Noriko, E-mail: nsato.epi@tmd.ac.jp [Department of Molecular Epidemiology, Medical Research Institute, Tokyo Medical and Dental University, 2-3-10 Kanda-surugadai, Chiyoda-ku, Tokyo 101-0062 (Japan)

2011-08-26

347

Genistein promotes DNA demethylation of the steroidogenic factor 1 (SF-1) promoter in endometrial stromal cells  

International Nuclear Information System (INIS)

Highlights: ? Genistein (GEN) is a phytoestrogen found in soy products. ? GEN demethylated/unsilenced the steroidogenic factor 1 gene in endometrial tissue. ? GEN thus altered mRNA expression in uteri of ovariectomized (OVX) mice. ? A high-resolution melting assay was used to screen for epigenetic change. ? We isolated an endometrial cell clone that was epigenetically modulated by GEN. -- Abstract: It has recently been demonstrated that genistein (GEN), a phytoestrogen in soy products, is an epigenetic modulator in various types of cells; but its effect on endometrium has not yet been determined. We investigated the effects of GEN on mouse uterine cells, in vivo and in vitro. Oral administration of GEN for 1 week induced mild proliferation of the endometrium in ovariectomized (OVX) mice, which was accompanied by the induction of steroidogenic factor 1 (SF-1) gene expression. GEN administration induced demethylation of multiple CpG sites in the SF-1 promoter; these sites are extensively methylated and thus silenced in normal endometrium. The GEN-mediated promoter demethylation occurred predominantly on the luminal side, as opposed to myometrium side, indicating that the epigenetic change was mainly shown in regenerated cells. Primary cultures of endometrial stromal cell colonies were screened for GEN-mediated alterations of DNA methylation by a high-resolution melting (HRM) method. One out of 20 colony-forming cell clones showed GEN-induced demethylation of SF-1. This clone exhibited a high proliferation capacity with continuous colony formation activity through multiple serial clonings. We propose that only a portion of endometrial cells are capable of receiving epigenetic modulation by GEN.

348

Frequency of endometrial tuberculosis in female infertility  

International Nuclear Information System (INIS)

Objective: To determine the frequency of endometrial tuberculosis in infertility patients. Design: an observational analytical study. Place and Duration of Study: Military Hospital Rawalpindi and Armed Forces Institute of Pathology, Rawalpindi from August 1998 to April 1999. Subjects and Methods: Endometrial biopsies were taken from 50 cases of infertility and subjected to culture on BACTEC 460 TB instrument. Results: Tuberculous endometritis was found in 10 % (n=5) of cases. Conclusion: It was concluded that endometrial tuberculosis is not an infrequent cause of infertility in our setup. (author)

349

Interdisciplinary stratification of patients with myoma-related symptoms; Interdisziplinaere Stratifizierung von Patientinnen mit myombedingten Beschwerden  

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With the establishment of uterine artery embolization (UAE), the individualization of treatment of the symptomatic myomatous uterus showed a general progression. The concrete therapy decision is made in an interactive process between doctor and patient. A series of factors influence the choice of a suitable, operative or non-operative, therapeutic procedure. In the weighting of therapeutic options between surgery or UAE, in addition to current results of studies which compare both techniques,recommendations made by expert committees and guidelines are helpful for a competent counseling of patients and additionally supportive in decision processes such as interdisciplinary stratification. (orig.) [German] Mit der Etablierung der Uterusarterienembolisation (UAE) wurde die Individualisierung der Behandlung beim symptomatischen Uterus myomatosus insgesamt weiter vorangetrieben. Die Therapieentscheidung wird individuell in einem interaktiven Prozess zwischen Arzt und Patientin getroffen. Eine Reihe von Faktoren beeinflusst die Auswahl eines geeigneten - operativen oder nichtoperativen - Therapieverfahrens. Bei der Abwaegung der Therapieoptionen Operation vs. UAE sind neben aktuellen Ergebnisse von Studien, die beide Verfahren vergleichen, fuer eine kompetente Beratung der Patientinnen Empfehlungen von Expertengremien bzw. Leitlinien hilfreich und in Entscheidungsprozessen wie der interdisziplinaeren Stratifizierung zusaetzlich unterstuetzend. (orig.)

David, M. [Campus Virchow-Klinikum, Charite - Universitaetsmedizin Berlin, Klinik fuer Frauenheilkunde und Geburtshilfe, Berlin (Germany)

2008-07-15

350

[Primary radiotherapy of endometrial carcinoma].  

Science.gov (United States)

From 1987 to 1993 21 patients with inoperable endometrial carcinoma of all stages received primary radiation therapy. Patients were treated either with combined external beam radiation (EBRT) and afterloading therapy (AL) or AL alone. AL was delivered in high dose rate (HDR) mode. According to tumor stage 3 to 6 times 7 or 10 Gy were applied to line A, one session per week. Due to changing dose prescriptions total doses for EBRT ranged from 45 to 50.4 Gy. 65% of patients died until the end of follow-up (range 6 to 66 months). 23% died due to progressing tumor or therapeutic sequelae (hemorrhagic colitis), 42% died from intercurrent disease. Only 6 patients are alive, one of them with tumor. After a complete course of radiation therapy there was no in-field relapse. One patient irradiated with curative intention developed paraaortal lymph node metastases. During the observation time of our study most patients died of no tumor related reasons. Primary radiation therapy does effectively control endometrial carcinoma. However, old age, reduced general condition and concomitant disease compromise survival rates after radiation therapy alone. PMID:7483883

Weiss, E; Arnold-Bofinger, H; Hirnle, P

1995-01-01

351

Staging of carcinoma of the uterine cervix and endometrium  

International Nuclear Information System (INIS)

Carcinoma of the uterine cervix and endometrium are common gynecologic malignancies. Both carcinomas are staged and managed by means of the International Federation of Gynecology and Obstetrics (FIGO) staging system. In uterine cervical cancer, the FIGO staging system is determined preoperatively by limited conventional procedures. Although this system is effective for early stage disease, it has inherent inaccuracies in advanced stage diseases and does not address nodal involvement. CT and MR imaging are widely used as comprehensive imaging modalities to evaluate tumor size and extent, and nodal involvement. MR imaging is an excellent modality for depicting invasive cervical carcinoma and can provide objective measurement of tumor volume, and provides high negative predictive value for parametrial invasion and stage IVA disease. In contrast, endometrial cancer is surgically staged. Beside recognition of the important prognostic factors, including histologic subtype and grade, accurate assessment of the tumor extent on preoperative MR imaging is expected to greatly optimize surgical procedure and therapeutic strategy. Contrast-enhanced MR imaging can offer ''one stop'' examination for evaluating the depth of myometrial invasion cervical invasion and nodal metastases. Evaluation of myometrial invasion on MR imaging may be an alternative to gross inspection of the uterus during the surgery. (orig.)

352

Robotic-Assisted Hysterectomy for Endometrial Cancer  

Medline Plus

Full Text Available ... the UNC Hospitals in Chapel Hill will perform live a robotic-assisted hysterectomy for endometrial cancer with ... MD: Good afternoon and welcome, everybody, to our live webcast from UNC-Chapel Hill. Today we’re ...

353

Robotic-Assisted Hysterectomy for Endometrial Cancer  

Medline Plus

Full Text Available ... perspective, endometrial cancer will affect about 40,000 women in the United States every year, making it ... we do in our open cases, so even women who have medical problems, including obesity, we have ...

354

Robotic-Assisted Hysterectomy for Endometrial Cancer  

Medline Plus

Full Text Available ... thanks – where we have been able to successfully stage essentially all of the patients that we have ... dissection regarding complications of the robotic endometrial cancer stage, he says, compared to our laparoscopic ones. In ...

355

Bilateral femur metastasis in endometrial adenocarcinoma.  

Directory of Open Access Journals (Sweden)

Bone metastasis of endometrial carcinoma is uncommon, and bilateral femur metastasis is extremely rare. A 48-year-old woman with Federation International of Gynecology and Obstetrics stage IIB grade 2-3 endometrial adenocarcinoma underwent curative radical hysterectomy, bilateral salpingo-oophorectomy, and pelvic and para-aortic lymphadenectomy followed by radiotherapy and chemotherapy. Twenty-two months after surgery, she suffered from progressive pain and then presented bilateral femur metastasis. She was administered the surgical excision of bony metastasis and adjuvant therapies including chemotherapy, palliative radiation, and hormone therapy. Three and a half years after treatment of bony metastasis, she remains clinically well. Bone metastasis of endometrial carcinoma may occur at some unusual sites, and bilateral femur metastasis should be considered in patients. Multimodal therapies are usually advocated for bone metastasis of endometrial carcinoma.

Yu Qin

2008-05-01

356

Molecular Biology and Prevention of Endometrial Cancer.  

Science.gov (United States)

To increase our understanding of the molecular aberrations associated with endometrial carcinogenesis and the biologic mechanisms underlying the protective effect of oral contraceptive (OC) therapy. 1) Oligonucleotide microarray analysis was performed on ...

G. L. Maxwell

2006-01-01

357

Robotic-Assisted Hysterectomy for Endometrial Cancer  

Medline Plus

Full Text Available ... have improved range of motion in the upper abdomen, combined with improved access to reach the deep pelvis. These advantages can be particularly helpful in staging endometrial cancer since the surgeon can readily access the periaortic ...

358

Robotic-Assisted Hysterectomy for Endometrial Cancer  

Medline Plus

Full Text Available ... EEA cisers. But as this patient has a clinical stage one endometrial cancer, there is no concern regarding the use of the Koh ring for this case. And you can see just a visualization as ...

359

Robotic-Assisted Hysterectomy for Endometrial Cancer  

Medline Plus

Full Text Available ... motion in the upper abdomen, combined with improved access to reach the deep pelvis. These advantages can ... staging endometrial cancer since the surgeon can readily access the periaortic lymph nodes for staging and the ...

360

Characteristics of endometrial carcinoma in obese women  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction. In most developed countries, endometrial cancer appears as most frequent invasive neoplasm of genital tract. Obesity is one of most important risk factors. Aim of study was to establish characteristics endometrial cancer in obese women. Material and methods. The study included 50 surgically treated women with endometrial cancer. According body mass index they were divided into two groups - group A (30 obese women, group B (20 non-obese women. Results and Discussion. Non-obese women with endometrial cancer are statistically significantly older than obese. Menopausal status, parity are not statistically significant. The obese group most frequently includes endometrioid type of tumor, while non-obese group most frequently includes non-endometrioid types of endometrial cancer. Over 50% thick myometrial invasion is statistically more frequent in non-obese group than in obese group. In obese group, less than 50% thick myometrial invasion, is statistically significant in comparison to non-obese group. High-differentiated endometrial cancer(G1 is statistically significantly more present in obese women than non-obese. Low-diferentiated endometrial cancer is statistically more frequent in non-obese women than in obese. Most frequent in both groups is NG2. According to FIGO stage I, disease is statistically significantly more frequent in obese group than in non-obese. In non-obese group, total number of deseased in higher stages (II and III is statistically significantly higher than in stage I. Conclusion. Endometrial cancer present in obese women is mostly endometroid type I, with slow myometrial invasion, with hystological grade I, nuclear grade II in FIGO stage I of disease. In non-obese women, non-endometrioid cancer - type II is more frequent, with faster myometrial invasion, hystological grade II and III, nuclear grade II, in FIGO stage II of disease.

Vukomanovi? Predrag

2010-01-01

 
 
 
 
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