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1

Selective uterine arterial embolization of uterine myoma  

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Objective: Study the value of clinical application of Baiji and absorbable Gelatin in embolizing uterine myoma together with its effect, side effect and complication. Methods: 21 women with uterine myoma undergoing selective uterine arterial embolization by Seldinger's technique were studied. After retrograde trans-femoral introduction of a 5 french catheter, the uterine arteries were successively catheterized. Baiji and absorbable Gelatin sponge particles were injected through free flow until devasculariztion. Results: Uterine myomas blood supply came from bilateral uterine arteries demonstrated by angiography. All the supplying artery images disappeared after the embolization. 3-6 months follow-up study showed: a marked reduction in the size of myomata by 38%-90%. Clinical symptoms were improved. There was one failure cas and then underwent uterotomy due to infection. Conclusions: The short-term effect of using Baiji and absorbable Gelatin for embolizing uterine myoma is clinically significant, while long-term effects is still waiting for research

2

Ultrasonographic findings of uterine myoma  

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Uterine myoma is one of the most commonly encountered gynecologic problem in daily ultrasonographic practice, and is one of the few conditions with which specific histologic diagnosis is possible by ultrasonography in selected patients as well. We recently analysed ultrasonograms of 132 cases of uterine myoma and 31 cases that showed similar ultrasonographic findings of myoma, histopathologically verified in both cases. The results were as follows. 1. The diagnostic accuracy by ultrasonography was 93%. 2. The most common ultrasonographic findings of uterine myoma were nodular enlargement of uterus and irregular internal echo texture changes. 3. It was not possible to differentiate the various kinds of secondary degeneration by ultrasonography, except for calcification and cystic change. 4. It was usually unable to differentiate solitary from multiple myoma, and subserosal, interstitial and submucosal types from each other by ultrasonographic findings alone, except for the usual cases of exophytically growing subserosal mass. 5. The most frequent disease that is hard to differentiate from small uterine myoma was adenomyosis, and therefore it is considered necessary to include the adenomyosis in differential diagnosis in the diagnosis of myoma causing moderately enlarged uterus

3

Uterine myoma and adenomyosis: sonographic findings and differentiation  

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Uterine myoma and adenomyosis are the two most likely diagnoses in women with hypermenorrhea, dysmenorrhea, and an enlarged uterus, but it is often not possible to make a distinction between them preoperatively. But their treatments can differ : myoma can be treated through myomectomy whereas adenomyosis require hysterectomy. In order to establish the characteristic and differential findings of myoma and adenomyosis sonographically, sonographic findings of 125 cases of pathologically proven myoma and adenomyosis were reviewed retrospectively. Histologic diagnosis were myoma in 94 patients and adenomyosis in 31 patients. The results were as follows : 1. The common sonographic findings of uterine myoma were globular enlargement or bulging contour of uterus 77.8%, loss of central endometrial echoes 66.0%, and homogeneous decreased internal echoes 35.1% or heterogeneous internal echoes 44.7%. 2. The common sonographic findings of adenomyosis were diffuse enlargement without contour change 80.6%, homogeneous hypoechoic or isoechoic internal textures 96.8%, preserved central endometrial echoes 80.6%, and thickening of posterior uterine wall 64.5%. 3. Adenomyosis was highly suggested if the uterus showed diffuse enlargement without contour change or visible nodule, homogeneous hypoechoic textures, and especially thickened posterior wall with anteriorly displaced central endometrial echoes. 4. Adenomyosis could be excluded if the patient was under 30 or above 50 years old, anent was under 30 or above 50 years old, and especially had no previous obstetric history

4

Uterine myoma and adenomyosis: sonographic findings and differentiation  

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Uterine myoma and adenomyosis are the two most likely diagnoses in women with hypermenorrhea, dysmenorrhea, and an enlarged uterus, but it is often not possible to make a distinction between them preoperatively. But their treatments can differ : myoma can be treated through myomectomy whereas adenomyosis require hysterectomy. In order to establish the characteristic and differential findings of myoma and adenomyosis sonographically, sonographic findings of 125 cases of pathologically proven myoma and adenomyosis were reviewed retrospectively. Histologic diagnosis were myoma in 94 patients and adenomyosis in 31 patients. The results were as follows : 1. The common sonographic findings of uterine myoma were globular enlargement or bulging contour of uterus 77.8%, loss of central endometrial echoes 66.0%, and homogeneous decreased internal echoes 35.1% or heterogeneous internal echoes 44.7%. 2. The common sonographic findings of adenomyosis were diffuse enlargement without contour change 80.6%, homogeneous hypoechoic or isoechoic internal textures 96.8%, preserved central endometrial echoes 80.6%, and thickening of posterior uterine wall 64.5%. 3. Adenomyosis was highly suggested if the uterus showed diffuse enlargement without contour change or visible nodule, homogeneous hypoechoic textures, and especially thickened posterior wall with anteriorly displaced central endometrial echoes. 4. Adenomyosis could be excluded if the patient was under 30 or above 50 years old, and especially had no previous obstetric history.

Lee, Yeong Hwan; Yun, Kwang Myeong; Kim, Ok Dong; Chung, Duck Soo [College of Medicine, Taegu Catholic Hospital, Taegu (Korea, Republic of)

1990-07-15

5

Super selective uterine arterio-embolization in treating uterine myoma  

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Objective: To study the clinical efficacy of super selective uterine arterio-embolization in treating uterine myoma. Methods: From February to August 2000, 28 cases of uterine myomas were under-gone bilateral arterio-embolization of tumor feeding vessels. Results: The successful rate of embolization catheterization reached 100%. B-mode ultrasound examination revealed the following during 1-6 months after the procedure, with an average shrinkage of 25% in volume for all cases in the first month follow up, complete disappearance of tumor in 8 cases and with an average shrinkage of 68% volumetrically for the other 20 cases, together with conspicuous decrease in volume of menstruation. Conclusions: Interventional treatment for uterine myoma is definite effective especially in submucosal uterine myoma

6

Differentiation of Sumucosal Myoma from Endometrial Polyp by Sonohysterography  

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To describe the characteristic sonohystero-graphic features of submucosal myoma and to determine the diagnostic usefulness of sonohysterography (SH) in the differentiation of submucosal myoma from endometrial polyp. We evaluated the SH findings of 15 (16 cases) patients with histologically confirmed submucosal myoma and compared these findings with 15 endometrial polyp patients (18 cases). The characteristics of echo patterns, angle between the mass and endometrium, and the presence of hyperechoic line overlying mass lesion and its thickness were compared between submucosal myoma and endometrial polyp. SH findings of submucosal myoma are iso (n = 14) or hypoechoic (n = 2) than myometrium, and show heterogenous echotexture (n =15) and posterior shadowings (n = 13). Angles between mass and endometrium are obtuse (n = 12). In all patients with submucosal myoma, hyperechoic line consistent with the layer of endometrium was detected as overlying the submucosal myoma in SH. Histologic findings of the endometrium were correlated. Visualization of endometrium overlying the submucosal myoma with SH allowed differentiation of submucosal myoma from endometrial polyp and SH is useful in the diagnosis and the proper management of submucosal myoma

Hwang, Yoon Joo; Lee, Eun Ju [Yonsei University College of Medicine, Seoul (Korea, Republic of); Joo, Hee Jae [Ajou University College of Medicine, Suwon (Korea, Republic of)

1996-12-15

7

Current and emerging treatments for uterine myoma – an update  

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Uterine myomas, the most common benign, solid, pelvic tumors in women, occur in 20%–40% of women in their reproductive years and form the most common indication for hysterectomy. Various factors affect the choice of the best treatment modality for a given patient. Asymptomatic myomas may be managed by reassurance and careful follow up. Medical therapy should be tried as a first line of treatment for symptomatic myomas, while surgical treatment should be reserved only for appropriate indicat...

Duhan, Nirmala

2011-01-01

8

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

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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.

9

MRI evaluation for conservative treatment in endometriosis and uterine myoma  

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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.)

10

MRI evaluation for conservative treatment in endometriosis and uterine myoma  

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Eighteen patients with endometriosis or uterine myoma underwent MRI before and after conservative treatment with Danazol (400 mg/day) or Buserelin (900 {mu}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.).

Kasai, Mayumi; Karibe, Akihiko; Sato, Ken; Suzuki, Hirosi; Iida, Hajime (Iwate Prefectural Central Hospital, Morioka (Japan)); Yamaya, Rie

1991-07-01

11

Current and emerging treatments for uterine myoma – an update  

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Full Text Available Nirmala DuhanPt Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, IndiaAbstract: Uterine myomas, the most common benign, solid, pelvic tumors in women, occur in 20%–40% of women in their reproductive years and form the most common indication for hysterectomy. Various factors affect the choice of the best treatment modality for a given patient. Asymptomatic myomas may be managed by reassurance and careful follow up. Medical therapy should be tried as a first line of treatment for symptomatic myomas, while surgical treatment should be reserved only for appropriate indications. Hysterectomy has its place in myoma management in its definitiveness. However, myomectomy, rather than hysterectomy, should be performed when subsequent childbearing is a consideration. Preoperative gonadotropin-releasing hormone analog treatment before myomectomy decreases the size and vascularity of the myoma but may render the capsule more fibrous and difficult to resect. Uterine artery embolization is an effective standard alternative for women with large symptomatic myomas who are poor surgical risks or wish to avoid major surgery. Its effects on future fertility need further evaluation in larger studies. Serial follow-up without surgery for growth and/or development of symptoms is advisable for asymptomatic women, particularly those approaching menopause. The present article is incorporated with multiple clear clinical photographs and simplified elaboration of the available management options for these tumors of uterine smooth muscle to facilitate clear understanding.Keywords: myomectomy, uterine artery embolization, pelvic tumor, hysterectomy, GnRH, leiomyoma

Duhan N

2011-08-01

12

State and development of uterine myoma embolization in Germany  

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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.)

13

Use of carboprost to facilitate hysteroscopic resection of submucous myomas.  

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Ten women with submucous myomas that could not be completely resected hysteroscopically were treated with intracervical carboprost. This caused uterine contraction and extrusion of the unresectable intramural component into the endometrial cavity. Eleven of 13 myomas in these patients could then be completely resected. One intramural myoma extruded into the endometrial cavity after injection of carboprost and was also completely resected. PMID:15104835

Indman, Paul D

2004-02-01

14

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

15

Uterine endometrial stromal sarcoma located in uterine myometrium: MRI appearance  

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Two cases of uterine endometrial stromal sarcoma whose main mass was located in uterine myometrium are reported. They mimicked uterine leiomyoma with cystic degeneration or uterine leiomyosarcoma. Endometrial stromal sarcoma should be suggested in the differential diagnosis of mass lesion in uterine myometrium. (orig.)

16

Uterine endometrial stromal sarcoma located in uterine myometrium: MRI appearance  

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Two cases of uterine endometrial stromal sarcoma whose main mass was located in uterine myometrium are reported. They mimicked uterine leiomyoma with cystic degeneration or uterine leiomyosarcoma. Endometrial stromal sarcoma should be suggested in the differential diagnosis of mass lesion in uterine myometrium. (orig.)

Ueda, M.; Otsuka, M.; Hatakenaka, M. [Dept. of Radiology, Medical Institute of Bioregulation, Kyushu University, Beppu (Japan); Torii, Y. [Dept. of Radiology, Saga Prefectural Hospital (Japan)

2000-05-01

17

Systemic thromboembolism after deep vein thrombosis caused by uterine myomas.  

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A systemic thrombus embolization after deep vein thrombosis (DVT) caused by uterine myomas is very rare. The authors recently had experienced this association in a single 46-year-old Thai woman with previous healthy history and no other known risk factors for development of DVT. On arrival at a nearby small hospital, the deceased had presented with an abrupt onset of right hemiparesis, and 34 hours after admission to the hospital, she suddenly developed a cardiopulmonary collapse and was pronounced dead. Autopsy examination revealed that her death was attributed to massive pulmonary thromboembolism with systemic embolization through coexistent patent foramen ovale after DVT of her bilateral lower extremities caused by uterine myomas. PMID:23835533

Srettabunjong, Supawon

2013-09-01

18

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

19

A mathematical model of the growth of uterine myomas.  

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Uterine myomas or fibroids are common, benign smooth muscle tumours that can grow to 10  cm or more in diameter and are routinely removed surgically. They are typically slow- growing, well-vascularised, spherical tumours that, on a macro-scale, are a structurally uniform, hard elastic material. We present a multi-phase mathematical model of a fully vascularised myoma growing within a surrounding elastic tissue. Adopting a continuum approach, the model assumes the conservation of mass and momentum of four phases, namely cells/collagen, extracellular fluid, arterial and venous phases. The cell/collagen phase is treated as a poro-elastic material, based on a linear stress-strain relationship, and Darcy's law is applied to describe flow in the extracellular fluid and the two vascular phases. The supply of extracellular fluid is dependent on the capillary flow rate and mean capillary pressure expressed in terms of the arterial and venous pressures. Cell growth and division is limited to the myoma domain and dependent on the local stress in the material. The resulting model consists of a system of nonlinear partial differential equations with two moving boundaries. Numerical solutions of the model successfully reproduce qualitatively the clinically observed three-phase "fast-slow-fast" growth profile that is typical for myomas. The results suggest that this growth profile requires stress-induced resistance to growth by the surrounding tissue and a switch-like cell growth response to stress. Analysis of large-time solutions reveal that while there is a functioning vasculature throughout the myoma, exponential growth results, otherwise power-law growth is predicted. An extensive survey of the effect of parameters on model solutions is also presented, and in particular, the enhanced growth caused by factors such as oestrogen is predicted by the model. PMID:25466579

Chen, C Y; Ward, J P

2014-12-01

20

Uterine Corpus Endometrial Carcinoma  

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Endometrial cancer develops in the cells that form the inner lining of the uterus, or the endometrium, and is one of the most common cancers of the female reproductive system among American women. In 2010, approximately 43,000 women in the United States were estimated to have been diagnosed and almost 8,000 to have died of endometrial cancer.1 This cancer occurs most commonly in women aged 60 years or older.

 
 
 
 
21

Uterine Artery Embolization as Nonsurgical Treatment of Uterine Myomas  

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The purpose of this study was to evaluate safety, efficacy or complications of uterine artery embolization (UAE). Patients with symptomatic uterine fibroids (n = 157) were treated by selective bilateral UAE using 350–500??m sized polyvinyl alcohol particles. Bilateral UAE was successful in 152 (96.8%) cases. Baseline measures of clinical symptoms and MRI taken before the procedure were compared to those taken 3, 6, and 12 months after embolotherapy. Also, complications and outcomes were ...

Tandara Marijan; Grandic Leo; Stipic Ivica; Radic Ante; Jelcic Dzenis; Jukic Marko; Vulic Marko; Cambi Sapunar Liana; Strinic Tomislav; Maskovic Josip; Kristina Situm

2011-01-01

22

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

23

Deep venous thrombosis due to massive compression by uterine myoma  

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Full Text Available A 42-year-old woman, gravida 3, para 3 was admitted to hospital because of painful oedema of her right lower extremity. Initial physical examination revealed a gross, firm tumour filling the entire peritoneal cavity. Doppler ultrasound scan revealed a thrombus in the right common iliac vein, extending to the right femur and popliteal veins, and partially into the calf deep vein. Computed tomography confirmed the existence of an abdominal tumour probably deriving from the genital organs and the presence of a thrombus in the said veins.The patient underwent hysterectomy where a myomatous uterine was removed. She was put on subcutaneous enoxaparine and compressive therapy of the lower extremities. Such symptoms as pain and oedema receded. Control Doppler scan showed fibrinolysis, partial organization of the thrombus and final vein recanalisation. After exclusion of other risk factors of deep vein thrombosis apart from stasis, we conclude that the described pathology was the effect of compression of regional pelvic structures by a uterine myoma.

Aleksandra Brucka

2010-10-01

24

Uterine myoma as a cause of iliac vein thrombosis and pulmonary embolism: common disease, rare complication  

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Uterine myoma is a common condition among women, which may very rarely be associated with deep venous thrombosis (VT). Few reports of myoma with associated VT have been reported in the English language and, of those, only three were associated with embolic events. This manuscript reports the case of a 29-year-old patient who presented with pulmonary embolism due to iliac VT secondary to extrinsic compression by a uterine myoma. Considering the high prevalence of myoma in the population, it is advisable to specifically consider this hypothesis in the case of female patients with pulmonary embolism or limb VT and menstrual abnormalities. This will help to avoid extensive thrombophilia investigation and to accurately determine the correct cause of VT.

Fernandes, Frederico Leon Arrabal; Dinardo, Carla Luana; Terra-Filho, Mario

2014-01-01

25

Uterine myoma as a cause of iliac vein thrombosis and pulmonary embolism: common disease, rare complication.  

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Uterine myoma is a common condition among women, which may very rarely be associated with deep venous thrombosis (VT). Few reports of myoma with associated VT have been reported in the English language and, of those, only three were associated with embolic events. This manuscript reports the case of a 29-year-old patient who presented with pulmonary embolism due to iliac VT secondary to extrinsic compression by a uterine myoma. Considering the high prevalence of myoma in the population, it is advisable to specifically consider this hypothesis in the case of female patients with pulmonary embolism or limb VT and menstrual abnormalities. This will help to avoid extensive thrombophilia investigation and to accurately determine the correct cause of VT. PMID:25530861

Fernandes, Frederico Leon Arrabal; Dinardo, Carla Luana; Terra-Filho, Mario

2014-12-01

26

[Krukenberg's tumor of the ovary and uterine myoma].  

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A case of Krukenberg's tumour of the ovary in a 41-year-old patient is described. A year before admission she had mild gastric trouble, repeated short-lasting amenorrhea followed by prolonged bleeding. The menstruations preceding hospitalization were normal and painless. More serious trouble developed suddenly, four days before admission, in the form of intense pain in the lower abdomen and moderate bleeding. The woman had delivered twice and had 6 abortions. Her mother died of intestinal cancer. On examination, the patient was found to have two tumours: one on the right side, the size of a newborn's head, and one on the left side, the size of a female fist, both kidney-shaped and mobile. Also numerous small knots on the small intestine, peritoneum, and omentum, as well as a considerable amount of ascites were observed. An uterine myoma was found as well. Histerectomy and ablation of both adnexa were performed. The therapy was continued by radiation but the patient died 5 months following the operation. PMID:190483

Janci?, A; Duri?, D

1976-01-01

27

Symptomatic improvement in uterine myomas after MRgFUS: 4 year follow up  

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Objective: To assess the long-term improvement in symptoms after magnetic resonance-guided focused ultrasound surgery (MRgFUS) for uterine myomas. Methods: Japanese women with symptomatic myomas underwent MRgFUS using the ExAblate 2000 system. The symptom severity score (SSS) was examined before and after the treatment at 3, 6, 12, 24, and 48 months. Simultaneously, we asked the patients' satisfaction level regarding the overall change of subjective symptoms: symptom free, improved a great deal, improved to some extent, no change, or worsened. The myoma volumes were measured at 6, 12, 24, 36 and 48 months after MRgFUS. Results: No severe adverse event occurred with any of the patients. The mean SSS value before treatment was 38.3±21.5 (n = 106), which diminished significantly during follow-up for 3-48 months after treatment. Patients' satisfaction level was favorable, although the response rate was low. Over 80% of the patients replied that their symptoms were improved to at least some extent, and over 50% of the patients replied that their symptoms were improved a great deal. This trend continued throughout this follow up period. The mean myoma volume was also decreased from the pretreatment volume in this follow up period. Conclusion: MRgFUS is an effective and safe method for treating symptomatic uterine myomas. Long-term symptomatic improvement is promising.

Funaki, Kaoru; Fukunishi, Hidenobu

2011-09-01

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

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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)

29

Actual management and its problem for uterine myoma using transcervical needle biopsy  

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Recent clinical introductions of gonadotropin releasing hormore (GnRH) agonists and uterine artery embolization have meant that the patients with uterine myoma, who might have previously undergone surgery, are now often managed conservatively. In both of the above situations, there is an important common clinical problem; that is distinguishing uterine sarcomas from benign leiomyomas. However, clinical differential diagnosis between uterine sarcomas and benign leiomyomas is difficult even with magnetic resonance imaging (MRI). The most reliable preoperative diagnostic method is a biopsy of the tumor. We have evaluated the accuracy and the practical problem of needle biopsy for uterine myoma-like tumors, a procedure that has been infrequently performed. Transcervical needle biopsy was performed in 694 patients with uterine myoma-like tumors. The biopsy specimens were classified into 5 groups for degree of malignancy according to the histopathological criteria proposed by Bell et al. Immunohistochemical analysis (49 cases) using Ki67 (MIB1), P53 and hTERT, and telomerase activity measured using TRAP (62 cases) were also evaluated for differential diagnosis. Histopathological evaluation of surgical specimens and clinical outcome of 2 years of follow-up were used as the reference standards. Among 694 patients, 11 had uterine sarcomas. Six cases, judged as Group V, were diagnosed as 'sarcoma' by needle biopsy alone. No sarcoma cases were included in those patients with Gros were included in those patients with Group I, II, and III. The cutoff level combining the highest sensitivity and specificity with respect to distinguishing uterine leiomyosarcoma from uterine leiomyoma was obtained was Group VI; sensitivity, specificity, positive, and negative predictive values were 100%, 98.9%, 69%, and 100.0%, respectively. Of the 3 immunohistochemical analyses, the evaluation using Ki67 showed the highest accuracy. At cutoff values of 20 units, telomerase activity in needle biopsy sample showed the highest accuracy; sensitivity and specificity were 85% and 100%, respectively. Transcervical needle biopsy using histopathological grouping is a reliable diagnostic test for differential diagnosis between uterine sarcomas and leiomyomas. This diagnostic method, combined with MRI screening, could support the conservative management for patients with uterine myoma more safely. (author)

30

Sonographic Findings of Uterine Endometrial Stromal Sarcoma  

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The study was performed to present the sonographic findings of uterine endometrial stromal sarcoma (ESS). We conducted a retrospective review of sonographic findings of 10 cases that were diagnosed as uterine ESS. The patients ages ranged from 25 to 51 years (mean age: 36.1 years). The reviews focused on the location, margin, size, number and echotexture of the lesions. Hysterectomy (n = 9) and myomectomy (n = 1) were performed and a pathologic diagnosis was obtained in all cases. The masses were located in the uterine wall (n = 6), or they presented as a polypoid mass protruding into the endometrial cavity from the myometrium (n = 3) or as a central cavity mass (n = 1). The lesion margins were smooth (n = 5), ill defined (n = 2), or smooth with partially nodular extensions (n = 3). The maximal mass length was 38 mm to 160 mm with a mean mass length of 83.5 mm. There were single lesions in eight cases and multiple lesions in two cases. The lesion echotextures were hypoechoic solid (n = 3), heterogeneously intermediate echoic (n = 5), diffuse myometrial thickening with heterogeneous echogenicity (n = 1) and septated cystic (n = 1). Endometrial stromal sarcoma presents with four patterns of its sonographic appearance; a polypoid mass with nodular myometrial extension, an intramural mass with an ill defined margin and heterogeneous echogenicity, an ill defined large central cavity mass or, diffuse myometrial thickening

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Comparison of the effect of gonadotropin-releasing hormone analog (Diphereline) and Cabergoline (Dostinex) treatment on uterine myoma regression.  

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OBJECTIVES To investigate the effect of cabergoline (Dostinex, a dopamine agonist) on the myoma growth compared to Diphereline (a gonadotropin-releasing hormone agonist). METHODS This study took place in the Department of Obstetrics and Gynecology of Tabriz University of Medical Sciences, Tabriz, Iran from July 2004 to December 2005. Fifty women with uterine myoma, who met the criteria of the study thoroughly, were randomly allocated in...

Sayyah Melli; Laya Farzadi; Madarek, Elaheh O. S.

2007-01-01

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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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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 endomet...

Potapov V.A.; Donskaya Yu.V.; Medvedev M.V.

2014-01-01

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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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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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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.

2008-12-01

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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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Magnetic Resonance-Guided High-Intensity Focused Ultrasound (MR-HIFU) in Treatment of Symptomatic Uterine Myomas  

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Magnetic Resonance-guided High-Intensity Focused Ultrasound (MR-HIFU) is a noninvasive technique for ablation therapy for uterine myomas, where focused ultrasound energy beam generates localized high temperature in the selected area and coagulates chosen tissue, leaving the skin and tissues in between unharmed. Magnetic resonance imaging enables accurate targeting for HIFU as well as temperature monitoring during treatment. MR guidance with 3D anatomical imaging provides reference data for tr...

Filipowska, Justyna; ?ozin?ski, Tomasz

2014-01-01

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[Morphofunctional disorders of uterine-placenta blood flow in multiple uterine myomas].  

Science.gov (United States)

Results of the right uterine artery dopplerometry at pregnancy 39-39 weeks and those of subsequent histotopographic and immunomorphologic study of the placental bed in the amputated uteri were compared in 50 pregnant women. Morphofunctional equivalent of a considerable reduction of the uterine-placental circulation depending on the myomatous tissue spread and particularly in rare observations of "the placenta on the node" were found. Pathogenesis of these disturbances is determined by deficiency of the second wave of interstitial cytotrophoblast invasion, by phenomenon of the uterine-placental circulation decrease due to arterial supply of myomatous nodes and local hormonal changes produced by alterations of cellular-tissular correlations in the uterine-placental bed. PMID:9854608

Milovanov, A P; Sidorova, I S; Trushina, O I; Kadyrov, M

1998-01-01

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Correlations between nonperfused ratio immediately after MRgFUS and color flow Doppler around uterine myomas  

Science.gov (United States)

Objective: To examine the relationship between color flow Doppler indices and MRgFUS ablation effect. Materials and Methods: This study includes forty-seven myoma patients who underwent magnetic resonance-guided focused ultrasound surgery (MRgFUS). Single myoma was treated in 27 patients, and two or more myomas were treated at once in 20 patients. All patients were assessed color flow Doppler of peri-myoma artery just before MRgFUS procedure. Peak velocity, pulsatility index (PI), resistant index (RI) were measured. Treated area ratio was defined as nonperfused ratio of each ablated myoma immediately after MRgFUS. The treated area ratio is considered as an assumed ablation area, and the relationship between color flow Doppler indices and treated area ratio were examined respectively. We have already reported that high-intensity myomas (type-3) on pretreatment T2-weighted MR imaging are less effectively treated by MRgFUS than low- (type-1) and intermediate- (type-2) intensity myomas, therefore, as of today, we ceased to treat type-3 myomas. We also compared the color flow Doppler indices based on myoma type. Results: This study included 19 type-1 patients and 28 type-2 patients. Peak velocity, PI and RI were almost the same regardless of the myoma type. In cases where multiple myomas were targeted, we investigated only the largest myoma; the treated myoma volumes were 248.9±196.5 cm3 (mean±standard deviation) and treated area ratios were 59.8±18.0%. Mild correlation between RI and treated area ratio was observed (r = 0.30), however no relations were found for peak velocity and PI. Conclusion: The peripheral artery color flow Doppler of myoma correlates with NPR immediately after MRgFUS. Abundant blood flow is one of the predictive factors of poor ablation after MRgFUS.

Funaki, Kaoru; Fukunishi, Hidenobu

2010-03-01

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Study of endometrial pathology in abnormal uterine bleeding  

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Full Text Available Background: Abnormal uterine bleeding (AUB is the commonest presenting symptom in gynaecology outpatient department. Endometrial sampling could be effectively used as a first diagnostic step in AUB, although at times, its interpretation could be quite challenging to the practicing obstetrician. This study was done to evaluate histopathology of endometrium for identifying endometrial causes of AUB. We observed the incidence of various pathology in different age groups presenting with abnormal uterine bleeding & with respect to it were offered pharmacological management. Methods: This was a study done at S B K S Medical Institute & Research Centre, Vadodara, India on 155 patients who presented with AUB from February 2010-2012, these were the cases of isolated endometrial pathology diagnosed on histopathology were selected for analyses. A statistical analysis between age of presentation and specific endometrial causes was done using chi - square test. Results: The most common age group presenting with AUB was 30- 40 yrs. The commonest pattern in these patients was normal cycling endometrium (32.65%.The commonest pathology irrespective of the age group was disordered proliferative endometrium (33.33%. Other causes identified were pregnancy associated conditions (0.08%, benign endometrial polyp (10.78%, endometrial hyperplasia without atypia (0.05%, chronic endometritis (0.03%, endometrial hyperplasia with atypia (0.04%. Endometrial causes of AUB and age pattern was statistically significant with p value < 0.05. Conclusions: There is an age specific association of endometrial lesions. In perimenopausal women AUB is most commonly dysfunctional in origin and in reproductive age group, one should rule out pregnancy associated conditions. The incidence of disordered proliferative pattern was significantly high in this study, suggesting an early presentation of these patients & procuring success with pharmacological management. [Int J Reprod Contracept Obstet Gynecol 2013; 2(2.000: 182-185

Jignasha Parmar

2013-04-01

 
 
 
 
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Management of dysfunctional uterine bleeding based on endometrial thickness  

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Full Text Available Ozgul Muneyyirci-Delale1,2, Anuja Gupta1,2, Cynthia Abraham1, Ashadeep Chandrareddy1, Charles H Bowers Jr2, Jed B Cutler2Departments of Obstetrics and Gynecology, 1SUNY Downstate Medical Center, 2Kings County Hospital Center, Brooklyn, New York, USAObjective: To manage patients with dysfunctional uterine bleeding (DUB according to endometrial thickness.Methods: A retrospective chart review of 49 patients who reported 8 or more days of bleeding was performed. They were then divided into three groups based on endometrial thickness (mm: less than 6, 6–11, and greater than 11. These three groups were treated with combined oral contraceptive pills (OCP, conjugated estrogen plus progesterone and megestrol respectively. Patients given megestrol also underwent endometrial biopsy before treatment. Patients recorded the degree of bleeding each day for one month after starting treatment.Results: Mean endometrial thickness in the combined OCPs, conjugated estrogen plus progesterone and megestrol groups were 4, 8 and 14 mm, respectively. Combined OCPs decreased bleeding from 46 to 8 days (P < 0.05, n = 8. Conjugated estrogen plus progesterone decreased the number of days of bleeding from a mean of 41 to 9 (P < 0.01, n = 16. Megestrol decreased bleeding from 54 to 3 days (P < 0.001, n = 25. 52% of patients given megestrol had endometrial hyperplasia.Conclusion: These results support the effectiveness of treating patients with DUB according to endometrial thickness.Keywords: DUB, abnormal uterine bleeding, endometrium, hyperplasia, megestrol acetate

Ozgul Muneyyirci-Delale

2010-09-01

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Magnetic Resonance-Guided High-Intensity Focused Ultrasound (MR-HIFU) in Treatment of Symptomatic Uterine Myomas  

Science.gov (United States)

Summary Magnetic Resonance-guided High-Intensity Focused Ultrasound (MR-HIFU) is a noninvasive technique for ablation therapy for uterine myomas, where focused ultrasound energy beam generates localized high temperature in the selected area and coagulates chosen tissue, leaving the skin and tissues in between unharmed. Magnetic resonance imaging enables accurate targeting for HIFU as well as temperature monitoring during treatment. MR guidance with 3D anatomical imaging provides reference data for treatment planning, while real-time temperature monitoring aids in controlling ablation process. This review provides basic information regarding methodology, clinical indications for this kind of treatment, expected outcome and patient management during MR-HIFU procedure. The aim of this work is to introduce a new, noninvasive treatment method for uterine leiomyomas and to present a comparison with other currently used methods. PMID:25469176

Filipowska, Justyna; ?ozi?ski, Tomasz

2014-01-01

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Magnetic Resonance-Guided High-Intensity Focused Ultrasound (MR-HIFU) in Treatment of Symptomatic Uterine Myomas.  

Science.gov (United States)

Magnetic Resonance-guided High-Intensity Focused Ultrasound (MR-HIFU) is a noninvasive technique for ablation therapy for uterine myomas, where focused ultrasound energy beam generates localized high temperature in the selected area and coagulates chosen tissue, leaving the skin and tissues in between unharmed. Magnetic resonance imaging enables accurate targeting for HIFU as well as temperature monitoring during treatment. MR guidance with 3D anatomical imaging provides reference data for treatment planning, while real-time temperature monitoring aids in controlling ablation process. This review provides basic information regarding methodology, clinical indications for this kind of treatment, expected outcome and patient management during MR-HIFU procedure. The aim of this work is to introduce a new, noninvasive treatment method for uterine leiomyomas and to present a comparison with other currently used methods. PMID:25469176

Filipowska, Justyna; Lozi?ski, Tomasz

2014-01-01

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Molecular markers of endometrial carcinoma detected in uterine aspirates.  

Science.gov (United States)

Endometrial cancer (EC) is the most frequent of the invasive tumors of the female genital tract. Although usually detected in its initial stages, a 20% of the patients present with advanced disease. To date, no characterized molecular marker has been validated for the diagnosis of EC. In addition, new methods for prognosis and classification of EC are needed to combat this deadly disease. We thus aimed to identify new molecular markers of EC and to evaluate their validity on endometrial aspirates. Gene expression screening on 52 carcinoma samples and series of real-time quantitative PCR validation on 19 paired carcinomas and normal tissue samples and on 50 carcinoma and noncarcinoma uterine aspirates were performed to identify and validate potential biomarkers of EC. Candidate markers were further confirmed at the protein level by immunohistochemistry and Western blot. We identified ACAA1, AP1M2, CGN, DDR1, EPS8L2, FASTKD1, GMIP, IKBKE, P2RX4, P4HB, PHKG2, PPFIBP2, PPP1R16A, RASSF7, RNF183, SIRT6, TJP3, EFEMP2, SOCS2 and DCN as differentially expressed in ECs. Furthermore, the differential expression of these biomarkers in primary endometrial tumors is correlated to their expression level in corresponding uterine fluid samples. Finally, these biomarkers significantly identified EC with area under the receiver-operating-characteristic values ranging from 0.74 to 0.95 in uterine aspirates. Interestingly, analogous values were found among initial stages. We present the discovery of molecular biomarkers of EC and describe their utility in uterine aspirates. These findings represent the basis for the development of a highly sensitive and specific minimally invasive method for screening ECs. PMID:21207424

Colas, Eva; Perez, Cristina; Cabrera, Silvia; Pedrola, Nuria; Monge, Marta; Castellvi, Josep; Eyzaguirre, Fernando; Gregorio, Jesus; Ruiz, Anna; Llaurado, Marta; Rigau, Marina; Garcia, Marta; Ertekin, Tugçe; Montes, Melania; Lopez-Lopez, Rafael; Carreras, Ramon; Xercavins, Jordi; Ortega, Alicia; Maes, Tamara; Rosell, Elisabet; Doll, Andreas; Abal, Miguel; Reventos, Jaume; Gil-Moreno, Antonio

2011-11-15

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Study of endometrial tissue in dysfunctional uterine bleeding.  

Science.gov (United States)

Dysfunctional uterine bleeding (DUB) is defined as heavy and or irregular menstruation in the absence of recognizable pelvic pathology, pregnancy or general bleeding disorder. Hyperplastic endometrium is abnormal histology finding found in DUB. Out of three type of hyperplasia, atypical type is associated with co-existent ca endometrium and the chance of progression to ca endometrium is very high. Thus this study was conducted to see the incidence of hyperplasia of endometrium in cases of DUB and to see the risk factors for endometrial hyperplasia. It was a prospective study carried out in span of two years (2010 JULY- 2013 Jan) in Nepal Medical College and Teaching Hospital. Hundred cases DUB who under went D&C or hysterectomy were included to study the age range, the relation of parity, patient symptom, contraceptive method and medical disease with the type of endometrial histology. It was found that DUB was common in perimenopusal age (49%) and the incidence increase with the increase of parity. Abnormal endometrial finding (hyperplasia) was found in 31% of the cases. Atypical and complex hyperplasia were associated with irregular menstruation and one third of the hyperplastic patient had hypertension (32.26%). Thus perimenopausal age, irregular menstruation and hypertension are risk factors for hyperplasia. So it is mandatory to do endometrial sampling in cases of perimenopausal age with irregular menstruation withor without hypertension. PMID:24592789

Kayastha, S

2013-03-01

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Pathologies of the uterine endometrial cavity: usual and unusual manifestations and pitfalls on magnetic resonance imaging  

Energy Technology Data Exchange (ETDEWEB)

The endometrial cavity may demonstrate various imaging manifestations such as normal, reactive, inflammatory, and benign and malignant neoplasms. We evaluated usual and unusual magnetic resonance imaging (MRI) findings of the uterine endometrial cavity, and described the diagnostic clues to differential diagnoses. Surgically proven pathologies of the uterine endometrial cavity were evaluated retrospectively with pathologic correlation. The pathologies included benign endometrial neoplasms such as endometrial hyperplasia and polyp, malignant endometrial neoplasms such as endometrial carcinoma and carcinosarcoma, endometrial-myometrial neoplasm such as endometrial stromal sarcoma, pregnancy-related lesions in the endometrial cavity such as gestational trophoblastic diseases (hydatidiform mole, invasive mole and choriocarcinoma) and placental polyp, myometrial lesions simulating endometrial lesions such as submucosal leiomyoma and some adenomyosis, endometrial neoplasms simulating myometrial lesions such as adenomyomatous polyp and endometrial lesions arising in the hemicavity of a septate/bicornate uterus, and fluid collections in the uterine cavity (hydro/hemato/pyometra). It is important to recognize various imaging findings in these diseases, in order to make a correct preoperative diagnosis. (orig.)

Takeuchi, Mayumi; Matsuzaki, Kenji; Yoshida, Shusaku; Nishitani, Hiromu [University of Tokushima, Department of Radiology, Tokushima (Japan); Uehara, Hisanori [University of Tokushima, Department of Molecular and Environmental Pathology, Tokushima (Japan); Shimazu, Hideki [Oe Kyoudo Hospital, Department of Radiology (Japan)

2005-11-01

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Pathologies of the uterine endometrial cavity: usual and unusual manifestations and pitfalls on magnetic resonance imaging  

International Nuclear Information System (INIS)

The endometrial cavity may demonstrate various imaging manifestations such as normal, reactive, inflammatory, and benign and malignant neoplasms. We evaluated usual and unusual magnetic resonance imaging (MRI) findings of the uterine endometrial cavity, and described the diagnostic clues to differential diagnoses. Surgically proven pathologies of the uterine endometrial cavity were evaluated retrospectively with pathologic correlation. The pathologies included benign endometrial neoplasms such as endometrial hyperplasia and polyp, malignant endometrial neoplasms such as endometrial carcinoma and carcinosarcoma, endometrial-myometrial neoplasm such as endometrial stromal sarcoma, pregnancy-related lesions in the endometrial cavity such as gestational trophoblastic diseases (hydatidiform mole, invasive mole and choriocarcinoma) and placental polyp, myometrial lesions simulating endometrial lesions such as submucosal leiomyoma and some adenomyosis, endometrial neoplasms simulating myometrial lesions such as adenomyomatous polyp and endometrial lesions arising in the hemicavity of a septate/bicornate uterus, and fluid collections in the uterine cavity (hydro/hemato/pyometra). It is important to recognize various imaging findings in these diseases, in order to make a correct preoperative diagnosis. (orig.)

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Pregnancy and Natural Delivery Following Magnetic Resonance Imaging-Guided Focused Ultrasound Surgery of Uterine Myomas  

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This report discusses a pregnancy case following a series of two consecutive magnetic resonance imaging-guided focused ultrasound surgery (MRgFUS) procedures for the treatment of two different myomas in an individual patient. Both procedures were completed without adverse events, and the patient conceived naturally four months after treatment. At 39 weeks, she gave birth to a healthy baby girl, via a vaginal delivery. There were no complications in the pregnancy or during labor.

Yoon, Sang-wook; Kim, Kyoung Ah; Kim, Sang Heum; Ha, Doo Hoe; Lee, Chan; Lee, Sun Young; Jung, Sang-geun; Kim, Seung-jo

2010-01-01

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Magnetic resonance imaging of endometrial cyst  

International Nuclear Information System (INIS)

A restrospective analysis was carried out of 17 magnetic resonance images obtained in 13 patients with histologically proven endometrial cyst. Endometrial cysts were seen as high-intensity areas on short and long spin echo and inversion recovery images. This is in sharp contrast with images of other gynecologic masses such as ovarian and uterine masses. Endometrial cysts had evidently decreased Tl when compared with other gynecologic masses. Magnetic resonance imaging proved to have a great potential in the differentiation of endometrial cysts from cystic ovarian masses and some uterus myoma that is frequently difficult on ultrasound and X-ray computed tomography. (Namekawa, K.)

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Endometrial implantation factors in women with submucous uterine fibroids.  

Science.gov (United States)

Uterine fibroids are benign tumours, which are associated with subfertility and early pregnancy loss. This study was carried out to examine the effect of submucous fibroids on concentrations of glycodelin, insulin-like growth factor binding protein-1 (IGFBP-1), interleukin-6 (IL-6), interleukin-10 (IL-10), tumour necrosis factor ? (TNF?) and osteopontin in uterine flushings. Premenopausal women with a certain diagnosis of submucous fibroid confirmed on three-dimensional saline infusion sonohysterography were recruited into the study. The control group included women without ultrasonic evidence of any uterine or endometrial pathology. All women had uterine flushings performed 7days post LH surge. Enzyme linked immunoassays were performed to analyse glycodelin, IL-6, IL-10, TNF? and osteopontin, whilst immunoradiometric assay was used to analyse IGFBP-1. In 23 women with submucous fibroids, the concentrations of glycodelin and IL-10 in uterine flushings were significantly lower compared with 17 women in the control group (P=0.002; P=0.007, respectively). There were no significant differences between the two groups in concentrations of IGFBP-1, IL-6, TNF? and osteopontin. Women with submucous fibroids had significantly lower concentrations of glycodelin and IL-10 in mid-luteal phase uterine flushings. This finding may explain the association with submucous fibroids and adverse reproductive outcomes. Uterine fibroids are small growths from the muscle of the uterus (womb). Submucous fibroids protrude into the cavity of the womb. We do not know what causes fibroids to form and grow. In most women, fibroids cause no symptoms and they are sometimes detected on routine gynaecological examination. In some women, however, fibroids can cause heavier and longer menstrual periods. Another problem associated with fibroids is bleeding between periods. The effect of fibroids on fertility is not clear, but some doctors believe that they may also cause infertility and early miscarriage. This study tried to see whether presence of submucous fibroids has any effect on various substances produced by the lining of the womb to facilitate development of early pregnancy. Women with a confirmed diagnosis of submucous fibroids were asked to attend the clinic and have the uterine cavity flushed with a special solution 7days after ovulation. The fluid, which was taken back from the womb, was then analysed to measure the amounts of substances that favour pregnancy development. Women with a normal uterine cavity were also asked to have the uterine cavity flushed to act as a comparison. The study showed that the uterine cavities of women with submucous fibroids were producing decreasing amount of substances favourable to early pregnancy development. We speculate that this may explain why some women with submucous fibroids have difficulties falling pregnant. Our findings should be helpful to doctors advising women with submucous fibroids who wish to start a family. PMID:20880745

Ben-Nagi, J; Miell, J; Mavrelos, D; Naftalin, J; Lee, C; Jurkovic, D

2010-11-01

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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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An incidentally found inflamed uterine myoma Causing low abdominal pain, using TC-99m-tektrotyd single photon emission computed tomography-CT hybrid imaging  

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We report the case of a 50-year-old woman presented with a history of right hemicolectomy due to an ileocecal neuroendocrine tumor and left breast metastasis. Owing to a slightly elevated chromogranin A-level and lower abdominal pain, single photon emission computed tomography-computer tomography (SPECT-CT) was performed. There were no signs of recurrence on the SPECT-CT scan, but the patient was incidentally found to have an inflamed intramural myoma. We believe that the slightly elevated chromogranin A-level was caused by the hypertension that the patient presented. In the clinical context, this is a report of an inflamed uterine myoma seen as a false positive result detected by TC-99m-Tc-EDDA/HYNIC-Tyr3-Octreotide (Tektrotyd) SPECT-CT hybrid imaging.

Zandieh, Shahin; Schuetz, Matthias; Bernt, Reinhard; Zwerina, Jochen; Haller, Joerg [Hanusch-Hospital, Teaching Hospital of Medical University of Vienna, Vienna (Australia)

2013-10-15

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An incidentally found inflamed uterine myoma causing low abdominal pain, using Tc-99m-tektrotyd single photon emission computed tomography-CT hybrid imaging.  

Science.gov (United States)

We report the case of a 50-year-old woman presented with a history of right hemicolectomy due to an ileocecal neuroendocrine tumor and left breast metastasis. Owing to a slightly elevated chromogranin A-level and lower abdominal pain, single photon emission computed tomography-computer tomography (SPECT-CT) was performed. There were no signs of recurrence on the SPECT-CT scan, but the patient was incidentally found to have an inflamed intramural myoma. We believe that the slightly elevated chromogranin A-level was caused by the hypertension that the patient presented. In the clinical context, this is a report of an inflamed uterine myoma seen as a false positive result detected by TC-99m-Tc-EDDA/HYNIC-Tyr3-Octreotide (Tektrotyd) SPECT-CT hybrid imaging. PMID:24043983

Zandieh, Shahin; Schütz, Matthias; Bernt, Reinhard; Zwerina, Jochen; Haller, Joerg

2013-01-01

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

Scientific Electronic Library Online (English)

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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Mifepristone versus placebo to treat uterine myoma: a double-blind, randomized clinical trial  

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Full Text Available Josep Lluis Carbonell Esteve,1 Rita Acosta,2 Yasmirian Pérez,2 Barbara Rodriguez,2 Isabel Seigler,2 Carlos Sanchez,2 Giuseppe Tomasi3 1Mediterránea Médica Clinic, Valencia, Spain; 2Eusebio Hernández Gynecology and Obstetrics Teaching Hospital, Havana, Cuba; 3University of The Basque Country, Bilbao, Spain Objective: To evaluate the efficacy, safety, and quality of life of 5 mg mifepristone per day compared with a placebo in treating uterine fibroids. Design: Randomized, double-blind clinical study. Location: Eusebio Hernández Gynecology and Obstetrics Teaching Hospital, Havana, Cuba. Subjects: One hundred twenty-four subjects with symptomatic uterine fibroids. Treatment: One daily capsule of 5 mg mifepristone or a mifepristone placebo over 3 months. Variables in evaluating safety: Changes in fibroid and uterine volumes, changes in symptom prevalence and intensity, and changes in quality of life. Results: Three months into treatment, fibroid volume was reduced by 28.5% in the mifepristone group with an increase of 1.8% in the placebo group (P = 0.031. There were significant differences between the groups with respect to pelvic pain prevalence (P = 0.006, pelvic pressure (P = 0.027, rectal pain (P = 0.013, hypermenorrhea (P < 0.001, and metrorrhagia (P = 0.002 at the end of treatment. Amenorrhea was 93.1% and 4.3% in the mifepristone and placebo groups, respectively (P < 0.001. Treatment side effects were significantly greater in the mifepristone group. Estradiol levels did not differ significantly between the placebo and mifepristone groups at the end of treatment. Improvement in quality of life was significantly greater in the categories of "symptoms" (P = 0.004 and "activity" (P = 0.045 in the mifepristone group. Conclusion: The 5 mg dosage of mifepristone presented significantly superior efficacy compared to the placebo. Keywords: mifepristone, leiomyoma, fibroid, antiprogestins

Esteve Carbonell JL

2013-06-01

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Localization and quantitative analysis of epidermal growth factor receptor (EGFR) and insulin-like growth factor-1 receptor (IGF-1R) uterine myoma  

International Nuclear Information System (INIS)

Objective: To study the role of EGFR and IGF-1R in the pathogenesis of uterine leiomyoma. Methods: EGFR and IGF-1R contents and expression levels of leiomyoma tissue and adjacent normal myometrium in 40 surgical specimens were detected with quantitative flow cytometry and immunohistochemical SP localization method respectively. The menstrual phase of the specimen was dictated by the histology of the endometrium. Results: The contents and expression levels of EGFR and IGF-1R were significantly bigger in the myoma tissue than those in the normal myometrium (p<0.01, p<0.01). Further analysis showed that the EGFR contents and expression in the myoma tissue were significantly higher than those in adjacent myometrium during the proliferative phase only (p<0.05) but not during the secretory phase. For IGF-1R, the contents and expression were significantly higher during both phases. Conclusion: The higher content and expression of EGFR and IGF-1R in the myoma tissue might regulate the growth of the tumor

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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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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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Comparison of Office Hysteroscopy, Transvaginal Ultrasonography and Endometrial Biopsy in Evaluation of Abnormal Uterine Bleeding  

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This is a prospective, observational study that utilizes hysteroscopy as the “gold standard” for evaluation of transvaginal ultrasound and endometrial biopsy in the detection of intrauterine pathology. The sensitivity and specificity for detecting focal intrauterine lesions are examined in order to suggest the most cost-effective approach in patients with abnormal uterine bleeding.

Pal, Lubna; Lapensee, L.; Toth, T. L.; Isaacson, K. B.

1997-01-01

 
 
 
 
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Comparison of an Additional Transdermal Fentanyl Patch Compared to Intravenous NSAID and Opioid Analgesics within 24 Hours of an Uterine Artery Embolization for Myoma and Adenomyosis  

International Nuclear Information System (INIS)

To evaluate the effectiveness of an additional transdermal fentanyl patch compared to intravenous analgesics in pain control during the 24-hour period following uterine artery embolization (UAE) for myoma and adenomyosis. Between September 2009 and August 2010, 42 patients underwent UAE for myoma or adenomyosis. Of these, 21 received an intravenous opioid (pethidine) and a nonsteroidal anti-inflammatory drug (group A), and 21 received an additional transdermal fentanyl patch (group B). Pain perception levels were established verbally on a 0-10 scale during the 24-hour period following UAE. Differences in pain trends, mean dose of intravenous pethidine, and adverse effects were compared between the two groups. Pain perception was most severe at 6 hours after UAE and the mean pain level of group B at that time was 6.3 ± 0.7, which was significantly lower than that of group A, 8.2 ± 0.7 (p0.05), and no evidence of respiratory distress was demonstrated. The addition of a transdermal fentanyl patch to intravenous analgesics is effective in reducing post-embolization pain during the 24-hour period after UAE.

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Comparison of an Additional Transdermal Fentanyl Patch Compared to Intravenous NSAID and Opioid Analgesics within 24 Hours of an Uterine Artery Embolization for Myoma and Adenomyosis  

Energy Technology Data Exchange (ETDEWEB)

To evaluate the effectiveness of an additional transdermal fentanyl patch compared to intravenous analgesics in pain control during the 24-hour period following uterine artery embolization (UAE) for myoma and adenomyosis. Between September 2009 and August 2010, 42 patients underwent UAE for myoma or adenomyosis. Of these, 21 received an intravenous opioid (pethidine) and a nonsteroidal anti-inflammatory drug (group A), and 21 received an additional transdermal fentanyl patch (group B). Pain perception levels were established verbally on a 0-10 scale during the 24-hour period following UAE. Differences in pain trends, mean dose of intravenous pethidine, and adverse effects were compared between the two groups. Pain perception was most severe at 6 hours after UAE and the mean pain level of group B at that time was 6.3 {+-} 0.7, which was significantly lower than that of group A, 8.2 {+-} 0.7 (p<0.05). The mean dose of intravenous pethidine was 114.3 {+-} 59.5 mg in group A and 90.5 {+-} 49.0 mg in group B, while the incidence of nausea was 67% in group A and 77% in group B. In both cases, the differences were not significantly different (p>0.05), and no evidence of respiratory distress was demonstrated. The addition of a transdermal fentanyl patch to intravenous analgesics is effective in reducing post-embolization pain during the 24-hour period after UAE.

Song, Suk Yun; Kang, Byung Chul; Rho, Kyung Min [Dept. of Radiology, Mokdong Hospital, Ewha Womans University School of Medicine, Seoul (Korea, Republic of)

2011-05-15

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

International Nuclear Information System (INIS)

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

64

Parasitic myoma after supracervical laparoscopic histerectomy  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 ...

Maurício Paulo Angelo Mieli; Ana Maria Sampaio Moreira Grell; Ricardo dos Santos Simões; Leandro Accardo de Mattos

2013-01-01

65

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 vi...

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

2012-01-01

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[Study on the accuracy of uterine endometrial dating].  

Science.gov (United States)

In order to examine the accuracy of endometrial dating, endometrial dating from 52 infertile women with normal luteal function was investigated. Dating from the histological findings was evaluated from three time points, the onset of the next menstrual period (NMP), the last day of the low phase of basal body temperature (BBT) and the urinary LH peak determined with the "Organon LH Color" kit (LH). Beside microscopic observation, morphometric analysis of endometrial findings was done by means of a high speed color image analysis system "Olympus SP-500". On the day of LH Color (+2), the serum LH level showed a maximum of 35.5 +/- 12.6 mIU/ml (Mean +/- S.D.) (n = 27). The correlation coefficients for histological dating and chronological dating based on NMP, BBT and LH were 0.685, 0.728 and 0.879 in gland and 0.620, 0.737 and 0.833 in stroma, respectively. The multiple correlation coefficient for histological dating evaluated by morphometric analysis and chronological dating based on LH was 0.959. So we conclude that endometrial dating evaluated by morphometric analysis seems to be the most objective and useful. PMID:2277206

Andoh, K; Nakazato, Y; Mizunuma, H; Yamada, K; Ibuki, Y; Igarashi, M

1990-12-01

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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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Low Grade Endometrial Stromal Sarcoma of Uterine: Review of 17 Cases  

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Full Text Available "nEndometrial stromal sarcomas (ESS are the second most common uterine sarcomas. Endometrial stromal sarcomas account for 0.25% of all uterine malignancies. Uterine sarcomas most often affect postmenopausal women. The aim of this retrospective study was to review the experience in the treatment and clinical outcome of low grade malignant endometrial stromal sarcoma. Seventeen patients with histologically proven low grade ESS in department of Gynecologic Oncology of the Vali-e-Asr Hospital, Tehran-Iran, between 1999 and 2008 were included in the analysis. Demographics, pathology, treatment, time to recurrence, salvage therapy and survival information was collected. The median age of our patients was 45.35±6.8 (range 36-61. The median parity of the patients was 5 (range 0-8. Most patients were diagnosed at FIGO stage I. The mean survival for patients with stage I and II was 73.5±35.09 and 57.6±5.37 months, respectively, with mortality rate of 5.9% through a median follow-up time of 68.82±30 months. Of 17 patients, seven cases (35.29% were disease free at 6 years after hysterectomy. Radiotherapy was administered to four patients (23.53%. Only one patient recurred at 10th month after surgery. Surgeries not preserving ovarian function were helpful to decrease the risk of recurrence compared with those sparing ovarian function.

Nadereh Behtash

2011-09-01

69

Uterine malignant degeneration after low-dose endometrial irradiation  

International Nuclear Information System (INIS)

The effectiveness of low-dose intrauterine irradiation for benign diseases and its possible carcinogenic effect on the uterus was studied in 190 patients who were treated during the years 1952-1974. The indications for irradiation were premenopausal functional bleeding, leukemia, hemophilia, fibroids, endometriosis or other benign reason. Radiation was also performed on patients with severe neurologic diseases that contraindicated surgery and on some mentally retarded patients whose restlessness and epileptic seizures were aggravated premenstrually and during menstruation. The mean follow-up period was 15 years. Uterine bleeding recurred in 21 percent of the patients. No cases of uterine malignant degeneration were found. (author)

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

Energy Technology Data Exchange (ETDEWEB)

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

71

Uterine superficial serous carcinomas and extensive serous endometrial intraepithelial carcinomas: clinicopathological analysis of 6 patients.  

Science.gov (United States)

Uterine superficial serous carcinoma (SSC) and serous endometrial intraepithelial carcinoma (SEIC) are unique malignancies found primarily in postmenopausal women. SSC and SEIC lesions measuring 1 cm or less are categorized as minimal uterine serous carcinoma (MUSC). Less well understood, however, the clinical behavior of SSC and SEIC lesions measuring more than 1 cm. We investigated 6 postmenopausal patients, aged 69-83 years, with SSC or SEIC and without hyperestrogenism. All but 1 patient had tumors originating from the surface of polyps, including 3 patients who each had an enormous polyp occupying the entire uterine cavity. Two patients had extensive SEICs measuring more than 1 cm; the others had SSCs, including 1 MUSC. The mesenchymal cells of the cancer-bearing polyps lacked the morphologic characteristics of endometrial stroma, and the cancer glands often immunostained negatively for estrogen receptors and progesterone receptors. Diffuse immunostaining for human epidermal growth factor receptor 2 was detected in 3 patients, and p53 was detected in all. Cyclin E, a downstream molecule of the F-box and WD repeat domain-containing 7 (FBXW7), was detected in all patients. Microdissected cancer glands showed p53 mutations in 2 patients and a FBXW7 mutation in 1 patient. These findings suggest that mutations of FBXW7 and p53 may contribute to the carcinogenesis of less invasive tumor subtypes. Pathologists and physicians should carefully evaluate SSC and SEIC lesions involving large polyps but lacking myometrial invasion. PMID:25550841

Ono, Kyoko; Hayashi, Hiroyuki; Tateno, Masatoshi; Tanaka, Reiko; Suzuki, Rie; Maruyama, Yasuyo; Miyagi, Yohei; Furuya, Mitsuko

2014-01-01

72

Giant myoma and erythrocytosis syndrome.  

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The objective of this study is to discuss the myomatous erythrocytosis syndrome in a patient with a giant subserous uterine myoma. She presented with plethora and an abdominal mass. After venesection of 4 units of blood, the preoperative haematocrit value of 53.3% and haemoglobin value of 17.5 g/dL had decreased to 48.6% and 16.8 g/dL levels, respectively. After the operative extraction of the giant subserous myoma with attached uterus weighing 14.2 kg, the haematocrit and the haemoglobin values had regressed to 40.3% and 14.3 g/dL levels, respectively. The findings indicated that the giant subserous myoma was the cause of the myomatous erythrocytosis syndrome in this patient. PMID:10554963

Ozsaran, A A; Itil, I M; Terek, C; Kazandi, M; Dikmen, Y

1999-08-01

73

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

74

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  

Scientific Electronic Library Online (English)

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

75

Clinicopathological Spectrum of Endometrial Changes in Peri-menopausal and Post-menopausal Abnormal Uterine Bleeding: A 2 Years Study  

Science.gov (United States)

Background: Abnormal uterine bleeding is the Common presenting complaint in Gynaecology Outpatient Department in all age groups. It is due to the anovulatory cycles which are commonly seen in adolescent and peri-menopausal women. Abnormal uterine bleeding is caused by wide variety of organic or non-organic causes. Histopathological examination of endometrial sample remains the gold standard for diagnosis of endometrial pathology. Aim: To study the clinicopathological spectrum of endometrium in abnormal uterine bleeding in peri-menopausal and post-menopausal age groups. Material and Methods: The study included prospective analysis of 119 cases of endometrial samples in patients of abnormal uterine bleeding above 40 years of age. The specimens were routinely processed and H&E stained slides were studied. Patients were categorized into peri-menopausal (40-49 years) and post-menopausal (> 50 years) age group. Results: A total of 119 specimens of endometrium were analyzed. Maximum number (73.94%) of cases were from peri-menopausal age group. The most common presenting complaint was menorrhagia (48.86%) followed by post-menopausal bleeding (26.05%). In peri-menopausal age group proliferative endometrium (35.22%) was the predominant histopathological pattern followed by endometrial hyperplasia (23.86%). Atrophic endometrium (25.80%) was the most frequent finding followed by endometrial hyperplasia (19.35%) in post-menopausal age group. Three cases of endometrial carcinoma were reported in post-menopausal age group only. Conclusion: A thorough histopathological work up and clinical correlation is mandatory in cases of abnormal uterine bleeding above the age of 40 years to find out organic lesions. Careful screening can detect early cancer of endometrium which has excellent prognosis and it will help in further management. PMID:24551634

Damle, Rajshri P.; Dravid, N.V.; Suryawanshi, Kishor H.; Gadre, Arundhati S.; Bagale, Priya S.; Ahire, Neelam

2013-01-01

76

Radiation Therapy With or Without Cisplatin in Treating Patients With Recurrent Endometrial Cancer  

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Endometrial Adenocarcinoma; Endometrial Adenosquamous Carcinoma; Endometrial Clear Cell Adenocarcinoma; Endometrial Endometrioid Adenocarcinoma, Variant With Squamous Differentiation; Endometrial Serous Adenocarcinoma; Recurrent Uterine Corpus Carcinoma

2015-01-26

77

Minimal deviation mucinous adenocarcinoma of the uterine cervix that proved difficult to differentiate from endometrial cancer: A case report.  

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Minimal deviation adenocarcinoma (MDA), also known as adenoma malignum of the uterine cervix, accounts for only ~1% of uterine cervical adenocarcinomas. Adenoma malignum of the uterine cervix was initially described by Gusserow in 1870. Using magnetic resonance imaging (MRI), MDA appears as multilocular lesions with solid components that extend from the endocervical glands to the deep cervical stroma. Cytological evaluation and biopsies have low detection rates, therefore, it is difficult to diagnose MDA accurately prior to treatment. The current study describes a rare case of MDA that was difficult to differentiate from endometrial adenocarcinoma of the corpus uteri preoperatively, as the endometrial biopsy results suggested a well-differentiated endometrioid adenocarcinoma and MRI did not show typical images for MDA. A total abdominal hysterectomy with bilateral salpingo-oophorectomy was performed under the diagnosis of endometrial cancer, and the mass was subsequently diagnosed as MDA of the uterine cervix by pathological examination of the hysterectomy specimen. Postoperatively, although two types of adjuvant chemotherapy were performed, the remaining tumor continued to grow, causing obstruction of the bilateral ureters and leading to bilateral hydronephrosis. The patient is currently alive with the disease 10 months following the surgery. PMID:25364411

Nishii, Yuko; Fukuda, Takeshi; Imai, Kenji; Yamauchi, Makoto; Hashiguchi, Yasunori; Ichimura, Tomoyuki; Yasui, Tomoyo; Sumi, Toshiyuki

2014-12-01

78

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

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A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting concordant endometrial cancer was found o 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

79

Immunohistochemical studies on uterine carcinosarcoma, leiomyosarcoma, and endometrial stromal sarcoma: expression and prognostic importance of ten different markers.  

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Uterine sarcomas are rare and aggressive gynecologic malignancies. In this immunohistochemical (IHC) study, expression of Ki-67, p53, CD10, CD44, desmin, smooth muscle actin, estrogen receptor ? (ER?), androgen receptor (AR), progesterone receptor A (PRA), and c-kit and their influence on survival in cases of uterine carcinosarcoma (CS), leiomyosarcoma (LMS), and endometrial stromal sarcoma (ESS) were evaluated. Medical records were reviewed and data collected concerning all uterine sarcomas treated during a 12-year period at Helsinki University Central Hospital. There was sufficient histological material for IHC analysis and slide review in 67 cases. Survival analysis was performed using the Kaplan-Meier method, and median survival times with 95% confidence intervals are given. Survival in cases of LMS was statistically significantly affected by the expression of p53, ER?, and PRA. Striking differences in expression of IHC markers when comparing results with those in earlier studies were the absence of AR immunoreactivity in all uterine sarcomas and low incidence of c-kit (15%; in endometrial stromal sarcoma). None of the markers was statistically significantly associated with survival of ESS and CS patients. The expression of p53, ER?, and PRA in uterine LMS may give prognostic information concerning the behavior of the disease. Hormonal therapy could be recommended as a treatment option in cases of hormone receptor-positive LMS. PMID:21161468

Koivisto-Korander, Riitta; Butzow, Ralf; Koivisto, Anna-Maija; Leminen, Arto

2011-06-01

80

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

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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)

 
 
 
 
81

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

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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 con...

Dadyar, M.; Mehdizadeh, P.; Fazaeli, M.; Hajibaratali, B.; Ghanbari, Z.

2006-01-01

82

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

83

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

84

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

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A 35 year old woman with endometrial cancer and cervical extension underwent F18 FDG PET CT and MRI studies after resection of a cervical mass presumed to be cervical myoma. The patient underwent cervical myomectomy and the histopathologic report revealed poorly differentiated invasive carcinoma. Cervical cancer was ruled out because the patient had no history of sexual intercourse and was negative for human papilloma virus infection. The patient underwent radical hysterectomy, bilateral salpingo oophorectomy, pelvic and para aortic lymph node dissection, and multiple biopsies. F18 FDG PET CT showed intense FDG uptake along the cervix wall. T2 weighted MRI also revealed a mass lesion with high SI involving the anterior and posterior lips of the uterine cervix. Another area of focal increased uptake above the endometrial lesion in the left pelvic cavity was observed on PET CT and MRI, possibly due to a functioning ovary. PET CT and MRI were interpreted as showing a dual concordant malignant lesion due to separated FDG uptakes and high SI without any connection between the cervical and endometrial lesions. F18 FDG PET CT showed intense FDG uptake along the endometrium. Given the patient's history and the fact that she was not menstruating at the time of imaging, this intense uptake was interpreted as another pathologic lesion, suggesting dual primary lesions. A suspected heterogeneous mass lesion along the endometrium suggesting 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.

Yoon, Seok Nam [Kwandong Univ. College of Medicine, Seoul (Korea, Republic of)

2012-09-15

85

Comparison of the effect of gonadotropin-releasing hormone agonist and dopamine receptor agonist on uterine myoma growth. Histologic, sonographic, and intra-operative changes.  

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This study found that Cabergoline is as effective as Diphereline in the shrinkage of myomas, accompanied by improvement in the sonographic, clinical, and intra-operative outcomes without any adverse pathological changes, and could be a good medical regimen as an adjunct to surgical management.

Manizheh Sayyah-Melli

2009-08-01

86

[A case of synchronous double cancer responding to UFT--dermoid cyst with secondary malignant transformation and uterine endometrial adenocarcinoma].  

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We report here a case of synchronous dermoid cyst with secondary malignant tumor and uterine endometrial adenocarcinoma that responded to UFT. A 35-year-old female complained of abdominal fullness and visited our hospital. She had an abdominal mass which was newborn-head size. We performed right salpingo-oophorectomy and partial omentectomy. The pathological findings were dermoid cyst with secondary malignant transformation. After the operation she had underwent cyclic chemotherapy with CDDP, CPA, THP and 5-FU. After three cycles of chemotherapy, a uterine recurrence was suspected from her uterine endocervical smear test. Then we performed a second operation, but radical surgery was impossible due to the presence of multiple metastases to pelvic lymph nodes. The pathological findings were primary uterine endometrial adenocarcinoma, not metastasis from dermoid cyst with secondary malignant tumor. After the second operation, she was treated with oral UFT (400 mg/day), as she refused chemotherapy and radiotherapy. Two months after the start of UFT, the tumor markers were reduced remarkably, and the patient maintained good QOL throughout the treatment without serious adverse events. We conclude that UFT might be benefical in the treatment of advanced gynecologic cancer. PMID:15675593

Takami, Masashi; Maruyama, Aya; Fukai, Hiroshi; Matsumoto, Hiroshi; Togo, Yoshichika; Takimoto, Toshirou; Sakamoto, Hideki; Yamamoto, Tatsuo

2005-01-01

87

Modulation of periovulatory endocrine profiles in beef cows: consequences for endometrial glucose transporters and uterine fluid glucose levels.  

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In beef cattle, proestrus estradiol and subsequent progesterone (P4) concentrations can regulate the endometrial characteristics and thereby determine maternal receptivity toward the embryo. However, the underlying mechanisms linking periovulatory endocrine profiles to receptivity, which is crucial to obtain pregnancy, need to be elucidated. We hypothesized that the size of the preovulatory follicle (POF) and subsequent circulating P4 concentrations, during early diestrus, modulate endometrial levels of glucose transporter transcripts and proteins, and subsequently affect the luminal glucose availability in the uterus. Therefore, follicle growth of Nelore cows was manipulated, and cows were assigned to 2 experimental groups: (1) large follicle and large corpus luteum (LF-LCL) group with a large POF and corpus luteum (CL); and (2) small follicle and small corpus luteum (SF-SCL) group with a small POF and CL. At day 7 post gonadotropin-releasing hormone induced ovulation (gonadotropin-releasing hormone treatment = day 0), animals were slaughtered (n = 18 per group), and uterine tissues and washings were collected for characterization of glucose transporters and glucose levels, respectively. The diameter of POF was larger (P cows compared with their SF-SCL counterparts (12.8 ± 0.4 vs 11.1 ± 0.4 mm). Furthermore, CL size (17.49 ± 0.88 vs 14.48 ± 0.52 mm) and circulating P4 concentrations at day 7 (4.5 ± 1.0 vs 3.3 ± 1.1 ng/mL, P cows compared with the SF-SCL cows. No differences (P > 0.05) were detected in gene expression patterns of SLC2A1, SLC2A3, SLC2A4, SLC2A5, SLC5A1, ATP1A2, ATP1B2, and SLC37A4. However, the protein abundance of endometrial SLC2A1was increased in the LF-LCL group compared with the SF-SCL group (P < 0.05). SLC2A1 and SLC2A4 protein products were mainly identified at the endometrial luminal and glandular epithelium membranes as well as in the endometrial stroma. Glucose concentrations in uterine washings were similar between groups. In conclusion, we provided information on the potential link between endocrine profiles and glucose transport pathways in the bovine endometrium. More specifically, our data reveal that the size of the POF, and subsequent P4 concentrations, do not functionally affect the main endometrial glucose transporter pathways or uterine fluid glucose concentrations during diestrus. PMID:25447883

França, M R; Mesquita, F S; Lopes, E; Pugliesi, G; Van Hoeck, V; Chiaratti, M R; Membrive, C B; Papa, P C; Binelli, M

2015-01-01

88

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

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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

89

Uterine Lesions  

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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 use...

Kurjak, A.; Kupesic, S.

2005-01-01

90

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

91

Comparison of the effect of gonadotropin-releasing hormone agonist and dopamine receptor agonist on uterine myoma growth. Histologic, sonographic, and intra-operative changes.  

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OBJECTIVES To investigate the effect of 2 medications; Diphereline and Cabergoline, on uterine leiomyoma growth, and its histologic, sonographic, and intra-operative changes. METHODS In an effort to treat large uterine leiomyoma in symptomatic patients in the Gynecology Clinics of the Alzahra Teaching Hospital of Tabriz University of Medical Sciences, Tabriz, Iran, from September 2007 to November 2008, 60 candidates randomized to receiv...

Manizheh Sayyah-Melli; Sepideh Tehrani-Gadim; Ali Dastranj-Tabrizi; Fatemeh Gatrehsamani; Ghojazadeh Morteza; Elaheh Ouladesahebmadarek; Laya Farzadi; Maryamalsadat Kazemi-Shishvan

2009-01-01

92

Microscopic endometrial perivascular epithelioid cell nodules: a case report with the earliest presentation of a uterine perivascular epithelioid cell tumor  

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Full Text Available Abstract Perivascular epithelioid cell (PEC tumors (PEComas are a family of related mesenchymal tumors composed of PECs which co-express melanocytic and smooth muscle markers. Although their distinctive histologic, immunohistochemical, ultrastructural, and genetic features have been clearly demonstrated, their histogenesis and normal counterpart remain largely unknown. Precursor lesions of PEComas have rarely been reported. We herein describe a tuberous sclerosis patient with microscopic PEC nodules in the endometrium of adenomyosis, pelvic endometriosis, an ovarian endometriotic cyst, and the endometrium of the uterine cavity. The nodules showed a mixture of spindle-shaped and epithelioid cells concentrically arranged around small arteries. The cells exhibited uniform nuclei, light eosinophilic cytoplasm, and immunoreactivity with HMB-45 and CD10. Some nodules revealed continuity with a PEComa in the myometrium. These findings support microscopic endometrial PEC nodules possibly being precursor lesions of uterine PEComas. The wide distribution of the nodules in the pelvis may be related to the multicentricity of PEComas in tuberous sclerosis patients. Owing to the immunoreactivity with CD10, microscopic endometrial PEC nodules may be misinterpreted as endothelial stromal cells unless melanocytic markers are stained. To the best of our knowledge, this is a case with the earliest manifestation of PEC lesions occurring in the endometrium. Virtual Slides The virtual slide(s for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9658280017862643

Fang Chia-Lang

2012-09-01

93

What Is Uterine Sarcoma?  

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... key statistics about uterine sarcoma? What is uterine sarcoma? Uterine sarcoma is a cancer of the muscle ... type of cell they developed from: Endometrial stromal sarcomas develop in the supporting connective tissue ( stroma ) of ...

94

Vaginal Myomectomy for Semipedunculated Cervical Myoma during Pregnancy.  

Science.gov (United States)

Objective?Cases of prolapsed myoma in which pregnancy was carried to full term or near term after vaginal myomectomy are very rare. Previously, only two such cases have been reported. In addition, both those patients had a pedunculated leiomyoma, which could be treated by twisting or clamping. Here, we report a case of a patient who was able to carry her pregnancy to term despite vaginal myomectomy for semipedunculated myoma at 13 weeks of pregnancy. Study Design?This study is a case presentation. Results?The myoma nucleus was removed by making an incision on the surface of the mass. Systemic and transvaginal antibiotics were prescribed after the surgery. Uterine contractions, short cervix, or cervical funneling was not observed in the remaining duration of pregnancy. Conclusion?While performing myomectomy during pregnancy, removal of the myoma nucleus is safer than twisting. In addition, postoperative administration of local or systemic antibiotic agents does not adversely affect pregnancy. PMID:25032058

Obara, Mikitaka; Hatakeyama, Yuko; Shimizu, Yasushi

2014-05-01

95

Hysteroscopic findings in postmenopausal patients with ultrasonographic diagnosis of endometrial thickening  

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Full Text Available Objective: To evaluate the results of hysteroscopy for investigating the uterine cavity of postmenopausal women presenting endometrial thickening on ultrasound. Methods: A cross-sectional study was conducted on hysteroscopic evaluations of 329 postmenopausal women presenting with endometrial thickening on transvaginal ultrasonography. Hysteroscopies were performed in an outpatient setting, using a 4 mm optic Hamou II microhysteroscope and gas (CO2 to distend the uterine cavity. A guided biopsy for histology was performed in all patients with suspected endometrial malignancies and in most patients with benign abnormalities. Rresults: Endometrial thickness ranged from 6 to 38 mm (mean of 10.03 ± 4.49 mm. The hysteroscopic findings were polyps in 183 patients (55.62%; atrophic endometrium in 55 patients (16.72%; synechia in 26 patients (7.90%; a “cerebroid” appearance lesion in 13 patients (3.95%; myoma in 12 patients (3.65%; endometrial hyperplasia in 11 patients (3.34%; focal thickening in ten patients (3.04%; proliferative endometrium in eight patients (2.43%; mucus in seven patients (2.13%; and cystic atrophy in four patients (1.22%. Endometrial carcinoma was confirmed by histology in 11 of 13 suspected cases, in which hysteroscopy showed the cerebroid appearance. Hyperplasias were confirmed in seven of 11 cases. The respective accuracy was 99.26 and 96.67%. Nine out of 11 endometrial cancer cases and six out of 12 hyperplasia cases presented uterine bleeding. Cconclusions: The most frequent findings were benign lesions (92.71%. Hysteroscopy with biopsy is an accurate method to detect intracavitary uterine disease.

Hosana Karinne de Marathaoan Souza Martins e Castello Branco

2008-09-01

96

Endometrial expression of the insulin-like growth factor system during uterine involution in the postpartum dairy cow.  

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Rapid uterine involution in the postpartum period of dairy cows is important to achieve a short interval to conception. Expression patterns for members of the insulin-like growth factor (IGF) family were determined by in situ hybridisation at day 14+/-0.4 postpartum (n=12 cows) to investigate a potential role for IGFs in modulating uterine involution. Expression in each uterine tissue region was measured as optical density units and data were analysed according to region and horn. IGF-I mRNA was localized to the sub-epithelial stroma (SES) of inter-caruncular and caruncular endometrium. Both IGF-II and IGF-1R expression was detected in the deep endometrial stroma (DES), the caruncular stroma and myometrium. IGFBP-2, IGFBP-4 and IGFBP-6 mRNAs were all localised to the SES of inter-caruncular and caruncular uterine tissue, and in the DES and caruncular stroma, with IGFBP-4 mRNA additionally expressed in myometrium. IGFBP-3 mRNA was only detectable in luminal epithelium. IGFBP-5 mRNA was found in myometrium, inter-caruncular and caruncular SES and caruncular stroma. These data support a role for IGF-I and IGF-II in the extensive tissue remodelling and repair which the postpartum uterus undergoes to return to its non-pregnant state. The differential expression of binding proteins between tissues (IGFBP-3 in epithelium, IGFBP-2, -4, -5 and -6 in stroma and IGFBP-4 and -5 in myometrium) suggest tight control of IGF activity within each compartment. Differential expression of many members of the IGF family between the significantly larger previously gravid horn and the previously non-gravid horn may relate to differences in their rate of tissue remodelling. PMID:18258405

Llewellyn, S; Fitzpatrick, R; Kenny, D A; Patton, J; Wathes, D C

2008-05-01

97

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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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

98

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

99

Role of MR in diagnosis of uterine leiomyoma  

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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.

Lee, Sung Moon; Lee, Hee Jung; Kim, Jung Sik; Joo, Yang Gu; Kim, Hong; Suh, Soo Jhi [Keimyung University School of Medicine, Daegu (Korea, Republic of)

1994-04-15

100

Epigenetic fingerprint in endometrial carcinogenesis: the hypothesis of a uterine field cancerization.  

Science.gov (United States)

Transcriptional silencing by CpG island hypermethylation plays a critical role in endometrial carcinogenesis. In a collection of benign, premalignant and malignant endometrial lesions, a methylation profile of a complete gene panel, such steroid receptors (ER?, PR), DNA mismatch repair (hMLH1), tumor-suppressor genes (CDKN2A/P16 and CDH1/E-CADHERIN) and WNT pathway inhibitors (SFRP1, SFRP2, SFRP4, SFRP5) was investigated in order to demonstrate their pathogenetic role in endometrial lesions. Our results indicate that gene hypermethylation may be an early event in endometrial endometrioid tumorigenesis. Particularly, ER?, PR, hMLH1, CDKN2A/P16, SFRP1, SFRP2 and SFRP5 revealed a promoter methylation status in endometrioid carcinoma, whereas SFRP4 showed demethylation in cancer. P53 immunostaining showed weak-focal protein expression level both in hyperplasic lesions and in endometrioid cancer. Non-endometrioid cancers showed very low levels of epigenetic methylations, but strong P53 protein positivity. Fisher exact test revealed a statistically significant association between hMLH1, CDKN2A/P16 and SFRP1 genes methylation and endometrioid carcinomas and between hMLH1 gene methylation and peritumoral endometrium (p < 0.05). Our data confirm that the methylation profile of the peritumoral endometrium is different from the altered molecular background of benign endometrial polyps and hyperplasias. Therefore, our findings suggest that the methylation of hMLH1, CDKN2A/P16 and SFRP1 may clearly distinguish between benign and malignant lesions. Finally, this study assessed that the use of an epigenetic fingerprint may improve the current diagnostic tools for a better clinical management of endometrial lesions. PMID:21709441

Di Domenico, Marina; Santoro, Angela; Ricciardi, Carmela; Iaccarino, Mirella; Iaccarino, Stefania; Freda, Mariagrazia; Feola, Antonia; Sanguedolce, Francesca; Losito, Simona; Pasquali, Daniela; Di Spiezio Sardo, Attilio; Bifulco, Giuseppe; Nappi, Carmine; Bufo, Pantaleo; Guida, Maurizio; De Rosa, Gaetano; Abbruzzese, Alberto; Caraglia, Michele; Pannone, Giuseppe

2011-09-01

 
 
 
 
101

Torsion of pedunculated subserous myoma--a rare cause of acute abdomen.  

Science.gov (United States)

Leiomyoma uteri are common benign genital neoplasia among women of late reproductive age. Most are asymptomatic. Among those having symptoms, abnormal uterine bleeding and pelvic pressure symptoms are common presenting features. Less common indications for treatment include infertility and abdominal distension. Acute onset severe abdominal pain is an unusual presenting complaint. When present, pain is usually related to complications involving the myoma including red degeneration, infection, process of expulsion of a submucous pedunculated myoma, uterine torsion, compression of myoma between the uterus and sacrum or torsion of a pedunculated subserous myoma. Standard gynecologic textbooks frequently mention torsion of pedunculated subserous myoma as one of the causes of myoma related acute abdomen. Literature search on the topic however does not yield many specific case reports of this myoma related complication or it's presenting features. The condition has not been reported from Ethiopia so far. A case of torsion of pedunculated subserous myoma presenting in early pregnancy that was managed in one of the maternity hospitals in Addis Ababa, Ethiopia is presented. PMID:17642178

Gaym, Asheber; Tilahun, Solomon

2007-04-01

102

The role of Doppler measurement in the adducting uterine veins in diagnosis of endometrial tumors  

International Nuclear Information System (INIS)

The work deals with investigation of the capabilities of transvaginal ultrasound investigation in combination with color, energetic and spectral Doppler investigation in differential diagnosis of benign endometrial hyperplasia and cancer. The work is based on complex investigation of 66 pre- and post- menopause patients with histologically verified pathology of the endometrium.

103

Uterine Cancer  

Science.gov (United States)

... is pregnant. There are different types of uterine cancer. The most common type starts in the endometrium, the lining of the uterus. This type of cancer is sometimes called endometrial cancer. The symptoms of ...

104

Body diffusion-weighted MR imaging of uterine endometrial cancer: Is it helpful in the detection of cancer in nonenhanced MR imaging?  

International Nuclear Information System (INIS)

Objective: In this study, the authors discussed the feasibility and value of diffusion-weighted (DW) MR imaging in the detection of uterine endometrial cancer in addition to conventional nonenhanced MR images. Methods and materials: DW images of endometrial cancer in 23 patients were examined by using a 1.5-T MR scanner. This study investigated whether or not DW images offer additional incremental value to conventional nonenhanced MR imaging in comparison with histopathological results. Moreover, the apparent diffusion coefficient (ADC) values were measured in the regions of interest within the endometrial cancer and compared with those of normal endometrium and myometrium in 31 volunteers, leiomyoma in 14 patients and adenomyosis in 10 patients. The Wilcoxon rank sum test was used, with a p -3 mm2/s, which was significantly lower thasup>/s, which was significantly lower than those of the normal endometrium, myometrium, leiomyoma and adenomyosis (p < 0.05). Conclusion: DW imaging can be helpful in the detection of uterine endometrial cancer in nonenhanced MR imaging.

105

Body diffusion-weighted MR imaging of uterine endometrial cancer: Is it helpful in the detection of cancer in nonenhanced MR imaging?  

Energy Technology Data Exchange (ETDEWEB)

Objective: In this study, the authors discussed the feasibility and value of diffusion-weighted (DW) MR imaging in the detection of uterine endometrial cancer in addition to conventional nonenhanced MR images. Methods and materials: DW images of endometrial cancer in 23 patients were examined by using a 1.5-T MR scanner. This study investigated whether or not DW images offer additional incremental value to conventional nonenhanced MR imaging in comparison with histopathological results. Moreover, the apparent diffusion coefficient (ADC) values were measured in the regions of interest within the endometrial cancer and compared with those of normal endometrium and myometrium in 31 volunteers, leiomyoma in 14 patients and adenomyosis in 10 patients. The Wilcoxon rank sum test was used, with a p < 0.05 considered statistically significant. Results: In 19 of 23 patients, endometrial cancers were detected only on T2-weighted images. In the remaining 4 patients, of whom two had coexisting leiomyoma, no cancer was detected on T2-weighted images. This corresponds to an 83% detection sensitivity for the carcinomas. When DW images and fused DW images/T2-weighted images were used in addition to the T2-weighted images, cancers were identified in 3 of the remaining 4 patients in addition to the 19 patients (overall detection sensitivity of 96%). The mean ADC value of endometrial cancer (n = 22) was (0.97 {+-} 0.19) x 10{sup -3} mm{sup 2}/s, which was significantly lower than those of the normal endometrium, myometrium, leiomyoma and adenomyosis (p < 0.05). Conclusion: DW imaging can be helpful in the detection of uterine endometrial cancer in nonenhanced MR imaging.

Inada, Yuki [Department of Radiology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686 (Japan)], E-mail: rad068@poh.osaka-med.ac.jp; Matsuki, Mitsuru; Nakai, Go; Tatsugami, Fuminari; Tanikake, Masato; Narabayashi, Isamu [Department of Radiology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686 (Japan); Yamada, Takashi; Tsuji, Motomu [Department of Pathology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka 569-8686 (Japan)

2009-04-15

106

Endometrial Imaging  

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  "nAbnormal uterine bleeding, whether in peri menopausal or postmenopausal patients, is an important clinical concern and results in much medical intervention. When bleeding occurs in women over 40 years of age as well as any postmenopausal women, endometrial assessment is mandatory. In the past and present, many clinicians prefer to begin such assessment with blind endometrial sampling. However, when an ultrasound-based approach to such patients is present, a thin distinct end...

Khadijeh Bakhtavar

2009-01-01

107

TWEAK Appears as a Modulator of Endometrial IL-18 Related Cytotoxic Activity of Uterine Natural Killers  

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BACKGROUND: TWEAK (Tumor necrosis factor like WEAK inducer of apoptosis) is highly expressed by different immune cells and triggers multiple cellular responses, including control of angiogenesis. Our objective was to investigate its role in the human endometrium during the implantation window, using an ex-vivo endometrial microhistoculture model. Indeed, previous results suggested that basic TWEAK expression influences the IL-18 related uNK recruitment and local cytotoxicity. METHODOLOGY/...

Petitbarat, M.; Rahmati, M.; Se?razin, V.; Dubanchet, S.; Morvan, C.; Wainer, R.; Mazancourt, P.; Chaouat, G.; Foidart, Jean-michel; Munaut, Carine; Le?de?e, N.

2011-01-01

108

Vascular endothelial growth factor-D over-expressing tumor cells induce differential effects on uterine vasculature in a mouse model of endometrial cancer  

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Full Text Available Abstract Background It has been hypothesised that increased VEGF-D expression may be an independent prognostic factor for endometrial cancer progression and lymph node metastasis; however, the mechanism by which VEGF-D may promote disease progression in women with endometrial cancer has not been investigated. Our aim was to describe the distribution of lymphatic vessels in mouse uterus and to examine the effect of VEGF-D over-expression on these vessels in a model of endometrial cancer. We hypothesised that VEGF-D over-expression would stimulate growth of new lymphatic vessels into the endometrium, thereby contributing to cancer progression. Methods We initially described the distribution of lymphatic vessels (Lyve-1, podoplanin, VEGFR-3 and VEGF-D expression in the mouse uterus during the estrous cycle, early pregnancy and in response to estradiol-17beta and progesterone using immunohistochemistry. We also examined the effects of VEGF-D over-expression on uterine vasculature by inoculating uterine horns in NOD SCID mice with control or VEGF-D-expressing 293EBNA tumor cells. Results Lymphatic vessels positive for the lymphatic endothelial cell markers Lyve-1, podoplanin and VEGFR-3 profiles were largely restricted to the connective tissue between the myometrial circular and longitudinal muscle layers; very few lymphatic vessel profiles were observed in the endometrium. VEGF-D immunostaining was present in all uterine compartments (epithelium, stroma, myometrium, although expression was generally low. VEGF-D immunoexpression was slightly but significantly higher in estrus relative to diestrus; and in estradiol-17beta treated mice relative to vehicle or progesterone treated mice. The presence of VEGF-D over-expressing tumor cells did not induce endometrial lymphangiogenesis, although changes were observed in existing vessel profiles. For myometrial lymphatic and endometrial blood vessels, the percentage of profiles containing proliferating endothelial cells, and the cross sectional area of vessel profiles were significantly increased in response to VEGF-D in comparison to control tumor cells. In contrast, no significant changes were noted in myometrial blood vessels. In addition, examples of invading cells or tumor emboli were observed in mice receiving VEGF-D expressing 293EBNA cells. Conclusions These results illustrate that VEGF-D over-expression has differential effects on the uterine vasculature. These effects may facilitate VEGF-D's ability to promote endometrial cancer metastasis and disease progression.

Stacker Steven A

2010-07-01

109

Role of diagnostic hysteroscopy in abnormal uterine bleeding  

Directory of Open Access Journals (Sweden)

Full Text Available Background: The objective of the study was to correlate hysteroscopic findings with histopathological findings in women with abnormal uterine bleeding and to study the accuracy of hysteroscopy in abnormal uterine bleeding. Methods: Settings: tertiary care hospital. Study design: prospective study. A prospective study was carried out in the Department of Obstetrics and Gynaecology at MMIMSR, Mullana, Ambala, from May 2011 to September 2013. 100 cases were selected for this study from patients who were admitted with history of abnormal uterine bleeding. Hysteroscopic examination was done in all patients post-menstrually, whenever possible, except in those cases where menstrual cycles were grossly irregular or patients came with continuous bleeding per vaginum. The patients then underwent dilatation and curettage and curettings was sent for histopathological examination. The correlation between findings on hysteroscopy and histopathological examination was done. Results: On hysteroscopy, 48% of the patients had either proliferative or secretory picture which was grouped as normal. The rest 52% of patients had some abnormality. Hyperplasia was the most common finding which was seen in 26% patients. The other findings included endometrial polyp 8%, myoma or myomatous polyp 7%, atrophic endometrium 4%, endometrial carcinoma, misplaced IUCD, and synechiae comprising 2% each and tubercular endometritis 1%. Conclusions: Hysteroscopy has a high sensitivity i.e. it can supplement and enhance the accuracy of tissue diagnosis. So, hysteroscopically directed biopsy would be an ideal procedure in abnormal uterine bleeding wherever facilities are available. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 544-551

Swati Singh

2014-06-01

110

Mioma uterino gigante / Giant myoma uteri  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish El útero es un órgano del aparato ginecológico, sitio de muchas afecciones benignas y malignas. Las primeras, más frecuentes, y dentro de ellas está el mioma o fibroma uterino. Entre la tercera y quinta décadas de la vida es el tiempo en el que aparece mayormente esta afección en la mujer. Los sínto [...] mas son variables, en consecuencia de la localización del mioma (submucoso, intramural o subseroso). El crecimiento del útero es variable, puede ir desde pequeñas tumoraciones hasta grandes masas intraabdominales, que se hacen visibles y llegan a palparse en el mesogastrio. Sus complicaciones son las que la hacen acreedoras de tratamiento quirúrgico. Un gran crecimiento del útero a consecuencia de un mioma puede llegar a convertirlo en un mioma gigante. Se presenta esta paciente con el objetivo de alertar al médico que se encuentre ante la sospecha de un tumor gigante intraabdominal. Abstract in english Uterus is an organ of the gynecological tract, site of many of them benign and malignant affections. The first ones, more frequent, and including the myoma or uterine fibroma. Between the third and the fifth decades of life is the time in which this affection is more frequent in the woman. Symptoms [...] are variables, as a result of the myoma location (submucous, intramural or subserous). The uterus growth is variable, may go from small tumors until large more evident intra-abdominal masses and to be enough palpable in the mesogastrium. Its complications are the reason for the surgical treatment. A significant growth of uterus caused by a myoma may become it in a giant myoma. The case of this patient is the objective to alert to physician facing the suspicion of a intra-abdominal giant tumor.

Gimel, Sosa Martín; Luis Raúl, Gutiérrez Gaytán; Adonis, Crespo Galán.

2011-12-01

111

CT differentiation of solid ovarian tumor and uterine subserosal leiomyoma  

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On the basis of CT findings, to differentiate between solid ovarian tumor and uterine subserosal myoma. In eight surgically proven cases of solid ovarian tumor and in ten uterine subserosal myoma patients, contrast-enhanced CT images were obtained. Two genitourinary radiologists reviewed the findings with regard to degree of enhancement of the mass as compared with enhancement of uterine myometrium, thickening of round ligaments, visualization of normal ovaries, contour of the mass, and the presence of ascites in the pelvic cavity. Six of eight ovarian tumors but only two of ten uterine myomas were less enhanced than normal uterine myometrium (p<0.05). Pelvic ascites were seen in six of eight ovarian tumors, but in only one of ten uterine myomas (P<0.05). Three of 16 ovaries in ovarian tumor patients, but 12 of 20 ovaries in uterine myoma patients, were normal (p<0.05). Six of 16 round ligaments of the uterus in ovarian tumor patients, were thichened but 11 of 20 round ligaments in uterine myoma patients, were thickened (p>0.05). The contour of the mass was lobulated in two of eight ovarian tumor patients, but in five of ten uterine myoma patients (p>0.05). CT findings suggestive of solid ovarian tumor were less contrast enhancement of the mass than of normal uterine myometrium, pelvic ascites, and nonvisualization of normal ovary.

Kim, Kyung Rae; Cho, Kyoung Sik [Asan Medical Center, Ulsan Univ. College of Medicine, Seoul (Korea, Republic of); Sohn, Chul Ho [Dongsan Medical Center, Keimyung Univ. College of Medicine, Taegu (Korea, Republic of); Ji, Eun Kyung [Bombit Hospital, Seoul (Korea, Republic of)

1999-06-01

112

Expression of steroid and xenobiotic receptor in uterine carcinosarcoma, leiomyosarcoma and endometrial stromal sarcoma  

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We analyzed the expression of the steroid and xenobiotic receptor (SXR) in human uterine sarcomas and evaluated its clinical significance. Forty-seven cases with archival specimens were examined for SXR expression using immunohistochemistry. All cases were scored using a semi-quantitative histological scoring (HSCORE) method. Specimens with a HSCORE >40 were regarded as SXR-positive. Various clinicopathological variables, including the expression status of estrogen receptor (ER)-?, progester...

Yue, Xiaoni; Utsunomiya, Hiroki; Akahira, Jun-ichi; Suzuki, Fumihiko; Ito, Kiyoshi; Nagase, Satoru; Sasano, Hironobu; Yaegashi, Nobuo

2012-01-01

113

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

DEFF Research Database (Denmark)

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

114

CT differentiation of solid ovarian tumor and uterine subserosal leiomyoma  

International Nuclear Information System (INIS)

On the basis of CT findings, to differentiate between solid ovarian tumor and uterine subserosal myoma. In eight surgically proven cases of solid ovarian tumor and in ten uterine subserosal myoma patients, contrast-enhanced CT images were obtained. Two genitourinary radiologists reviewed the findings with regard to degree of enhancement of the mass as compared with enhancement of uterine myometrium, thickening of round ligaments, visualization of normal ovaries, contour of the mass, and the presence of ascites in the pelvic cavity. Six of eight ovarian tumors but only two of ten uterine myomas were less enhanced than normal uterine myometrium (p0.05). The contour of the mass was lobulated in two of eight ovarian tumor patients, but in five of ten uterine myoma patients (p>0.05). CT findings suggestive of solid ovarian tumor were less contrast enhancement of the mass than of normal uterine myometrium, pelvic ascites, and nonvisualization of normal ovary

115

Parasitic Myoma After Morcellation  

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We report an interesting case of parasitic fibroid which developed from a morcellation remnant following laparoscopic myomectomy. The patient presented with incidental finding of pelvic mass in 2005. She underwent laparoscopic myomectomy for a myoma extending from the Pouch of Douglas to both sides of broad ligament. She subsequently presented with abdominal pain 3 years later in 2008. She underwent total laparoscopic hysterectomy with removal of broad ligament fibroids. During her hysterecto...

Sinha, Rakesh; Sundaram, Meenakshi; Lakhotia, Smita; Kadam, Pratima; Rao, Gayatri; Mahajan, Chaitali

2009-01-01

116

Cervical myomectomy with uterine artery ligation at its origin.  

Science.gov (United States)

This study was performed to examine the feasibility, blood loss, duration of surgery, and complications in patients with cervical myomas in whom the uterine artery was ligated before myomectomy. Laparoscopic cervical myomectomy was performed in 12 women with cervical myomas and menorrhagia. The uterine artery was ligated at its origin from the internal iliac as an initial step to reduce the blood loss. Myomectomy was subsequently performed, and the myomas were enucleated by incising the capsule anteriorly or posteriorly depending on their location. Hysterectomy was not necessary in any patient. Even large cervical myomas were removed with minimal blood loss. Laparoscopic cervical myomectomy is a minimally invasive and technically safe procedure. PMID:19835802

Sinha, Rakesh; Sundaram, Meenakshi; Lakhotia, Smita; Hegde, Aparna

2009-01-01

117

Comparative analysis between the cytobrush and low-volume uterine flush techniques for endometrial cytology in clinically normal postpartum crossbred dairy cows
Comparação das técnicas de citologia endometrial escova citológica e lavado uterino de baixo volume no pós-parto de vacas leiteiras mestiças
 

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This study compared two frequently employed techniques for the collection of endometrial and inflammatory cells and characterized postpartum endometrial cytology (EC) of clinically normal postpartum crossbred dairy cows in dairy farming system in Southwestern Brazil. Thirty-four crossbred, clinically healthy dairy cows with normal delivery and puerperium, complete uterine involution and without any treatment were monitored until 42 days in milk (DIM). All cows were evaluated by complete clini...

João Paulo Elsen Saut; Selwyn Arligton Headley; Nayara Resende Nasciutti; Cícero Fleury Martins; Suzana Akemi Tsuruta; Alvaro Moriya Shiota; Raphael Soares de Barros Ramos Oliveira; Ricarda Maria dos Santos; Antonio Vicente Mundim

2013-01-01

118

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

Science.gov (United States)

... 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 ...

119

Endometrial Imaging  

Directory of Open Access Journals (Sweden)

Full Text Available   "nAbnormal uterine bleeding, whether in peri menopausal or postmenopausal patients, is an important clinical concern and results in much medical intervention. When bleeding occurs in women over 40 years of age as well as any postmenopausal women, endometrial assessment is mandatory. In the past and present, many clinicians prefer to begin such assessment with blind endometrial sampling. However, when an ultrasound-based approach to such patients is present, a thin distinct endometrial echo excludes significant pathology, assuming it is performed at an appropriate time if the patient is, in fact, cycling. When a thin distinct endometrial echo is not visualized (inadequate visualization or presence of thickened echo then saline infusion sonohysterography can help to triage patients to no anatomic pathology, globally thickened anatomic pathology that may then be evaluated with blind endometrial sampling, and focal abnormalities that must be evaluated under direct vision. Such an ultrasound-based approach will not only help to exclude endometrial carcinoma, but also to identify the source of any bleeding for better clinical management. MRI has no role as a screening technique for endometrial carcinoma however the accuracy of MRI in differentiating non invasive from invasive carcinoma is high.   

Khadijeh Bakhtavar

2009-01-01

120

Parasitic myoma after morcellation.  

Science.gov (United States)

We report an interesting case of parasitic fibroid which developed from a morcellation remnant following laparoscopic myomectomy. The patient presented with incidental finding of pelvic mass in 2005. She underwent laparoscopic myomectomy for a myoma extending from the Pouch of Douglas to both sides of broad ligament. She subsequently presented with abdominal pain 3 years later in 2008. She underwent total laparoscopic hysterectomy with removal of broad ligament fibroids. During her hysterectomy, a right lumbar mass attached to the omentum was detected, which was excised laparoscopically. Histopathology of the mass confirmed it to be consistent with leiomyoma. This mass could probably be a morcellation remnant that has grown to this size taking blood supply from the omentum. We report this case to emphasize that all tissue pieces that are morcellated should be diligently removed. Even small bits displaced into the upper abdomen can result in parasitic fibroids. Thus, it can be concluded that parasitic myomas can arise from morcellated remnants and grow depending on the blood supply. PMID:22442523

Sinha, Rakesh; Sundaram, Meenakshi; Lakhotia, Smita; Kadam, Pratima; Rao, Gayatri; Mahajan, Chaitali

2009-07-01

 
 
 
 
121

Diagnostic value of saline contrast sonohysterography comparing with hysteroscopy for detecting endometrial abnormalities in women with abnormal uterine bleeding  

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Background: Abnormal uterine bleeding is a common presentation of uterine abnormalities among premenopausal and postmenopausal women.Objective: To evaluate and compare the diagnostic accuracy of saline contrast sonohysterography and hysteroscopy for detecting the cause of abnormal uterine bleeding.Materials and Methods: A total of 65 women with abnormal uterine bleeding were enrolled in this study. A prior saline contrast sonohysetrography followed by a hysteroscopy was performed in all cases...

Farzaneh Goharzad; Razieh Dehghani Firouzabadi; Mohammad Ali Karimzadeh

2011-01-01

122

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

123

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  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese 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 sangram [...] ento 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. Abstract in english 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 chan [...] ges 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; Elmar Gonzaga, Gonçalves.

2000-06-01

124

Role of MR in diagnosis of uterine leiomyoma  

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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 presee in patient who need myomectomy for preservation of childbearing function

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193 progesterone concentrations and messenger RNA expression of progesterone receptors in endometrial tissue of bovine uterine horn ipsilateral and contralateral to corpus luteum.  

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Generally, conception is established in the uterine horn ipsilateral to the corpus luteum (CL) in cattle. When a bovine embryo is transferred into the uterine horn contralateral to CL, conception rate is low. Since progesterone (P4) is essential for the establishment of pregnancy in cattle, locational effects of P4 released from CL at the uterus may cause the differences in fertility. The aim of this study was to determine the endometrial tissue P4 concentrations (EndP4) and the mRNA expression of nuclear progesterone receptor (PGR), and progesterone receptor component-1 (PGRMC-1) and -2 (PGRMC-2) in the endometrial tissues from the ipsi- and contralateral horn. The uteruses of Holstein cows were obtained at a local abattoir. Endometrial tissues were collected from both horns. Based on ovarian morphology, the oestrus cycle of the cow was estimated as follows: early luteal phase (ELP, Day 5-6, Day 0=oestrus), mid luteal phase (MLP, Day 8-12), late luteal phase (LLP, Day 15-17), and follicular phase (FP, Day 18-20). EndP4 was measured by enzyme immunoassay. Expressions of mRNA were analysed by real-time RT-PCR. Two-way factorial ANOVA and the Steel-Dwass test were applied for a multiple comparison of means. The interrelations between both parameters were expressed by Spearman correlation coefficient. At ELP and MLP, EndP4 in ipsi-horn were higher than that in contra-horn (P<0.05, see Table 1). Higher mRNA expression of PGRMC-1 in ipsi-horn was observed at ELP compared with contra-horn (P<0.05). Expressions of mRNA for PGR and PGRMC-2 were similar in both horns. In ipsi-horn at ELP, EndP4 was positively correlated with PGRMC-1 mRNA (r=0.87, P<0.05), but was negatively correlated with PGR mRNA (r=-0.76, P<0.05). However, in contra-horn, EndP4 has no correlation to mRNA expression of P4 receptors. In conclusion, EndP4 was influenced by the location of CL and stage of oestrus cycle. Higher expression of PGRMC-1 mRNA in endometrial tissue of ipsi-horn at ELP might be up-regulated by higher EndP4. These locational effects of CL on uterus may provide an intrauterine environment suitable for embryo development. PMID:25472242

Takahashi, H; Haneda, S; Matsui, M

2014-12-01

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Endometrial expression of the insulin-like growth factor system during uterine involution in the postpartum dairy cow?  

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Rapid uterine involution in the postpartum period of dairy cows is important to achieve a short interval to conception. Expression patterns for members of the insulin-like growth factor (IGF) family were determined by in situ hybridisation at day 14 ± 0.4 postpartum (n = 12 cows) to investigate a potential role for IGFs in modulating uterine involution. Expression in each uterine tissue region was measured as optical density units and data were analysed according to region and horn. IGF-...

Llewellyn, S.; Fitzpatrick, R.; Kenny, D. A.; Patton, J.; Wathes, D. C.

2008-01-01

127

The utility of diffusion-weighted MR imaging for differentiating uterine sarcomas from benign leiomyomas  

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The usefulness of diffusion-weighted (DW) magnetic resonance (MR) imaging for the diagnosis of uterine sarcomas was investigated, as well as whether DW images and quantitative measurement of apparent diffusion coefficient (ADC) values can facilitate differentiating uterine sarcomas from benign leiomyomas. MR images including DW images were obtained in 43 surgically treated patients with 58 myometrial tumors, including seven uterine sarcomas (five leiomyosarcomas and two endometrial stromal sarcomas) and 51 benign leiomyomas (43 ordinary leiomyomas, two cellular leiomyomas and six degenerated leiomyomas). Qualitative analysis of non-enhanced and postcontrast MR images and DW images and quantitative measurement of ADC values were performed for each myometrial tumor. Both uterine sarcomas and cellular leiomyomas exhibited high signal intensity on DW images, whereas ordinary leiomyomas and most degenerated leiomyomas showed low signal intensity. The mean ADC value (10-3 mm2/s) of sarcomas was 1.17 ± 0.15, which was lower than those of the normal myometrium (1.62 ± 0.11) and degenerated leiomyomas (1.70 ± 0.11) without any overlap; however, they were overlapped with those of ordinary leiomyomas and cellular leiomyomas. In addition to morphological features on nonenhanced and postcontrast MR sequences, DW imaging and ADC measurement may have a potential ability to differentiate uterine sarcomas from benign leiomyomas. (orig.)myomas. (orig.)

128

Adenocarcinoma involving the uterine cervix: magnetic resonance imaging findings in tumours of endometrial, compared with cervical, origin  

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To determine the distinctive magnetic resonance imaging (MRI) features of cervical and endometrial adenocarcinoma that present clinically as cervical mass. From 1999 to 2002, 56 patients with adenocarcinoma on the initial biopsy of a cervical mass underwent MRI at our institution. Of these, 42 had a visible mass on MRI. Pathology review of all available tissue was the reference standard. A site of origin was determined by the pathologist in 38 of the 42 patients, and these were the cases evaluated; of these patients, 32 cases had adenocarcinoma and 6 had adenosquamous cancers. Findings were significantly more prevalent in patients with adenocarcinomas of endometrial, compared with cervical, origin for endometrial thickening (11 [73%] and 3 [13%], respectively; P = 0.0003), endometrial mass (11 [73%] and 1 [4%], respectively; P < 0.0001), endometrial cavity expansion by a mass (9 [60%] and 2 [9%], respectively; P = 0.001), and invasion of myometrium from endometrium (9 [60%] and 0, respectively; P < 0.0001). Adenocarcinomas of the endometrium that involve the cervix have MRI features that help distinguish them from primary adenocarcinomas of the cervix. (author)

Haider, M.A. [Univ. of Toronto, Dept. of Medical Imaging, Univ. Health Network, Mount Sinai Hospital, Toronto, Ontario (Canada)]. E-mail: mhaider@utoronto.ca; Patlas, M. [McMaster Univ., Dept. of Radiology, Hamilton General Hospital, Hamilton, Ontario (Canada); Jhaveri, K. [Univ. of Toronto, Dept. of Medical Imaging, Univ. Health Network, Mount Sinai Hospital, Toronto, Ontario (Canada); Chapman, W. [Univ. of Toronto, Dept. of Pathology, Univ. of Health Network, Toronto, Ontario (Canada); Fyles, A. [Univ. of Toronto, Dept. of Radiation Oncology, Princess Margaret Hospital, Univ. Health Network, Toronto, Ontario (Canada); Rosen, B. [Univ. of Toronto, Dept. of Obstetrics and Gynecology, Univ. Health Network, Toronto, Ontario (Canada)

2006-02-15

129

Role of transvaginal sonography and hysteroscopy in abnormal uterine bleeding: does the diagnostic yield increase by combining transvaginal sonography, hysteroscopy and biopsy?  

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Methods: This was a descriptive cross sectional study between January 2013 to June2014 in Sri Manakula Vinayagar medical college and hospital. After obtaining ethics committee approval, 100 consecutive patients with abnormal uterine bleeding between the age group of 35 and 55 years, who consented to participate in the study, were subjected to transvaginal sonography followed by diagnostic hysteroscopy combined with a directed biopsy. TVS and hysteroscopy was performed by two different investigators. The endometrial curettings and any intracavitary lesion were subjected to histopathological examination. Results tabulated and analysed using MS EXCEL and cross tabulation using Epi-info. Sensitivity, specificity, PPV, NPV for each pathology by TVS and hysteroscopy with HPE as the gold standard was calculated. Also the pathology causing abnormal uterine bleeding was computed by taking into account the endometrial characteristics and the associated lesions diagnosed by TVS, hysteroscopy and histopathological examination report. Results: 61 patients had only single lesions in the form of normal endometrium, atrophic endometrium, endometrial hyperplasia, endometrial polyp, malignancy and IU synechiae whereas 39 patients had lesions like intramural fibroids, adenomyosis, submucus myoma and polyps associated with different types of endometrium. The diagnostic accuracy of TVS and hysteroscopy were comparable for normal endometrium whereas hysteroscopy was found to be more accurate for endometrial polyps, endometrial hyperplasia and atrophic endometrium. Conclusions: The combination of transvaginal sonography, hysteroscopy and directed biopsy was found to increase the diagnostic yield in patients with abnormal uterine bleeding. As the diagnostic accuracy increased by combining the three modalities, an effective and appropriate management can be planned. [Int J Reprod Contracept Obstet Gynecol 2014; 3(4.000: 919-923

Nivedita Krishnamoorthy

2014-08-01

130

[Uterine cancer].  

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It is thought that robotic surgery is highly useful for uterine malignant tumor such as endometrial cancer and cervical cancer. It is nothing but that robotic surgery enables us the correct and delicate movement of forceps, which is necessary for operative procedures at the deep and narrow space in the pelvic cavity and the perivascular lymphadenectomy. By our experience, significant reduction of blood loss and shortening of the hospital stay were accepted in the cases of endometrial cancer and cervical cancer. At present the robotic surgery in uterine cancer in Japan lags far behind the USA In order not to miss the trend in the world, it is required for the robotic surgery of uterine cancer to spread widely in Japan from now on. For this purpose, it is necessary to accumulate cases on the assumption that advanced medical care and also insurance adaptation. PMID:25434437

Isaka, Keiichi; Kato, Rina; Ito, Hiroe

2014-11-01

131

Low grade Endometrial Stromal Sarcoma of uterine corpus, a clinico-pathological and survey study in 14 cases  

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Full Text Available Abstract Background Endometrial stromal sarcoma (ESS is a rare disease with probably less than 700 new cases in the USA or Europe per year. The aim of this study was to evaluate the behavior of low-grade endometrial stromal sarcoma (LGESS in relation to their clinical and pathological features and to identify possible prognostic factors. Patients and methods Fourteen patients with histologically proven ESS were included in the analysis. Endometrial stromal sarcoma is characterized by proliferations composed of cells with Endometrial stromal cell differentiation. Low-grade endometrial stromal sarcoma has an infiltrating margin and typically show extensive worm-like vessel invasion. Results The median age was 44.35 ± 6 years. The most common presenting symptom was vaginal bleeding, occurring in twelve patients (86%. Diagnosis was made through Fractional dilatation and curettage in four patients (28.5%. Eight patients had a total abdominal hysterectomy and salpingo-ophorectomy (57%. Radiotherapy as adjuvant therapy was administered to four patients (28.5%. The median follow-up time was 45.6 months (range 24–84. The median overall survival of the 14 patients was 45.35 ± 21 months (range 20–83. Three of 14 patients demonstrated a recurrence of disease at 9, 72, and 96 months respectively. The recurrent diseases were treated with surgery, chemotherapy, and radiotherapy. No patient died of the disease. Clinico-pathological parameters did not significantly differ between patients with and without recurrence, but patients with no myometrial invasion and low mitotic count Conclusion Five-year survival rate was 93%. Survival probabilities were calculated by the product limit method of Kaplan and Meier that showed, patients with no myometrial invasion and low mitotic count

Shariat Mamak

2006-08-01

132

Coffee and Endometrial Cancer Risk  

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Full Text Available ... the lower right-hand corner of the player. Coffee and Endometrial Cancer Risk HealthDay February 6, 2015 ... Pages Diets Uterine Cancer Women's Health Transcript Drinking coffee may help reduce the risk of the most ...

133

Coffee and Endometrial Cancer Risk  

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Full Text Available ... hand corner of the player. Coffee and Endometrial Cancer Risk HealthDay February 6, 2015 Related MedlinePlus Pages Diets Uterine Cancer Women's Health Transcript Drinking coffee may help reduce ...

134

Transcriptional profile of endometrial TLR4 and 5 genes during the estrous cycle and uterine infection in the buffalo (Bubalus bubalis).  

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Endometritis is one of the leading causes of infertility in the cattle and buffalo and innate immune mechanism plays an important role in clearing the infection. In this regard, endometrial expression and function of Toll Like Receptors (TLR) are focus of investigation in the recent years. In this study, we report the transcriptional profiles of TLR4 and 5 in the buffalo endometrium during the follicular, early, mid and late luteal phases of estrous cycle and 'subclinical and clinical endometritis' and also at true anestrus (n?=?10 for each stage) using RT-PCR and qRT-PCR as they are the ligands for the lipopolysaccharide and flagellin components of E.coli, the most common cause of postpartum endometritis. We found a significant positive correlation between TLR4 and 5 in all the groups (r?=?0.696-0.803; P??0.05). Chi-square analysis showed that the qualitative expression of endometrial TLR4 and 5 transcripts was significantly associated with the phase of estrous cycle and also with uterine infection (P?

Ajevar, Ganesan; Muthu, Sankar; Sarkar, Mihir; Kumar, Harendra; Das, Goutam Kumar; Krishnaswamy, Narayanan

2014-06-01

135

Ulipristal Acetate for Symptomatic Uterine Fibroids and Myoma-Related Hypermenorrhea Joint Statement by the German Society for Gynecological Endocrinology and Reproductive Medicine (DGGEF) and the German Professional Association of Gynecologists (BVF)  

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Approximately 24 million European and more than 20 million North American women between the ages of 35 and 55 are suffering from uterine fibroids, i.e. 40% of all women in this age group are affected. The symptoms are excessive uterine bleeding, anaemia, pain and infertility. Many women find their quality of life severely compromised, and this leads to hysterectomy in many cases. So far there has been no effective and well-tolerated drug. The only approved drugs for the treatment of symptomat...

Rabe T; Hj, Ahrendt; Albring C; Bitzer J; Bouchard P; Cirkel U; Egarter C; König K; Harlfinger W; Matzko M; Ao, Mueck; Römer T; Schollmeyer T (?); Sinn P; Strowitzki T.

2013-01-01

136

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

137

Ulipristal Acetate for Symptomatic Uterine Fibroids and Myoma-Related Hypermenorrhea Joint Statement by the German Society for Gynecological Endocrinology and Reproductive Medicine (DGGEF and the German Professional Association of Gynecologists (BVF  

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Full Text Available Approximately 24 million European and more than 20 million North American women between the ages of 35 and 55 are suffering from uterine fibroids, i.e. 40% of all women in this age group are affected. The symptoms are excessive uterine bleeding, anaemia, pain and infertility. Many women find their quality of life severely compromised, and this leads to hysterectomy in many cases. So far there has been no effective and well-tolerated drug. The only approved drugs for the treatment of symptomatic uterine fibroids are GnRH agonists, but their use is relatively limited because of severe side effects due to the resulting low levels of estrogen causing hot flushes, depression, mood swings, loss of libido, vaginitis and loss of bone mineral density. As fibroid growth is dependent on progesterone, progesterone receptor modulators have proven effective in pilot studies. Two randomised double-blind studies have shown the effectiveness of the progesterone receptor modulator ulipristal acetate in the preoperative treatment of leiomyomas and the control of concomitant menorrhagia. No significant side effects have occurred under a dosage of 5 and 10 mg UPA over 3 months. A cessation of menorrhagia was observed after only 7 days, and a volume reduction of the uterine fibroids by 40% was achieved within 3 months and seemed to persist even 6 months after discontinuing the drug. A preparation with a dosage of 5 mg ulipristal acetate is available as Esmya® from the spring of 2012 for the preoperative treatment of leiomyomas.

Rabe T

2013-01-01

138

Rare peritoneal tumour presenting as uterine fibroid  

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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

139

Treatment of uterine leiomyoma with magnetic resonance-guided focused ultrasound surgery (MRgFUS)  

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Uterine leiomyoma is the most common pelvic tumor in women. Although hysterectomy has long been the standard treatment for uterine myoma, some uterus-preserving alternatives are available today. Among these, magnetic resonance-guided focused ultrasound surgery (MRgFUS) is a minimally-invasive procedure that uses high intensity ultrasound waves to ablate tissue. The present study investigates the efficacy of MRgFUS in the treatment of uterine myoma and the histopathological features on extirpated myoma tissue, when alternative surgical treatment is requisite. The Ethics Committee of Shinsuma Hospital approved the treatment of uterine myoma by MRgFUS, and written informed consent was obtained from all of the patients in compliance with the principles of good clinical practice. Between June 2004 and March 2007, 81 premenopausal patients with 125 myomas confirmed by T2-weighted MRI were treated by MRgFUS. The myomas were classified into 3 types based on signal intensity of T2-weighted images type I, low intensity; type II, intermediate intensity and type III, high intensity. The ablation (the non-perfused ratio of gadolinium injection) was about 55% in type I and type II, and 38% in type III. There was no correlation between the ablation ratio and the location or the size of the myoma. The uterine muscle was spared ablation when 2 combined myomas were treated as one tumor, suggesting that the vascularity was richer in the uterine muscle layer than in the myoma Sufficient muscle layer than in the myoma Sufficient ablation of the myoma near the Os sacrum is not able to attain immediately after the treatment; however, in several cases a complete non-perfusion margin was observed 3 or 6 months after the treatment. These cases yield very satisfactory results and it is meaningful to search for the reason why such good results were induced. Alternative treatment such as hysterectomy, myomectomy, trans cervical resection (TCR) or uterine artery embolization (UAE) was indicated for 13.6% of the patients. Here, we demonstrate a case of leiomyosarcoma disclosed after MRgFUS and display T2-weighted schemas of myoma and leiomyosarcoma before and 6 months after treatment, attesting to the essentiality of follow-up after the procedure. MRgFUS was of little effect in cases of cellular leiomyoma in which regrowth of leiomyoma cells was observed at the periphery of the myoma. Necl-2 and COX-2 were positive in cellular leiomyoma tissue, as are myogenic stem cells in skeletal muscle. Moreover, numerous mast cells and abundant vascularity was found in cellular leiomyomas. These results suggest that cellular leiomyoma and myoma with hypervascularity or degenerative changes are resistant to MRgFUS treatment. (author)

140

The role of myoma in women infertility  

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Full Text Available The aim was to examine which is the role of myoma in women infertility. We analyzed 100 patients with infertility that underwent classic abdominal myomesctomy from 2000. to 2003. year. Frequency of conception was 46%. Most patients were over 30 years old. Conception happened in 80% patients aged 30-39 years. In 69,6% patients with secondary infertility happened conception. Pregnancies occurred more often in infertility shorter than 36 months, in front wall myoma and in intramural-subserose or subserose type. In 11 patients with intramural-submucose myomas, uteral cave was opened and only two of them got pregnant. Recidives of myoma happened in 18%, and postoperative adhesions in 29% of patients. Age, duration of pre-operative infertility and characteristics of myoma did not have statistically significant influence on the conception. Miomectomy is the important method in treatment of infertility, especially if the other possible causes were excluded.

Marinkovi? D.

2008-01-01

 
 
 
 
141

Saline infusion sonohysterography - an effective tool for evaluation of the endometrial cavity in women with abnormal uterine bleeding.  

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We evaluated the diagnostic accuracy of saline infusion sonohysterography (SISH) over transvaginal sonography (TVS) for the detection of intrauterine abnormalities using hysteroscopy as the gold standard in a retrospective study of 70 women mostly presenting with abnormal uterine bleeding. TVS was normal in 32 women, while in the others polyps or fibroids projecting into the cavity (n = 19) or a thick endometrium (n = 19) were suspected. On performing SISH the uterine cavity was found to be normal in 29 women, while 35 had suspected polyps/fibroids and 6 had other abnormalities. Hysteroscopy proved to be normal in 28 women, 35 had polyps/fibroids and 7 had other abnormalities. The sensitivity, specificity, positive and negative predictive values for TVS were 72.4%, 100%, 100% and 74%, respectively, while for SISH the corresponding figures were 91.4%, 92.6%, 89.3% and 94.1%. SISH is a simple, minimally invasive and cost-effective investigative tool enhancing the diagnostic accuracy of TVS and can be an effective screening test prior to hysteroscopy. PMID:19832547

Mathew, Mariam; Gowri, Vaidyanathan; Rizvi, Syed Gauhar

2010-01-01

142

Enzymes of the AKR1B and AKR1C subfamilies and uterine diseases  

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Full Text Available Endometrial and cervical cancers, uterine myoma, and endometriosis are very common uterine diseases. Worldwide, more than 800,000 women are affected annually by gynecological cancers, as a result of which, more than 360,000 die. During their reproductive age, about 70% of women develop uterine myomas, 10% to 15% suffer from endometriosis, and 35% to 50% from infertility associated with endometriosis. Uterine diseases are associated with aberrant inflammatory responses and concomitant increased production of prostaglandins (PG. They are also related to decreased differentiation, due to low levels of protective progesterone and retinoic acid, and to enhanced proliferation, due to high local concentrations of estrogens. The pathogenesis of these diseases can thus be attributed to disturbed PG, estrogen and retinoid metabolism and actions. Five human members of the aldo-keto reductase 1B (AKR1B and 1C (AKR1C superfamilies, i.e., AKR1B1, AKR1B10, AKR1C1, AKR1C2 and AKR1C3, have roles in these processes and can thus be implicated in uterine diseases. AKR1B1 and AKR1C3 catalyze the formation of PGF2alpha which stimulates cell proliferation. AKR1C3 converts PGD2 to 9alpha,11beta-PGF2, and thus counteracts the formation of 15deoxy-PGJ2, which can activate pro-apoptotic peroxisome-proliferator-activated receptor beta. AKR1B10 catalyzes the reduction of retinal to retinol, and in thus lessens the formation of retinoic acid, with potential pro-differentiating actions. The AKR1C1-AKR1C3 enzymes also act as 17-keto- and 20-ketosteroid reductases to varying extents, and are implicated in increased estradiol and decreased progesterone levels. This review comprises a short introduction to uterine diseases, followed by an overview of the current literature on the AKR1B and AKR1C expression in the uterus and in uterine diseases. The potential implications of the AKR1B and AKR1C enzymes and their pathophysiologies are then discussed, followed by conclusions and future perspectives.

TeaLanisnik Rizner

2012-03-01

143

Primary uterine lymphoma: a case report  

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Primary lymphoma of the uterus is a rare disease, the reported characteristic MR imaging findings being homogeneous intermediate signal intensity of the indistinct mass on T1-and T2-weighted images, and the preservation of endometrial lining and uterine architecture. We report a case of primary uterine lymphoma which showed tumoral necrosis, endometrial disruption and diffuse anterior vaginal wall involvement. (author)

144

Primary uterine lymphoma: a case report  

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Primary lymphoma of the uterus is a rare disease, the reported characteristic MR imaging findings being homogeneous intermediate signal intensity of the indistinct mass on T1-and T2-weighted images, and the preservation of endometrial lining and uterine architecture. We report a case of primary uterine lymphoma which showed tumoral necrosis, endometrial disruption and diffuse anterior vaginal wall involvement. (author)

Cheong, In Joo; Kim, Se Hyun; Park, Cheol Min [Korea University Guro Hospital, Guro (Korea, Republic of)

2000-12-01

145

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

146

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

International Nuclear Information System (INIS)

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

147

Abnormal uterine bleeding. Diagnostic value of hysteroscopy.  

Directory of Open Access Journals (Sweden)

Hysteroscopy was more sensitive than curettage in detecting endometrial polyps and submucous fibroids, but less sensitive than curettage in detecting endometrial hyperplasia and endometrial carcinoma. Hysteroscopy should be carried out in conjunction with curettage for evaluating women with abnormal uterine bleeding. Office hysteroscopy with directed biopsies could be carried out, to reduce hospital diagnostic dilatation and curettage.

S. M. Madan

2001-02-01

148

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 m...

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

2014-01-01

149

Ulipristal acetate in the management of symptomatic uterine fibroids: facts and pending issues.  

Science.gov (United States)

Various treatment options have been proposed for the management of human symptomatic uterine fibroids (or myomas). Despite this, the most popular one is surgery (myomectomy or hysterectomy). Ulipristal acetate (UA) is a selective progesterone receptor modulator. In women programmed for surgical treatment for uterine fibroids, oral UA treatment (5 or 10 mg/day) controls symptoms, reduces tumor size and improves quality of life as compared to placebo and is not inferior to monthly intramuscular injection of leuprolide acetate for 3 months. Women treated with up to 4 courses of UA (10 mg/day for 3 months) followed or not by norethisterone acetate (10 mg/day for 10 days or placebo) reported a high rate of bleeding control, and improved quality of life, pain anxiety and depression. Median fibroid volume after successive courses of UA treatment ranged from -63% to -72% as compared to baseline value. Endometrium showed benign histological changes without hyperplasia, while adverse events were mild or moderate throughout the several courses of treatment. There is a need for global cost assessment of UA treatment for uterine fibroids, including those women that do not reach their expected outcome and need other complementary explorations or treatments. Studies are needed in non-Caucasian women, in infertile patients and in cases of fibroids associated with adenomyosis. Furthermore, assessment of long-term UA treatment should include endometrial, cardiocirculatory and neurological endpoints. PMID:25390187

Pérez-López, F R

2014-11-12

150

Embryo-Endometrial Interaction  

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Full Text Available Embryonic implantation, the process by which the human embryo orientates towards,attaches to and finally invades the underlying maternal endometrial tissue, requires a receptiveendometrium, a functionally normal blastocyst and an adequate cross-communicationbetween them. During apposition, human blastocysts find a location in which to implant,while they are guided to a specific area in the maternal endometrium. In the adhesion phase,which occurs 6 to 7 days after ovulation, within the so-called “implantation window”, directcontact occurs between the endometrial epithelium (EE and the trophectoderm (TE.Finally, in the invasion phase, the embryonic trophoblast traverses the basement membraneand passes the endometrial stroma and reaches the uterine vessels. Many molecules (hormones,cytokines, integrins, enzymes, etc take part in the dialogue between the human blastocystand the maternal endometrium to achieve implantation. Here, we present our publisheddata on the embryonic regulation of endometrial epithelial molecules such aschemokine receptors and the leptin system.

Carlos Simón Valles

2006-02-01

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Sensibilidade e especificidade da histerossonografia nas afecções endometriais em mulheres assintomáticas pós-menopausa / Sensitivity and specificity of hysterosonography in endometrial abnormalities in asymptomatic postmenopausal women  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVOS: 1) Estimar sensibilidade e especificidade da histerossonografia nas afecções endometriais, utilizando-se como padrão-ouro a histeroscopia diagnóstica; 2) comparar concordância entre a ultra-sonografia, a histerossonografia e a histeroscopia através do índice de Kappa (K). MÉTODOS: Foram e [...] studadas 50 mulheres assintomáticas após menopausa, todas tinham suspeita de afecções endometriais pela ultra-sonografia transvaginal e, por isso, complementaram avaliação endometrial com a histerossonografia, a histeroscopia diagnóstica e a biópsia orientada. Para comparação dos resultados entre esses exames utilizou-se índice de Kappa. RESULTADOS: Afecções endometriais mais freqüentes: pólipos (58%), sinéquias (20%), mioma submucoso (12%) e espessamento endometrial (6%). Cavidade normal (4%) dos exames histeroscópicos. A sensibilidade da histerossonografia para diagnóstico de pólipo foi de 89,7%; a especificidade de 81% e o (K) de 71,1%. Para sinéquia a sensibilidade foi de 80%, a especificidade 100% e o (K) de 86,5%; para mioma submucoso: a sensibilidade foi de 83,3%; a especificidade de 97,7% e o (K) de 81,1% e para espessamento endometrial a sensibilidade foi de 33,3%, a especificidade de 89,4% e o (K) de15,5%. CONCLUSÕES: A histerossonografia apresentou ótima concordância com a histeroscopia para sinéquias e miomas submucosos; boa concordância para pólipo e péssima concordância para espessamentos endometriais. Revelou-se, também, tratar-se de método simples, eficiente e que pode ser utilizado para a avaliação da cavidade uterina em mulheres após menopausa. Abstract in english BACKGROUND: To estimate sensitivity and specificity of hysterosonography for diagnosis of endometrial cavity abnormalities. The gold-standard was hysteroscopy; to compare the agreement between ultrasonographic, hysterosonographic and hysteroscopic findings using the KIA (Kappa Index Agreement). METH [...] ODS: Fifty asymptomatic postmenopausal women that had a suspicion of endometrial abnormalities based upon transvaginal ultrasonography were studied. Hysterosonography, diagnostic hysteroscopy and oriented biopsy were performed and the Kia was used to compare results. RESULTS: The most frequent abnormalities were polyps (58%), synechiae (20%), submucous myoma (12%) and endometrial thickening (6%). The uterine cavity was considered normal in 4% of the evaluations by hysteroscopy. The sensitivity of hysterosonography to diagnose polyps was of 89.7%, the specificity of 81.0% and the KIA of 71.1%. For synechia sensitivity of hysterosonography was of 80%, specificity of 100% and the KIA of 86.5%; for submucous myoma sensitivity was of 83.3%; specificity of 97.7% and the KIA of 81.1%, and for endometrial thickening, sensitivity was of 33.3%, specificity of 89.4% and the KIA of 15.5%. CONCLUSION: Hysterosonography showed very good agreement with hysteroscopy for the diagnosis of synechiae and submucous myomas; good agreement for polyps and poor agreement for endometrial thickening. Based upon this data hysterosonography may be deemed a simple, efficient, and accurate method for the evaluation of the uterine cavity in the postmenopausal period.

Sonia, Tamanaha; José Mendes, Aldrighi; Roberto Euzébio dos, Santos; Roberto Adelino Almeida, Prado.

2004-12-01

152

Sensibilidade e especificidade da histerossonografia nas afecções endometriais em mulheres assintomáticas pós-menopausa Sensitivity and specificity of hysterosonography in endometrial abnormalities in asymptomatic postmenopausal women  

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Full Text Available OBJETIVOS: 1 Estimar sensibilidade e especificidade da histerossonografia nas afecções endometriais, utilizando-se como padrão-ouro a histeroscopia diagnóstica; 2 comparar concordância entre a ultra-sonografia, a histerossonografia e a histeroscopia através do índice de Kappa (K. MÉTODOS: Foram estudadas 50 mulheres assintomáticas após menopausa, todas tinham suspeita de afecções endometriais pela ultra-sonografia transvaginal e, por isso, complementaram avaliação endometrial com a histerossonografia, a histeroscopia diagnóstica e a biópsia orientada. Para comparação dos resultados entre esses exames utilizou-se índice de Kappa. RESULTADOS: Afecções endometriais mais freqüentes: pólipos (58%, sinéquias (20%, mioma submucoso (12% e espessamento endometrial (6%. Cavidade normal (4% dos exames histeroscópicos. A sensibilidade da histerossonografia para diagnóstico de pólipo foi de 89,7%; a especificidade de 81% e o (K de 71,1%. Para sinéquia a sensibilidade foi de 80%, a especificidade 100% e o (K de 86,5%; para mioma submucoso: a sensibilidade foi de 83,3%; a especificidade de 97,7% e o (K de 81,1% e para espessamento endometrial a sensibilidade foi de 33,3%, a especificidade de 89,4% e o (K de15,5%. CONCLUSÕES: A histerossonografia apresentou ótima concordância com a histeroscopia para sinéquias e miomas submucosos; boa concordância para pólipo e péssima concordância para espessamentos endometriais. Revelou-se, também, tratar-se de método simples, eficiente e que pode ser utilizado para a avaliação da cavidade uterina em mulheres após menopausa.BACKGROUND: To estimate sensitivity and specificity of hysterosonography for diagnosis of endometrial cavity abnormalities. The gold-standard was hysteroscopy; to compare the agreement between ultrasonographic, hysterosonographic and hysteroscopic findings using the KIA (Kappa Index Agreement. METHODS: Fifty asymptomatic postmenopausal women that had a suspicion of endometrial abnormalities based upon transvaginal ultrasonography were studied. Hysterosonography, diagnostic hysteroscopy and oriented biopsy were performed and the Kia was used to compare results. RESULTS: The most frequent abnormalities were polyps (58%, synechiae (20%, submucous myoma (12% and endometrial thickening (6%. The uterine cavity was considered normal in 4% of the evaluations by hysteroscopy. The sensitivity of hysterosonography to diagnose polyps was of 89.7%, the specificity of 81.0% and the KIA of 71.1%. For synechia sensitivity of hysterosonography was of 80%, specificity of 100% and the KIA of 86.5%; for submucous myoma sensitivity was of 83.3%; specificity of 97.7% and the KIA of 81.1%, and for endometrial thickening, sensitivity was of 33.3%, specificity of 89.4% and the KIA of 15.5%. CONCLUSION: Hysterosonography showed very good agreement with hysteroscopy for the diagnosis of synechiae and submucous myomas; good agreement for polyps and poor agreement for endometrial thickening. Based upon this data hysterosonography may be deemed a simple, efficient, and accurate method for the evaluation of the uterine cavity in the postmenopausal period.

Sonia Tamanaha

2004-12-01

153

Endometrial carcinoma  

International Nuclear Information System (INIS)

Magnetic resonance imaging (MRI) is the method of choice in staging endometrial cancer. Using MRI early tumor invasion (stage IA) can be differentiated from a deep tumor growth (stage IB) of the myometrium with reported sensitivities of 85-95%.Tumor invasion of the uterine cervix can be depicted with a sensitivity of 80% and specificity of 96%. In demonstrating lymph node metastases MRI shows a sensitivity of 50%, a specificity of 95% and and accuracy of 90%. These diagnostic criteria are decisive for the choice of therapy procedures. So a simple hysterectomy will be performed in early stage IA disease while an extended surgical procedure with pelvic lymphadenectomy and radiotherapy will be considered in advanced stages IB and II disease. Vaginal ultrasound shows lower values in tumor staging with accuracies of 73-95%. Staging accuracies of computed tomography also show lower results with 61-76%. For planning radiotherapy and detection of cancer recurrence MRI is the most valuable tool. (orig.)

154

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

155

Endometrial ossification in a postmenopausal woman.  

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A case of endometrial ossification in a 62 year old woman is reported. The patient presented with increased vaginal discharge. On transvaginal ultrasonography, a hyperechoic area within the uterine cavity, suggestive of an intrauterine foreign body, was noted. Histological examination of the endometrial curettage showed mature bone with neutrophilic infiltration. There was no evidence of malignancy. Endometrial ossification in postmenopausal women is very rare; most women presenting with this...

Shimizu, M.; Nakayama, M.

1997-01-01

156

Endometrial metastasis of colorectal cancer with coincident endometrial adenocarcinoma  

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Metastasis to the uterine corpus is uncommon and secondary colorectal tumours of the endometrium are rare. We describe a uterine tumour with components of both primary endometrial and metastatic colorectal carcinomata. In this case, a 72-year-old obese woman presented with a 2-week history of postmenopausal bleeding per vaginum and weight loss. She had an abdominoperineal resection 3 years previously for a Dukes stage B rectal carcinoma. A transvaginal ultrasonography showed a thickened endom...

Colling, Richard; Lopes, Tito; Das, Nagiindra; Mathew, Joe

2010-01-01

157

Miomatosis uterina e infertilidad: ¿qué evidencias tenemos como causa y como tratamiento? / Uterine fibroids and infertility: what evidence do we have regarding cause and treatment?  

Scientific Electronic Library Online (English)

Full Text Available SciELO Colombia | Language: Spanish Abstract in spanish Objetivos: revisar las evidencias actuales que determinen el impacto de la miomatosis uterina en la infertilidad, así como la seguridad y la eficacia de las diferentes formas de tratamiento quirúrgico conservador. Metodología: revisión sistemática cualitativa, consultando las fuentes de datos de Coc [...] hrane (Menstrual Disorders and subfertility), Medline (PubMed -MeSH), y de OVID (EBM); desde 1995 a 2008. Resultados: muchos estudios observacionales han sugerido que los miomas causantes de infertilidad son todos los submucosos, los intramurales mayores de 5 cm que alteren la cavidad uterina y también los subserosos cuya cantidad y tamaño distorsionen la fisiología reproductiva. Pero no hay estudios aleatorizados controlados (RCTs) que soporten estas afirmaciones. En la actualidad, las miomectomías constituyen la mejor forma de tratamiento para pacientes infértiles. Por histeroscopia se deben resecar miomas submucosos menores de 5 cm, tipos 0 y I; por laparoscopia miomas intramurales o subserosos menores de 10 cm y no más de 5 miomas; finalmente, por laparotomía es posible resecar todo tipo de miomas, independientemente de su localización, tamaño y número. No hay RCTs que comparen la histeroscopia con otras técnicas de miomectomías; pero sí los hay mostrando que las indicaciones para laparotomía y laparoscopia son igualmente efectivas en resultados reproductivos. Conclusión: hay evidencias limitadas soportando la miomatosis como causante de infertilidad, y las miomectomías por histeroscopia respecto a otros tratamientos conservadores. Sin embargo, hay RCTs que muestran iguales resultados reproductivos al realizar miomatomías intramurales o subserosas por laparoscopia y por laparotomía en pacientes seleccionadas. Abstract in english Objectives: reviewing the evidence to determine the impact of fibroids on infertility and different types of conservative surgical treatment’s efficacy and safety. Methodology: the Cochrane Menstrual Disorders and Sub-fertility Review Group specialized register of controlled trials, MEDLINE (PUBMED- [...] MeSH), and OVID (EBM) were searched from 1995 to 2008 for carrying out a qualitative systematic review. Main results: many observational, retrospective studies have suggested that all infertility-producing myomas are submucosal, intramural myomas bigger than 5 cm thereby altering the endometrial cavity and subserosal myomas whose size distorts reproductive physiology; however, no randomised controlled trials (RCT) were found to support such affirmations. Submucosal myomas must be removed by hysteroscopy (with the exception of myomas bigger than 5 cm or type II); however, no RCTs were found comparing hysteroscopic treatment with other types of treatment. Intramural and subserosal myomas must be removed by laparoscopy or laparotomy (depending on their localisation and size) supported by RCTs showing that there are no outcome differences in terms of reproductive results. Conclusions: there is limited evidence for suggesting the impact of uterine myomas on infertility and the removal of submucosal myomas by hysteroscopy. Some RCTs show no differences in fertility efficacy outcome if intramural or subserosal myomas are removed via laparotomy or laparoscopy.

Luis Ernesto, Pérez; Ivonne, Díaz; Luis, Ospina.

2008-12-01

158

Abnormal uterine bleeding.  

Science.gov (United States)

Abnormal uterine bleeding is a common presenting symptom in the family practice setting. In women of childbearing age, a methodical history, physical examination, and laboratory evaluation may enable the physician to rule out causes such as pregnancy and pregnancy-related disorders, medications, iatrogenic causes, systemic conditions, and obvious genital tract pathology. Dysfunctional uterine bleeding (anovulatory or ovulatory) is diagnosed by exclusion of these causes. In women of childbearing age who are at high risk for endometrial cancer, the initial evaluation includes endometrial biopsy; saline-infusion sonohysterography or diagnostic hysteroscopy is performed if initial studies are inconclusive or the bleeding continues. Women of childbearing age who are at low risk for endometrial cancer may be assessed initially by transvaginal ultrasonography. Postmenopausal women with abnormal uterine bleeding should be offered dilatation and curettage; if they are poor candidates for general anesthesia or decline dilatation and curettage, they may be offered transvaginal ultrasonography or saline-infusion sonohysterography with directed endometrial biopsy. Medical management of anovulatory dysfunctional uterine bleeding may include oral contraceptive pills or cyclic progestins. Menorrhagia is managed most effectively with nonsteroidal anti-inflammatory drugs or the levonorgestrel intrauterine contraceptive device. Surgical management may include hysterectomy or less invasive, uterus-sparing procedures. PMID:15117012

Albers, Janet R; Hull, Sharon K; Wesley, Robert M

2004-04-15

159

Tamoxifen induced endometrial abnormalities: evaluation by saline infusion sonohysterography.  

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Patients receiving tamoxifen therapy for breast cancer are at an increased risk for endometrial hyperplasia, polyps, and adenocarcinoma. Therefore, any bleeding in the post-menopausal patient on tamoxifen warrants further investigation. Sonohysterography is a new technique for evaluating the uterine cavity and clarifying the location of endometrial and peri-endometrial processes. Differentiating subendometrial cyst formation from endometrial proliferation can save patients from further, invasive investigative diagnostic procedures. PMID:9294952

Jaeger, B M; Grumbach, K

1997-09-01

160

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

 
 
 
 
161

Role of emmprin in endometrial cancer  

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Full Text Available Abstract Background Extracellular matrix metalloproteinase inducer (Emmprin/CD147 is a transmembrane glycoprotein that belongs to the immunoglobulin superfamily. Enriched on the surface of many tumor cells, emmprin promotes tumor growth, invasion, metastasis and angiogenesis. We evaluated the clinical importance of emmprin and investigated its role in endometrial cancer. Methods Emmprin expression was examined in uterine normal endometrium, endometrial hyperplasia and cancer specimens by immunohistochemistry. In addition, the biological functions and inhibitory effects of an emmprin knockdown were investigated in HEC-50B and KLE endometrial cancer cell lines. Results The levels of emmprin expression were significantly increased in the endometrial cancer specimens compared with the normal endometrium and endometrial hyperplasia specimens (p?p?p? Conclusions The present findings suggest that low emmprin expression might be a predictor of favorable prognosis in endometrial cancer patients, and that emmprin may represent a potential therapeutic target for endometrial cancer.

Nakamura Keiichiro

2012-05-01

162

Usefulness of Sonohysterography in the Differentiation of Endometrial and EndometriaI Cavity Abnormalities :Comparison with TransvaginaI Sonography  

International Nuclear Information System (INIS)

The purpose of this study was to evaluate the diagnostic accuracy and usefulness odsonohysterography(SH) in the diagnosis of endometrial and endometrial cavity abnormalities. 51 patients with suspected endometrial abnormalities were examined with both transvaginal sonography(TVS) and SH. The results of both techniques were correlated with pathologic findings obtained by surgical procedures and the accuracies of the techniques were compared. Of 55 histologically proven lesions, there were endometrialhyperplasia(n=4), endometrial polyp(n=30), endometrial polyp with hyperplasia(n=2), placental polyp(n=3), submucosal myoma(n=10) and synechia(n=6). The diagnostic accuracy in differentiation of endometrial and endometrial cavity abnormalities was increased from 79% in conventional TVS to 95% in SH(p<0.001). SH was a simple and well-tolerated technique to perform, favorably depicting the endometrial and endometrial cavity abnormalities that were equivocal on TVS

163

Transcriptional response of the bovine endometrium and embryo to endometrial polymorphonuclear neutrophil infiltration as an indicator of subclinical inflammation of the uterine environment.  

Science.gov (United States)

The aim of the present study was to analyse the effect of subclinical endometritis on endometrial and embryonic gene expression. A total of 49 cows at either Day 0 or Day 7 of the oestrous cycle (62-83 days post partum) following superovulation were classified as having subclinical endometritis (SE-0, SE-7) or a healthy endometrium (HE-0, HE-7) on the basis of endometrial cytological evaluation. Endometrial samples and associated embryos were subjected to global transcriptome analysis using the Bovine GeneChip (Affymetrix, Santa Clara, CA, USA) and aberrant transcript profiles were observed in SE-0 and SE-7 cows. At Day 0, 10 transcripts were found to be differentially expressed in endometrial samples. Specifically, the PDZK1, PXDN, DDHD2, GPLD1 and SULT1B1 genes were downregulated, whereas the PKIB, LOC534256, BT29392, LYZ and S100A14 genes were upregulated in SE-0 cows. Similarly, 11 transcripts were found to be differentially regulated on Day 7. Of these, GNPTG, BOLA-DQA5, CHD2, LOC541226, VCAM1 and ARHGEF2 were found to be downregulated, whereas PSTPIP2, BT236441 and MGC166084 were upregulated in SE-7 cows. Accordingly, endometrial health status affected the number of flushed, transferable embryos. In all, 20 genes were differentially regulated in blastocysts derived from HE-7 and SE-7 cows. Of these, GZMK, TCEAL4, MYL7, ADD3 and THEM50B were upregulated, whereas NUDCD2, MYO1E, BZW1, EHD4 and GZMB were downregulated. In conclusion, endometrial polymorphonuclear neutrophil infiltration as an indicator of subclinical endometritis is associated with changes in endometrial gene expression patterns, including genes involved in cell adhesion and immune modulation. Consequently, subclinical endometritis affects gene expression in embryos, including the expression of genes related to membrane stability, the cell cycle and apoptosis. PMID:22781929

Hoelker, Michael; Salilew-Wondim, Dessie; Drillich, Marc; Christine, Grosse-Brinkhaus; Ghanem, Nasser; Goetze, Leopold; Tesfaye, Dawit; Schellander, Karl; Heuwieser, Wolfgang

2012-01-01

164

Gastric leiomyoma and hyperplastic polyposis coli in a patient with multiple cutaneous and uterine leiomyomatosis  

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BACKGROUND: Cutaneous leiomyomatosis has been associated with multiple uterine myomas and, more recently, with germline heterozygous mutations of the FH gene and certain types of renal cancer. Despite the growing amount of knowledge concerning this genodermatosis, its clinical spectrum remains incompletely characterized. OBJECTIVE: We report the observation of a patient with multiple cutaneous and uterine leiomyomatosis (MCUL) with unusual gastrointestinal manifestations. METHODS ...

Serra, D.; Amaro, P.; Gonc?alo, Margarida; Silva, M.; Ferrando, B.; Figueiredo, A.

2012-01-01

165

Sarcoma del estroma endometrial de grado alto / High degree endometrial stromal sarcoma  

Scientific Electronic Library Online (English)

Full Text Available SciELO Cuba | Language: Spanish Abstract in spanish El sarcoma del estroma endometrial es un tumor infrecuente, que comprende menos del 1 % de los tumores malignos ginecológicos. Presentamos el caso de una adolescente de 16 años con hemorragia uterina anormal a la que se le realizó histerectomía subtotal. Microscópicamente, la neoplasia estaba consti [...] tuida por una proliferación maligna de células estromales del endometrio. El estudio inmuno-histoquímico mostró positividad para vimentina, desmina, CD10, CD117. El CD10 es un marcador inmuno-histoquímico del estroma endometrial normal y de los tumores del estroma endometrial, y es útil para el diagnóstico diferencial entre el sarcoma del estroma endometrial y el leiomioma celular o el leiomiosarcoma uterino. Las mejores opciones de tratamiento se obtienen con un enfoque multidisciplinario y en centros especializados. Abstract in english Endometrial stromal sarcoma is a rare tumor comprising less than 1 % of gynecological malignancies. We report the case of a 16 year-old adolescent with abnormal uterine bleeding who underwent hysterectomy subtotal. At microscopy the neoplasm was composed of malignant proliferation of endometrial str [...] omal cells. Immunohistochemical studies were positive for vimentin, desmin, CD10 and CD117. CD10 is an immunohistochemical marker of normal endometrial stroma and of endometrial stromal neoplasms. This marker is useful in the differential diagnosis of endometrial stromal sarcoma versus uterine cellular leiomyoma or uterine leiomyosarcoma. The best treatment options are obtained with a focus multidisciplinary, in specialized centers.

Mariuska, Forteza Sáez; Maylin América, Ramos Alfonso; Migdalia, Pérez Trejo; Dulvis Amanda, Almeida Arias; Danay, Corrales Otero.

2014-09-01

166

Water Intoxication during Transcervical Electrosurgical Resection of Uterine Myoma  

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Full Text Available Submucous leiomyomas, the most common benign tumors of the female genital tract, affect 20%to 30% of all women of reproductive age. Transcervical electrosurgical resection (TCR is usuallyperformed for patients with chronic menorrhagia caused by submucous leiomyomas. We report a caseof severe intraoperative hyponatremia resulting from water intoxication during TCR. Although waterintoxication during TCR is not common due to its short surgical duration, anesthesiologists shouldstill be alert to the manifestation of intraoperative water intoxication and surgeons should also keep inmind the possibility of water intoxication during extended surgical procedures. With appropriate proceduresin place, more complications will be avoided.

Chih-Chung Tsai

2006-08-01

167

Achados histeroscópicos em mulheres na pós-menopausa com diagnóstico de espessamento endometrial por ultra-sonografia transvaginal / Hysteroscopic findings in postmenopausal women with endometrial thickening diagnosed by transvaginal ultrasound  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: correlacionar espessamento endometrial diagnosticado por ultra-sonografia com os achados histeroscópicos, em mulheres na pós-menopausa. MÉTODOS: foi realizado estudo transversal com avaliação histeroscópica em 121 mulheres na pós-menopausa, com diagnóstico de espessamento do endométrio por [...] ultra-sonografia transvaginal. Das pacientes incluídas, 23 (19%) recebiam diferentes esquemas de hormonioterapia e 98 não referiam uso de reposição hormnonal.; 55 pacientes queixavam-se de sangramento por via vaginal e as restantes apresentavam-se sem esta condição. Os exames endoscópicos foram realizados ambulatorialmente, utilizando-se histeroscópio rígido de 4 mm. Para a distensão da cavidade uterina empregou-se gás carbônico (CO2). Biópsia foi praticada em todas as pacientes, com auxílio de cureta tipo Novak, de 3 mm, e o material obtido submetido a estudo histopatológico. RESULTADOS: a espessura do endométrio variou entre 6 e 38 mm, com média de 10,7 ± 5,3 mm. Os achados histeroscópicos foram: lesão polipóide, em 51 pacientes (42,1%); endométrio atrófico, em 15 (12,4%); sinéquia senil, em 15 (12,4%); espessamento focal, em 13 (10,7%); lesão cerebróide, em 6 (5,0%); endométrio proliferativo, em 5 (4,1%); muco, em 5 (4,1%); mioma, em 4 (3,3%); endométrio secretor, em 3 (2,5%); hiperplasia endometrial, em 3 (2,5%) e atrofia cística, em 1 (0,8%). Observou-se correlação entre os achados histeroscópicos e os resultados da histopatologia em 30 dos 51 casos de pólipo, em 12 dos 15 de endométrio atrófico e na totalidade dos casos sugestivos de hiperplasia endometrial e de adenocarcinoma. CONCLUSÃO: na maioria das pacientes, o exame histeroscópico revelou que não se tratava de real espessamento endometrial, mas sim de outras variedades de lesão da cavidade uterina. Abstract in english PURPOSE: to correlate endometrial thickening diagnosed by ultrasonography with hysteroscopic findings in postmenopausal women. METHODS: a transversal study with hysteroscopic evaluation was performed in 121 postmenopausal women, with endometrial thickening diagnosed through transvaginal ultrasonogra [...] phy. In 98 women there was no history of hormonal replacement therapy, while the remaining 23 received different types of hormone; 55 patients complained of vaginal bleeding and the remaining did not present this condition. The endoscopic examinations were performed in the outpatient clinic, using a 4 mm rigid hysteroscope. For uterine cavity distention carbon dioxide (CO2) was used. Biopsy was performed in all patients, with a 3 mm Novak type curette, and the collected material was submitted to a histopathological study. RESULTS: endometrial thickening varied from 6 to 38 mm, with a mean of 10.7 ± 5.3 mm. The hysteroscopic findings were: polypoid lesion in 51 patients (42.1%); atrophic endometrium in 15 patients (12.4%); senile synechia in 15 patients (12.4%), focal thickening in 13 patients (10.7%); cerebroid lesion in 6 patients (5.0%); proliferative endometrium in 5 patients (4.1%); mucus in 5 patients (4.1%); myoma in 4 patients (3.3%); secreting endometrium in 3 patients (2.5%); endometrial hyperplasia in 3 patients (2.5%); and cystic atrophy in 1 patient (0.8%). Correlation between hysteroscopic findings and cytopathology was observed in 30 of 51 cases of polypoid lesion, in 12 of 15 cases of atrophic endometrium and in all cases in which the diagnosis of endometrial hyperplasia or adenocarcinoma was suspected. CONCLUSION: in the majority of the patients, the hysteroscopic examinations revealed that there was no genuine endometrial thickening but rather other types of lesion in the uterine cavity.

Adriana Bittencourt, Campaner; Sebastião, Piato; Paulo Ayrosa Galvão, Ribeiro; Tsutomo, Aoki; Ricardo da Fonseca, Nadais; Roberto Adelino de Almeida, Prado.

2004-02-01

168

Achados histeroscópicos em mulheres na pós-menopausa com diagnóstico de espessamento endometrial por ultra-sonografia transvaginal Hysteroscopic findings in postmenopausal women with endometrial thickening diagnosed by transvaginal ultrasound  

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Full Text Available OBJETIVO: correlacionar espessamento endometrial diagnosticado por ultra-sonografia com os achados histeroscópicos, em mulheres na pós-menopausa. MÉTODOS: foi realizado estudo transversal com avaliação histeroscópica em 121 mulheres na pós-menopausa, com diagnóstico de espessamento do endométrio por ultra-sonografia transvaginal. Das pacientes incluídas, 23 (19% recebiam diferentes esquemas de hormonioterapia e 98 não referiam uso de reposição hormnonal.; 55 pacientes queixavam-se de sangramento por via vaginal e as restantes apresentavam-se sem esta condição. Os exames endoscópicos foram realizados ambulatorialmente, utilizando-se histeroscópio rígido de 4 mm. Para a distensão da cavidade uterina empregou-se gás carbônico (CO2. Biópsia foi praticada em todas as pacientes, com auxílio de cureta tipo Novak, de 3 mm, e o material obtido submetido a estudo histopatológico. RESULTADOS: a espessura do endométrio variou entre 6 e 38 mm, com média de 10,7 ± 5,3 mm. Os achados histeroscópicos foram: lesão polipóide, em 51 pacientes (42,1%; endométrio atrófico, em 15 (12,4%; sinéquia senil, em 15 (12,4%; espessamento focal, em 13 (10,7%; lesão cerebróide, em 6 (5,0%; endométrio proliferativo, em 5 (4,1%; muco, em 5 (4,1%; mioma, em 4 (3,3%; endométrio secretor, em 3 (2,5%; hiperplasia endometrial, em 3 (2,5% e atrofia cística, em 1 (0,8%. Observou-se correlação entre os achados histeroscópicos e os resultados da histopatologia em 30 dos 51 casos de pólipo, em 12 dos 15 de endométrio atrófico e na totalidade dos casos sugestivos de hiperplasia endometrial e de adenocarcinoma. CONCLUSÃO: na maioria das pacientes, o exame histeroscópico revelou que não se tratava de real espessamento endometrial, mas sim de outras variedades de lesão da cavidade uterina.PURPOSE: to correlate endometrial thickening diagnosed by ultrasonography with hysteroscopic findings in postmenopausal women. METHODS: a transversal study with hysteroscopic evaluation was performed in 121 postmenopausal women, with endometrial thickening diagnosed through transvaginal ultrasonography. In 98 women there was no history of hormonal replacement therapy, while the remaining 23 received different types of hormone; 55 patients complained of vaginal bleeding and the remaining did not present this condition. The endoscopic examinations were performed in the outpatient clinic, using a 4 mm rigid hysteroscope. For uterine cavity distention carbon dioxide (CO2 was used. Biopsy was performed in all patients, with a 3 mm Novak type curette, and the collected material was submitted to a histopathological study. RESULTS: endometrial thickening varied from 6 to 38 mm, with a mean of 10.7 ± 5.3 mm. The hysteroscopic findings were: polypoid lesion in 51 patients (42.1%; atrophic endometrium in 15 patients (12.4%; senile synechia in 15 patients (12.4%, focal thickening in 13 patients (10.7%; cerebroid lesion in 6 patients (5.0%; proliferative endometrium in 5 patients (4.1%; mucus in 5 patients (4.1%; myoma in 4 patients (3.3%; secreting endometrium in 3 patients (2.5%; endometrial hyperplasia in 3 patients (2.5%; and cystic atrophy in 1 patient (0.8%. Correlation between hysteroscopic findings and cytopathology was observed in 30 of 51 cases of polypoid lesion, in 12 of 15 cases of atrophic endometrium and in all cases in which the diagnosis of endometrial hyperplasia or adenocarcinoma was suspected. CONCLUSION: in the majority of the patients, the hysteroscopic examinations revealed that there was no genuine endometrial thickening but rather other types of lesion in the uterine cavity.

Adriana Bittencourt Campaner

2004-02-01

169

Uterine neoplasms: MR imaging  

International Nuclear Information System (INIS)

Magnetic resonance (MR) studies were performed on 20 healthy volunteers and 41 patients with proved cervical and uterine neoplasms. MR imaging demonstrated normal uterine landmarks in all patients. On T2-weighted images, the normal uterine wall could be differentiated into three distinct layers: a central high-intensity zone, a junctional low-intensity band, and a peripheral medium-intensity area. While most of the normal cervices had only two distinct zones (central high-intensity zone and peripheral low-intensity zone), a small percentage had three layers of signal intensity, similar to the uterine body. Primary cervical and uterine neoplasms could be identified on MR images. In 18 of 22 patients with proved carcinoma, a mass with a signal intensity higher than that of normal cervical lips was seen on T2-weighted images. Endometrial carcinoma was most often identified as expansion of the central high-intensity area; discrete tumor nodules were visible in nine of 15 patients. Mixed mullerian sarcoma appeared as a large pelvic mass with complete obliteration of normal uterine landmarks. MR imaging delineates primary cervical and endometrial carcinoma better than computed tomography does

170

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

Science.gov (United States)

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

171

The value of uterine artery embolization in treatment of hysteromyoma  

International Nuclear Information System (INIS)

Objective: To investigate the value of UAE in treatment of Hysteromyoma. Methods: Select 20 cases of patients with symptomatic uterine fibroids, intubate with Uterine artery, then inject Polyvinyl alcohol particles transcatheter Embolizae Uterine artery. After the operation, observe the patient follow-up for 6-18 months, to find the situation of symptom improvement and the change of the size of uterus and myoma. Results: After the operation of UAE 2-6 months, the symptoms of the patients improve significantly or disappear. After 6-18 months, B-mode ultrasonography shows that Myoma volume narrow 30%-85%, average to narrow 60%. Uterine volume narrow 25%-70%, average to narrow 50%. No Serious complications. Conclusion: UAE is a safe and effective method to cure Hysteromyoma. It worth promoting in clinical sicience. (authors)

172

Endometrial Hyperplasia  

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... is endometrial hyperplasia? Endometrial hyperplasia occurs when the endometrium , the lining of the uterus , becomes too thick. ... to cancer of the uterus. How does the endometrium normally change throughout the menstrual cycle? The endometrium ...

173

Comparative analysis between the cytobrush and low-volume uterine flush techniques for endometrial cytology in clinically normal postpartum crossbred dairy cowsComparação das técnicas de citologia endometrial escova citológica e lavado uterino de baixo volume no pós-parto de vacas leiteiras mestiças  

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Full Text Available This study compared two frequently employed techniques for the collection of endometrial and inflammatory cells and characterized postpartum endometrial cytology (EC of clinically normal postpartum crossbred dairy cows in dairy farming system in Southwestern Brazil. Thirty-four crossbred, clinically healthy dairy cows with normal delivery and puerperium, complete uterine involution and without any treatment were monitored until 42 days in milk (DIM. All cows were evaluated by complete clinical and gynecological examinations at days 0, 7, 14, 21, 28, and 42 DIM. The gynecological examinations were done by transrectal palpation, ultrasonography, vaginoscopy, evaluation of the vaginal mucus and EC by using the cytobrush (CB and low-volume uterine flush (LVF techniques. The agreement (Kappa statistic between the two technicians was good for CB (86% and LVF (80.3% for the counting of the percentage of neutrophils. The average number of neutrophils was significantly higher throughout the experiment for LVF, but a reduced percentage of neutrophils were observed during the postpartum period for both techniques. The amount of macrophages, lymphocytes, and eosinophils were not affected during postpartum and there was no significant difference relative to these cells when the two techniques were compared. There were significant differences in the percentage of cows with subclinical endometritis only at d28 by CB (22.2% and LVF (59.3%.Objetivou-se comparar duas técnicas frequentemente usadas na colheita de células endometriais e inflamatórias e caracterizar a citologia endometrial (CE de vacas leiteiras mestiças no pós-parto fisiológico, criadas em sistemas de fazendas leiteiras do sudoeste do Brasil. Foram utilizadas 34 vacas clinicamente sadias com parto e puerpério fisiológico, completa involução uterina e sem qualquer tratamento até os 42 dias pós-parto (dpp. Realizou-se o exame clínico e ginecológico no parto e aos 7, 14, 21, 28 e 42 dpp. O exame ginecológico foi executado pela palpação retal, ultrassonografia, vaginoscopia, avaliação de muco vaginal e CE realizada com escova citológica (CB ou por lavado uterino de baixo volume (LVF. A concordância (Kappa statistic entre os técnicos na contagem da porcentagem de neutrófilos foi boa para CB (86% e para LVF (80,3%. A média de neutrófilos foi maior em todos os momentos na técnica de LVF, porém a redução de neutrófilos foi observada durante o pós-parto nas duas técnicas de citologia. A contagem de macrófagos, linfócitos e eosinófilos não variou durante o pós-parto e não houve diferença entre as técnicas CB e LVF. Houve diferença apenas aos 28 dpp, na porcentagem de vacas com endometrite subclínica, entre as técnicas CB (22.2% e LVF (59.3%.

João Paulo Elsen Saut

2013-10-01

174

Differential diagnosis of myoma uteri by computed tomography  

International Nuclear Information System (INIS)

Although CT can be diagnostic easily in evaluating myoma uteri as well as ultrasound, some cases are difficult to differentiate from ovarian tumors. 150 cases with myoma uteri and 250 cases with ovarian tumors are evaluated with CT and pathological diagnosis. 19 cases (4.8 %) of them are difficult to differentiate both of them. Especially the pedunculated and degenerated myoma uteri without continuity to the uterus and ovarian tumors with less degeneration adjacent to the uterus are very difficult to diagnose. (author)

175

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

176

Evaluation of uterine adenomyosis by magnetic resonance imaging  

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To assess the capability of magnetic resonance imaging (MR imaging) to enable the detection of the characteristic findings of uterine adenomyosis, 50 pathologically proved adenomyosis lesions (27 cases accompanied with uterine myoma) were chosen and their MRI findings were reviewed. MR imaging was performed with a superconducting magnet, Magnex 150/HP ( 1.5 Tesla), 100 ( 1.0 Tesla) and {alpha} (0.5 Tesla). When both T1-weighted images and T2-weighted images were analyzed, the detection rate of adenomyosis was 82%. In 9 cases (18%), adenomyosis was not detected, due to motion artifact in 2 cases, diffuse hypointensity of the myometrium in 3 cases and distortion of the endometrium by myoma node in 4 cases. On the T1-weighted image, adenomyosis was detected as an enlarged uterus with a smooth external configuration in 20%, within half of which high signal intensity spots representing islands of menstrual hemorrhagic areas were seen. A specific diagnosis of adenomyosis could be made in those cases. On the T2-weighted image, high signal intensity spots (thought to represent heterotopic endometrium) were seen in 46%. On the T2-weighted image, adenomyosis was demonstrated as thickening of the junctional zone (JZ) extending through the myometrium in 80%. Dynamic enhanced MR imaging was performed in 5 cases, 4 of which were accompanied with uterine myoma. Adenomyosis showed sparse contrast enhancement in the early phase, while uterine myoma had no morked enhancement in the early phase but became gradually enhanced in the late phase. In conclusion, MR imaging is useful for detection of adenomyosis. However, when it is difficult to detect adenomyosis or to distinguish it from uterine myoma, dynamic enhanced MR imagings may provide more useful information. (author)

Kakiuchi, Hideo [Tokyo Medical Coll. (Japan)

1997-03-01

177

Endometrial Stromal Sarcoma Presenting As Puberty Menorrhagia  

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Full Text Available Endometrial stromal sarcomas are rare uterine tumours usually seen in perimenopausal females. We report here a case of low grade malignant endometrial stromal sarcoma in an adolescent girl, presenting as puberty menorrhagia. She underwent total hysterectomy with bilateral salpingo-oophorectomy and pelvic node sampling. She also received adjuvant chemotherapy and radiotherapy. She is disease free at completion of one year of follow-up.

Rema Prabhakaran Nair

2005-05-01

178

Sonohysterography for endometrial abnormalities: preliminary results.  

Science.gov (United States)

In examinations where the etiology of an abnormal endometrial sonographic image is not clear, saline infusion through a fine flexible catheter during transvaginal sonography provides visual contrast and uterine expansion. In 39 women, polyps, myomata, synechiae, endometrial hyperplasia, and cancer were correctly described as verified at surgery. Hyperplasia and neoplasia are not distinguishable, but the approach for biopsy and therapy is established by this simple and well-tolerated technique, which is here called sonohysterography. PMID:8381140

Parsons, A K; Lense, J J

1993-02-01

179

Endometrial stromal sarcoma presenting as puberty menorrhagia  

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Endometrial stromal sarcomas are rare uterine tumours usually seen in perimenopausal females. We report here a case of low grade malignant endometrial stromal sarcoma in an adolescent girl, presenting as puberty menorrhagia. She underwent total hysterectomy with bilateral salpingo-oophorectomy and pelvic node sampling. She also received adjuvant chemotherapy and radiotherapy. She is disease free at completion of one year of follow-up.

Rema Prabhakaran Nair; Paul Sebastian

2005-01-01

180

Uterine leiomyoma and its association with menstrual pattern and history of depo-medroxyprogesterone acetate injections  

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Full Text Available L Amanti2, H Sadeghi-Bazargani1, H Abdollahi2, F Ehdaeivand31Statistics and Epidemiology Department, Faculty of Health and Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran; 2Tabriz University of Medical Sciences, Tabriz, Iran; 3Faculty of Medicine, Ardabil University of Medical Sciences, Ardabil, IranBackground and aim: Despite the high prevalence of uterine leiomyoma, according to recent review studies there is uncertainty and a paucity of information regarding its predisposing or protective factors. The aim of this study was to assess the possible association between menstrual cycle pattern and occurrence of surgically treated myomas and also to check if depo-medroxyprogesterone acetate (DMPA injection earlier in reproductive life can affect the later occurrence of myomas needing surgical treatment.Methods: In a case–control study in Ardabil, 85 women with definite diagnosis of surgically treated uterine leiomyoma and 154 community controls were enrolled. Possible predictors of myoma including menstrual cycle and menstrual bleeding patterns were assessed. Data were analyzed using SPSS software (SPSS, IBM, Somers, NY. Odds ratios were used as the main statistic in assessing the strength of observed associations.Results: Mean age of the participants was 41.8 ± 8.5 years. Length of menstrual cycle was associated with myoma and a higher likelihood of myoma was observed among those having shorter menstrual cycles (P < 0.05. Number of menstrual bleeding days was also associated with surgically treated myoma and longer bleeding periods increased the likelihood of myoma (P < 0.05. Only one of the eight women who had a history of depo-medroxyprogesterone acetate injections had developed surgically treated uterine leiomyoma and the others belonged to the control group without a history of surgical treatment for uterine leiomyoma.Conclusion: Menstrual cycle pattern is associated with developing leiomyomas requiring surgical treatment. DMPA, other than its role in myoma treatment, is also assumed to have a role in preventing myomas, but due to the small sample size in this study, larger scale prospective trials are needed in the future.Keywords: myoma, uterine leiomyoma, DMPA, medroxyprogesterone, menstrual cycle, menstrual, depo-provera

Amanati L

2011-07-01

 
 
 
 
181

Uterine arterial embolization for uterine leiomyoma: efficacy and clinical outcome  

International Nuclear Information System (INIS)

To determine the efficacy and clinical outcome of uterine arterial embolization as a new approach to the management of uterine leiomyomas. Uterine arterial embolization was performed in 21 patients aged 26-62(mean, 42) years. Twenty of these had menorrhagia, dysmenorrhea, and mass-related symptoms (low abdominal discomfort, backache, urinary frequency, etc.) and one was diagnosed incidentally. Bilateral uterine arteries were selected individually and polyvinyl alcohol and/or gelfoam was used as an embolic material. Nineteen patients were followed up after embolization. Seventeen (89.5 %)reported satisfactory improvement of symptoms and follow-up sonography three months later showed a 58.5 % reduction in mean myoma volume. In 17 patients (89.5 %), the menstrual cycle returned to normal. All patients experienced pain after the procedure and other complications were vaginal bleeding (26.3 %) and fever (23.8 %). Uterine arterial embolization represents a new approach to the management of uterine leiomyoma-related symptoms. Further investigations and long-term follow-up are, however, enquired

182

Uterine arterial embolization for uterine leiomyoma: efficacy and clinical outcome  

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To determine the efficacy and clinical outcome of uterine arterial embolization as a new approach to the management of uterine leiomyomas. Uterine arterial embolization was performed in 21 patients aged 26-62(mean, 42) years. Twenty of these had menorrhagia, dysmenorrhea, and mass-related symptoms (low abdominal discomfort, backache, urinary frequency, etc.) and one was diagnosed incidentally. Bilateral uterine arteries were selected individually and polyvinyl alcohol and/or gelfoam was used as an embolic material. Nineteen patients were followed up after embolization. Seventeen (89.5 %)reported satisfactory improvement of symptoms and follow-up sonography three months later showed a 58.5 % reduction in mean myoma volume. In 17 patients (89.5 %), the menstrual cycle returned to normal. All patients experienced pain after the procedure and other complications were vaginal bleeding (26.3 %) and fever (23.8 %). Uterine arterial embolization represents a new approach to the management of uterine leiomyoma-related symptoms. Further investigations and long-term follow-up are, however, enquired.

Park, Jeong Seon; Lee, Do Yon; Kim, Yong Tae; Park, Ki Hyun; Park, Yong Won; Cho, Jae Sung; Kim, Myung Jun [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of); Won, Je Hwan [Ajou Univ. College of Medicine, Suwon (Korea, Republic of); Kang, Byung Chul [Ewha Womans Univ. College of Medicine, Seoul (Korea, Republic of)

1999-09-01

183

Endometrial stromal tumors: the new WHO classification.  

Science.gov (United States)

Endometrial stromal tumors are rare uterine mesenchymal neoplasms that have intrigued pathologists for years, not only because they commonly pose diagnostic dilemmas, but also because the classification and pathogenesis of these tumors has been widely debated. The current World Health Organization recognizes 4 categories of endometrial stromal tumor: endometrial stromal nodule (ESN), low-grade endometrial stromal sarcoma (LG-ESS), high-grade endometrial stromal sarcoma (HG-ESS), and undifferentiated uterine sarcoma (UUS). uterine sarcoma. These categories are defined by the presence of distinct translocations as well as tumor morphology and prognosis. Specifically, the JAZF1-SUZ12 (formerly JAZF1-JJAZ1) fusion identifies a large proportion of ESN and LG-ESSs, whereas the YWHAE-FAM22 translocation identifies HG-ESSs. The latter tumors appear to have a prognosis intermediate between LG-ESS and UUS, which exhibits no specific translocation pattern. This review (1) presents the clinicopathologic features of endometrial stromal tumors; (2) discusses their immunophenotype; and (3) highlights the recent advances in molecular genetics which explain their pathogenesis and lend support for a new classification system. PMID:25299308

Conklin, Christopher M J; Longacre, Teri A

2014-11-01

184

Endometrial spiral artery Doppler parameters in unexplained infertility patients: is endometrial perfusion an important factor in the etiopathogenesis?  

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Objective: Uterine perfusion, particularly the endometrial blood flow, may have an important role in endometrial receptivity. In order to assess the contribution of sub endometrial blood flow in the etiopathogenesis of unexplained infertility mid luteal- peri-implantation period spiral artery transvaginal color Doppler parameters were measured and compared with fertile controls. Material and Methods: Forty-two consecutive patients admitted to Izmir Katip Celebi University Ataturk Training an...

Selda Uysal; Elif Pelin Özün Özbay; Tekin Ekinci; Hayri Aksüt; ?ebnem Karasu; Ahmet Zeki I??k; Ferit Soylu

2012-01-01

185

Retained uterine fundus after vaginal hysterectomy.  

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We report a case of retained uterine fundus after vaginal hysterectomy that was subsequently removed at laparoscopy. The patient had undergone vaginal hysterectomy 8 years previously and came to our hospital with abdominal pain. Examination revealed a supravesical mass. Laparoscopy was performed and showed the uterine fundus with its cornual attachments. The mass was excised and sent for histopathologic analysis, which confirmed that it was uterine tissue. Retained uterine tissue or myoma tissue has been reported, usually after morcellation. However, to our knowledge, our case is only the second reported case of retained fundus after complete vaginal hysterectomy. Because of adhesions, it is possible that the uterus was not completely removed. In such cases, laparoscopic assistance is extremely useful. PMID:20129338

Sinha, Rakesh; Lakhotia, Smita; Sundaram, Meenakshi; Manaktala, Gayatri; Shah, Parul; Mahajan, Chaitali

2010-01-01

186

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

187

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  

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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

188

Abnormal uterine bleeding: the role of ultrasound.  

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Abnormal uterine bleeding is an important clinical concern and accounts for much medical intervention. This article presents an ultrasound-based approach to help exclude endometrial carcinoma and identify the source of bleeding for better clinical management. Saline infusion sonohysterography can help to triage patients to (1) no anatomic pathology, (2) globally thickened anatomic pathology that may be evaluated with blind endometrial sampling, or (3) focal abnormalities that must be evaluated under direct vision. PMID:17147992

Goldstein, Steven R

2006-11-01

189

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

190

Uterine infarction in a patient with uterine adenomyosis following biochemical pregnancy  

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Adenomyosis is a common gynecological disorder characterized by the presence of endometrial glands and stroma deep within the myometrium associated with myometrial hypertrophy and hyperplasia. Focal uterine infarction after IVF-ET in a patient with adenomyosis following biochemical pregnancy has not been previously reported, although it occurs after uterine artery embolization in order to control symptoms caused by fibroids or adenomyosis. We report a case of a nulliparous woman who had uterine adenomyosis presenting with fever, pelvic pain and biochemical abortion after undergoing an IVF-ET procedure and the detection of a slightly elevated serum hCG. Focal uterine infarction was suspected after a pelvic magnetic resonance imaging demonstrated preserved myometrium between the endometrial cavity and inner margin of the necrotic myometrium. This case demonstrates that focal uterine infarction should be considered in the differential diagnosis of acute abdominal pain, vaginal bleeding and infectious signs in women experiencing biochemical abortion after an IVF-ET procedure.

Lee, Jae-Yeon; Won, Kyu-Hee; Lee, Da-Yong; Jeon, Hye-Won; Moon, Min-Hwan

2014-01-01

191

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

192

Megestrol Acetate or Levonorgestrel-Releasing Intrauterine System in Treating Patients With Atypical Endometrial Hyperplasia or Endometrial Cancer  

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Atypical Endometrial Hyperplasia; Endometrial Adenocarcinoma; Recurrent Endometrial Carcinoma; Stage IA Endometrial Carcinoma; Stage IB Endometrial Carcinoma; Stage II Endometrial Carcinoma; Stage IIIA Endometrial Carcinoma; Stage IIIB Endometrial Carcinoma; Stage IIIC Endometrial Carcinoma; Stage IVA Endometrial Carcinoma; Stage IVB Endometrial Carcinoma

2014-09-09

193

Suppressed expression of type 2 3?/type 5 17?-hydroxysteroid dehydrogenase (AKR1C3) in endometrial hyperplasia and carcinoma  

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The diagnosis of endometrial hyperplasia and endometrial type adenocarcinoma arising within the uterine cavity has long been rested on morphologic criteria. Although distinction between normal endometrial epithelium from adenocarcinoma is usually straightforward, the separation between normal and hyperplastic endometrium, particularly those cases without atypia, can be a diagnostic challenge. The same is true in separation of hyperplastic endometrium with atypia from endometrial-type endometr...

Zakharov, Vladislav; Lin, Hsueh-kung; Azzarello, Joseph; Mcmeekin, Scott; Moore, Kathleen N.; Penning, Trevor M.; Fung, Kar-ming

2010-01-01

194

Abnormal uterine bleeding: a clinicohistopathological analysis  

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Background: Abnormal uterine bleeding (AUB) is one of the most common problem for the patients and the gynecologists. It adversely effects on the quality of life and psychology of women. It is of special concern in developing country as it adds to the causes of anemia. Management of Abnormal Uterine Bleeding (AUB) is not complete without tissue diagnosis especially in perimenopausal and post-menopausal women. Histological characteristics of endometrial biopsy material as assessed by light mic...

Anupamasuresh Y; Yv, Suresh; Prachi Jain

2014-01-01

195

Coffee and Endometrial Cancer Risk: MedlinePlus Health News Video  

Science.gov (United States)

... the lower right-hand corner of the player. Coffee and Endometrial Cancer Risk HealthDay February 6, 2015 ... Pages Diets Uterine Cancer Women's Health Transcript Drinking coffee may help reduce the risk of the most ...

196

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

197

Avaliação da cavidade uterina com hístero-sonografia em pacientes com falha de implantação após fertilização in vitro Evaluation of the uterine cavity by sonohysterography in patients with implantation failure after in vitro fertilization  

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Full Text Available OBJETIVO: analisar a acurácia da hístero-sonografia (HSoG na avaliação da cavidade uterina nas pacientes que tiveram falha de implantação na primeira tentativa de fertilização in vitro. MÉTODOS: foram analisadas prospectivamente, em estudo duplo-cego, pacientes previamente submetidas à transferência de pelo menos um embrião e que apresentaram falha de implantação. As pacientes foram submetidas a HSoG e em seguida a histeroscopia diagnóstica, realizadas por equipes diferentes, não havendo troca de informações sobre os resultados das mesmas. Os resultados foram agrupados e interpretados somente após o término da pesquisa. A HSoG foi realizada após cateterização do colo uterino por sonda uretral nº 8 e injeção de soro fisiológico. A interface anecóica proporcionada pela solução salina permite determinar as anormalidades, tais como pólipos uterinos ou miomas submucosos. A histeroscopia diagnóstica foi realizada com equipamento Karl Storz, óptica rígida de 4 mm a 30°, e distensão da cavidade uterina com soro fisiológico. Não utilizou-se anestesia local nem houve a necessidade de realizar dilatação cervical. RESULTADOS: foram estudadas 28 pacientes das 33 inicialmente selecionadas para o presente estudo. A HSoG diagnosticou anormalidades em 8 pacientes, sendo que em cinco pacientes foram encontrados pólipos endometriais (62,5%, pólipos endocervicais em duas pacientes (25,0% e mioma submucoso em uma (12,5%. A histeroscopia (padrão-ouro diagnosticou alterações em 7 pacientes, sendo que em duas pacientes (28,6% foram encontrados pólipos endometriais, em outras duas pacientes (28,6% pólipos cervicais e em uma paciente, mioma submucoso (14,2%. A HSoG, quando comparada com a histeroscopia diagnóstica, apresentou sensibilidade de 71,4%, especificidade de 85,7%, valor preditivo positivo de 62,5% e valor preditivo negativo de 90%. CONCLUSÕES: por apresentar valor preditivo positivo baixo, todas as vezes que a HSoG for anormal, sugerimos confirmar o exame pela histeroscopia diagnóstica. Pelo fato de a HSoG apresentar boa especificidade e bom valor preditivo negativo, poderíamos sugerir que diante de HSoG normal não há necessidade de indicação de se avaliar a cavidade uterina pela histeroscopia diagnóstica antes de realizar a fertilização in vitro. Concluímos que a histero-sonografia é bom método para rastreamento de lesões polipóides da cavidade uterina que possam responder pela falha de implantação nas técnicas de fertilização in vitro.PURPOSE: to analyze the accuracy of sonohysterography for the evaluation of the uterine cavity in patients with an implantation failure, at the first attempt of an in vitro fertilization cycle. METHODS: in a prospective double blind study, the authors analyzed patients previously submitted to at least one embryo transfer, who presented implantation failures. The patients were submitted to a sonohysterographic examination followed by a diagnostic hysteroscopic examination, carried out by different professionals each of whom was not aware of the results of the other. The results were recorded and only interpreted after the end of the trial. Sonohysterography was performed by the introduction of a urethral catheter 8 into the uterine cervix followed by infusion of physiological saline. The anechoic interface shown by the physiological saline can reveal abnormalities, like uterine polyps or submucosal myomas. Hysteroscopy was performed with a Karl Storz equipment, 4 mm 30º rigid telescope, and infusion of physiological saline for uterine cavity distention. RESULTS: twenty-eight of the 33 originally selected patients for this study were analyzed. Sonohysterography detected abnormalities in 8 patients, five with endometrial polyps (62.5%, two with endocervical polyps (25.0%, and one with submucosal myoma (12.5%. Hysteroscopy (gold standard detected abnormalities in 7 patients, two with endometrial polyps (28.6%, two with cervical polyps (28.6% and one with submucosal myoma (14.2%. Sonohysterography, when compared with diag

Teiichi Ninomiya

2003-08-01

198

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

199

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

Directory of Open Access Journals (Sweden)

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

200

Hysteroscopic findings in postmenopausal patients with ultrasonographic diagnosis of endometrial thickening  

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Objective: To evaluate the results of hysteroscopy for investigating the uterine cavity of postmenopausal women presenting endometrial thickening on ultrasound. Methods: A cross-sectional study was conducted on hysteroscopic evaluations of 329 postmenopausal women presenting with endometrial thickening on transvaginal ultrasonography. Hysteroscopies were performed in an outpatient setting, using a 4 mm optic Hamou II microhysteroscope and gas (CO2) to distend the uterine cavity. A guided biop...

Castello Branco, Hosana Karinne Marathaoan Souza Martins E.; Daniella de Baptista Depes; Fausto Farah Baracat; Umberto Gazi Lippi; Winny Hirome Takahashi; Reginaldo Guedes Coelho Lopes

2008-01-01

 
 
 
 
201

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 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

202

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

203

Endometrial Cancer  

Science.gov (United States)

... my treatment last? I once took tamoxifen for breast cancer. Should I be tested for endometrial cancer on a regular basis? How often after my treatment ends will I have to come in to see the doctor for follow-up exams? What are some of the side effects ...

204

Pre-cycle saline infusion sonography minimizes assisted reproductive technologies cycle cancellation due to endometrial polyps.  

Science.gov (United States)

Pre-ART cycle screening with saline infusion sonohysterography is effective at limiting cycle cancellation caused by endometrial polyps to 0.5%. Although a thickened lining at the time of baseline ultrasound can be indicative of a uterine polyp, a normal endometrial lining does not eliminate the possibility that a polyp will be discovered during the cycle. PMID:18155202

Yauger, Belinda J; Feinberg, Eve C; Levens, Eric D; Gustofson, Robert L; Larsen, Frederick W; DeCherney, Alan H

2008-10-01

205

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

206

Studies on the diagnosis of uterine tumor by 201-thallium-chloride  

International Nuclear Information System (INIS)

Cases of gynecological tumor mainly uterine benign and malignant tumors were evaluated using 201Thallium-Chloride (201Tl-Cl) after intravenous injection. The positive scans of 100% in 42 cases of uterine myoma including 29 cases of leiomyoma, 8 cases of adenomyosis and 5 cases of combined type myoma, also 100% in 8 cases of body cancer indicating adenocarcinoma and 25% in 12 cases of cervical cancer indicating squamous cell carcinoma were observed. The smallest focal lesion for the positive scans was needed approximately more 5 cm in diameter in the cases of leimyoma. The most accumulation of activities was showed in adenomyosis or adenocarcinoma with much adenoid structure in the pathological study. Accumulation of 201Tl in uterine benign and malignant tumors was suggested the analog of potassium. The mechanism of tumor affinity was correlated to perfusion volume and the acceleration of the potassium metabolism in a tumor. On the other hand, we suggested the diagnosis of the malignant uterine tumor should be attended due to 201Tl was accumulation also in the benign uterine tumor. The uterine scanning using 201Tl-Cl was acknowledged to be very useful and safe indicating early detection at 20 minutes after the injection, (non-traumatic procedure and non-visualized bone tissues). In conclusion, this radioisotopical procedure was indicated high value of screening examination in the diagnosis of uterine tumor. (authorin the diagnosis of uterine tumor. (author)

207

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

208

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

209

Cytogenetics of multiple uterine leiomyomas, parametrial leiomyoma and disseminated peritoneal leiomyomatosis.  

Science.gov (United States)

Using banding techniques the chromosomes were studied in 15 leiomyomas. The material comprised nine uterine myomas from one patient, one parametrial leiomyoma from a second patient and five tumors from a third patient with disseminated peritoneal leiomyomatosis. The results were considered together with pooled data from the literature. From this it could be concluded that: (1) each leiomyoma was the product of a separate clonal development; (2) different leiomyomas from the same patient sometimes showed an identical abnormal stemline (possibly because of etiological influences); (3) uterine and extra-uterine leiomyomas seemed to follow similar evolutionary pathways in their chromosomal progression. PMID:2018368

Mark, J; Havel, G; Dahlenfors, R; Wedell, B

1991-01-01

210

MRI appearances of benign uterine disease.  

Science.gov (United States)

Benign uterine disease is a common entity affecting women of all ages. Ultrasound has historically been the predominant imaging method used in the evaluation of benign gynaecological disease, magnetic resonance imaging (MRI) being reserved for use in the staging of malignant uterine and cervical disease. MRI is now increasingly used in the diagnosis of benign uterine disease as well as a tool for problem-solving in cases of diagnostic dilemma. It allows detailed assessment of benign conditions, such as endometrial lesions, leiomyomas, and adenomyosis, and can be helpful in the stratification of patients to different treatment modalities, including surgical resection, uterine artery embolization, and medical therapies. In this article, we review the MRI findings in the common benign uterine diseases. PMID:25017452

Sudderuddin, S; Helbren, E; Telesca, M; Williamson, R; Rockall, A

2014-11-01

211

Uterine Fibroids  

Medline Plus

Full Text Available ... focused ultrasounds that are guided by magnetic resonance images to target and destroy uterine fibroids. The procedure ... the bowel or bladder and those outside the image area cannot be treated with FUA. Summary Uterine ...

212

Diffusion-Weighted Magnetic Resonance Imaging of Endometrial Cancer: Differentiation from Benign Endometrial Lesions and Preoperative Assessment of Myometrial Invasion  

Energy Technology Data Exchange (ETDEWEB)

Background: Uterine endometrial cancer is the most common gynecologic malignancy, and benign endometrial hyperplasia or polyps should be differentiated from endometrial cancer. In evaluating endometrial cancer on magnetic resonance imaging (MRI), the assessment of the depth of myometrial invasion is important because it closely correlates with the patient's prognosis. Purpose: To verify the feasibility of diffusion-weighted magnetic resonance imaging (DWI) to distinguish benign and malignant endometrial lesions, and to evaluate myometrial invasion of endometrial cancer. Material and Methods: Sixty-seven endometrial lesions including 45 cancers and 22 benign lesions (hyperplasia and polyps) were evaluated by DWI with apparent diffusion coefficient (ADC) measurement. The staging accuracies of DWI and gadolinium-enhanced T1-weighted images in the assessment of myometrial invasion were evaluated in 33 patients with endometrial cancer. Results: The ADC values (x10-3 mm2/s) in cancer and benign lesions were 0.84+-0.19 and 1.58+-0.36, respectively (P<0.01). The staging accuracy (superficial or deep myometrial invasion) was 94% for DWI and 88% for gadolinium-enhanced T1-weighted images. Coexisting adenomyosis and infiltrative myometrial invasion caused staging errors on gadolinium-enhanced T1-weighted images, whereas DWI could demonstrate the tumor extent correctly. Conclusion: DWI provides helpful information in evaluating benign and malignant endometrial lesions.

Takeuchi, M.; Matsuzaki, K.; Nishitani, H. (Dept. of Radiology, Univ. of Tokushima, Tokushima (Japan))

2009-10-15

213

Integrated genomic characterization of endometrial carcinoma  

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We performed an integrated genomic, transcriptomic and proteomic characterization of 373 endometrial carcinomas using array- and sequencing-based technologies. Uterine serous tumours and ~25% of high-grade endometrioid tumours had extensive copy number alterations, few DNA methylation changes, low oestrogen receptor/progesterone receptor levels, and frequent TP53 mutations. Most endometrioid tumours had few copy number alterations or TP53 mutations, but frequent mutations in PTEN, CTNNB1, PIK...

2012-01-01

214

Uterine Fibroids  

Medline Plus

Full Text Available ... deal with fibroids. These include the following: • Myolysis • Uterine Fibroid Embolization or UFE • Focused Ultrasound Ablation Myolysis Myolysis is ... com og280106 Last reviewed: 09/20/2013 4 Uterine Fibroid Embolization (UFE) Uterine fibroid embolization is a very safe ...

215

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

216

Staging in local endometrial carcinoma  

International Nuclear Information System (INIS)

Possible deep (more than an inner third of the uterine wall) myometrial invasion and cervical extension of endometrial carcinoma were evaluated prospectively using magnetic resonance (MR) and transabdominal real-time sonography (US) in 20 and 10 patients, respectively. The data obtained from these examinations were compared with hysterosalpingography (HSG) and clinical modalities including hysteroscopy, sounding and histopathologic findings after surgery. The concordance of outlining cervical extension was between MR and hysteroscopy 85 per cent, and between US and hysteroscopy 50 per cent. Deep myometrial tumor invasion was suggested in 4/10 patients by US and in 6/20 by MR, and was confirmed in all but one in each group at histologic examination of the resected uterus. There were no false negative US or MR examinations. Transabdominal US did not prove accurate in defining local endometrial carcinoma (distinguishing between stages I and II), but it may be used as an additional tool in revealing myometrial invasion. MR, however, seems to refine the delineation of uterine tumor growth. (orig.)

217

Studies on the diagnosis of uterine tumor by 201-thallium-chloride  

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Cases of gynecological tumor mainly uterine benign and malignant tumors were evaluated using /sup 201/Thallium-Chloride (/sup 201/Tl-Cl) after intravenous injection. The positive scans of 100% in 42 cases of uterine myoma including 29 cases of leiomyoma, 8 cases of adenomyosis and 5 cases of combined type myoma, also 100% in 8 cases of body cancer indicating adenocarcinoma and 25% in 12 cases of cervical cancer indicating squamous cell carcinoma were observed. The smallest focal lesion for the positive scans was needed approximately more 5 cm in diameter in the cases of leiomyoma. The most accumulation of activities was shown in adenomyosis or adenocarcinoma with much adenoid structure in the pathological study. Accumulation of /sup 201/Tl in uterine benign and malignant tumors was suggested the analog of potassium. The mechanism of tumor affinity was correlated to perfusion volume and the acceleration of the potassium metabolism in a tumor. On the other hand, we suggested the diagnosis of the malignant uterine tumor should be attended due to /sup 201/Tl accumulation also in the benign uterine tumor. The uterine scanning using /sup 201/Tl-Cl was acknowledged to be very useful and safe indicating early detection at 20 minutes after the injection, (non-traumatic procedure and non-visualized bone tissues). In conclusion, this radioisotopical procedure was indicated to be a high value screening examination in the diagnosis of uterine tumor.

Tobari, C.; Muroi, K.; Watanabe, H.; Noguchi, S.; Kurosawa, H. (Toho Univ., Tokyo (Japan). School of Medicine)

1981-10-01

218

Development of uterine neoplasms following radiotherapy for carcinoma of uterine cervix: a clinical evaluation of 47 patients  

International Nuclear Information System (INIS)

Objective: To analysis the characteristics and clinical features of uterine neoplasms developed after radiation therapy for cervical carcinoma. Methods: The clinical data of 47 patients of uterine neoplasm developed following radiotherapy for uterine cervical carcinoma were retrospectively reviewed. Results: The median age on diagnosis of uterine neoplasms was 62 years (range 38-77), and the median latency from the initial therapy to the development of uterine neoplasm was 14 years (range 5-35). Thirty of 47 patients had endometrial carcinoma, of which 3 were uterine papillary serous carcinoma(UPSC). Seventeen of 47 patients had uterine sarcoma, all of which were carcinosarcoma. The distribution by stage, grade, and histology of 30 patients with endometrial carcinoma was: stage Ib, 1 patient; stage Ic, 2 patients; stage II, 6; stage III a, 4; stage III b, 2; stage III c, 11; stage IV, 4; grade 1, 2 patients; grade 2, 9; grade 3 (include 3 UPSC patients), 17; unknown grade, 2; endometriod, 27; UPSC, 3. Seven of 30 patients with en- dometrial carcinoma deleloped recurrence, at median time of 24 months. Their median survival time was 26 m. The overall 3- and 5-year survival rate was 60% and 38%, respectively. Of the 17 patients with uterine sarcoma, the median survival was 10 months. Six patients developed recurrence, at a median time of 9 months, and their median survival was 6 months. The overall 3- and 5-year survival rate was 12% and 0, respectively. Conclnsions: The 12% and 0, respectively. Conclnsions: The main uterine neoplasm developed after radiotherapy for uterine cervical carcinoma is endometrial carcinoma, of which there is a preponderance of high-risk histological subtype and poor prognosis. Most of the uterine sarcoma which occur following radiation therapy for uterine cervical carcinoma is carcinosarcoma and its prognosis is very poor. (authors)

219

Pólipos endometriais Endometrial polyps  

Directory of Open Access Journals (Sweden)

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

220

Magnetic resonance imaging of the uterus after endometrial resection  

Energy Technology Data Exchange (ETDEWEB)

The majority of amenorrhoeic and all menstruating women have residual endometrium after endometrial resection. The lack of communication of islands of residual endometrium with the uterine cavity results in haematometra formation, fallopian tube dilatation and possibly free intraperitoneal fluid. (N.C.)

Turnbull, L.; Jumaa, A.; Dhawan, S.; Horsman, A.; Killick, S

1998-02-01

 
 
 
 
221

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

LENUS (Irish Health Repository)

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

222

Evaluation of endometrium in peri-menopausal abnormal uterine bleeding  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 endometri...

Kotdawala, Parul; Kotdawala, Sonal; Nagar, Nidhi

2013-01-01

223

Histopathological study of endometrium in cases of abnormal uterine bleeding  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Abnormal uterine bleeding is one of the commonest complaints in women and when it occurs without organic lesions like tumor, inflammation, it is called as dysfunctional uterine bleeding. Aim of current study was to find out the histopathological pattern of endometrium in Abnormal Uterine Bleeding (AUB also to study organic causes of AUB. Methods: Specimens received as endometrial curettage and hysterectomy specimens were studied followed by correlation of histopathology with age and clinical presentation. Results: The patients were mainly from the age group of 30-49 years (74.24%. The most common menstrual disorder was menorrhagia (46.86%. In dysfunctional uterine bleeding the most common histological pattern of endometrium includes proliferative endometrium (22.8% followed by endometrial hyperplasia (19.40%, atrophic endometrium (7.16%, secretory endometrium (5.97%, irregular shedding [1.80%], irregular ripening (1.20% and anovulatory endometrium (0.59%. Organic lesions encountered in AUB cases were leiomyoma (17.92%, endometrial polyp (1.79%, endometrial carcinoma (1.50%, endometriosis (0.59% and choriocarcinoma (0.29%. Conclusion: It is important to know the histological pattern of the endometrium like proliferative endometrium, endometrial hyperplasia, atrophic endometrium, secretory endometrium, irregular ripening and shredding and organic lesions in patients diagnosed as AUB in different age groups since recognition of these conditions will help and will avoid further complications. [Int J Res Med Sci 2014; 2(4.000: 1378-1381

Saroj A. Bolde

2014-08-01

224

[Submucosal isthmicocervical myoma--problems of diagnosis, labor and puerperium].  

Science.gov (United States)

A case of submucosal isthmicocervical myoma, 85 mm in diameter, diagnosed for first time during CS. The neonate is with atrophy of left m. sternocleidomastoideus and facial asymmetry due to impression in the left temporoparietal region, without neurological impairment. Multiple ultrasound examinations were done but the fibroids vas not diagnosed. During one examination we presume that the fibroid was mistaken for the head because the BPD was in great discrepancy with other ultrasound parameters of the fetus. During the operation OICC was not found that is why the dilatation was made through the vagina. A myomectomy was not made during the operation. Because of the pressure and the deformation of the cervical canal from the myoma a drain was inserted through the canal to facilitate the evacuation of the lochia. The post operative period passed without any complications, the drainage was taken off on the 7th post operative day and the patient was discharged on the 8th day. PMID:14682012

Dimitrov, A; Bosev, D; Nikolov, A; Stoianov, S

2003-01-01

225

Uterine morphology and peristalsis in women with polycystic ovary syndrome  

Energy Technology Data Exchange (ETDEWEB)

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

226

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

227

Saline infusion sonohysterography versus hysteroscopy for uterine cavity evaluation  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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

228

Integrated genomic characterization of endometrial carcinoma.  

Science.gov (United States)

We performed an integrated genomic, transcriptomic and proteomic characterization of 373 endometrial carcinomas using array- and sequencing-based technologies. Uterine serous tumours and ?25% of high-grade endometrioid tumours had extensive copy number alterations, few DNA methylation changes, low oestrogen receptor/progesterone receptor levels, and frequent TP53 mutations. Most endometrioid tumours had few copy number alterations or TP53 mutations, but frequent mutations in PTEN, CTNNB1, PIK3CA, ARID1A and KRAS and novel mutations in the SWI/SNF chromatin remodelling complex gene ARID5B. A subset of endometrioid tumours that we identified had a markedly increased transversion mutation frequency and newly identified hotspot mutations in POLE. Our results classified endometrial cancers into four categories: POLE ultramutated, microsatellite instability hypermutated, copy-number low, and copy-number high. Uterine serous carcinomas share genomic features with ovarian serous and basal-like breast carcinomas. We demonstrated that the genomic features of endometrial carcinomas permit a reclassification that may affect post-surgical adjuvant treatment for women with aggressive tumours. PMID:23636398

Kandoth, Cyriac; Schultz, Nikolaus; Cherniack, Andrew D; Akbani, Rehan; Liu, Yuexin; Shen, Hui; Robertson, A Gordon; Pashtan, Itai; Shen, Ronglai; Benz, Christopher C; Yau, Christina; Laird, Peter W; Ding, Li; Zhang, Wei; Mills, Gordon B; Kucherlapati, Raju; Mardis, Elaine R; Levine, Douglas A

2013-05-01

229

Avaliação da cavidade uterina com hístero-sonografia em pacientes com falha de implantação após fertilização in vitro / Evaluation of the uterine cavity by sonohysterography in patients with implantation failure after in vitro fertilization  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: analisar a acurácia da hístero-sonografia (HSoG) na avaliação da cavidade uterina nas pacientes que tiveram falha de implantação na primeira tentativa de fertilização in vitro. MÉTODOS: foram analisadas prospectivamente, em estudo duplo-cego, pacientes previamente submetidas à transferênci [...] a de pelo menos um embrião e que apresentaram falha de implantação. As pacientes foram submetidas a HSoG e em seguida a histeroscopia diagnóstica, realizadas por equipes diferentes, não havendo troca de informações sobre os resultados das mesmas. Os resultados foram agrupados e interpretados somente após o término da pesquisa. A HSoG foi realizada após cateterização do colo uterino por sonda uretral nº 8 e injeção de soro fisiológico. A interface anecóica proporcionada pela solução salina permite determinar as anormalidades, tais como pólipos uterinos ou miomas submucosos. A histeroscopia diagnóstica foi realizada com equipamento Karl Storz, óptica rígida de 4 mm a 30°, e distensão da cavidade uterina com soro fisiológico. Não utilizou-se anestesia local nem houve a necessidade de realizar dilatação cervical. RESULTADOS: foram estudadas 28 pacientes das 33 inicialmente selecionadas para o presente estudo. A HSoG diagnosticou anormalidades em 8 pacientes, sendo que em cinco pacientes foram encontrados pólipos endometriais (62,5%), pólipos endocervicais em duas pacientes (25,0%) e mioma submucoso em uma (12,5%). A histeroscopia (padrão-ouro) diagnosticou alterações em 7 pacientes, sendo que em duas pacientes (28,6%) foram encontrados pólipos endometriais, em outras duas pacientes (28,6%) pólipos cervicais e em uma paciente, mioma submucoso (14,2%). A HSoG, quando comparada com a histeroscopia diagnóstica, apresentou sensibilidade de 71,4%, especificidade de 85,7%, valor preditivo positivo de 62,5% e valor preditivo negativo de 90%. CONCLUSÕES: por apresentar valor preditivo positivo baixo, todas as vezes que a HSoG for anormal, sugerimos confirmar o exame pela histeroscopia diagnóstica. Pelo fato de a HSoG apresentar boa especificidade e bom valor preditivo negativo, poderíamos sugerir que diante de HSoG normal não há necessidade de indicação de se avaliar a cavidade uterina pela histeroscopia diagnóstica antes de realizar a fertilização in vitro. Concluímos que a histero-sonografia é bom método para rastreamento de lesões polipóides da cavidade uterina que possam responder pela falha de implantação nas técnicas de fertilização in vitro. Abstract in english PURPOSE: to analyze the accuracy of sonohysterography for the evaluation of the uterine cavity in patients with an implantation failure, at the first attempt of an in vitro fertilization cycle. METHODS: in a prospective double blind study, the authors analyzed patients previously submitted to at lea [...] st one embryo transfer, who presented implantation failures. The patients were submitted to a sonohysterographic examination followed by a diagnostic hysteroscopic examination, carried out by different professionals each of whom was not aware of the results of the other. The results were recorded and only interpreted after the end of the trial. Sonohysterography was performed by the introduction of a urethral catheter 8 into the uterine cervix followed by infusion of physiological saline. The anechoic interface shown by the physiological saline can reveal abnormalities, like uterine polyps or submucosal myomas. Hysteroscopy was performed with a Karl Storz equipment, 4 mm 30º rigid telescope, and infusion of physiological saline for uterine cavity distention. RESULTS: twenty-eight of the 33 originally selected patients for this study were analyzed. Sonohysterography detected abnormalities in 8 patients, five with endometrial polyps (62.5%), two with endocervical polyps (25.0%), and one with submucosal myoma (12.5%). Hysteroscopy (gold standard) detected abnormalities in 7 patients, two with endometrial polyps (28.6%), two

Teiichi, Ninomiya; Luiz Eduardo Trevisan de, Albuquerque; Daniele Mansur, Varjão; Karina Bertono de, Faria; Rudson Carlos Martins de, Oliveira; Luiz Eduardo Vieira, Diniz.

2003-08-01

230

Abnormal uterine bleeding: a clinicohistopathological analysis  

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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

231

Uterine arterial embolization to treat uterine leiomyoma  

International Nuclear Information System (INIS)

Objective: To assess the clinical effects of uterine arterial embolization on uterine leiomyoma. Methods: The authors treated 21 patients with uterine leiomyoma by Seldinger's uterine arterial embolization. The 4.0 F Cobra catheter was laced into the double uterine arteries with Polyvinyl Alcohol Foam (PVA) particles as the embolization. At 3 and 6 months postoperatively, the authors investigated the effects of the embolization. Results: After uterine arterial embolization, the volume of uterine leiomyoma decreased and menorrhagia was under controlled. The symptoms of anemia and oppression were relieved. The physiologic functions of ovary and uterus were preserved completely. Conclusions: Uterine arterial embolization is an effective and less invasive way to treat uterine leiomyoma

232

Tissue selective estrogen complexes (TSECs) differentially modulate markers of proliferation and differentiation in endometrial cells.  

Science.gov (United States)

Selective estrogen receptor modulators (SERMs) have tissue-specific estrogen receptor (ER) modulating properties. Combining an SERM with one or more estrogens to form a tissue selective estrogen complex (TSEC) can provide an improved blend of tissue-specific ER agonist and antagonist effects. While both estrogens and SERMs affect the uterine endometrium, not all TSECs reverse the endometrial effects of estrogens preventing endometrial proliferation and hyperplasia. Their action in uterine cells is not completely understood. HOXA 10, leukemia inhibitory factor (LIF), progesterone receptor (PR), and EMX2 are genes known to regulate endometrial proliferation and differentiation. The expression of these genes was used to assess endometrial effects of SERMs and TSECs. We evaluated the effects of raloxifene (RAL), tamoxifen (TAM), lasofoxifene (LAS), bazedoxifene acetate (BZA), and progesterone (P) alone and in combination with estradiol (E2) in Ishikawa cells. Increased HOXA10, LIF, PR, and EMX2 messenger RNA (mRNA) expression was noted in E2-treated cells compared with vehicle-treated controls. All TSECs maintained E2-induced PR expression and all except TAM prevented estrogen-induced LIF expression. The TSEC containing BZA uniquely decreased HOXA10 expression and increased EMX2 expression. The TSECs alter endometrial cell proliferation by selective modulation of estrogen responsive genes, maintaining the antiproliferative effects mediated by PR and inhibiting LIF. The differential effect of TSECs on endometrial gene expression suggests a mechanism by which they manifest differential effects on endometrial safety against the risk of estrogen-induced endometrial hyperplasia. PMID:23171676

Kulak, Jaime; Ferriani, Rui A; Komm, Barry S; Taylor, Hugh S

2013-02-01

233

Miomatosis uterina gigante Giant uterine myomatosis  

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Full Text Available El gran tamaño de algunos tumores ha sido descrito con asombro a través del tiempo. Entre ellos se incluyen los ginecológicos, sobre los cuales se describen casos de crecimiento descomunal, e incluyen los uterinos u ováricos. El caso de mayor tamaño fue descrito por Hunt en 1888 como hallazgo en una necropsia, con el "asombroso" peso de 63,5 kg. La terminología de estos tumores de gran tamaño contiene calificativos muy variados y confusos, entre los cuales se incluyen "inmensos", "enormes" "extensos", "voluminosos", "masivos", "grandes", "muy grandes", "gigantes", "gigantescos". Beacham y otros, en 1971 definieron como "gigantes" a los tumores uterinos u ováricos con peso superior a 25 lbs (11,3 kg. Briceño-Pérez y otros en el año 2001 propusieron utilizar el término de "grandes miomas uterinos" (GMU para aquellos con peso entre 0,8 Kg (peso límite aproximado para decidir la vía quirúrgica abdominal o vaginal y 11,3 Kg (peso límite establecido por Beacham y colaboradores para los miomas uterinos gigantes. El caso que se presenta fue operado el día 20 de enero de 2009 en el Centro de Investigaciones Médico Quirúrgicas, al cual se le realizó histerectomía total con el diagnóstico de miomatosis gigante del útero cuyo peso fue de 11,31 kg. Se hacen recomendaciones para el manejo quirúrgico de las pacientes con tumores ginecológicos gigantes.The large size of some tumors has been described with surprise over the time. Among them are included the gynecologic ones, on which are presented cases of an enormous growth and the uterine and ovarian types are also included. The largest size of a tumor was described by Hunt in 1888 as a necropsy finding, which weighing 63,5 kg. Terminology of these large size tumors include very varied and confused epithets: "inmenses", "huges", "extensive", "bulkies", "mass", "larges", "very larges", "giants" , and "gigantics". Beachman et al, in 1971 defined as "giants" the uterine or ovarian tumors weighing more than 25 pounds (11,3 kg. Briceño-Pérez et al in 2001 proposed the use of the term "large uterine myomas" (LUM for those weighing between 0,8 kg (limit weight established by Beacham et al for the giant uterine myomas. Present case was operated on in January 20, 2009 in Medical and Surgical Researches Center, performing a total hysterectomy diagnosed with uterine giant myomatosis weighing 11,31 kg. Authors made recommendations on surgical management of patients presenting giant gynecological tumors.

Miguel Sarduy Nápoles

2009-09-01

234

Uterine Fibroids  

Medline Plus

Full Text Available ... Uterine fibroids are made of nodules of smooth muscle cells and fibrous tissue that develop in the ... embolization. FUA uses a device that combines two systems – a magnetic resonance imaging (MRI) machine to visualize ...

235

Uterine Fibroids  

Medline Plus

Full Text Available ... the advice of a doctor or a healthcare professional for your specific condition. ©1995-2013, The Patient Education ... Some women who have uterine fibroids may experience symptoms, such ...

236

Uterine Fibroids  

Medline Plus

Full Text Available ... procedure. Uterine fibroid embolization is a treatment that cuts off the blood supply to the uterus and ... particles that are put into the fibroids to cut off their blood supply travel to the ovaries. ...

237

Uterine Fibroids  

Medline Plus

Full Text Available ... in women who are of reproductive age or old enough to have periods. About 25% of women ... to medical advances, patients with uterine fibroids can live a very healthy and normal life! This document ...

238

Uterine Fibroids  

Medline Plus

Full Text Available ... is able to expand greatly in size. The middle, muscular layer of the uterus creates labor contractions, ... Fibroids Uterine fibroids are benign tumors in the middle layer of the uterus, the muscular layer that ...

239

Uterine Fibroids  

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Full Text Available ... monitor the temperature of the uterine tissue after heating, and a focused ultrasound beam that heats and ... sound waves. The treatment requires repeated targeting and heating of fibroid tissue while the patient lies inside ...

240

Uterine Fibroids  

Medline Plus

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 ...

 
 
 
 
241

Uterine Fibroids  

Medline Plus

Full Text Available ... migration of the egg, which can result in infertility. After surgical removal of the fibroid, fertility is ... focused ultrasounds that are guided by magnetic resonance images to target and destroy uterine fibroids. The procedure ...

242

Uterine Fibroids  

Medline Plus

Full Text Available ... Ablation uses 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 ...

243

Evaluation and management of abnormal uterine bleeding in premenopausal women.  

Science.gov (United States)

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

244

Significance of negative hysteroscopic view in abnormal uterine bleeding.  

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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 agr...

Parasnis H; Parulekar S

1992-01-01

245

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

246

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 svements 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

247

Late leiomyoma expulsion after uterine artery embolization.  

Science.gov (United States)

A case of late expulsion of a leiomyoma after uterine artery embolization (UAE) is reported in a 49-year-old woman who underwent UAE for a huge (13 cm x 12 cm; 1,061 cm(3)) bleeding- and bulk-related intramural leiomyoma diagnosed with ultrasonography. Free-flow embolization was performed with 150-400-microm polyvinyl alcohol particles and absorbable particle sponge. Symptoms and myoma size were successfully controlled until 44 months, at which time the patient reported vaginal discharge. A 7-cm necrotic, partly submucosal leiomyoma was detected. The patient refused hysterectomy and spontaneously expelled the leiomyoma through the cervix 6 months later. In conclusion, UAE necessitates long-term follow-up and women should be warned of late complications. PMID:15590809

Marret, Henri; Keris, Yann Le Brun; Acker, Olivier; Cottier, Jean Philippe; Herbreteau, Denis

2004-12-01

248

A Case of Endometrial Stromal Sarcoma with Synchronous Bilateral Adenocarcinoma of Ovary  

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Endometrial stromal tumor is a rare mesenchymal uterine tumor. We report the case of a patient with endometrial stromal sarcoma and concomitant bilateral endometrioid adenocarcinoma of the ovary in the context of pelvic endometriosis. The patient underwent a complete cytoreduction including total hysterectomy and bilateral adnexectomy, pelvic lymphadenectomy, appendicectomy, infracolic omentectomy, and pelvic peritonectomy. This is the first report to our knowledge that describes a synchronou...

Olga Caramelo; Carol Marinho; Teresa Rebelo; Natália Amaral; Fernando Mota; Fernanda Xavier da Cunha; Isabel Torgal

2012-01-01

249

Fluid Within the Endometrial Cavity in an IVF Cycle—A Novel Approach to Its Management  

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Fluid within the endometrial cavity before embryo transfer in IVF cycles is associated with failure of implantation. The etiology of endometrial fluid is surrounded in controversy but it is associated with hydrosalpinges, polycystic ovarian disease, and subclinical uterine infections. The current treatment consists of postponing embryo transfer. This of course has biological and psychological disadvantages; a decreased implantation rate from frozen embryo transfer, and frustration and disappo...

Griffiths, Anthony N.; Watermeyer, Sean R.; Klentzeris, Lucas D.

2002-01-01

250

Surveillance for endometrial cancer with transvaginal ultrasonography of breast cancer patients under tamoxifen treatment  

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The association of endometrial thickness with the risk of developing endometrial cancer (EC) within 2 years was investigated in a consecutive cohort of 1205 breast cancer patients under tamoxifen treatment, undergoing transvaginal ultrasonography (TVUS) for follow-up purpose (asymptomatic, 1068) or for abnormal uterine bleeding (AUB, 137). Linkage with tumour registry allowed for the follow-up of 3184.3 person-years. According to underlying incidence, 1.85 EC cases were expected in the study ...

Ciatto, S.; Cecchini, S.; Gervasi, G.; Landini, A.; Zappa, M.; Crocetti, E.

2003-01-01

251

Effect of Letrozole on Endometrial Histology in Patients with Disordered Proliferative Endometrium and Simple Hyperplasia  

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Objectives: This is a preliminary study investigating the efficacy of aromatase inhibitor letrozol on endometrial histology in patients with disordered proliferative endometrium or simple hyperplasia. Materials and Methods: In a randomized clinical trial, 92 patients with abnormal uterine bleeding who had disordered proliferative endometrium or simple hyperplasia in endometrial biopsy, were randomized into case and control groups. patients received 2.5 mg of letrozole daily in case group (...

Parvin Mostafa Gharabaghi; Azadeh Azadi; Ali Dastranj Tabrizi; Elaheh Ouladsahebmadarek; Parinaz Tasbihi; Neda Shoari

2014-01-01

252

Sildenafil Effect on Nitric Oxide Secretion by Normal Human Endometrial Epithelial Cells Cultured In vitro  

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Background: Sildenafil is a selective inhibitor of cyclic-guanosine monphosphat-specificphosphodiesterase type 5. It increases intracellular nitric oxide (NO) production in some cells.There are reports on its positive effect on uterine circulation, endometrial thickness, and infertilityimprovement. Endometrial epithelial cells (EEC) play an important role in embryo attachment andimplantation. The present work investigates the effect of sildenafil on human EEC and their NOsecretion in vitro.Ma...

Farzaneh Chobsaz; Rostam Ghorbani; Shiva Roshankhah; Mozafar Khazaei

2011-01-01

253

Utility of immunohistochemistry method in expression of thyroid transcription factor-1 in endometrial and endocervical adenocarcinoma  

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"nBackground: Thyroid transcription factor-1 (TTF-1) is widely used in the diagnosis of lung and thyroid carcinomas. Although there have been reports of TTF-1 immunoreactivity in tumors other than those originating from the lung or thyroid, endocervical and endometrial adenocarcinomas have not been studied in large numbers in this regard."n "nMethods: Thirteen endocervical adenocarcinomas, 39 endometrioid endometrial adenocarcinomas and four uterine serous carcinomas which had ...

Janbazvatan A; Foruhesh Tehrani Z; Izadi Mood N; Malayeri A

2011-01-01

254

MRI staging of endometrial and cervical carcinoma  

International Nuclear Information System (INIS)

Magnetic resonance imaging (MRI) has proven to be a suitable imaging modality for the evaluation of uterine neoplasms. In contrast to computed tomography and ultrasound, MRI allows multiplanar observer-independent imaging of the whole female pelvis with high tissue-specific contrast. This article reviews the advantages and limitations of MRI in the staging of endometrial and cervical carcinoma, focusing on MRI with reference to other imaging modalities. New technical developments are discussed and an imaging approach for these tumor types is suggested. (orig.)

255

Conservative management of a recurrent puerperal uterine inversion with bakri<sup>®</sup> balloon tamponade  

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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 li...

Jesús Joaquín Hijona Elósegui; Francisco Javier Frutos Arenas; Antonio Carballo García; Juan Antonio López López; Gabriel Castilla Peinado Peinado; Juan Manuel Torres Martí

2011-01-01

256

Sonohysterography: technique, endometrial findings, and clinical applications.  

Science.gov (United States)

Transvaginal ultrasound-guided saline infusion sonohysterography (SHG) is a relatively new technique for evaluation of the uterine cavity. As new studies declare the clinical usefulness of this technique, SHG may quickly become part of the routine ultrasound evaluation of the female pelvis. In this article, the SHG procedure is described and normal findings are discussed. Common endometrial pathological findings such as atrophy, polyps, fibroids, hyperplasia, and carcinoma are reviewed. The newly touted roles of SHG for screening patients on long-term tamoxifen therapy and for evaluating patients with infertility are introduced. Finally, we present a practical ultrasound-based flow chart for the workup of menopausal and perimenopausal patients with abnormal uterine bleeding. PMID:10457565

Sohaey, R; Woodward, P

1999-08-01

257

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

Directory of Open Access Journals (Sweden)

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

258

Uterine Disorders in 50 Pet Rabbits.  

Science.gov (United States)

ABSTRACT Although the incidence of uterine disorders in pet rabbits is high there are only a few retrospective studies and case reports on genital tract disease in female rabbits. Uterine disorders were assessed in 50 pet rabbits. In 31 pet rabbits with suspected clinical uterine disease, medical records were further reviewed regarding clinical signs, diagnostic workup, treatment as well as the outcome itself. Uterine adenocarcinoma (54%) was most frequently diagnosed, followed by endometrial hyperplasia (26%). Serosanguineous vaginal discharge was the predominant clinical sign observed by the rabbit owners. In approximately 50% of the rabbits with suspected uterine disorders, abdominal palpation revealed enlarged and/or irregular masses in the caudoventral abdomen indicating uterine lesions. Out of 23 rabbits undergoing ovariohysterectomy, four were either euthanized or died shortly after surgery because they were clinically unstable. Overall, 80% of the ovariohysterectomized animals were still alive 6 mo after surgery. In female pet rabbits that are not breeding, either ovariohysterectomy should be performed at an early age or routine checks including ultrasonography of the abdomen are recommended on a regular basis. PMID:25415217

Künzel, Frank; Grinninger, Petra; Shibly, Sarina; Hassan, Jasmin; Tichy, Alexander; Berghold, Petra; Fuchs-Baumgartinger, Andrea

2014-11-21

259

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

260

Imaging of endometrial lesion  

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Introduction & Background: The main role of imaging of endometrium is to differentiate between normal and abnormal endometrium and triage patients to those patients requiring guided biopsy vs. those patients that can be managed by blind biopsy. Endometrial thickness of 5mm has been proven to be a reliable threshold to ex-clude endometrial cancer. Transvaginal sonography (TVS) can detect focal pathology in most cases. Endo-metrial polyp and submucosal fibroid (SMF) have distinguishing feat...

Atri, M.

2005-01-01

 
 
 
 
261

Review: Human uterine stem/progenitor cells: Implications for uterine physiology and pathology.  

Science.gov (United States)

The human uterus is composed of the endometrial lining and the myometrium. The endometrium, in particular the functionalis layer, regenerates and regresses with each menstrual cycle under hormonal control. A mouse xenograft model has been developed in which the functional changes of the endometrium are reproduced. The myometrium possesses similar plasticity, critical to permit the changes connected with uterine expansion and involution associated with pregnancy. Regeneration and remodeling in the uterus are likely achieved through endometrial and myometrial stem cell systems. Putative stem/progenitor cells in humans and rodents recently have been identified, isolated and characterized. Their roles in endometrial physiology and pathophysiology are presently under study. These stem/progenitor cells ultimately may provide a novel means by which to produce tissues and organs in vitro and in vivo. PMID:23332213

Maruyama, T; Miyazaki, K; Masuda, H; Ono, M; Uchida, H; Yoshimura, Y

2013-03-01

262

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

263

Effectiveness of Hysteroscopic Repair of Uterine Lesions in Reproductive Outcome  

Directory of Open Access Journals (Sweden)

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

264

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)

265

What is the influence of cyclooxygenase-2 on postmenopausal endometrial polyps?  

Science.gov (United States)

Background The genesis of the endometrial polyp is as yet unclear. There is evidence that the polyp is related to the inflammatory process and that it interacts with the cyclooxygenase-2 (COX-2) enzyme. Objective To review the influence of COX-2 on the postmenopausal endometrial polyp. Methods A systematic review was made of the Medline, Embase, and Cochrane databases, covering the years of 2001-2014. The inclusion criteria were: experimental studies with immunohistological analysis of COX-2 in endometrial polyps; women; hysteroscopic and surgical evaluation; and studies with comparisons between the endometrial polyp and other tissues (normal endometrium, adjacent endometrium, and other uterine diseases). The exclusion criteria were: polyps in other organs; genetic polymorphisms; endometrial cancer exclusively; abnormal uterine bleeding unrelated to polyps. The search key words (taken from the Medical Subject Headings - MeSH) were endometrial polyp and cyclooxygenase-2. Results Seven of ten articles were selected. Results showed positive COX-2 expression in the glandular epithelium of the polyps, and expression was more intense when the polyp was malignant. However, there was a study which did not find any difference between polyps and the normal endometrium, and there was another which compared polyps in menacme with postmenopausal polyps. Conclusion There is no consensus in the literature as to the participation of COX-2 in the development of benign and/or malignant endometrial polyps. In all of the studies, COX-2 was present in the postmenopausal polyps and with greater intensity in the malignant ones. PMID:25242379

Pereira, A K C; Garcia, M T; Pinheiro, W; Ejzenberg, D; Soares, J M; Baracat, E C

2014-11-19

266

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  

Scientific Electronic Library Online (English)

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

267

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  

Directory of Open Access Journals (Sweden)

Full Text Available 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 estromal. 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.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. Immunohistochemistry 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

2012-12-01

268

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 ...

Terzi? Milan

2008-01-01

269

An Unusual Extremely Distant Noncommunicating Uterine Horn with Myoma and Adenomyosis Treated with Laparoscopic Hemihysterectomy  

Digital Repository Infrastructure Vision for European Research (DRIVER)

A 41-year-old woman referred to us with dysmenorrhea and severe pelvic pain although she was previously submitted to right laparotomic adnexectomy for ovarian endometrioma and to a subsequent operative laparoscopy for pelvic adhesions. After ultrasound examination, the patient underwent diagnostic hysteroscopy and operative laparoscopy which confirmed the clinic suspect of an unicornuate uterus. However, it was very unusual to see an extremely distanced right horn, without communication w...

Morelli, Michele; Venturella, Roberta; Mocciaro, Rita; Lico, Daniela; Zullo, Fulvio

2013-01-01

270

Tranexamic Acid: A Potential Adjunct to Resectoscopic Endometrial Ablation  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Abnormal uterine bleeding (AUB) is a substantial cause of ill health in women worldwide. In this study, our aim was to evaluate the effectiveness of endometrial ablation using a modified urologic resectoscope along with tranexamic acid in AUB. Sixty patients were enrolled in this study. All patients underwent resectoscopic surgery. Patients were randomly divided into two groups. Group 1 (n = 30) received 500 mg of tranexamic acid. Group 2 (n = 30) served as the control group and underwent sur...

Ergun, Bulent; Bastu, Ercan; Ozsurmeli, Mehmet; Celik, Cem

2012-01-01

271

Usefulness of sonohysterography in differentiating endometrial cancer from endometrial hyperplasia  

Energy Technology Data Exchange (ETDEWEB)

To characterize the sonohysterographic (SH) findings of endometrial hyperplasia and cancer and to determine the role of SH in differentiating endometrial cancer from hyperplasia. The clinical, pathologic and SH findings of 38 patients with histologically confirmed endometrial hyperplasia (n=21), atypical hyperplasia 9n=6), and cancer (n=11) were reviewed retrospectively. We evaluate the presence and morphologic characteristics 9 surface contour ehcogenicity, echotexture) of endometrial thickening and mass, obliteration of endometrial cavity, and disruption of endometrial-myometrial interface on SH. SH findings of endometrial hyperplasia were endometrial thickening in 17 cases (81%), mass in 8 cases (38%), and regular surface of endometrium and mass in 16 (76%) and 6 cases (75%) respectively. Obliteration of endometrial cavity was seen only in 3 cases (14%) of endometrial hyperplasia and 1 case (17%) of atypical hyperplasia and disruption of endometrial-myometrial interface was not seen. Endometrial cancer showed endometrial thickening in 6 cases (55%), mass in 7 cases (64%), irregular surface of endometrium and mass in 10 (91%) and 7 cases (100%) respectively, obliteration of endometrial cavity in 10 cases(91%), and disruption of endometrial-myometrial interface in 4 of 8 cases with myometrial invasion. Using endometrial thickening or mass with irregular surface and obliteration of endometrial cavity as the positive findings for SH diagnosis of endometrial cancer, we observed sensitivity of 90.9%, specificity of 85.2%, and accuracy of 86.8%. The demonstration of the irregular surface with endometrial thickening or mass and obliteration of endometrial cavity through SH were suggestive of endometrial cancer.

Lee, Eun Ju; Kim, Min Jung; Ryu, Hee Sug [Aju University School of Medicine, Suwon (Korea, Republic of)

1999-06-15

272

Foley catheter balloon endometrial ablation: successful treatment of three cases.  

Science.gov (United States)

Endometrial ablation is one of the most effective methods for treatment of dysfunctional uterine bleeding (DUB). Balloon devices with circulating hot water inside or electrodes on the outer surface and radiofrequency-induced thermal destructors are the most recently introduced available tools for endometrial ablation. All of these methods are effective and simple but expensive technologies. The aim of this brief report is to evaluate the effectiveness and safety of a new, simple and money-saving procedure, namely foley catheter balloon endometrial ablation (FCBEA), for treatment of DUB. We present our experience with FCBEA performed on 3 women with severe meno-metrorrhagia unresponsive to medical therapy. There were no procedure-related complications with achievement of complete amenorrhea for a 19 months follow-up period. Although FCBA has yielded encouraging results, there exists a need for further investigation and validation on larger groups, before its universal application. PMID:22764467

Api, Murat; Api, Olus

2012-03-01

273

Does hysteroscopy produce intraperitoneal spread of endometrial cancer cells?  

Science.gov (United States)

Hysteroscopy is the tool of choice for the evaluation of the endometrial cavity, including the assessment of abnormal uterine bleeding (AUB). The combination of endometrial biopsy and diagnostic hysteroscopy could replace dilation and curettage in most patients. However, hysteroscopy might disseminate endometrial cells into the peritoneum, thereby potentially raising the stage and decreasing the survival of a patient with endometrial cancer. The purpose of this article is to explore the dilemma of whether hysteroscopy produces intraperitoneal spread of endometrial cancer cells, and, if the answer is yes, what is the prognostic significance of isolated malignant cells in the peritoneal cavity. We conducted a literature search using MEDLINE using the following key words: hysteroscopy, endometrial carcinoma, and dissemination for the years 1980 through 2001. Retrospective data shows a correlation between fluid-based hysteroscopy and the presence of cancer cells in the peritoneal cavity. It cannot, however, be determined whether positive peritoneal washings are the result of hysteroscopy or whether the endometrial cells are found in the peritoneum as a result of other mechanism. Because no prospective, randomized studies have been performed on the dissemination of cancer cells by diagnostic hysteroscopy, no definite conclusions can be made concerning the risk of diagnostic hysteroscopy. In addition, the prognostic significance of isolated malignant cells in the peritoneal cavity of women with endometrial cancer is unclear. Although there might be an increased risk of peritoneal contamination by cancer cells after hysteroscopy, there is currently no evidence that these patients face worse prognosis than patients who have undergone other diagnostic procedures. PMID:15024228

Revel, Ariel; Tsafrir, Avi; Anteby, Shaul O; Shushan, Asher

2004-04-01

274

??mTc-octreotide uptake in the uterus and a subserosal myoma mimicking tumoral masses.  

Science.gov (United States)

The diagnostic usefulness of somatostatin receptor scintigraphy in the localization of tumors has been evaluated in several studies. Here, we present the case of a patient with a subserosal myoma diagnosed by (99m)Tc-labeled octreotide acetate scintigraphy. Oval and ring-shaped areas of hyperactivity in the pelvis were confirmed on MR imaging to be the uterus and a subserosal myoma. The presented case indicates that somatostatin receptors may be present in the uterus and in leiomyomas, especially in young women, and demonstrates that somatostatin may be a promising therapy for treatment of myoma. The case also demonstrates that subserosal myoma or dislocation of the uterus can result in a false-positive diagnosis, highlighting the importance of correlative imaging for accurate interpretation of the study. PMID:24480920

Pirayesh, Elahe; Amoui, Mahasti; Assadi, Majid

2014-03-01

275

BAJA INCIDENCIA DE PATOLOGIA ENDOMETRIAL EN MUJERES POSTMENOPAUSICAS CON SANGRADO ANORMAL QUE RECIBEN TERAPIA DE REEMPLAZO HORMONAL  

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Full Text Available Se realiza un estudio para analizar la frecuencia de patología endometrial en mujeres posmenopáusicas sanas con sangrado uterino anormal bajo terapia de reemplazo hormonal (TRH. Se estudiaron 104 mujeres posmenopáusicas que presentaron sangrado uterino anormal (irregular o excesivo durante TRH con estrógenos y progesterona en diferentes esquemas (57% secuencial continuo; 31% combinado continuo; 12% secuencial discontinuo. A todas las pacientes se les realizó una biopsia ambulatoria aspirativa de endometrio. El procedimiento fue bien tolerado y no se observaron complicaciones hemorrágicas o infecciosas. Los resultados histológicos fueron los siguientes: endometrio secretor 38,5%; endometrio proliferativo 25%; endometrio atrófico 11,5%; hierplasia endometrial sin atipias 4,8%; pólipo endometrial benigno 2,9%; tejido endometrial benigno, inactivo o fragmentos de epitelio 11,5%; adenocarcinoma de endometrio 1% y ausencia de tejido endometrial 4,8%. La biopsia aspirativa de endometrio permitió conocer la situación endometrial en alrededor del 95% de las pacientes. Muestra insuficiente para diagnóstico se obtuvo en un 5% de los casos sugiriendo atrofia endometrial o patología focal no diagnosticada por el método. La ausencia de lesiones premalignas y la baja incidencia de patología maligna de endometrio en nuestro estudio confirman su baja incidencia en mujeres que reciben esquemas adecuados de terapia de reemplazo hromonalObjetive: To analyze the frequency of endometrial pathology in healthy postmenopausal women who presented abnormal uterine bleeding during hormone replacement therapy (HRT. Material and method: 104 postmenopausal women presenting abnormal uterine bleeding (irregular or excessive while using HRT with estrogen and progestin in different schemes. All the patients underwent endometrial aspiration biopsies. Results: Endometrial biopsy was well tolerated and no infectious or hemorrhagic complications related to the procedure were observed. Results of endometrial sampling were as followed: secretor endometrium 38.5%; proliferative endometrium 25%; atrophic endometrium 11.5%; hyperplastic endometrium without atypia 4.8%; benign endometrial polyps 2.9%; benign endometrial tissue, inactive or fragment of epithelium 11.5%: endometrial adenocarcinoma 1%; and absence of endometrial tissue 4.8%. No samples with diagnosis of endometrial hyperplasia with atypia were found. Conclusions: Aspirative curettage of the endometrium permitted to know the endometrial condition in about 95% of patients. Histologic sample for diagnosis was not obtained in 5% of cases, thus suggesting endometrial atrophy or focal pathology misdiagnosed by the method used. The abscense of premalignant and the low incidence of malignant pathology in our study confirms their low incidence in patients receiving adquate regime of HRT

Marcelo Bianchi P.

2002-01-01

276

BAJA INCIDENCIA DE PATOLOGIA ENDOMETRIAL EN MUJERES POSTMENOPAUSICAS CON SANGRADO ANORMAL QUE RECIBEN TERAPIA DE REEMPLAZO HORMONAL  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish Se realiza un estudio para analizar la frecuencia de patología endometrial en mujeres posmenopáusicas sanas con sangrado uterino anormal bajo terapia de reemplazo hormonal (TRH). Se estudiaron 104 mujeres posmenopáusicas que presentaron sangrado uterino anormal (irregular o excesivo) durante TRH con [...] estrógenos y progesterona en diferentes esquemas (57% secuencial continuo; 31% combinado continuo; 12% secuencial discontinuo. A todas las pacientes se les realizó una biopsia ambulatoria aspirativa de endometrio. El procedimiento fue bien tolerado y no se observaron complicaciones hemorrágicas o infecciosas. Los resultados histológicos fueron los siguientes: endometrio secretor 38,5%; endometrio proliferativo 25%; endometrio atrófico 11,5%; hierplasia endometrial sin atipias 4,8%; pólipo endometrial benigno 2,9%; tejido endometrial benigno, inactivo o fragmentos de epitelio 11,5%; adenocarcinoma de endometrio 1% y ausencia de tejido endometrial 4,8%. La biopsia aspirativa de endometrio permitió conocer la situación endometrial en alrededor del 95% de las pacientes. Muestra insuficiente para diagnóstico se obtuvo en un 5% de los casos sugiriendo atrofia endometrial o patología focal no diagnosticada por el método. La ausencia de lesiones premalignas y la baja incidencia de patología maligna de endometrio en nuestro estudio confirman su baja incidencia en mujeres que reciben esquemas adecuados de terapia de reemplazo hromonal Abstract in english Objetive: To analyze the frequency of endometrial pathology in healthy postmenopausal women who presented abnormal uterine bleeding during hormone replacement therapy (HRT). Material and method: 104 postmenopausal women presenting abnormal uterine bleeding (irregular or excessive) while using HRT wi [...] th estrogen and progestin in different schemes. All the patients underwent endometrial aspiration biopsies. Results: Endometrial biopsy was well tolerated and no infectious or hemorrhagic complications related to the procedure were observed. Results of endometrial sampling were as followed: secretor endometrium 38.5%; proliferative endometrium 25%; atrophic endometrium 11.5%; hyperplastic endometrium without atypia 4.8%; benign endometrial polyps 2.9%; benign endometrial tissue, inactive or fragment of epithelium 11.5%: endometrial adenocarcinoma 1%; and absence of endometrial tissue 4.8%. No samples with diagnosis of endometrial hyperplasia with atypia were found. Conclusions: Aspirative curettage of the endometrium permitted to know the endometrial condition in about 95% of patients. Histologic sample for diagnosis was not obtained in 5% of cases, thus suggesting endometrial atrophy or focal pathology misdiagnosed by the method used. The abscense of premalignant and the low incidence of malignant pathology in our study confirms their low incidence in patients receiving adquate regime of HRT

Marcelo, Bianchi P.; Eugenio, Arteaga U.; Paulina, Villaseca D..

277

Uterine Fibroids  

Medline Plus

Full Text Available ... com og280106 Last reviewed: 09/20/2013 3 Treatment Most fibroids do not cause any symptoms and do not ... an alternative to leiomyomectomy, hysterectomy, watchful waiting, hormone therapy, or uterine fibroid embolization. FUA uses a device that combines two ...

278

Uterine Cancer  

Science.gov (United States)

... factors may increase a woman’s risk for uterine cancer: • Being older than 50. • Being obese (having a high amount of extra body fat). • Taking estrogen by itself for hormone replacement during menopause (without also taking the other female hormone, progesterone). • Having had trouble getting pregnant, or ...

279

Uterine Fibroids  

Medline Plus

Full Text Available ... to become pregnant. FUA is a non-invasive surgery. It is an alternative to leiomyomectomy, hysterectomy, watchful waiting, hormone therapy, or uterine fibroid embolization. FUA uses a device that combines two systems – a magnetic resonance imaging (MRI) machine to visualize ...

280

Uterine Fibroids  

Medline Plus

Full Text Available ... you to go into early menopause. Too few women have gotten pregnant after UFE for researchers to know if there ... 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 ...

 
 
 
 
281

Adenovirus mediated homozygous endometrial epithelial Pten deletion results in aggressive endometrial carcinoma  

International Nuclear Information System (INIS)

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 inactivation of the wild type allele of Pten in both CAH and UEC. In the present study, we injected adenoviruses expressing Cre into the uterine lumen of adult Pten floxed mice in an attempt to somatically delete both alleles of Pten specifically in the endometrium. Our results demonstrate that biallelic inactivation of Pten results in an increased incidence of carcinoma as compared to the Pten+/- mouse model. In addition, the carcinomas were more aggressive with extension beyond the uterus into adjacent tissues and were associated with decreased expression of nuclear ER? as compared to associated CAH. Primary cultures of epithelial and stromal cells were prepared from uteri of Pten floxed mice and Pten was deleted in vitro using Cre expressing adenovirus. Pten deletion was evident in both the epithelial and stromal cells and the treatment of the primary cultures with estrogen had different effects on Akt activation as well as Cyclin D3 expression in the two purified components. This study demonstrates that somatic biallelic inactivation of Pten in endometrial epithelium in vivo results in an increased incidence and aggressiveness of endometrial carcinoma compared to mice carrying a germline deletion of one allele and provides an important in vivo and in vitro model system for understanding the genetic underpinnings of endometrial carcinoma.

282

Long-term follow up after uterine artery embolization for symptomatic uterine leiomyomas  

DEFF Research Database (Denmark)

Uterine artery embolization is one of the established treatment options for symptomatic uterine leiomyomas, with a proven effect on the size of leiomyomas and providing short-term relief of symptoms. Only few studies have addressed long-term satisfaction with the treatment. We conducted a historical cohort study of 96 patients. The patients were treated at a median age of 43years (range 23-59years). The median size of the largest myoma was 69mm (range 20-170mm). By use of a postal questionnaire (response rate 86%) and audit of patient files, we found that 53% reported full recovery of symptoms and 36% some effect on symptoms after a median of 8.9years (range 8-9.4years). Overall, 25% of the women reported a need for further treatment. The rate of eventual hysterectomy was 22%. We confirm that uterine artery embolization is a safe and well-tolerated procedure with a high long-term satisfaction rate.

Poulsen, Bente; Munk, Torben

2011-01-01

283

The role of magnetic resonance imaging in the diagnosis of uterine cervical carcinoma  

International Nuclear Information System (INIS)

One hundred and thirteen magnetic resonance (MR) images of the gynecologic organs, which were available after the introduction of 0.1 Tesla Asahi Mark J MR-CT unit in 1983, were reviewed retrospectively. Sagittal and coronal MR images provided useful information on tumor invasion. Myoma had lower signal intensity on the T1-weighted images than the normal uterine tissues and carcinomatous lesions, making it easy to differentiate myoma from cancer. Regarding the presence or absence of tumor invasion to the pelvic wall, MR imaging concurred well with physical findings (87 %), as compared with X-ray CT (77 %). MR imaging seemed to have a great potential in diagnosing recurrence of the pelvic wall and metastasis to the abdominal lymph nodes that are difficult to palpate or inspect. (Namekawa, K.)

284

Analysis of amenorrhea after transcatheter uterine artery embolization for uterine fibroids  

International Nuclear Information System (INIS)

Objective: To investigate the causes of amenorrhea after transcatheter uterine artery embolization (TUAE) for uterine fibroids. Methods: Two hundreds thirty-one cases of uterine fibroids with the range of age from 29 to 51 years (mean, 39.5 years) underwent TUAE between April 1999 and May 2004. TUAE was performed by injecting lipiodol-pingyangmycine emulsion (LPE) into bilateral uterine arteries, followed by administration of gelatin sponge particles in 186 of 231 patients. LPE was prepared with pingyangmycine 8-16 mg and ultra fluid lipiodol 6-20 ml. Results: Amenorrhea occurred in 2 of 231 (0.87%) patients respectively at 3 and 4 months after TUAE. Premature ovarian failure was proved to be etiology of amenorrhea in one patient because her serum estradiol (E2) became decreased and serum follicle-stimulating hormone (FSH) level increased. This woman had normal amenorrhea later after receiving estrogen-progestogen sepuential therapy for 12 months. Another patient's amenorrhea was proved to be associated with endometrial atrophy after TUAE by hysteroscope. Conclusion: Amenorrhea caused by premature ovarian failure and endometrial atrophy may occur in a tiny minority of women undergoing TUAE. (authors)

285

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

286

Ressecção Histeroscópica do Endométrio: Resultados e Fatores de Risco para insucesso / Hysteroscopic Endometrial Resection: Results and Risk Factors for Failures  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese Objetivo: estudar o resultado da ablação endometrial histeroscópica, com o uso de ressectoscópio, em pacientes com sangramento uterino anormal de etiologia benigna e refratária ao tratamento clínico, e relatar os fatores associados aos insucessos. Métodos: foram avaliados retrospectivamente informaç [...] ões sobre 64 pacientes com sangramento uterino anormal de causa benigna, submetidas à intervenção entre abril de 1994 e fevereiro de 2000. A média de idade foi de 42,9 anos e a paridade média, de 2,6 partos. Foi realizada histeroscopia diagnóstica com biópsia endometrial pré-operatoriamente. Duas pacientes receberam previamente gestrinona, seis danazol e 44 análogo do GnRH. No ato cirúrgico realizou-se a cauterização elétrica do fundo uterino e das regiões cornuais. Depois, com o ressectoscópio, foi removido o endométrio até 1 cm cranialmente ao orifício interno e na profundidade de 2 a 3 mm na musculatura. A distensão uterina se fazia com glicina a 1,5% até há dois anos, quando se passou a usar o manitol a 3%. O seguimento foi de 11,5 meses em média. Resultados: estabeleceu-se amenorréia em 31,2% das pacientes e hipomenorréia em 45,3%. Houve persistência do sangramento anormal em 23,5%. Houve uma perfuração uterina na cérvico-dilatação (1,5%). Os resultados foram melhores nas pacientes com mais de 40 anos de idade, nas multíparas e nas que usaram análogos do GnRH. Nos casos de falhas houve freqüência estatisticamente significante (p=0,04) de miomas submucosos de 46,6% contra 20,6% no grupo com hipomenorréia e 20% no grupo com amenorréia. O uso de análogo do GnRH fez decrescer de modo significante (p=0,03) os insucessos. No grupo de pacientes nos quais se considerou haver falha da cirurgia, 46% tiveram, ao exame anatomopatológico, endométrio secretor; no grupo com hipomenorréia, 10,3% tiveram este resultado histológico e no grupo com amenorréia, 10%, o que não apresentou significância estatística (p=0,12). Conclusão: o método mostrou-se útil para tratar o sangramento uterino anormal de etiologia benigna. Recomenda-se o uso de análogos do GnRH previamente à intervenção. Sugere-se que as pacientes mais jovens, com menor paridade e com diagnóstico pré-operatório de mioma submucoso recebam atenção especial, pois entre elas ocorrem falhas com maior freqüência. Abstract in english Purpose: to evaluate the results of 64 hysteroscopic endometrial ablations using a resectoscope in women with abnormal uterine bleeding of benign etiology and nonresponsive to clinical measures and to describe the failures and their associated conditions. Methods: sixty-four patients with abnormal u [...] terine bleeding were submitted to the intervention between April 1994 and February 2000. The mean age was 42.9 years and the mean parity, 2.6 deliveries. Diagnostic hysteroscopy and endometrial biopsy were performed preoperatively. Before surgery, two women received gestrinone, six danazol and 44 GnRH analogue. During the surgery electric cauterization of the fundus uteri and cornual regions was made. Afterwards, with a resectoscope, the endometrium was removed as far as 1 cm above the internal ostium, and as deep as 2 to 3 mm into the myometrium. The uterine distension was obtained with 1.5% glycine and since two years ago with 3% manitol. The average follow-up was 11.5 months. After six months of endometrial ablation, the patients with persistence of symptoms were submitted to hysterectomy. Results: amenorrhea occurred in 31.2% of the patients and hypomenorrhea in 45.3%. The abnormal bleeding was maintained in 23.5%. There was one uterine perforation during the dilatation of the cervix. Results were better in the higher age and parity ranges and in the women who received GnRH analogues (p=0.03). Where the method was not successful there was a statistically significant frequency of submucous myoma (p=0.04) and a nonsignificant increase of secretory endometrium (p=0.12). Conclusions: the method is usefu

Frederico Faria, Rodrigues; Michelle Soares de, Moura; Eduardo Camargo, Millen; José Francisco Dória, Ramos; Salete, Yatabe; Reginaldo Guedes Coelho, Lopes; Umberto Gazi, Lippi.

2001-08-01

287

PATOLOGIA ENDOMETRIAL EN MUJERES CON SANGRADO ANORMAL DURANTE TERAPIA DE REEMPLAZO HORMONAL  

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Full Text Available Se presenta un estudio para analizar la incidencia de patología endometrial en mujeres sanas posmenopáusicas que reciben terapia de reemplazo hormonal (TRH y que presentan sangrado uterino anormal. Se estudiaron 188 mujeres posmenopáusicas que presentaron flujo rojo uterino anormal (irregular o excesivo durante TRH con estrógenos y progesterona en diferentes esquemas (49% secuencial continuo; 39% combinado continuo; 12% secuencial discontinuo. Al 100% de las pacientes se les realizó en forma ambulatoria un estudio biópsico aspirativo de endometrio. El procedimiento fue bien tolerado y no se observaron complicaciones hemorrágicas o infecciosas. Los resultados histológicos fueron los siguientes: endometrio secretor 28,8%; endometrio proliferativo 31,3%; endometrio atrófico 18,0%; hiperplasia endometrial sin atipías 4,3%; pólipo endometrial benigno 2,7%; tejido endometrial benigno, inactivo o fragmentos de epitelio 11,7%; adenocarcinoma de endometrio 0,5% y ausencia de tejido endometrial 2,7%. La biopsia aspirativa de endometrio permitió conocer la situación endometrial en 97,3% de las pacientes. Muestra insuficiente para diagnóstico se obtuvo en un 2,7% de los casos sugiriendo atrofia endometrial o patología focal no diagnosticada por el método. Se concluye que la baja incidencia de patología maligna de endometrio en nuestro estudio confirma su baja incidencia en mujeres que reciben esquemas adecuados de terapia de reemplazo hormonalObjetive: To analyze the frequency of endometrial pathology in healthy postmenopausal women who presented abnormal uterine bleeding during HRT. Subject and Methods: The case of 188 postmenopausal women (54,8 + 6.6 years of age and 38,1 months of therapy presenting abnormal uterine bleeding (irregular or excessive while using HRT with estrogen and progestin in different schemes (49% sequential continuous; 39% combined continuous; 12% sequential discontinuous. All the patients underwent endometrial aspiration biopsies between January 1996 and October 2002 using a 2 mm (Z sampler aspiration curette. The samples were preserved in formaline, processed with standard methods and stained by hematoxylin and eosin. Results: We found secretor endometrium 28,8%; proliferative endometrium 31,3%; atrophic endometrium 18,0%; hyperplastic endometrium without atypia 4,3%; benign endometrial polyps 2,7%; benign endometrial tissue, inactive or fragment of epithelium 11,7%: endometrial adenocarcinoma 0,5%; and absence of endometrial tissue 2,7%. Conclusions: Aspirative curettage of the endometrium permitted to know the endometrial condition in 97.3% of patients; the remaining 2.7% could correspond to atrophic endometrium of misdiagnosed focal pathology. We conclude that on standard HRT regimens the prevalence of malignant pathology in patients with irregular bleeding is very low

Marcelo Bianchi P.

2003-01-01

288

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 theology 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

289

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

290

Imaging of endometrial lesion  

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Full Text Available Introduction & Background: The main role of imaging of endometrium is to differentiate between normal and abnormal endometrium and triage patients to those patients requiring guided biopsy vs. those patients that can be managed by blind biopsy. Endometrial thickness of 5mm has been proven to be a reliable threshold to ex-clude endometrial cancer. Transvaginal sonography (TVS can detect focal pathology in most cases. Endo-metrial polyp and submucosal fibroid (SMF have distinguishing features on TVS. Endometrial polyp is recog-nized by the presence of a complete endometrial stripe sign. SMF presenting as endometrial mass shows stretched overlying endometrium and continuity with myometrium as specific features. Sonohysterography (SHG is indicated when TVS is suboptimal or inconclusive as well as for staging of SMF prior to surgery. Hys-teroscopic removal of SMF requires that more than 50% of the mass is intracavitary. Some technical points re-lated to SHG and the mechanism and sonographic changes of endometrium due to tamoxifen are also dis-cussed. An algorithm is presented for sonographic-based assessment of endometrial thickening.

M. Atri

2005-08-01

291

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

292

Mapping the immunosuppressive environment in uterine tumors: implications for immunotherapy.  

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The major hurdle for cancer vaccines to be effective is posed by tumor immune evasion. Several common immune mechanisms and mediators are exploited by tumors to avoid immune destruction. In an attempt to shed more light on the immunosuppressive environment in uterine tumors, we analyzed the presence of PD-L1, PDL2, B7-H4, indoleamine 2,3-dioxygenase (IDO), galectin- 1, galectin-3, arginase-1 activity and myeloid-derived suppressor cell (MDSC) infiltration. IDO, PD-L1, PD-L2 and B7-H4 were analyzed by immunohistochemistry. PDL2 was mostly expressed at low levels in these tumors. We found high IDO expression in 21 % of endometrial carcinoma samples and in 14 % of uterine sarcoma samples. For PD-L1 and B7-H4, we found high expression in 92 and 90 % of endometrial cancers, respectively, and in 100 and 92 % of the sarcomas. Galectin-1 and 3 were analyzed in tissue lysates by ELISA, but we did not find an increase in both molecules in tumor lysates compared with benign tissues. We detected expression of galectin-3 by fibroblasts, immune cells and tumor cells in single-cell tumor suspensions. In addition, we noted a highly significant increase in arginase-1 activity in endometrial carcinomas compared with normal endometria, which was not the case for uterine sarcomas. Finally, we could demonstrate MDSC infiltration in fresh tumor suspensions from uterine tumors. These results indicate that the PD-1/PD-L1 interaction and B7-H4 could be possible targets for immune intervention in uterine cancer patients as well as mediation of MDSC function. These observations are another step toward the implementation of inhibitors of immunosuppression in the treatment of uterine cancer patients. PMID:24658839

Vanderstraeten, Anke; Luyten, Catherine; Verbist, Godelieve; Tuyaerts, Sandra; Amant, Frederic

2014-06-01

293

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.

294

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

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Full Text Available 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 tratadas 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 benignaObjective: 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

2007-01-01

295

Avaliação de morfologia e histologia endometrial de mulheres após a menopausa / Assessment of endometrial morphology and histology in postmenopausal women  

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Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese OBJETIVO: Avaliar ambulatorialmente a morfologia e histologia endometrial de mulheres sem sangramento genital após a menopausa. MÉTODOS: Em estudo descritivo foram selecionadas 52 mulheres, após a menopausa, entre 50 e 60 anos, sem terapia hormonal nos últimos seis meses. Todas foram submetidas a ex [...] ame ultrassonográfico, histeroscópico e biópsias endometriais. RESULTADOS: Das 52 mulheres selecionadas 32 (61,5%) apresentaram ultrassonografia normal, cavidade uterina normal com endométrio atrófico à histeroscopia, confirmada pela biópsia endometrial. Vinte (38,4%) apresentaram achados histeroscópicos ou histológicos anormais, sendo que apenas cinco destas mostraram endométrio com espessura superior a cinco milímetros ao ultrassom. CONCLUSÃO: A histeroscopia diagnóstica associada à biópsia aspirativa (Pipelle) pode evidenciar alterações não observadas ao ultrassom transvaginal. Abstract in english OBJECTIVE: Evaluate in outpatients , the endometrial morphology and histology of non- bleeding postmenopausal women. METHODS: We conducted a descriptive study where 52 menopausal women were selected, between 50 and 60 years of age, who had not used hormone replacement therapy in the last six months [...] and did not present any kind of vaginal bleeding after menopause. These women underwent ultrasound examination, hysteroscopy and biopsy, and then endometrial findings were analyzed. RESULTS: Of the 52 women selected, thirty two (61,5%) had normal ultrasound, normal uterine cavity with atrophic endometrium, hysteroscopy, confirmed by endometrial biopsy. Twenty (38,4%) had hysteroscopuc and histologic alterations and only five women showed by ultrasound an endometrial thickness of more than five millimeters. CONCLUSION: Diagnostic Hysteroscopy associated with aspiration biopsy (Pipelle) performed in the day care facility can reveal endometrial alterations that cannot be diagnosed by transvaginal ultrasound.

Luis Paulo Galvao, Wolff; André Aguiar do, Monte; Ana Carolina de Souza, Atti; Ilza Maria Urbano, Monteiro.

296

Beta3 Integrin Expression within Uterine Endometrium and its Relationship with Unexplained Infertility  

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Full Text Available The aim of this study was to investigate whether the endometrium of women with unexplained infertility differs in the presence of the beta 3 (?3 integrin molecule from the endometrium of normal fertile women. In a retrospective case-control study 30 endometrial biopsies from hysterectomies with nonendometrial pathology and 30 endometrial samples from women with a history of unexplained infertility were collected during the window of implantation. Immunohistochemically staining with a monoclonal antibody against ?3 integrin subunit in endometrial biopsies was performed and then assessed semiquantitively by microscope on different endometrial compartments including glandular epithelial cells, vessels, lymphocytes, macrophages and stromal cells. Chi-square test was used to compare the expression and defect of ?3 integrin subunit between two groups. The results showed that ?3 integrin molecules were present in fertile and infertile endometrial uterine tissues. The majority of glandular epithelial cells expressed ?3 integrin in fertile endometrium. However, the endometrial expression of ?3 integrin was reduced significantly in infertile endometrium during the window of implantation (p<0.05. A few numbers of vessels and stromal cells expressed ?3 integrin molecule with no statistical significance between the two groups. In conclusion Abnormal endometrial integrin expression is a frequent finding in women with unexplained infertility. A therapeutic potential approach in improving uterine endometrium receptivity together with up-regulation of ?3 integrin in this population of women suggested.

M. Ghafourian Boroujerdnia

2008-01-01

297

Beta3 integrin expression within uterine endometrium and its relationship with unexplained infertility.  

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The aim of this study was to investigate whether the endometrium of women with unexplained infertility differs in the presence of the beta 3 (beta3) integrin molecule from the endometrium of normal fertile women. In a retrospective case-control study 30 endometrial biopsies from hysterectomies with nonendometrial pathology and 30 endometrial samples from women with a history of unexplained infertility were collected during the window of implantation. Immunohistochemically staining with a monoclonal antibody against beta3 integrin subunit in endometrial biopsies was performed and then assessed semiquantitively by microscope on different endometrial compartments including glandular epithelial cells, vessels, lymphocytes, macrophages and stromal cells. Chi-square test was used to compare the expression and defect of beta3 integrin subunit between two groups. The results showed that beta3 integrin molecules were present in fertile and infertile endometrial uterine tissues. The majority of glandular epithelial cells expressed beta3 integrin in fertile endometrium. However, the endometrial expression of beta3 integrin was reduced significantly in infertile endometrium during the window of implantation (p < 0.05). A few numbers of vessels and stromal cells expressed beta3 integrin molecule with no statistical significance between the two groups. In conclusion Abnormal endometrial integrin expression is a frequent finding in women with unexplained infertility. A therapeutic potential approach in improving uterine endometrium receptivity together with up-regulation of beta3 integrin in this population of women suggested. PMID:19205270

Boroujerdnia, M Ghafourian; Nikbakht, R

2008-11-01

298

Uterine tumors resembling ovarian sex cord tumors (UTROSCT) with metastasis: clinicopathological study of two cases  

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Uterine tumors with sex cord-like elements are divided in two groups; uterine tumors resembling ovarian sex cord tumors (UTROSCT), and endometrial stromal tumors with sex cord-like elements (ESTSCLE). UTROSCT is currently defined as the neoplasm predominantly or exclusively composed of sex cord-like elements, and generally behaves in a benign fashion. We studied two unusual cases of UTROSCT with metastasis. One case was a 38-year-old multiparous woman presented with hypermenorrhea. The tumor ...

Umeda, Shigeaki; Tateno, Masatoshi; Miyagi, Etsuko; Sakurai, Koji; Tanaka, Reiko; Tateishi, Yoko; Tokinaga, Aya; Ohashi, Kenichi; Furuya, Mitsuko

2014-01-01

299

Endometrial Cancer Prevention  

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... pregnant. This increases the risk of endometrial cancer. Tamoxifen Tamoxifen is one of a group of drugs called selective estrogen receptor modulators , or SERMs. Tamoxifen acts like estrogen on some tissues in the ...

300

Genetics of Endometrial Cancers  

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Endometrial cancers exhibit a different mechanism of tumorigenesis and progression depending on histopathological and clinical types. The most frequently altered gene in estrogen-dependent endometrioid endometrial carcinoma tumors is PTEN. Microsatellite instability is another important genetic event in this type of tumor. In contrast, p53 mutations or Her2/neu overexpression are more frequent in non-endometrioid tumors. On the other hand, it is possible that the clear cell type may arise fro...

Takashi Okai; Masaki Hayashi; Miki Morioka; Masaaki Nagatsuka; Akihiko Sekizawa; Yuditiya Purwosunu; Tsuyoshi Okuda

2010-01-01

 
 
 
 
301

Estrogen receptor expression and glucose metabolism of uterine tumors  

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We aimed to clarify the relationship between estrogen receptor (ER) expression and glucose metabolism using 16 ?-[18F]fluoro-17?-estradiol (FES) and fluorodeoxyglucose positron emission tomography (FDG PET) in patients with benign and malignant uterine tumors. Endometrial carcinoma and sarcoma showed greater standardized uptake value (SUV) for FDG than for FES. In contrast, hyperplasia and leiomyoma showed opposite patterns for tracer accumulation. ER expression and glucose metabolism measured by PET showed opposite tendencies. PET studies with both FES and FDG could provide pathophysiologic information for the differential diagnosis of uterine tumors. (author)

302

Defining postpartum uterine disease and the mechanisms of infection and immunity in the female reproductive tract in cattle.  

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Uterine microbial disease affects half of all dairy cattle after parturition, causing infertility by disrupting uterine and ovarian function. Infection with Escherichia coli, Arcanobacterium pyogenes, and bovine herpesvirus 4 causes endometrial tissue damage. Toll-like receptors on endometrial cells detect pathogen-associated molecules such as bacterial DNA, lipids, and lipopolysaccharide (LPS), leading to secretion of cytokines, chemokines, and antimicrobial peptides. Chemokines attract neutrophils and macrophages to eliminate the bacteria, although persistence of neutrophils is associated with subclinical endometritis and infertility. Cows with uterine infections are less likely to ovulate because they have slower growth of the postpartum dominant follicle in the ovary, lower peripheral plasma estradiol concentrations, and perturbation of hypothalamic and pituitary function. The follicular fluid of animals with endometritis contains LPS, which is detected by the TLR4/CD14/LY96 (MD2) receptor complex on granulosa cells, leading to lower aromatase expression and reduced estradiol secretion. If cows with uterine disease ovulate, the peripheral plasma concentrations of progesterone are lower than those in normal animals. However, luteal phases are often extended in animals with uterine disease, probably because infection switches the endometrial epithelial secretion of prostaglandins from the F series to the E series by a phospholipase A2-mediated mechanism, which would disrupt luteolysis. The regulation of endometrial immunity depends on steroid hormones, somatotrophins, and local regulatory proteins. Advances in knowledge about infection and immunity in the female genital tract should be exploited to develop new therapeutics for uterine disease. PMID:19439727

Sheldon, I Martin; Cronin, James; Goetze, Leopold; Donofrio, Gaetano; Schuberth, Hans-Joachim

2009-12-01

303

Uterine fibroids: clinical manifestations and contemporary management.  

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Uterine fibroids (leiomyomata) are extremely common lesions that are associated with detrimental effects including infertility and abnormal uterine bleeding. Fibroids cause molecular changes at the level of endometrium. Abnormal regulation of growth factors and cytokines in fibroid cells may contribute to negative endometrial effects. Understanding of fibroid biology has greatly increased over the last decade. Although the current armamentarium of Food and Drug Administration-approved medical therapies is limited, there are medications approved for use in heavy menstrual bleeding that can be used for the medical management of fibroids. Emergence of the role of growth factors in pathophysiology of fibroids has led researchers to develop novel therapeutics. Despite advances in medical therapies, surgical management remains a mainstay of fibroid treatment. Destruction of fibroids by interventional radiological procedures provides other effective treatments. Further experimental studies and clinical trials are required to determine which therapies will provide the greatest benefits to patients with fibroids. PMID:24819877

Doherty, Leo; Mutlu, Levent; Sinclair, Donna; Taylor, Hugh

2014-09-01

304

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

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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.

305

Ultrasonographic pattern in endometrial carcinoma: Analysis of 45 cases based on endovaginal ultrasonography  

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The purpose of the present report is to determine the most common presentations of endometrial cancer according to endovaginal (EV) ultrasonography. The ultrasound findings obtained by transvaginal exploration were analyzed in 45 confirmed cases of endometrial cancer studied in our hospital between March 1993 and October 1994. The parameters assessed were as follows: emometrial thickness of 8 mm or more; well defined or poorly defined margins; homogeneous or heterogeneous, echogenic or hypoechogenic contents; diseases extension to myometrium and/or uterine cervix at the time of diagnosis. The most common finding (91.1%) was an endometrial thickness of over 8 mm, with a mean thickness of 20.6 mm. The most common pattern in our series was as follows: thickened endometrial structure (91.1.%), with poorly defined margins (62.2%), heterogeneity (68.9%) and echogenicity (88.8%). Sixty percent of patients presented evidence of myometrial invasion and cervix was involved in 26.6%. (Author) 12 refs

306

[Malignant neoplasms of the uterus in women treated with uterine artery embolization for presumed leiomyoma--description of three cases].  

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Leiomyomas are the most common tumors of the uterus. Uterine artery embolization has been accepted as an alternative method for myomectomy or hysterectomy However lack of histologic conformation carries the risk of misdiagnosis of cancer so a thorough diagnostic testing is needed. Leiomyosarcomas are rare but very aggressive tumors of the uterine tract. The risk of leiomyosarcoma in myomata is very low, but it is necessary to remember about it, especially when we have no tissue for histological examination. Our report presents three cases of women diagnosed with leiomyosarcomas or endometrial cancer after uterine artery embolization for suspected symptomatic uterine fibroids. PMID:23700853

Gajewska, Ma?gorzata; Panek, Grzegorz

2013-03-01

307

Uterine Fibroid Embolization  

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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 inc...

Malek, R.; Padidar, A.

2003-01-01

308

Coffee and Endometrial Cancer Risk  

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Full Text Available ... according to new research. The study evaluated the association of dietary factors with endometrial cancer risk. The ... foods and nutrients, 9 were found to have associations with endometrial cancer, but only one could be ...

309

Risks of Endometrial Cancer Screening  

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... Health history and certain medicines can affect the risk of developing endometrial cancer. Anything that increases your ... have abnormal vaginal bleeding, check with your doctor. Risks of Endometrial Cancer Screening Screening tests have risks. ...

310

Estriolum treatment in the bitch: a risk for uterine infection?  

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Purulent vaginal discharge in a bitch in which ovariohysterectomy has been performed is often caused by inflammation of the uterine stump. The inflammation is due to either cystic endometrial hyperplasia (CEH) induced primarily by progesterone from remnant ovarian tissue or exogenous progestagens, or it is due to the presence of unabsorbed suture material. This report describes a 9-year-old Irish setter with hemopurulent vaginal discharge and non-pruritic symmetrical alopecia, which had under...

Schotanus, B. A.; Gier, J.; Lugt, J. J.; Schaefers-okkens, A. C.; Penning, L. C.

2008-01-01

311

POSSIBILITIES OF PHARMACALOGIC THERAPY APPLIED IN ABNORMAL UTERINE BLEEDING  

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The range of alternatives to hysterectomy includes ‘expanded’ oral medical regimens, the levonorgestrel-releasing intrauterine system (LNG-IUS), a wide range of endometrial ablative techniques, and where fibroids are the primary pathology—myomectomy and uterine artery embolization. Since the research has shown that hysterectomy is a highly effective treatment, these alternatives must be assessed against the recognized high satisfactory rates and improved quality of life reported followi...

Valentina Nikolic; Milan Stefanovic; Srdjan Pesic

2006-01-01

312

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

313

Clinical evaluation of high-intensity focused ultrasound in treating uterus myomas  

International Nuclear Information System (INIS)

Objective: To explore the safety and efficacy of high-intensity focused ultrasound (HIFU) for the treatment of uterus myomas. Methods: HIFU was performed in 47 patients with symptomatic hysteromyoma, who had a childbearing history and were 26-59 years old. Postoperative follow-up was carried out. Clinical symptoms and the tumor's size were observed before and after the HIFU treatment. The results were compared with each other. Results: After HIFU treatment, the symptoms such as dysmenorrhea and hypermenorrhea were markedly improved. Some patients developed hematuria or lower limb pain, which was relieved after symptomatic management. The average volume of myoma before the treatment was (47.6 ± 24.1) cm3 and it was reduced to (17.7 ± 13.1) cm3 at 6 months after the treatment, the difference was statistically significant (P < 0.05). Conclusion: HIFU is a safe and effective treatment for uterus myomas. (authors)

314

Annexin-A2 as predictor biomarker of recurrent disease in endometrial cancer.  

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Endometrial carcinomas, the most common malignant tumour of the female genital tract, are usually diagnosed at an early stage with uterine-confined disease and an overall favourable prognosis. However, up to 20% of endometrial carcinomas will end up in recurrent disease, associated with a drop in survival and representing the major clinical challenge. Management of this group of risk patients relies on robust biomarkers that may predict which endometrial carcinomas will relapse. For this, we performed a proteomic analysis comparing primary lesions with recurrences and identified ANXA2 as a potential biomarker associated with recurrent disease that we further validated in an independent series of samples by immunohistochemistry. We demonstrated in vitro a role for ANXA2 in the promotion of metastasis rather than interfering with sensitivity to radio/chemotherapy. In addition, ANXA2 silencing resulted in a reduced metastatic pattern in a mice model of endometrial cancer dissemination, with a limited presence of circulating tumor cells. Finally, a retrospective study in a cohort of 93 patients showed that ANXA2 effectively predicted those endometrioid endometrial carcinomas that finally recurred. Importantly, ANXA2 demonstrated a predictive value also among low risk Stage I endometrioid endometrial carcinomas, highlighting the clinical utility of ANXA2 biomarker as predictor of recurrent disease in endometrial cancer. Retrospective and prospective studies are ongoing to validate ANXA2 as a potential tool for optimal stratification of patients susceptible to receive radical surgery and radio/chemotherapy. PMID:25219463

Alonso-Alconada, Lorena; Santacana, Maria; Garcia-Sanz, Pablo; Muinelo-Romay, Laura; Colas, Eva; Mirantes, Cristina; Monge, Marta; Cueva, Juan; Oliva, Esther; Soslow, Robert A; Lopez, Maria Angeles; Palacios, Jose; Prat, Jaime; Valls, Joan; Krakstad, Camilla; Salvesen, Helga; Gil-Moreno, Antonio; Lopez-Lopez, Rafael; Dolcet, Xavier; Moreno-Bueno, Gema; Reventos, Jaume; Matias-Guiu, Xavier; Abal, Miguel

2015-04-15

315

[The morphological features of the uterine body adenocarcinoma].  

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The anthors studied the morphological features of uterine adenocarcinoma using immunohistochemical methods. The endometrial tissue was studed resulting from surgery - hysterectomy with oophorectomy in 103 patients aged 45-76 years with a clinical diagnosis of endometrial cancer. To exclude false-positive and false-negative results, we carry out same investigation on 12 patients with morphological diagnosis easy-glandular hyperplasia of the endometrium. The results showed that the endometrioid adenocarcinomas exhibit the high and moderate expression of estrogen and progesterone receptors and low rate of the proliferation marker Ki-67. For serous-paapillary andenocarcionoma of the uterine body the negative ER-PR-receptor over expression phenotype and proliferation marker Ki-67 superexpression are characteristic. The results showed that in a simple-glandular endometrial hyperplasia is determined a moderate expression of estrogen and progesterone receptors, as for the Ki-67 proliferation marker an expression was found only in the single arears with an average of 5-8% of findings. Based at shis study it may be concluded thate the use of immunohistochemical studies particularly a detection of negative estrogen and progesterone resceptor phenotype and high expression of the proliferation marker Ki-67 is an additional defferential diagnostic eriterion for the diagnosis of serous papillary adenocarcinoma of the uterine body thet will ensure adepuate therapeutis approach to patients suffering from this disorder. Given he fact that serous papillary carcinoma of the endometrium is the most common neoplesm of the rarer forms of endometrial cancer with an extremely peculiar aggressive coures a ssurgical treatment as in overian cancer is recommended for this parthology, including a hysterectomy with bilateral oophorectomy, lymphadenectomy, omentektomy, cytological examination of the abdomend and biopsy of suspicious areas of the abdominal cavity, with adjuvant treatment including chemotherapy and radiation therapy. The absence of estrogen and progesterone receptors on serous-papilary adenocarcinoma of the uterine body justifies the inadvisability of hormone therapy in these patients. Since the patients with serous-papillary adenocarcinoma of the uterine body need a larger voluve surgical treatment the patients with ?ndometrioid adenocarcinoma of the uterine body. We consider that this morphological type of uterine cancer should be diagnosed preoperatively. PMID:25020177

2014-06-01

316

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

317

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

318

Saline infusion sonohysterography versus hysteroscopy for uterine cavity evaluation  

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Full Text Available 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 uterine bleeding. Design and Setting: A prospective study in the ultrasound department of the Women?s Specialized Hospital, King Fahad Medical City, Riyadh, Saudi Arabia from January 2008 to February 2010. Patients and Methods: 0One hundred and one patients with abnormal uterine bleeding, suspected to have endometrial abnormality by 2D and 3D transvaginal scan, were prospectively studied. Of these, 55 patients had undergone both 3D SIS and DH, followed by verification of results with histopathology. Results: Upon comparison of 3D SIS and DH individually with histopathology, specificity and sensitivity for 3D SIS were 67% and 100%, respectively, and for hysteroscopy 67% and 98%, respectively. In addition, the positive predictive value and negative predictive value were 98% and 100%, respectively, for 3D SIS, while for DH they were 98% and 67%, respectively. Conclusion: 3D SIS is a safe alternative to hysteroscopy. However, larger randomized controlled trials should be conducted to ascertain the validity and reliability of this advantageous, less-invasive procedure, for women with abnormal uterine bleeding, who require evaluation of the endometrial cavity.

Khan Faryal

2011-01-01

319

YWHAE-FAM22 endometrial stromal sarcoma: diagnosis by reverse transcription-polymerase chain reaction in formalin-fixed, paraffin-embedded tumor.  

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A subset of endometrial stromal sarcoma harbors t(10;17)(q23;p13), which results in the genetic fusion between YWHAE and 1 of 2 highly homologous FAM22 family members-FAM22A or FAM22B. In contrast to classic low-grade endometrial stromal sarcoma with JAZF1-SUZ12 fusions, YWHAE-FAM22 endometrial stromal sarcoma displays high-grade histologic features and is associated with more aggressive disease course. Ancillary fluorescence in situ hybridization assay demonstrating the presence of YWHAE rearrangement can be used to support the diagnosis, but the detection of fusion transcript would be the most definitive test. We describe here an optimized reverse transcription-polymerase chain reaction assay for detection of YWHAE-FAM22 fusion transcript in formalin-fixed and paraffin-embedded tumor samples. We studied a series of 6 YWHAE-FAM22 endometrial stromal sarcomas, 7 JAZF-SUZ12 endometrial stromal sarcomas, 3 JAZF1-PHF1/EPC1-PHF1 endometrial stromal sarcomas, 6 undifferentiated endometrial sarcomas, 4 uterine leiomyosarcomas, and 4 uterine adenosarcomas. All 6 YWHAE-FAM22 endometrial stromal sarcomas were confirmed by fluorescence in situ hybridization assay, whereas all non-YWHAE-FAM22 tumors were confirmed to lack YWHAE rearrangement by fluorescence in situ hybridization assay. The reverse transcription-polymerase chain reaction assay optimized for formalin-fixed and paraffin-embedded samples detected YWHAE-FAM22 fusion transcripts in all 6 YWHAE-FAM22 endometrial stromal sarcomas and none of the 24 non-YWHAE-FAM22 uterine sarcomas. These findings show that this reverse transcription-polymerase chain reaction assay is sensitive and specific for detection of YWHAE-FAM22 fusion transcript and can serve as a useful adjunct diagnostic assay to confirm the diagnosis of YWHAE-FAM22 endometrial stromal sarcoma in formalin-fixed and paraffin-embedded tumor samples. PMID:23159154

Isphording, Anna; Ali, Rola H; Irving, Julie; Goytain, Angela; Nelnyk, Nataliya; Hoang, Lien N; Gilks, C Blake; Huntsman, David G; Nielsen, Torsten O; Nucci, Marisa R; Lee, Cheng-Han

2013-05-01

320

Metaplasia óssea e esterilidade primária Endometrial osseous metaplasia and primary infertility  

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Full Text Available A metaplasia óssea do endométrio é uma condição rara e pode ser explicada por uma neoformação no endométrio, com deposição de sais de cálcio. Entretanto, a situação mais comum é a história prévia de abortamento com permanência de ossículos na cavidade uterina. Foi relatado um caso de ossificação endometrial em uma mulher de 31 anos, sem gravidez prévia ou história de aborto, apresentando dismenorréia e infertilidade. A ultra-sonografia pélvica mostrou área hiperecóica no fundo da cavidade uterina. A histeroscopia foi realizada e uma imagem sugestiva de tecido ósseo foi encontrada. Este tecido foi retirado e a histopatologia confirmou a ossificação endometrial.Endometrial metaplastic ossification is a rare condition and can be partially explained by a neoformation in the endometrium, with calcium deposition. However, a common situation is the previous history of abortion with persistence of ossicles in the uterine cavity. The endometrial ossification was reported in a 31-year-old woman, without previous pregnancy or history of abortion. This patient presented dysmenorrhea and infertility. Pelvic ultrasonography showed a hyperechoic area in the uterine fundus. Histeroscopy was performed and an image suggestive of bone was seen. This tissue was removed by histeroscopy and the histopathological analysis confirmed endometrial ossification.

Celeste P. Demeterco Reggiani

2001-03-01

 
 
 
 
321

Atypical uterine bleeding-Histopathological audit of endometrium A study of 638 cases  

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Full Text Available Background: AUB is one of the most common problems in women of all ages especially those in the peri-menopausal age group. The abnormal bleeding can be caused by a wide variety of disorders and it is one of the commonest complaints leading to endometrial sampling. Objectives: Our study aimed at determining the types and frequencies of endometrial pathologies in patients presenting with abnormal uterine bleeding at our hospital which caters largely to women of low socioeconomic status. Material and Methods: The present study was conducted at the Hakeem Abdul Hameed Centenary Hospital, New Delhi. This was a retrospective age specific comparative analysis of 638 women presenting with abnormal uterine bleeding, who underwent endometrial sampling at our hospital. The pattern of endometrial histopathological changes were identified and classified. Results: Age of the patients ranged from 15 to 70 years, maximum patients (35.89 % in the age group 41-50 years. The most common clinical presentation was represented by menorrhagia (41% Various patterns on histopathology were secretory endometrium(28.99%the commonest, followed by proliferative endometrium (24.92%. Incidence of malignancy was low in the present study. Conclusion: Endometrial curetting and biopsy is an important diagnostic procedure in evaluation of AUB.. Endometrial causes of AUB are age related, therefore it is specially recommended in women of the perimenopausal age presenting with AUB, to rule out preneoplasia and malignancy.

Zeeba S. Jairajpuri

322

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).

323

Uterine Cancer Statistics  

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... Prostate Skin Vaginal and Vulvar Cancer Home Uterine Cancer Statistics Language: English Español (Spanish) Share Compartir Uterine cancer ... comparing incidence and death counts. â? Source: U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2011 ...

324

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 ...

325

HER2 gene amplification and EGFR expression in a large cohort of surgically staged patients with nonendometrioid (type II) endometrial cancer  

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Type II endometrial cancers (uterine serous papillary and clear cell histologies) represent rare but highly aggressive variants of endometrial cancer (EC). HER2 and EGFR may be differentially expressed in type II EC. Here, we evaluate the clinical role of HER2 and EGFR in a large cohort of surgically staged patients with type II (nonendometrioid) EC and compare the findings with those seen in a representative cohort of type I (endometrioid) EC. In this study HER2 gene amplification was studie...

Konecny, G. E.; Santos, L.; Winterhoff, B.; Hatmal, M.; Keeney, G. L.; Mariani, A.; Jones, M.; Neuper, C.; Thomas, B.; Muderspach, L.; Riehle, D.; Wang, H-j; Dowdy, S.; Podratz, K. C.; Press, M. F.

2008-01-01

326

Endometrial epithelial cells are potent producers of tracheal antimicrobial peptide and serum amyloid A3 gene expression in response to E. coli stimulation  

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Endometrial epithelial cells play a critical role in mediating inflammatory mechanisms key to bacterial clearance and tissue re-modelling postpartum. This study characterised innate immune gene expression by bovine endometrial epithelial cells from three animals in response to Escherichia coli, a common cause of bovine uterine disease. Expression of key innate immune genes, encoding Toll-like receptor 4 (TLR4), the transcription factor NFkB1, the chemokine interleukin 8 (IL8), ...

Chapwanya, Aspinas; Meade, Kieran G.; Doherty, Michael L.; Callanan, John J.; O’farrelly, Cliona

2013-01-01

327

Interdisciplinary stratification of patients with myoma-related symptoms  

International Nuclear Information System (INIS)

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.)

328

Uterine leiomyoma  

International Nuclear Information System (INIS)

To correlate the signal intensity of uterine leiomyoma with its pathologic characteristics, with particular emphasis on the fibrous component, 33 magnetic resonance (MR) examinations that revealed 93 leiomyomas were prospectively studied. All patients were imaged in axial and sagittal planes with different spin-echo pulse sequences to obtain T1-, T2-weighted, and proton density images. Nondegenerative leiomyomas (N-62) showing a homogeneous signal of low intensity, and degenerative leiomyomas (N-31) with a heterogeneous signal of variable intensity on T2-weighted images could be correlated. Histopathological assessment of fiber constitution and degeneration, and MR intensity were interpreted by independent observers. There was excellent accord between the averages for MR intensity, T2 relaxation time and fiber content, although the intensity values in each fiber grade showed a wide range. The greater the fiber content the lower the MR intensity on T2-weighted images, and the shorter the T2 relaxation time (p<0.0001). In addition, the manner in which fiber distribution affected MR appearance was also elucidated. These data contribute to guidelines for precise tissue differentiation of myogenic tumors on MR images, and for MR imaging tissue diagnosis of any lesion with a considerable fibrous element. (author)

329

Xanthogranulomatous appendicitis causing an endometrial abscess: radiological findings.  

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Xanthogranulomatous inflammation (XGI) is a rare chronic inflammatory condition most commonly involving the kidneys and gallbladder. The condition is histopathologically characterized by the presence of foamy histiocytes, lymphocytes, and plasma cells. A few reports describing appendicitis caused by XGI have appeared in the English-language literature. However, no study has yet focused on the imaging features of xanthogranulomatous appendicitis (XGA). We present a pathologically confirmed case of XGA with an endometrial abscess; the patient underwent ultrasonography, computed tomography, and magnetic resonance imaging. To the best of our knowledge, this is the first case of XGA with uterine and right adnexal involvement presenting as a complicated pelvic abscess on radiological imaging. PMID:25412596

Altay, Canan; Yavuz, Esra; Egeli, Tufan; Canda, Emre Aras; Sarioglu, Sulen; Secil, Mustafa

2014-11-21

330

Effects of operative hysteroscopy with anti-adhesive solution in the patients who have abnormal uterine bleeding or intrauterine lesions  

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Full Text Available Objective: The purpose of this study was to evaluate the efficacy, safety, and benefits of hysteroscopic surgery in the treatment of dysfunctional uterine bleeding (DUB or intrauterine lesions causing uterine bleeding. Methods: This study prospectively enrolled 100 patients who underwent operative hysteroscopy in tertiary referral university center because of uterine bleeding due to endometrial polyps or uterine submucosal leiomyomas diagnosed by transvaginal ultrasonogram. Indications for the operative hysteroscopies included abnormal uterine bleeding (AUB, ultrasound findings indicative of intrauterine lesions, and DUB. After operative hysteroscopic management, we inserted anti-adhesive solution, sodium hyaluronate and carboxymethyl cellulose into the uterine cavity. Results: Operative hysteroscopy was a successful procedure in 100 of 100 cases (100% but it needed to be repeated in three cases with large uterine submucosal leiomyoma and after two endometrial polypectomy. Mean duration of the procedure was 23.2 minutes (range 5 - 67 and postoperative hospital stay was 7 hours (range 3 - 48. Most common indication was DUB (39%, submucosal leiomyoma was 21%, and endometrial polyp was 17%. There were five cases with postoperative uterine bleeding and none with fluid overload syndrome. During postoperative follow-up (3 - 28 months the majority of patients (90/100, 90% were free of symptoms. Conclusion: Hysteroscopic procedure is an effective and safe method for the management of benign intracavitary pathology or the treatment of dysfunctional uterine bleeding. Although sodium hyaluronate and carboxymethyl cellulose seems to be effective in the prevention of adhesion in uterine cavity, further study will be needed to prove the effectiveness of anti-adhesive solution.

Junsik Park

2013-05-01

331

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 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. PMID:25276729

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

2013-01-01

332

Evaluation of endometrium in peri-menopausal abnormal uterine bleeding.  

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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

333

Center for Uterine Fibroids  

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... collaboration to search for the causes of and treatments for uterine fibroids. The Mission of the Center for Uterine Fibroids ... growth and development To develop and test innovative treatment options for uterine fibroids including growth factor-directed therapy and gene therapy ...

334

21 CFR 884.1185 - Endometrial washer.  

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...2010-04-01 2010-04-01 false Endometrial washer. 884.1185 Section 884.1185 Food...Diagnostic Devices § 884.1185 Endometrial washer. (a) Identification. An endometrial washer is a device used to remove...

2010-04-01

335

Oxytocin stimulated release of PGF2? and its inhibition by a cyclooxygenase inhibitor and an oxytocin receptor antagonist from equine endometrial cultures.  

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Uterine inflammation results in a poor uterine environment and early embryonic loss in the mare due to an inhibition of maternal recognition of pregnancy caused from increased prostaglandin F2? (PGF2?). Oxytocin binds to endometrial cell receptors to activate prostaglandin synthesis. An oxytocin receptor antagonist (Atosiban) and a cyclooxygenase inhibitor (indomethacin) both decrease PGF2? production. The aim of this study was to evaluate the in vitro effects of Atosiban and indomethacin on equine uterine prostaglandin secretion. Equine endometrial explants were harvested on day two of behavioral estrus. Endometrial explant cultures were challenged with oxytocin (250nM) and PGF2? concentrations were measured over time. Explants were also cultured with Atosiban and indomethacin for 6h to determine the influence on PGF2? secretion. When endometrial explants were challenged with oxytocin, PGF2? concentrations were greater (PAtosiban or indomethacin. These findings show equine endometrial explants can be stimulated with oxytocin to increase secretion of PGF2? and this secretion can be inhibited through an oxytocin receptor antagonist and a Cox inhibitor, suggesting that this response to oxytocin involves an oxytocin receptor mediated event that activates the prostaglandin synthesis cascade through cyclooxygenase. Furthermore, this data suggests a role for the use of these inhibitors in vivo to decrease uterine PGF2? secretion and prevent early luteal regression and embryonic loss. PMID:23664650

Penrod, Leah V; Allen, Ronald E; Rhoads, Michelle L; Limesand, Sean W; Arns, Mark J

2013-06-01

336

Colonic low-grade endometrial stromal sarcoma and orthotopic endometrial stromal tumor with limited infiltration sharing the JAZF1-SUZ12 gene fusion.  

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Endometrial stromal tumors (ESTs) are composed of cells resembling endometrial stroma, and are divided into benign and malignant types based on morphology. Endometrial stromal nodule (ESN) is a benign localized tumor, and endometrial stromal sarcoma (ESS) is an infiltrative and potentially metastatic neoplasm. A series of genetic aberrations contribute to pathological diagnosis of ESTs. At present, subsets of ESN and ESS-low grade (ESS-LG) are characterized as JAZF1-SUZ12/JJAZ1 gene fusion. The ESTs that show higher grade atypia but lack nuclear pleomorphism include YWHAE-FAM22?ESS. Here we report an unusual case of ESTs. Sudden colonic perforation occurred to the patient, and emergency surgery was performed. Pathological findings suggested metastatic ESS. Thorough medical examination of the genital organs detected a 1?cm-sized well-demarcated uterine tumor. Microscopically, the tumor lacked infiltrative features, conforming to the definition of ESN. Both lesions demonstrated identical cytology and shared JAZF1-SUZ12 gene fusion. Endometriosis was not found in any areas of the resected organs, strongly suggesting that the uterine orthotopic tumor metastasized. The current case uncovered the problems of differential diagnosis between ESN and ESS-LG. We demonstrate detailed pathological features of the two lesions, and discuss the possibility of orthotopic EST with limited infiltration to develop into ESS-LG. PMID:24750188

Tokinaga, Aya; Furuya, Mitsuko; Niino, Hitoshi; Udaka, Naoko; Asai-Sato, Mikiko; Sekido, Hitoshi; Miyagi, Etsuko

2014-04-01

337

Low Grade Endometrial Stromal Sarcoma: A Case Report  

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Endometrial stromal sarcoma (ESS) is a rare malignant tumor of the endometrium, occurring in the age group of 40–50 years. We report a case of low-grade ESS in a 39-year-old woman, presenting as rapid enlargement of a uterine fibroid polyp associated with irregular and excessive vaginal bleeding. Polypectomy followed by pan hysterectomy was performed. Histopathological examination and immunohistochemistry confirmed LGESS. As the tumor is rarely encountered, management protocols are still questionable. In our case, we tried a different post-surgical protocol and the patient is being closely followed up. Although rare, ESS should be considered in the differential diagnosis of all women who present with a rapid enlargement of a uterine leiomyoma.

Jain, Reena; Batra, Swaraj; Ahmad, Ayesha; Elahi, Arifa Anwar; Gupta, Monika; Saith, Poonam

2015-01-01

338

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

339

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

340

Urocortin expression is downregulated in human endometrial carcinoma.  

Science.gov (United States)

Urocortin (UCN) is a 40-amino acid neuropeptide sharing 45% sequence homology with corticotropin-releasing factor (CRF). The human endometrium expresses both UCN and CRF, and CRF/UCN receptors type-1 (CRF-R1) and -2 (CRF-R2). CRF-R1 activation inhibits cell growth and proliferation of a tumor cell line derived from the human endometrium, and the UCN signaling pathway has been implicated in tumorigenesis of several tissues. Therefore, we investigated whether UCN mRNA and peptide are expressed by human endometrial adenocarcinoma, and whether their expression changes compared to controls. Samples of well (grade 1; n = 6 endometrioid adenocarcinoma, of whom n = 1 with squamous differentiation, and n = 1 clear-cell carcinoma) and poorly differentiated (grade 3; n = 3 endometrioid adenocarcinoma) endometrial adenocarcinoma were collected from nine women (age range 61-79 years) enrolled at the time of diagnosis. Healthy endometrium was collected from postmenopausal women (controls; n = 13; age range 64-78 years), who underwent hysterectomy for uterine prolapse. Immunohistochemistry was used to evaluate cellular UCN localization, with the intensity of immunostaining scored on a subjective scale. Quantitative real-time reverse transcriptase (RT)-PCR analysis was used to estimate mRNA expression changes and restriction analysis was used to confirm PCR products identity. UCN mRNA expression was significantly reduced (P mRNA and peptide expressions are decreased in endometrial adenocarcinoma. These data and the evidence that endometrial cancer expresses UCN receptors and UCN is involved in tumorigenesis of several tissues together suggest a role for UCN in endometrial tumoral cell growth and proliferation. PMID:16837614

Florio, Pasquale; De Falco, Giulia; Leucci, Eleonora; Torricelli, Michela; Torres, Paulo B; Toti, Paolo; Dell'Anna, Arianna; Tiso, Ennio; Santopietro, Rosa; Leoncini, Lorenzo; Petraglia, Felice

2006-07-01

 
 
 
 
341

Cervical carcinoma vs endometrial carcinoma, involving both corpus and cervix : comparison of growing pattern with MR imaging  

International Nuclear Information System (INIS)

To evaluate the growth pattern depicted by MR imaging and used to differentiate between uterine cervical and endometrial carcinoma where the mass involves both the uterine corpus and cervix. The tumor growth pattern observed on MR images obtained between November 1989 and January in 1999 in 37 of 784 cervical carcinomas and 9 of 47 endometrial carcinomas in which the tumor involved both the uterine corpus and cervix was analysed. The histologic type was squamous (n=29), adenocarcinomatous (n=6) or adenosquamous (n=2) in cervical carcinoma, and carcinomatous (n=8) or adenosquamous (n=1) in endometrial carcinoma. A 1.5-T (Magnetom Vision, Siemens, Germany) and a 2.0-T unit (Spectro-20000, Goldstar, Korea) were used to obtain T1-and T2-weighted axial, T2-weighted sagittal and Gd-enhanced images. Tumor involvement of the uterine cervix was classified as Cp-n, Cp-x, or Cp-b according to involvement of the endocervix, exocervix or both. Tumors of the uterine corpus were classified as involving the mucosa(U-mu), myometrium(U-my) or serosa(U-se). In 37 cases of cervical carcinoma, all three involving the endocervix(Cp-n) invaded the endometrium(U-mu), three involving both the endo- and exocervix(Cp-b) invaded the endometrium(U-mu, 1 case), myometrium(U-my, 1 case), or serosa(U-se, 1 case), and 31 involving the full-thickness of the uterine cervix(Ct) invaded the endometrium (U-mu, 6 cases) or serosa(U-se, 25 cases). In nine cases of endometrial carcinoma, three involving the ndometrial carcinoma, three involving the endometrium(U-mu) and five involving the myometrium(U-my) invaded the endocervix(Cp-n), and one involving the serosa(U-se) invaded the full-thickness of the uterine cervix(Ct). Cervical carcinoma tended to involve the entire cervix and the full thickness of the uterine corpus, but endometrial carcinoma tended to involve the endometrium or myometrium of the uterine corpus and endocervix

342

Cervical carcinoma vs endometrial carcinoma, involving both corpus and cervix : comparison of growing pattern with MR imaging  

Energy Technology Data Exchange (ETDEWEB)

To evaluate the growth pattern depicted by MR imaging and used to differentiate between uterine cervical and endometrial carcinoma where the mass involves both the uterine corpus and cervix. The tumor growth pattern observed on MR images obtained between November 1989 and January in 1999 in 37 of 784 cervical carcinomas and 9 of 47 endometrial carcinomas in which the tumor involved both the uterine corpus and cervix was analysed. The histologic type was squamous (n=29), adenocarcinomatous (n=6) or adenosquamous (n=2) in cervical carcinoma, and carcinomatous (n=8) or adenosquamous (n=1) in endometrial carcinoma. A 1.5-T (Magnetom Vision, Siemens, Germany) and a 2.0-T unit (Spectro-20000, Goldstar, Korea) were used to obtain T1-and T2-weighted axial, T2-weighted sagittal and Gd-enhanced images. Tumor involvement of the uterine cervix was classified as Cp-n, Cp-x, or Cp-b according to involvement of the endocervix, exocervix or both. Tumors of the uterine corpus were classified as involving the mucosa(U-mu), myometrium(U-my) or serosa(U-se). In 37 cases of cervical carcinoma, all three involving the endocervix(Cp-n) invaded the endometrium(U-mu), three involving both the endo- and exocervix(Cp-b) invaded the endometrium(U-mu, 1 case), myometrium(U-my, 1 case), or serosa(U-se, 1 case), and 31 involving the full-thickness of the uterine cervix(Ct) invaded the endometrium (U-mu, 6 cases) or serosa(U-se, 25 cases). In nine cases of endometrial carcinoma, three involving the endometrium(U-mu) and five involving the myometrium(U-my) invaded the endocervix(Cp-n), and one involving the serosa(U-se) invaded the full-thickness of the uterine cervix(Ct). Cervical carcinoma tended to involve the entire cervix and the full thickness of the uterine corpus, but endometrial carcinoma tended to involve the endometrium or myometrium of the uterine corpus and endocervix.

Kim, Byung Keuk; Lee, Jin Hee; Kim, Hong; Suh, Soo Ji [Keimyung Univ. School of Medicine, Taegu (Korea, Republic of); Kim, Jung Sik [Kim Jung Sik Radiological Clinic, Taegu (Korea, Republic of)

2001-10-01

343

Surgical Treatment of Endometrial Cancer  

Digital Repository Infrastructure Vision for European Research (DRIVER)

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...

Lanowska Malgorzata; Brink-Spalink Verena; Hasenbein Kati; Schneider Achim; Marnitz Simone; Köhler Christhardt

2010-01-01

344

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.

345

BIOPSIA ENDOMETRIAL AMBULATORIA: EXPERIENCIA PRELIMINAR  

Scientific Electronic Library Online (English)

Full Text Available SciELO Chile | Language: Spanish Abstract in spanish 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 endomet [...] rial 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 endometrio Abstract in english Objective: 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%), 1 [...] 10 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; Jessica, Zamora F; Sandra, Barrera P; Ximena, Tacla F.

346

The postpartum endometrial inflammatory response: a normal physiological event with potential implications for bovine fertility.  

Science.gov (United States)

After calving, the bovine endometrium undergoes marked morphological and functional changes that are necessary for subsequent re-breeding. Regulation and integration of these key events are largely uncharacterised. Here, endometrial swabs and biopsies were taken at 15, 30 and 60 days postpartum (DPP) from 13 healthy primiparous cows, 10 of which subsequently conceived, with a view to characterising innate and inflammatory gene expression profiles. Endometrial biopsies exhibited severe inflammation (>75 leukocytes per high-power field) at 15 DPP, which had begun to resolve by 30 DPP and had completely resolved by 60 DPP. The severe inflammation at 15 DPP coincided with uterine infection in all cows and a significant increase (P uterine involution. PMID:22948010

Chapwanya, Aspinas; Meade, Kieran G; Foley, Cathriona; Narciandi, Fernando; Evans, Alexander C O; Doherty, Michael L; Callanan, John J; O'Farrelly, Cliona

2012-01-01

347

Cesarean scar defects: an underrecognized cause of abnormal uterine bleeding and other gynecologic complications.  

Science.gov (United States)

The gynecologic sequelae due to deficient uterine scar healing after cesarean section are only recently being identified and described. These include conditions such as abnormal bleeding, pelvic pain, infertility, and cesarean scar ectopic pregnancy, as well as a potentially higher risk of complications and difficulties during gynecologic procedures such as uterine evacuation, hysterectomy, endometrial ablation, and insertion of an intrauterine device. The proposed mechanism of abnormal uterine bleeding is a pouch or "isthmocele" in the lower uterine segment that causes delayed menstrual bleeding. The prevalence of symptomatic or clinically relevant cesarean scar defects (CSDs) ranges from 19.4% to 88%. Possible risk factors for CSD include number of cesarean sections, uterine position, labor before cesarean section, and surgical technique used to close the uterine incision. There are no accepted guidelines for the diagnostic criteria of CSD. We propose that a CSD be defined on transvaginal ultrasound or saline infusion sonohysterography as a triangular hypoechoic defect in the myometrium at the site of the previous hysterotomy. We also propose a classification system to aid in standardized classification for future research. Surgical techniques for repair of CSD include laparoscopic excision, resectoscopic treatment, vaginal revision, and endometrial ablation. PMID:23680518

Tower, Amanda M; Frishman, Gary N

2013-01-01

348

Endometrial stromal sarcoma  

Directory of Open Access Journals (Sweden)

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

349

Tuberculosis endometrial polyp.  

Science.gov (United States)

Tuberculosis can cause infertility when it infects the genital tract (e.g., endometritis). A 31-year-old woman (origin: Algeria) was referred to our academic gynecological institute for unexplained primary infertility. The patient presented with no complaint. Hysteroscopy showed a 10?mm sized endometrial polyp. The polyp was removed. Pathology showed lymphocytic and plasmacytic chronic inflammatory modification, granulomatous modification, and gigantocellular modification,which lead to the diagnosis of tuberculosis. No acid fast organism was seen on Ziehl-Neelsen staining. A chest thorax X-ray revealed no sign of pulmonary tuberculosis. The patient underwent antituberculosis therapy during one year. Posttreatment hysteroscopy revealed no abnormality. This is the first reported case of endometrial tuberculosis diagnosed following removal of a polyp with classical benign appearance. PMID:23607011

Seror, Julien; Faivre, Erika; Prevot, Sophie; Deffieux, Xavier

2013-01-01

350

GnRH analogues may increase endometrial Hoxa10 promoter methylation and affect endometrial receptivity.  

Science.gov (United States)

The present study aimed to investigate whether gonadotropin-releasing hormone analogues (GnRH-as), including GnRH agonists and antagonists, affect endometrial homeobox (Hox) a10 DNA methylation during the implantation window in mice. GnRH analogue mouse models were used and were treated with either human menopausal gonadotropin (HMG) and a GnRH agonist or HMG and a GnRH antagonist. Uterus samples were collected 48 h after GnRH analogue treatment or ovulation. Bisulfite sequencing polymerase chain reaction (PCR), quantitative-PCR and western blot analysis were performed to assess Hoxa10 and integrin ?3 expression. Scanning electron microscope analyses were conducted to analyze pinopode development. Compared with the natural cycle control mice, mice in the GnRH analogue groups were found to exhibit increased levels of methylation at the Hoxa10 promoter, decreased Hoxa10 mRNA and protein expression and disrupted pinopode development. These findings suggest that GnRH-as may be associated with altered Hoxa10 DNA methylation, thus GnRH-as may affect uterine Hoxa10 expression and endometrial receptivity. PMID:25323439

Li, Fei; Zhang, Ming; Zhang, Yuanzhen; Liu, Teng; Qu, Xinlan

2015-01-01

351

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

Energy Technology Data Exchange (ETDEWEB)

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

352

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

International Nuclear Information System (INIS)

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

353

Phospholipase A2 regulation of bovine endometrial (BEND) cell prostaglandin production  

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Abstract Background Prostaglandins (PG), produced by the uterine endometrium, are key regulators of several reproductive events, including estrous cyclicity, implantation, pregnancy maintenance and parturition. Phospholipase A2 (PLA2) catalyzes the release of arachidonic acid from membrane phospholipids, the rate-limiting step in PG biosynthesis. The bovine endometrial (BEND) cell line has served as a model system for investigating regulation of signaling mechanisms involved ...

Guan Wei; Elgayyar Mona; Roberts Mary P; Godkin James D; Tithof Patricia K

2008-01-01

354

Claudin-3 and Claudin-4 expression in serous papillary, clear cell, and endometrioid endometrial cancer  

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The tight junction (TJ) proteins claudin-3 and claudin-4 have been reported to be differentially expressed in uterine serous papillary carcinoma (USPC), a rare form of endometrial cancer characterized by a particularly high recurrence rate and poor prognosis. Preclinical experiments suggest that increased expression of both TJ proteins may in part mediate the biologically aggressive phenotype of USPC. Our aim was to determine claudin-3 and claudin-4 expression in a large cohort of surgically ...

Konecny, Gottfried E.; Mariani, Andrea; Keeney, Gary A.; Winterhoff, Boris; Thomas, Bijoy; Riehle, Darren; Murphy, Linda; Neuper, Christina; Jones, Monica; Dowdy, Sean C.; Wang, He-jing; Morin, Patrice J.; Podratz, Karl C.

2008-01-01

355

Endometrial Tumorigenesis in Pten+/? Mice Is Independent of Coexistence of Estrogen and Estrogen Receptor ?  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Numerous studies support the role for mutations in the phosphatase and tensin homologue (PTEN) tumor suppressor gene and unopposed estrogen stimulation in the pathogenesis of uterine endometrioid carcinoma. However, the relation between PTEN signaling and estrogen/estrogen receptor in endometrial tumorigenesis remains unresolved. We used genetically engineered mice as a model to address this relation. Mice with a single deleted Pten allele (Pten+/?) spontaneously develop complex atypical hy...

Joshi, Ayesha; Wang, Hong; Jiang, Gaofeng; Douglas, Wayne; Chan, Joanna S. Y.; Korach, Kenneth S.; Ellenson, Lora H.

2012-01-01

356

Tuberculosis Endometrial Polyp  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Tuberculosis can cause infertility when it infects the genital tract (e.g., endometritis). A 31-year-old woman (origin: Algeria) was referred to our academic gynecological institute for unexplained primary infertility. The patient presented with no complaint. Hysteroscopy showed a 10?mm sized endometrial polyp. The polyp was removed. Pathology showed lymphocytic and plasmacytic chronic inflammatory modification, granulomatous modification, and gigantocellular modification,which lead to the ...

Julien Seror; Erika Faivre; Sophie Prevot; Xavier Deffieux

2013-01-01

357

Stimulation of decidua development by transplantation of endometrial stem cells  

Directory of Open Access Journals (Sweden)

Full Text Available On all terms of pregnancy, insolvency of decidual reaction of endometrial cells is one of the reasons of miscarriages and fetal growth delay. The insufficient decidualization of endometrum leads to infertility in such pathologies, as Asherman’s syndrome and an endometrium atrophy. However, there are data on successful application of autologous bone marrow MSCs for Asherman’s syndrome treatment. The aim of this work was to assay the effect of endometrial mesenchymal stem cell (eMSC transplantation for decidualization process in pseudopregnant rat. Our study showed that injection of human eMSC suspension into the uterine lumen of pseudopregnant rats facilitated more intensive development of decidua in comparison with phosphate buffed saline (PBS injection in the control uterine horn. Histological analysis of decidua sections did not reveal any alterations in cell differentiation or tissue structure. In conclusion, we demonstrated for the first time that eMSC transplantation assists the development of all decidual tissue elements. It opens the possibility that eMSCs may be applied for cell therapy of infertility associated with decidualzation insufficiency.

Alisa P. Domnina

2013-08-01

358

Metaplasia óssea e esterilidade primária / Endometrial osseous metaplasia and primary infertility  

Scientific Electronic Library Online (English)

Full Text Available SciELO Brazil | Language: Portuguese Abstract in portuguese A metaplasia óssea do endométrio é uma condição rara e pode ser explicada por uma neoformação no endométrio, com deposição de sais de cálcio. Entretanto, a situação mais comum é a história prévia de abortamento com permanência de ossículos na cavidade uterina. Foi relatado um caso de ossificação end [...] ometrial em uma mulher de 31 anos, sem gravidez prévia ou história de aborto, apresentando dismenorréia e infertilidade. A ultra-sonografia pélvica mostrou área hiperecóica no fundo da cavidade uterina. A histeroscopia foi realizada e uma imagem sugestiva de tecido ósseo foi encontrada. Este tecido foi retirado e a histopatologia confirmou a ossificação endometrial. Abstract in english Endometrial metaplastic ossification is a rare condition and can be partially explained by a neoformation in the endometrium, with calcium deposition. However, a common situation is the previous history of abortion with persistence of ossicles in the uterine cavity. The endometrial ossification was [...] reported in a 31-year-old woman, without previous pregnancy or history of abortion. This patient presented dysmenorrhea and infertility. Pelvic ultrasonography showed a hyperechoic area in the uterine fundus. Histeroscopy was performed and an image suggestive of bone was seen. This tissue was removed by histeroscopy and the histopathological analysis confirmed endometrial ossification.

Celeste P. Demeterco, Reggiani; Marcelo K., Murata; Marcelo G., Cequinel; César A., Cornel; Jorjan, Cruz; Jean F., Francisco; Augusto F., Beduschi.

2001-03-01

359

Angiogenesis Following Three-Dimensional Culture of Isolated Human Endometrial Stromal Cells  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Endometriosis is the presence of endometrial tissue outside of the uterine cavity andis the most common gynecologic disorder in women of reproductive age. We have preliminaryevidence that in the presence of a 3-dimensional (3-D fibrin matrix, human endometrial glands,stroma, and neovascularization can develop in vitro, mimicking the earliest stages of endometriosis.The aim of the present study was to determine if angiogenesis can be developed in a 3-D culture ofhuman stromal cells in vitro.Materials and Methods: This was an in vitro study of human endometrial biopsies in 3-D cultureof fibrin matrix and conducted at a university affiliated infertility center. Biopsies were taken fromten normal ovulating women undergoing infertility treatment. The samples obtained from fundusof the uterine cavity were minced, stromal cells isolated and placed in a 3-D fibrin matrix culturesystem. Degree of proliferation of stromal cells, invasion of the fibrin matrix, gland formation, vesselsprouting and immunohistochemical characterization of cellular components were recorded.Results: Three-dimensional culture of human stromal cells formed sheets of cells in the fibrinmatrix. By 3-4 weeks, endothelial cell branching was observed and rudimentary capillary-likestructures formed and endothelial cells confirmed by CD31 immunostaining.Conclusion: These data show that stromal cells from endometrial explants can proliferate andinvade a fibrin matrix in vitro generating new vessels. This procedure represents a controlled,quantifiable model for the study of angiogenesis during the menstrual cycle, and in conditions suchas endometriosis and cancer.

Navid Esfandiari

2008-01-01

360

Investigations on the endometrial response to intrauterine administration of N-acetylcysteine in oestrous mares.  

Science.gov (United States)

In mares, mating-induced persistent endometritis contributes to low fertility. The condition is in part related to delayed clearance of mucus accumulated within the uterine lumen. The objective of this study was to investigate the endometrial response of healthy mares to intrauterine (i.u.) treatment with N-acetylcysteine (NAC). Oestrous mares (n = 12) were randomly assigned to a treatment (TM) or control (C) group and received an i.u. infusion of 5% NAC and saline (total volume 140 ml), respectively. Endometrial biopsies were collected in five of the mares 24 h after treatment, in the remaining seven mares 72 h after treatment. Endometrial biopsies were evaluated for integrity of the luminal epithelium, number of polymorphonuclear neutrophils (PMN), staining for cyclooxygenase 2 (COX2), staining with Kiel 67 antigen (Ki-67), lectins and periodic acid-Schiff (PAS). The integrity of endometrial epithelial cells was not affected by treatment (no statistical differences between groups or times). At 24 h after treatment, the mean number of PMN in endometrial biopsies from NAC- and C-mares did not differ, but at 72 h after treatment, number of PMN was significantly higher (p NAC-treated mares (2.3 ± 0.2 PMN/field). At 72 h after treatment, the intensity of staining for COX2 was significantly higher after saline than after NAC treatment (p NAC-treated mares than in C-mares 72 h after treatment (p mucus in deep uterine glands differed significantly between groups at 24 h after treatment (p NAC does not adversely affect the endometrial function. Moreover, an anti-inflammatory effect on the equine endometrium was observed. PMID:23186260

Melkus, E; Witte, T; Walter, I; Heuwieser, W; Aurich, C

2013-08-01

 
 
 
 
361

Cine MR imaging of uterine peristalsis in patients with endometriosis  

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Endometriosis is one of the most important causes of infertility; however the precise mechanism by which it affects female fertility is unclear. The objective of this study was to study the functional aspects of the uterus by evaluating uterine contractility in patients with endometrial cysts of the ovary. The study population was recruited from two institutes and consisted of 26 women (periovulatory (10), luteal (13), and menstrual phase (3); age range: 19-51 years) with untreated endometriosis; the control group consisted of 12 healthy women (age range: 22-41 years). Cine MR imaging obtained by a 1.5T magnet was visually evaluated at 12 x faster than real speed, focusing on the presence of uterine peristalsis, the direction and frequency of peristalsis, and the presence of sustained uterine contractions. Uterine peristalsis was identifiable in 3/10, 3/13, and 3/3 of the endometriosis patients in each menstrual cycle, respectively, and in 11/12, 3/12, and 5/12 of their control subjects. Peristaltic detection rate and frequency were significantly less for the endometriosis group than for the controls in the periovulatory phase only (p<0.05). Sustained contractions were recognized in 19/36 control subjects and in 13/26 endometriosis patients, but the difference was not significant. Uterine peristalsis appears to be suppressed during the periovulatory phase in patients with endometriosis, which may have an adverse effect on sperm transport. (orig.)

Kido, Aki; Togashi, Kaori; Koyama, Takashi; Fujimoto, Ryota [Kyoto University, Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto (Japan); Nishino, Mizuki [Beth Israel Deaconess Medical Center, Department of Radiology, Kyoto (Japan); Miyake, Kanae; Hayakawa, Katsumi [Kyoto City Hospital, Department of Radiology, Kyoto (Japan); Iwasaku, Kazuhiro [Kyoto City Hospital, Department of Obstetrics and Gynecology, Kyoto (Japan); Fujii, Shingo [Kyoto University, Department of Gynecology and Obstetrics, Kyoto (Japan)

2007-07-15

362

Cine MR imaging of uterine peristalsis in patients with endometriosis  

International Nuclear Information System (INIS)

Endometriosis is one of the most important causes of infertility; however the precise mechanism by which it affects female fertility is unclear. The objective of this study was to study the functional aspects of the uterus by evaluating uterine contractility in patients with endometrial cysts of the ovary. The study population was recruited from two institutes and consisted of 26 women (periovulatory (10), luteal (13), and menstrual phase (3); age range: 19-51 years) with untreated endometriosis; the control group consisted of 12 healthy women (age range: 22-41 years). Cine MR imaging obtained by a 1.5T magnet was visually evaluated at 12 x faster than real speed, focusing on the presence of uterine peristalsis, the direction and frequency of peristalsis, and the presence of sustained uterine contractions. Uterine peristalsis was identifiable in 3/10, 3/13, and 3/3 of the endometriosis patients in each menstrual cycle, respectively, and in 11/12, 3/12, and 5/12 of their control subjects. Peristaltic detection rate and frequency were significantly less for the endometriosis group than for the controls in the periovulatory phase only (p<0.05). Sustained contractions were recognized in 19/36 control subjects and in 13/26 endometriosis patients, but the difference was not significant. Uterine peristalsis appears to be suppressed during the periovulatory phase in patients with endometriosis, which may have an adverse effect on sperm transport. (orig.)m transport. (orig.)

363

Mouse models of uterine corpus tumors: clinical significance and utility.  

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Uterine tumors, whether benign or malignant, are diagnosed in a significant portion of women and are associated with a number of co-morbidities that negatively impact quality of life. Uterine tumors can be derived from the epithelial (endometrial hyperplasia or carcinoma) and mesenchymal (leiomyoma, sarcoma) layers of the uterus. The exact etiologies of the various tumor types are yet to be defined. Collectively their development and progression often results from aberrant steroid hormone exposure or dysregulation of related growth factor signaling and apoptotic pathways, reflecting the role of steroid hormone-dependent signaling and survival pathways in the cycles of cell growth and involution that characterize normal uterine physiology. While molecular analyses of human tumors can identify candidate genetic and epigenetic lesions contributing to uterine tumor initiation and progression, in vivo genetic models are needed to establish the functional significance of such lesions and their contribution to tumorigenesis. For this purpose, genetically-engineered mouse models have proven valuable. Here we review genetically-modified mouse models that develop uterine tumors and compare their pathology, utility/feasibility, and discuss their clinical relevance. PMID:20515761

Friel, Anne M; Growdon, Whitfield B; McCann, Christopher K; Olawaiye, Alexander B; Munro, Elizabeth G; Schorge, John O; Castrillon, Diego H; Broaddus, Russell R; Rueda, Bo R

2010-01-01

364

Perforated endometrial appendicitis in pregnancy  

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Background: Endometriosis is a common disorder in women of reproductive age. A rare localization is the appendix, which, in most cases, is an incidental finding during appendectomies. The incidence of symptomatic appendiceal endometriosis or endometrial appendicitis might be increased in pregnancy. Moreover, endometrial appendicitis in pregnancy is more likely to present in an advanced stage, given the physiologic changes characterizing the gravid abdomen.

Giorgakis, E.; Karydakis, V.; Farghaly, A.

2012-01-01

365

POSSIBILITIES OF PHARMACALOGIC THERAPY APPLIED IN ABNORMAL UTERINE BLEEDING  

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Full Text Available The range of alternatives to hysterectomy includes ‘expanded’ oral medical regimens, the levonorgestrel-releasing intrauterine system (LNG-IUS, a wide range of endometrial ablative techniques, and where fibroids are the primary pathology—myomectomy and uterine artery embolization. Since the research has shown that hysterectomy is a highly effective treatment, these alternatives must be assessed against the recognized high satisfactory rates and improved quality of life reported following hysterectomy. Additional issues that would also need to be addressed include complication rates, side-effects, and cost-effectiveness. For women with prolonged abnormal uterine bleeding, recent research suggests that hysterectomy is significantly superior to an expanded medical treatment regimen for health-related quality-of-life measures. Satisfaction with the treatment, and health-related quality of life and psychosocial well-being, are reportedly similar between hysterectomy and the LNG-IUS, but the latter has the advantage of reduced cost. Endometrial ablation reduces menstrual blood flow, but its benefits relative to hysterectomy lessen over time. No large-scale studies have adequately compared uterine artery embolization or myomectomy to hysterectomy. Perhaps, the most telling finding from recent research with respect to the place of alternative therapies to hysterectomy is that the existence or advent of these alternatives has not reduced hysterectomy rates, but merely increased treatment options and interventions for excessive menstrual loss.

Valentina Nikolic

2006-07-01

366

Laparoscopic hysterectomy in the treatment of endometrial cancer: NCI experience  

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The standard treatment for women with endometrial cancer is total abdominal hysterectomy and pelvic lymphadenectomy for surgical staging. Total laparoscopic radical hysterectomy (TLH) is an alternative approach providing surgical and patient related advantages to laparoscopy. Methods: Twenty female patients with early stage endometrial cancer were operated upon by TLH and pelvic lymphadenectomy, aiming to assess the safety and efficacy of TLH. Results: The mean operative time was 296.8 min conversion to laparotomy was done in one patient due to bleeding from the uterine vessels. The mean blood loss was 517.5 cc. The uterus was removed transvaginally in 18 patients (90%) and via a small Pfannenstiel incision in two patients (10%). The mean number of pelvic lymph nodes retrieval was 21.2. Postoperative bleeding occurred in one patient (5%) which necessitated exploration. One patient (5%) suffered a pulmonary embolism. Four patients (20%) developed pyrexia, and one patient (5%) suffered from a chest infection. One patient (5%) had wound infection. The mean hospital stay was 4.5 days (range 3-10). Conclusion: TLH with pelvic lymphadenectomy is a safe and effective approach in the treatment of early endometrial carcinoma.

367

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

368

Uterine arterial embolization for the treatment of uterine leiomyomas: its dynamic imaging monitoring and therapeutic mechanism  

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Objective: To study the dynamic imaging changes of the uterine leiomyomas before and after uterine arterial embolization (UAE) treatment and to discuss its therapeutic mechanism. Methods: Color Doppler sonography and both plain and enhanced MRI scanning were performed in 45 patients with uterine leiomyomas before and after UAE. Plain CT scan was performed in all patients after UAE. All the patients were followed up for 3-16 months (average 10 ± 3.5 months). Results: In 41 of the total 45 cases, the color Doppler sonography showed rich blood flow signals in leiomyomas and myometrium before UAE and no or less blood flow signals in both leiomyomas and myometrium on the first day after UAE. On the seventh day, the blood flow signal was still absent in leiomyomas while it was restored in myometrium, and the same phenomena remained in the first, the third and the twelfth month after UAE. In the other four cases, color Doppler sonography demonstrated blood flow signals inside leiomyomas on the seventh day after UAE and it remained till twelve months after embolization. The embolic agent(Lipiodol) was found in both leiomyomas and myometrium on CT scan for 45 cases on the first day of UAE. CT scan also showed the deposit of the Lipiodol in myometrium, but Lipiodol gradually vanished in leiomyomas at one, three and the twelve months after UAE. The enhancement was apparent in leiomyomas and myometrium on MRI scan in all 45 cases before UAE. The enhancement was found in the myomAE. The enhancement was found in the myometrium, but not in leiomyomas, on MRI scan in 39 cases 3 months after UAE. The other six cases demonstrated different degrees of enhancement in leiomyomas after embolization. In two cases the detachment of the leiomyomas were observed after embolization and the desquamating materials were pathologically proved to be necrotic tissue. The difference in the measuring data about leiomyoma volume between MRI and color Doppler sonography was of no statistical significance (P > 0.05). Conclusion: The therapeutic mechanism of UAE for uterine leiomyomas is selectively embolizing the vascular bed of uterus, leading to subsequent necrosis of leiomyomas. The color Doppler sonography should be the first choice for the dynamic imaging follow-up after UAE. (authors)

369

Atypical endometrial cells and atypical glandular cells favor endometrial origin in Papanicolaou cervicovaginal tests: Correlation with histologic follow-up and abnormal clinical presentations  

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The 2001 Bethesda system recommends further classifying atypical glandular cells (AGCs) as either endocervical or endometrial origin. Numerous studies have investigated the clinical significance of AGC. In this study, we investigated the incidence of clinically significant lesions among women with liquid-based Papanicolaou cervicovaginal (Pap) interpretations of atypical endometrial cells (AEMs) or AGC favor endometrial origin (AGC-EM). More importantly, we correlated patients of AEM or AGC-EM with their clinical presentations to determine if AEM/AGC-EM combined with abnormal vaginal bleeding is associated with a higher incidence of significant endometrial pathology. All liquid-based Pap tests with an interpretation of AEM and AGC-EM from July, 2004 through June, 2009 were retrieved from the database. Women with an interpretation of atypical endocervical cells, AGC, favor endocervical origin or AGC, favor neoplastic were not included in the study. The most severe subsequent histologic diagnoses were recorded for each patient. During this 5-year period, we accessioned 332,470 Pap tests of which 169 (0.05%) were interpreted as either AEM or AGC-EM. Of the 169 patients, 133 had histologic follow-up within the health care system. The patients ranged in age from 21 to 71 years old (mean 49.7). On follow-up histology, 27 (20.3%) had neoplastic/preneoplastic uterine lesions. Among them, 20 patients were diagnosed with adenocarcinoma (18 endometrial, 1 endocervical, and 1 metastatic colorectal), 3 with atypical endometrial hyperplasia, and 4 with endometrial hyperplasia without atypia. All patients with significant endometrial pathology, except one, were over 40 years old, and 22 of 25 patients reported abnormal vaginal bleeding at the time of endometrial biopsy or curettage. This study represents a large series of women with liquid-based Pap test interpretations of AEM and AGC-EM with clinical follow-up. Significant preneoplastic or neoplastic endometrial lesions were identified in 20.3% of patients. Patients with Pap test interpretations of AEM or AGC-EM and the clinical presentation of abnormal vaginal bleeding should be followed closely. PMID:25506385

Chen, Longwen; Booth, Christine N.; Shorie, Julie A.; Brainard, Jennifer A.; Zarka, Matthew A.

2014-01-01

370

Pregnancy Following Uterine Artery Embolization with Polyvinyl Alcohol Particles for Patients with Uterine Fibroid or Adenomyosis  

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Purpose:To determine whether uterine fibroid embolization (UFE) with polyvinyl alcohol (PVA) particles affects fertility in women desiring future pregnancy.Methods:Of 288 patients managed with UFE with PVA particles for uterine myoma or adenomyosis between 1998 and 2001, 94 patients were enrolled in this study. The age range of participants was 20-40 years. The data were collected through review of medical records and telephone interviews. Mean duration of follow-up duration was 35 months (range 22-60 months). Patients using contraception and single women were excluded, and the chance of infertility caused by possible spousal infertility or other factors was disregarded. Contrast-enhanced magnetic resonance imaging was performed in all patients before and after UFE, and the size of PVA particles used was 255-700 ?m.Results:Among 94 patients who underwent UFE with PVA, 74 were on contraceptives, 6 had been single until the point of interview, and 8 were lost to follow-up. Of the remaining 6 patients who desired future pregnancy, 5 (83%) succeeded in becoming pregnant (1 patient became pregnant twice). Of a total of 8 pregnancies, 6 were planned pregnancies and 2 occurred after contraception failed. Five deliveries were vaginal, and 2 were by elective cesarean. Artificial abortion was performed in 1 case of unplanned pregnancy. There was 1 case of premature rupture of membrane (PROM) followed by preterm labor and delivery of an infant who was small-for-gestational-age.infant who was small-for-gestational-age. After UFE, mean volume reduction rates of the uterus and fibroid were 36.6% (range 0 to 62.6%) and 69.3% (range 36.3% to 93.3%), respectively.Conclusion:Although the absolute number of cases was small, UFE with PVA particles ultimately did not affect fertility in the women who underwent the procedure

371

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.

372

Intracavity irradiation of endometrial cancer of large uteri using a two-phase afterloading technique  

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A specific intracavitary two-phase technique was developed for irradiation of endometrial cancer located in uteri with a large uterine cavity. In this technique an insertion catheter (external diameter 9 mm) was used for the introduction and precise location of the treatment catheter (external diameter 6.4 mm). During the first phase of the therapy, one lateral half of the uterine body was irradiated. Thereafter the positions of the catheters were changed by 180 degrees, followed by irradiation of the other lateral half of the uterine body. Using a wax phantom and extirpated uteri as models, we observed that the dose distributions followed the uterine shape and the calculated doses in the radiographs. Clinical observations from 34 patients treated so far, and followed-up for periods of 3 months to 6 years, prove that this method yields similar results to those observed in previous studies employing the Heyman packing method or afterloading techniques with a one-source tandem in the intracavitary irradiation of endometrial cancer. (author)

373

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

374

Transvaginal ultrasonography and saline infusion sonohysterography for the detection of intra-uterine lesions in pre- and post-menopausal women with abnormal uterine bleeding.  

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This prospective study investigated 79 pre- and 25 post-menopausal women with abnormal uterine bleeding who underwent conventional transvaginal ultrasonography (TVS) and saline infusion sonohysterography (SIS) and compared the results with histopathological findings obtained by dilatation and curettage, hysteroscopy or hysterectomy. Histological examination revealed normal endometrial histology in 28 patients, intracavitary polyps in 46 patients, submucosal fibroids in 18 patients, intramural fibroids in six patients and endometrial hyperplasia in six patients. The sensitivity and specificity of TVS in detecting endometrial polyps were 65.2% and 87.9%, respectively, compared with 91.3% and 93.1% for SIS. The sensitivity and specificity of TVS in detecting uterine fibroids were 95.8% and 95.0%, respectively, versus 91.6% and 98.7% for SIS. These results show that SIS is a satisfactory method of identifying lesions and that it is easy and cost-effective, and improves on the diagnostic utility of TVS. SIS is also a less invasive alternative to hysteroscopy, so should result in less morbidity in the evaluation of abnormal uterine bleeding in women. PMID:19094428

Yildizhan, B; Yildizhan, R; Ozkesici, B; Suer, N

2008-01-01

375

Systematic dissection of the mechanisms underlying progesterone receptor downregulation in endometrial cancer  

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Progesterone, acting through its receptor, PR (progesterone receptor), is the natural inhibitor of uterine endometrial carcinogenesis by inducing differentiation. PR is downregulated in more advanced cases of endometrial cancer, thereby limiting the effectiveness of hormonal therapy. Our objective was to understand and reverse the mechanisms underlying loss of PR expression in order to improve therapeutic outcomes. Using endometrial cancer cell lines and data from The Cancer Genome Atlas, our findings demonstrate that PR expression is downregulated at four distinct levels. In well-differentiated cancers, ligand-induced receptor activation and downregulation are intact. miRNAs mediate fine tuning of PR levels. As differentiation is lost, PR silencing is primarily at the epigenetic level. Initially, recruitment of the polycomb repressor complex 2 to the PR promoter suppresses transcription. Subsequently, DNA methylation prevents PR expression. Appropriate epigenetic modulators reverse these mechanisms. These data provide a rationale for combining epigenetic modulators with progestins as a therapeutic strategy for endometrial cancer. Significance: Traditional hormonal therapy for women with endometrial cancer can be molecularly enhanced by combining progestins with epigenetic modulators, thereby increasing progesterone receptor expression and significantly improving treatment efficacy. PMID:25229191

Yang, Shujie; Jia, Yichen; Liu, Xiaoyue; Winters, Christopher; Wang, Xinjun; Zhang, Yuping; Devor, Eric J.; Hovey, Adriann M.; Reyes, Henry D.; Xiao, Xue; Xu, Yang; Dai, Donghai; Meng, Xiangbing; Thiel, Kristina W.; Domann, Frederick E.; Leslie, Kimberly K.

2014-01-01

376

Diffusion-Weighted MRI and FDG-PET in Diagnosis of Endometrial Stromal Nodule  

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Preoperative differentiation of benign endometrial stromal nodule (ESN) from malignant low-grade endometrial sarcoma (LGESS) is challenging, because it requires histological evaluation of the tumor-myometrium interface, which is difficult to obtain in conventional endometrial curettage. A 72-year-old postmenopausal woman presented with 5-year history of persistent vaginal bleeding. Histological examination of the endometrial curettage specimen revealed hyperplasia of apparently normal endometrial stromal cells. T2-weighted magnetic resonance imaging (T2W-MRI) showed polypoid tumor occupying the entire uterine cavity. The tumor exhibited high signal intensity in diffusion-weighted MRI (DW-MRI) and intense accumulation of 18F-fluorodeoxyglucose (FDG) in positron emission tomography (PET). Intense FDG accumulation was also observed in the left internal iliac region. Total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy were performed under the diagnosis of LGESS with lymph node metastasis. However, postoperative histological examination proved that the tumor was ESN without lymph node metastasis. Since mitotic figure is no longer included in the diagnostic criteria of ESN or LGESS, ESN could exhibit high cellularity and high proliferative activit