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1

Lipid peroxidation and antioxidant status in blood of patients with uterine myoma, endometrial polypus, hyperplastic and malignant endometrium  

Scientific Electronic Library Online (English)

Full Text Available Abstract in english Oxidative stress is considered to be involved in pathogenesis of many disorders of the female genital tract. In this study, we explored the lipid peroxidation levels and antioxidant enzyme activities in women diagnosed with different forms of uterine diseases in order to evaluate the extent of oxidative stress in blood of such patients. Blood samples of healthy subjects and gynecological patients were collected and subjected to assays for superoxide dismutase, catalase, g (more) lutathione peroxidase, glutathione reductase and lipid hydroperoxides. The results show that alterations of measured parameters vary with the enzyme type and diagnosis. However, both reduction in antioxidants and elevation of lipid peroxidation were observed in general. Lipid hydroperoxides level was negatively correlated to superoxide dismutase and glutathione peroxidase activities, as well as positively correlated to catalase activity. In addition, the lipid hydroperoxides/ glutathione peroxidase ratio was found to be increased, according to the type of uterine disease. The obtained results show that perturbation of antioxidant status is more pronounced in blood of patients with premalignant (hyperplastic) and malignant (adenocarcinoma) lesions, compared to those with benign uterine changes such as polypus and myoma

PEJIC, SNEZANA; KASAPOVIC, JELENA; TODOROVIC, ANA; STOJILJKOVIC, VESNA; PAJOVIC, SNEZANA B

2006-01-01

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Lipid peroxidation and antioxidant status in blood of patients with uterine myoma, endometrial polypus, hyperplastic and malignant endometrium  

Directory of Open Access Journals (Sweden)

Full Text Available Oxidative stress is considered to be involved in pathogenesis of many disorders of the female genital tract. In this study, we explored the lipid peroxidation levels and antioxidant enzyme activities in women diagnosed with different forms of uterine diseases in order to evaluate the extent of oxidative stress in blood of such patients. Blood samples of healthy subjects and gynecological patients were collected and subjected to assays for superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and lipid hydroperoxides. The results show that alterations of measured parameters vary with the enzyme type and diagnosis. However, both reduction in antioxidants and elevation of lipid peroxidation were observed in general. Lipid hydroperoxides level was negatively correlated to superoxide dismutase and glutathione peroxidase activities, as well as positively correlated to catalase activity. In addition, the lipid hydroperoxides/ glutathione peroxidase ratio was found to be increased, according to the type of uterine disease. The obtained results show that perturbation of antioxidant status is more pronounced in blood of patients with premalignant (hyperplastic) and malignant (adenocarcinoma) lesions, compared to those with benign uterine changes such as polypus and myoma

SNEZANA PEJIC; JELENA KASAPOVIC; ANA TODOROVIC; VESNA STOJILJKOVIC; SNEZANA B PAJOVIC

2006-01-01

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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

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[Uterine artery embolization for myomas treatment].  

Science.gov (United States)

Myoma treatment by uterine artery embolisation (UAE) using non-spherical PVA particles or calibrated tris-acryl microspheres>500?m is effective in more than 90 % of cases in the short-term. In the long-term, menorrhagia, bulk-related symptoms and pelvic pain are significantly improved or eliminated in 75 % of cases at 5 to 7 years. At 6 months, uterine volume reduction and larger myoma volume reduction varies between 30 to 60 % and 50 to 80 % respectively. During hospital stay the complication rate is very low, less than 3 % mostly urinary infection and pain. Secondary hysterectomy for complication is less than 2 % at 3 months. Definitive amenorrhea is reported in less than 5 % of cases in women of more than 45-year of age. No significant impact of embolization on hormonal function has been reported in women less than 45 years with normal baseline function. UAE is not indicated for submucous myomas. Randomized studies comparing embolization to hysterectomy demonstrate that reinterventions are more frequently performed after embolization. Secondary hysterectomy is performed in 13 to 24 % of cases at 2 years and in up to 28 % of cases at 5 years. Hospital stay, duration of recovery and time off work are shorter after embolization compared to hysterectomy. Embolization is cheaper than hysterectomy at 12 and 24 months even taking into consideration the additional costs of imaging and reinterventions. UAE is a good alternative treatment in women with unique myoma of less than 10cm and multiple myomas around 15cm. This treatment should be proposed to women each time possible. Randomized studies comparing embolization to myomectomy demonstrate that in the short and mid-term there is no difference in terms of control of menorrhagia and bulk-related symptoms. Uterine volume reduction and quality of life were not different at 6 months. Periprocedural and 30-day complication rates are not different. At 6 months, the rate of complications is higher after myomectomy. Reinterventions are more frequent after embolization compared to myomectomy. Hospital stay, duration of recovery and time off work are shorter after embolization compared to myomectomy. UAE is less aggressive than myomectomy and should be proposed as a conservative alternative treatment. Embolization should be considered with caution in pregnancy-seeking women since there is still a lack of good quality data available in the specific group of patients. FSH level is more frequently elevated after embolization compared to myomectomy. Pregnancy rate and term pregnancy rate are higher after myomectomy compared to embolization. Spontaneous abortion is more frequent after embolization than after myomectomy. At this time, UAE is not indicated excepted in studies or in specific cases when the woman want a pregnancy. Embolization performed before myomectomy (preoperative or combined procedures) can be discussed for an individual patient but there is not enough data to support its routine use. PMID:23602353

Kahn, Vanessa; Pelage, Jean-Pierre; Marret, Henri

2013-04-18

5

[Uterine artery embolization for myomas treatment].  

UK PubMed Central (United Kingdom)

Myoma treatment by uterine artery embolisation (UAE) using non-spherical PVA particles or calibrated tris-acryl microspheres>500?m is effective in more than 90 % of cases in the short-term. In the long-term, menorrhagia, bulk-related symptoms and pelvic pain are significantly improved or eliminated in 75 % of cases at 5 to 7 years. At 6 months, uterine volume reduction and larger myoma volume reduction varies between 30 to 60 % and 50 to 80 % respectively. During hospital stay the complication rate is very low, less than 3 % mostly urinary infection and pain. Secondary hysterectomy for complication is less than 2 % at 3 months. Definitive amenorrhea is reported in less than 5 % of cases in women of more than 45-year of age. No significant impact of embolization on hormonal function has been reported in women less than 45 years with normal baseline function. UAE is not indicated for submucous myomas. Randomized studies comparing embolization to hysterectomy demonstrate that reinterventions are more frequently performed after embolization. Secondary hysterectomy is performed in 13 to 24 % of cases at 2 years and in up to 28 % of cases at 5 years. Hospital stay, duration of recovery and time off work are shorter after embolization compared to hysterectomy. Embolization is cheaper than hysterectomy at 12 and 24 months even taking into consideration the additional costs of imaging and reinterventions. UAE is a good alternative treatment in women with unique myoma of less than 10cm and multiple myomas around 15cm. This treatment should be proposed to women each time possible. Randomized studies comparing embolization to myomectomy demonstrate that in the short and mid-term there is no difference in terms of control of menorrhagia and bulk-related symptoms. Uterine volume reduction and quality of life were not different at 6 months. Periprocedural and 30-day complication rates are not different. At 6 months, the rate of complications is higher after myomectomy. Reinterventions are more frequent after embolization compared to myomectomy. Hospital stay, duration of recovery and time off work are shorter after embolization compared to myomectomy. UAE is less aggressive than myomectomy and should be proposed as a conservative alternative treatment. Embolization should be considered with caution in pregnancy-seeking women since there is still a lack of good quality data available in the specific group of patients. FSH level is more frequently elevated after embolization compared to myomectomy. Pregnancy rate and term pregnancy rate are higher after myomectomy compared to embolization. Spontaneous abortion is more frequent after embolization than after myomectomy. At this time, UAE is not indicated excepted in studies or in specific cases when the woman want a pregnancy. Embolization performed before myomectomy (preoperative or combined procedures) can be discussed for an individual patient but there is not enough data to support its routine use.

Kahn V; Pelage JP; Marret H

2013-07-01

6

Diagnostic imaging of large subserous and pedunculated uterine myoma  

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We describe two caces of large subserous and pedunculated uterine myoma, which were difficult to differentiate from ovarian tumor because of marked degeneration. Problems in the differential diagnosis of this type of tumors are discussed.

Masumoto, Hiroshi; Kuwano, Haruo; Kudo, Sho; Hayashi, Takamoto; Kishikawa, Takashi; Kawarabayashi, Tatuhiko

1987-08-01

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GENESIS, CLINICAL PRESENTATION, DIAGNOSIS AND TREATMENT OF UTERINE MYOMAS  

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Full Text Available The aim of the paper was to consider the pathophysiological genesis of uterine myomas, especially diagnostic and therapeutic modalities, stressing the principles leading to rational decision-making process in individualized myoma management.The method presents a review of the recent literature on uterine myomas and synthesis of different authors' experiences. Uterine myomas are the most common solid tumors in the female pelvic cavity. There is an increasing body of evidence of their genetic basis and of their growth related to genetic predisposition, hormonal influences and various growth factors. Diagnostic proceedings are numerous. There is a broad range of therapeutic options, including medicamentous, surgical and radiologic interventions. Most uterine myomas should be be serially monitored, observing the development of theirsymptoms or progressive growth. In the last 50 years, highly sophisticated diagnostic and therapeutic technologies have been developed regarding uterine myomas. Nowadays, the available means allow us to be more flexible, with safe treatment modalities which can be and must be adjusted to respective clinical situations.

Vekoslav Lilic; Biljana Djordjevic; Zorica Stanojevic; Aleksandra Petric; Goran Lilic; Radomir Zivadinovic; Sonja Pop-Trajkovic

2007-01-01

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MRI evaluation for conservative treatment in endometriosis and uterine myoma  

Energy Technology Data Exchange (ETDEWEB)

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

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MRI evaluation for conservative treatment in endometriosis and uterine myoma  

International Nuclear Information System (INIS)

[en] 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.)

1991-01-01

10

[The glycogen content of blood and uterine tissue in women with myoma and endometriosis (author's transl)  

UK PubMed Central (United Kingdom)

The amount of glycogen in venous blood and uterine tissue from 135 women undergoing gynecologic surgery was quantitatively determined. One group had myoma (n = 48), another endometriosis (n = 30). 18 women had myoma combined with endometriosis of the myometrium. 39 women served as control group. The following samples of the uterus were obtained immediately after removal: endometrium, myometrium, cervix and "tumour". The glycogen content in pathological cases was compared to normal tissue of comparative endocrine state, parity status and glucose tolerance. The significance levels were determined by standard analysis of variance and "t" tests. In the group with endometriosis, a significant difference occurred in the amount of blood glycogen, while a significant decrease was observed in the myometrial tissue. The cervical tissue glycogen levels of patients with myoma or endometriosis were significantly higher and did not exhibit cyclic or menopausal changes. There were no significant cyclic differences in the amount of endometrial tissue glycogen in women with myoma or endometriosis. In these cases the glycogen content was significantly higher than in healthy endometrial tissue. Blood glucose and plasma insulin levels were found to be in a normal spectrum. Pathological glucose tolerance and parity status showed no correlation to the variation of uterine tissue glycogen.

Muck BR; Hommel G

1976-09-01

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Systemic thromboembolism after deep vein thrombosis caused by uterine myomas.  

UK PubMed Central (United Kingdom)

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.

Srettabunjong S

2013-09-01

12

Immunocytochemical characteristics of submucosal uterine myomas  

Directory of Open Access Journals (Sweden)

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; Mladenovi?-Bogdanovi? Zorica; Mitrovi? Predrag; Tanaskovi? Irena; Ušaj-Kneževi? Slavica; Stanojevi? Marija

2010-01-01

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Systemic thromboembolism after deep vein thrombosis caused by uterine myomas.  

Science.gov (United States)

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

14

[Myoma uteri permagnum, adenocarcinoma endometrii et hematometra  

UK PubMed Central (United Kingdom)

The author presents a case of isthmocervical myoma coupled with endometrial adenocarcinoma and hematometra in a 70-year-old patient. The correct diagnosis was established on the material obtained at surgery. The operation was technically complicated and carried out in an atypical manner. The causal relationship between estrogen and the appearance of endometrial adenocarcinoma and uterine myoma is discussed.

Mastilovi? M

1976-05-01

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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...

Tomislav, Strinic; Josip, Maskovic; Liana, Cambi Sapunar; Marko, Vulic; Marko, Jukic; Ante, Radic; Dzenis, Jelcic

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Processes of apoptosis and cell proliferation in uterine myomas originating from reproductive and perimenopausal women  

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Full Text Available We studied uterine myomas originating from females of reproductive age and from females of perimenopausal age. Uterine myomas represent benign tumors of the myometrium, and they develop frequently in women of reproductive age. The frequency of uterine myomas increases with age until women reach the menopause. The study included patients with a myomatous uterus, in the reproductive age or peri-menopausal age, independently evaluating small and large myomas. Myometrial alterations in their direct vicinity were evaluated independently of the myomas. The study included evaluation of immunolocalization of two index proteins which participate in myoma cells growth control: Ki-67 nuclear antigen and caspase 3. In women of reproductive age, both in small and large myomas, elevated immunostaining of Ki-67 was noted in parallel to low levels of caspase 3 staining, which indicated the ongoing process of proliferation. In women of peri-menopausal age with small or large myomas, no Ki-67 immunostaining was detected, while staining of caspase 3 manifested low levels. Proliferation in reproductive age women myomas is higher than in the peri-menopausal age. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 3, pp. 398–404)

Andrzej Plewka; Danuta Plewka; Pawe? Madej; Gra?yna Nowaczyk; Karolina Sieron-Stoltny; Beata Jakubiec-Bartnik

2011-01-01

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Uterine Artery Embolization as Nonsurgical Treatment of Uterine Myomas  

Science.gov (United States)

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 analyzed after procedure. All patients had an uneventful recovery and were able to return to normal activity within two weeks of embolization. After the procedure, most patients experienced crampy pelvic pain, of variable intensity, which was well managed with the standard analgesia protocol. Five (3%) of participants had persisting amenorrhea after procedure. None reported any new gynecologic or medical problem during the follow-up period. There were no deaths and no major permanent injuries. Reductions in mean uterine volume were 61% (P < 0.01) and in dominant fibroid volume 66% (P?0.01). The follow-up showed significant improvement of bleeding. In conclusion, uterine artery embolization is a successful, minimal invasive treatment of uterine fibroids that preserves the uterus, had minimal complications, and requires short hospitalization and recovery.

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

2011-01-01

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Uterine artery embolization as nonsurgical treatment of uterine myomas.  

UK PubMed Central (United Kingdom)

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 analyzed after procedure. All patients had an uneventful recovery and were able to return to normal activity within two weeks of embolization. After the procedure, most patients experienced crampy pelvic pain, of variable intensity, which was well managed with the standard analgesia protocol. Five (3%) of participants had persisting amenorrhea after procedure. None reported any new gynecologic or medical problem during the follow-up period. There were no deaths and no major permanent injuries. Reductions in mean uterine volume were 61% (P < 0.01) and in dominant fibroid volume 66% (P?0.01). The follow-up showed significant improvement of bleeding. In conclusion, uterine artery embolization is a successful, minimal invasive treatment of uterine fibroids that preserves the uterus, had minimal complications, and requires short hospitalization and recovery.

Tomislav S; Josip M; Liana CS; Marko V; Marko J; Ante R; Dzenis J; Leo G; Ivica S; Marijan T; Situm K

2011-01-01

19

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.

de Vries Marjolijn; Perquin Denise

2010-01-01

20

[Krukenberg's tumor of the ovary and uterine myoma  

UK PubMed Central (United Kingdom)

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.

Janci? A; Duri? D

1976-07-01

 
 
 
 
21

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

Science.gov (United States)

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

22

Clinical efficacy of goserelin (Zoladex) in the treatment of uterine myomas in infertile patients.  

UK PubMed Central (United Kingdom)

This study investigated the efficacy of Zoladex depot 3.6 mg (goserelin acetate) during a 4-month treatment of infertile patients with uterine myomas of different size and location. The investigation comprised 30 patients aged 22-42 years, distributed into 2 groups regarding uterine and myoma volume. The first group included patients with uterine myomas less than 70 ml and uterus less than 300 ml. The second group included patients in whom these volumes exceeded the above mentioned values. Zoladex depot was administered every 28 days for 4 months with ultrasonographic follow-up of volume decrease, whereas patients with submucous myomas underwent control hysteroscopy. The obtained results point to efficacy of Zoladex in decreasing the volumes of both myomas and uterus by more than 50%, which correlates with literature data. Of particular interest is complete disappearance of myomas in about 60% of patients of the first group. Serum concentrations of follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) were followed-up prior to and during Zoladex therapy where multivariate variance analysis showed statistically significant differences. The side effects were recorded and are similar to those of other GnRH analogues.

Kopitovi? V; Bujas M; Fistes Topalski N; Pjevi? M; Ili? D; Kapamadzija A; Bujas I

2001-07-01

23

Clinical efficacy of goserelin (Zoladex) in the treatment of uterine myomas in infertile patients.  

Science.gov (United States)

This study investigated the efficacy of Zoladex depot 3.6 mg (goserelin acetate) during a 4-month treatment of infertile patients with uterine myomas of different size and location. The investigation comprised 30 patients aged 22-42 years, distributed into 2 groups regarding uterine and myoma volume. The first group included patients with uterine myomas less than 70 ml and uterus less than 300 ml. The second group included patients in whom these volumes exceeded the above mentioned values. Zoladex depot was administered every 28 days for 4 months with ultrasonographic follow-up of volume decrease, whereas patients with submucous myomas underwent control hysteroscopy. The obtained results point to efficacy of Zoladex in decreasing the volumes of both myomas and uterus by more than 50%, which correlates with literature data. Of particular interest is complete disappearance of myomas in about 60% of patients of the first group. Serum concentrations of follicle stimulating hormone (FSH), luteinizing hormone (LH) and estradiol (E2) were followed-up prior to and during Zoladex therapy where multivariate variance analysis showed statistically significant differences. The side effects were recorded and are similar to those of other GnRH analogues. PMID:11905182

Kopitovi?, V; Bujas, M; Fistes Topalski, N; Pjevi?, M; Ili?, D; Kapamadzija, A; Bujas, I

24

[Changes in the human uterine vascular bed in myoma  

UK PubMed Central (United Kingdom)

With scanning and transmission electron microscopy characteristic changes in the endothelial lining of myometrial vessels of uterus affected with myoma were revealed. In the presence of longitudinally oriented folds and microgrowths on the luminal surface in a healthy myometrial part, a number of changes were observed in the myoma vessels. These included the disappearance of cell surface derivatives, disturbance of tight junction of endothelial cells borders, the rise of cells over the endothelial monolayer and formation of crateriform pits. The partition of the endothelial cells on myoma vessels was accompanied by the disturbance of the microvesicular transendothelial transport.

Skopichev VG; Savitski? GA

1992-01-01

25

Pregnancy after uterine artery embolization for the treatment of myomas: a case series.  

UK PubMed Central (United Kingdom)

PURPOSE: Uterine artery embolization (UAE) has become an alternative therapy for the treatment of symptomatic myomas. The questions of fertility and pregnancy outcome after uterine artery embolization are still not answered. The study presents the results of pregnancies after UAE. The main goal was to evaluate the course of these pregnancies and concentrate on possible complications. METHODS: This was a prospective study from June 2009 till October 2011. Patients with symptomatic uterine myomas were included. The evaluation of the symptoms was done by quality of life questionnaire and bleeding charts. UAE was performed by superselective microcatheterization technique. Women still planning pregnancy were included in the study after signing detailed informed consent. Pregnant women after UAE were followed as high-risk pregnancies. RESULTS: A total of 98 patients underwent uterine artery embolization for symptomatic myomas; 21 expressed their wish to become pregnant, out of which 6 had successful spontaneous conception (23.08 %) and 1 patient was pregnant twice, and altogether there were seven pregnancies. During gestation and delivery, there was no serious complication. There was one missed abortion and one placental retention. Myomas did not show growth pattern during pregnancy. CONCLUSIONS: Data from further prospective, randomized trials comparing fertility and pregnancies after UAE with other treatment modalities are needed. UAE, with the new techniques of superselective microcatheterization, could be, in the future, a possible approach even in women with future maternity plans.

Redecha M Jr; Miži?ková M; Javorka V; Redecha M Sr; Kurimská S; Holomá? K

2013-01-01

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Prevalence of uterine myoma detected by ultrasound examination in the atomic bomb survivors  

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Benign tumors of several organs have been demonstrated to occur as late effects of atomic bomb exposure, and a recent addition to the list of affected organs in the uterus. The increased incidence of uterine myoma noted in Radiation Effects Research Foundation (REFR) Adult Health Study Report 7, however, was based on self-reported information, optional gynecological examination and patient-requested ultrasound examination. Thus the possibility of dose-related bias in case detection was a serious concern. Therefore, the relationship between the prevalence of uterine myoma and dose to the uterus was examined after excluding as much bias as possible by asking all women who had undergone biennial examinations from December 1991 through December 1993 to undergo ultrasound examinations. Among 2506 female participants in Hiroshima, the uterus was visualized by ultrasound examination in 1190, and 238 were found to have uterine nodules. Multiple logistic analysis using Dosimetry System 1986 uterine doses revealed a significant dose response for the prevalence of uterine nodules. The odds ratio at 1 Gy was 1.61 (95% confidence interval: 1.12-2.31). It is unlikely that the observed relationship after adjusting for bladder filling, volume of the uterus, age and menopause status was the result of dose-related bias. These results support previous findings at RERF and provide further evidence that radiation exposure is one of the factors associated with uterine myoma. 28 refs., 3 figs., 4 tabs.

Kawamura, Sachiko [Radiation Effects Research Foundation, Hiroshima (Japan)]|[Hiroshima Univ. School of Medicine (Japan); Kodama, Kazunori; Fujiwara, Saeko [Radiation Effects Research Foundation, Hiroshima (Japan)] [and others

1997-06-01

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

International Nuclear Information System (INIS)

[en] 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)

2005-01-01

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

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Full Text Available 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. Sensitivity, specificity, positive and negative predictive value and test accuracy were calculated.Results: As the most common abnormality, SCSH showed hyperplasia in 19 patients while hysteroscopy diagnosed polyp in 15 cases. A sensitivity of 73.3%, 71.4% and 90.9% were reported for polyp, hyperplasia and submucous myoma respectively whereas the specificity was calculated 96% for polyps, 82.3% for hyperplasia and 90.7% for submucous myoma.Conclusion: Comparing with hysteroscopy, sonohysterography showed a high sensitivity and specificity for detecting submucous myoma but not for endometrial polyp and endometrial hyperplasia

Mohammad Ali Karimzadeh; Razieh Dehghani Firouzabadi; Farzaneh Goharzad

2011-01-01

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Simultaneous laparoscopic uterine artery ligation and laparoscopic myomectomy for symptomatic uterine myomas with and without in situ morcellation.  

UK PubMed Central (United Kingdom)

BACKGROUND: To determine the optimal surgical approach for laparoscopic uterine artery ligation (LUAL) combined with myomectomy in the management of women with symptomatic uterine fibroids. METHODS: This is a prospective study. One hundred and six women with symptomatic uterine myomas underwent LUAL + laparoscopic morcellation after enucleation (enucleation group) (n = 51) or LUAL + laparoscopic in situ morcellation (ISM group) (n = 55). The outcome was measured by comparing surgical techniques, symptom control, recurrence and pregnancy during a 3-year follow-up in both groups. RESULTS: General characteristics of the patients were similar in both groups, except the myomas were larger in the ISM group. The operative time (mean ± SD) was significantly shorter in the ISM group than the enucleation group (107 ± 30 min versus 128 ± 49 min, P = 0.009). There were no differences in the therapeutic outcomes of the two groups at the 3-year follow-up, with low recurrence rates and good symptom control rates. Of the sexually active patients without contraception, the pregnancy and live birth rates were 87.5 and 100% in the ISM group and 66.7 and 83.3% in the enucleation group (all NS). CONCLUSIONS: The LUAL + myomectomy, either by enucleation or ISM, is acceptable in the management of symptomatic uterine fibroids. However, the LUAL + ISM technique might be more feasible, as it requires less operative time.

Chang WC; Chou LY; Chang DY; Huang PS; Huang SC; Chen SY; Sheu BC

2011-07-01

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Laparoscopic radiofrequency volumetric thermal ablation of uterine myomas with 12 months of follow-up.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To confirm the results of an earlier study assessing the safety and efficacy of a laparoscopic radiofrequency volumetric thermal ablation (RFVTA) system among women with symptomatic myomas. METHODS: In a prospective study at the Hospital of Francisco Marroquin University, Guatemala City, consecutive premenopausal women with symptomatic myomas seeking uterine-sparing treatment were enrolled between August 2008 and July 2011. The women were treated by RFVTA. Uterine fibroid symptom and health-related quality-of-life (UFS-QOL) questionnaires were completed at 0, 3, 6, and 12 months. RESULTS: Among 114 women screened, 36 were enrolled (ages 33-51 years), and 35 were followed for 12 months. Symptom severity scores reduced significantly (P<0.05): baseline (63.3), 3 months (23.1), 6 months (15.4), 12 months (9.6). Health-related quality-of-life scores improved significantly (P<0.05): baseline (37.3), 3 months (79.9), 6 months (85.1), 12 months (87.7). The mean ± SD difference in uterine volume from baseline (215.2 ± 117.9 cm(3)) to 12 months (167.0 ± 120.8 cm(3)) was 48.2 cm(3) (95% CI: -22.8 to 119.2; P=0.192). Nine adverse events among 8 individuals were minor and unrelated to the procedure. CONCLUSION: RFVTA of fibroids resulted in significantly improved symptom severity and quality-of-life scores and provides an outpatient uterine-sparing option for treatment of myomas.

Robles R; Aguirre VA; Argueta AI; Guerrero MR

2013-01-01

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State and development of uterine myoma embolization in Germany; Stand und Entwicklung der Uterusmyomembolisation in Deutschland  

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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 of treatment options in uterine myomas. (orig.) [German] Ziel dieser Arbeit war es, Stand, Entwicklung und Implementierung der Embolisationstherapie von Uterusmyomen (UME) in das Behandlungskonzept von Patientinnen mit symptomatischen Uterusmyomen in Deutschland zu evaluieren. Ein Fragebogen zum Thema der Embolisation von Uterusmyomen wurde an 164 Abteilungen fuer Gynaekologie und Radiologie im gesamten Bundesgebiet versandt. Erfragt wurden Informationen zur klinischen Symptomatik, mit der sich die Patientinnen vorstellen, zu den empfohlenen Behandlungsstrategien, zur Interventionsvorbereitung, zur technischen Durchfuehrung und zu den Komplikationen der UME. Von den angeschriebenen Abteilungen antworteten 33 radiologische und 19 gynaekologische Abteilungen. Nur 7 Abteilungen fuer Radiologie berichteten ueber eigene Erfahrungen bei der Durchfuehrung der UME, waehrend nur 2 gynaekologische Abteilungen die UME in das Repertoire moeglicher Therapieoptionen fuer Patientinnen mit symptomatischen Uterusmyomen aufnehmen. Insgesamt bieten 18 radiologische Abteilungen die UME an, koennen jedoch nicht alle ueber eine Zuweisung zur Therapie berichten. Bezueglich der Diagnosesicherung mit Ultraschall und MRT, der Indikationsstellung, der bevorzugten Lokalisation der Myome, des technischen Vorgehens und des Schmerzmanagements herrschte abteilungsuebergreifend hohe Uebereinstimmung. Die UME zur Behandlung von Patientinnen mit symptomatischen Uterusmyomen hat sich trotz der weltweit dokumentierten Behandlungserfolge und niedriger Komplikationsrate in Deutschland bisher nicht etablieren koennen. Gynaekologen und interventionelle Radiologen muessen gemeinsam die Indikation zur UME stellen, um der UME einen Stellenwert als Alternative zur klassischen chirurgischen Therapie zu verschaffen. (orig.)

Jakobs, T.F.; Helmberger, T.K.; Reiser, M.F. [Institut fuer Klinische Radiologie, Klinikum der Universitaet Muenchen - Grosshadern (Germany)

2003-08-01

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[The effect of transcerebral electrical impulse exposures on regional hemodynamics after the surgical treatment of uterine myoma  

UK PubMed Central (United Kingdom)

After surgical treatment of uterine myoma 28 patients with cardiovascular diseases experienced disturbances of cerebral, upper limb and small pelvis circulation. The course of transcerebral electrotherapy (short bipolar nonsymmetrical impulses with large amplitude of the negative part) relieved the symptoms as a results of better cerebral and upper limb hemodynamics.

Strugatski? VM; Landekhovski? IuD; Arslanian KN; Omarova MR; Burenko BN; Shekhtman MM; Azabekian AB; Medvedev MB

1997-05-01

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[The effect of transcerebral electrical impulse exposures on regional hemodynamics after the surgical treatment of uterine myoma].  

Science.gov (United States)

After surgical treatment of uterine myoma 28 patients with cardiovascular diseases experienced disturbances of cerebral, upper limb and small pelvis circulation. The course of transcerebral electrotherapy (short bipolar nonsymmetrical impulses with large amplitude of the negative part) relieved the symptoms as a results of better cerebral and upper limb hemodynamics. PMID:9334063

Strugatski?, V M; Landekhovski?, Iu D; Arslanian, K N; Omarova, M R; Burenko, B N; Shekhtman, M M; Azabekian, A B; Medvedev, M B

34

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

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Since glutathione S-transferase (GST) enzymes are involved in cellular protection, we aimed to determine the distribution of GSTT1 and GSTM1 null genotypes in women in central Serbia in order to assess the risk of development of uterine myoma. The study consisted of 34 clinically diagnosed uteri...

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

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Telomerase activity in needle biopsied uterine myoma-like tumors: differential diagnosis between uterine sarcomas and leiomyomas.  

Science.gov (United States)

Preoperative differential diagnoses between uterine sarcomas and leiomyomas are difficult. As telomerase activation is thought to be essential for the immortality of malignant cells, it is considered a potentially useful diagnostic marker. The aim of the present study was to evaluate the potential diagnostic use of measuring telomerase activity in needle biopsy samples to distinguish uterine sarcoma from leiomyoma. Sixty-two patients with suspected uterine sarcomas based on clinical findings or magnetic resonance imaging findings, and who were scheduled for surgery, underwent transcervical ultrasound-guided needle biopsy. Three samples were obtained per patient for histopathological examination and telomerase activity measurement. Telomerase activity was measured using the telomeric repeat amplification protocol and correlated with final histopathological findings of surgical specimens. Of the 62 patients, 6 leiomyosarcomas and 1 endometrial stromal sarcoma (high grade) were diagnosed by histopathology. In 6 of the 7 samples from uterine sarcomas, relatively high telomerase activity (22-102 units) was detected, whereas only low telomerase activity (11-18 units) existed in 3 of the remaining 55 samples from benign or borderline uterine smooth muscle tumors. At a cut-off value of 20 units, sensitivity, specificity, positive predictive, and negative predictive values for detecting uterine sarcoma were 86% (95% confidence interval, 59-100%), 100% (94-100%), 100% (54-100%) and 98% (95-100%), respectively. The results indicated that telomerase activity in needle biopsy samples is a useful diagnostic marker to distinguish uterine sarcoma from leiomyoma. PMID:11788902

Tsujimura, Akemi; Kawamura, Naoki; Ichimura, Tomoyuki; Honda, Ken-Ichi; Ishiko, Osamu; Ogita, Sachio

2002-02-01

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Interleukin 11 is upregulated in uterine lavage and endometrial cancer cells in women with endometrial carcinoma  

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Full Text Available Abstract Background Interleukin (IL) 11 is produced by human endometrium and endometrial cancer tissue. It has roles in endometrial epithelial cell adhesion and trophoblast cell invasion, two important processes in cancer progression. This study aimed to determine the levels of IL11 in uterine lavage fluid in women with endometrial cancer and postmenopausal women. It further aimed to determine the levels of IL11 protein and its signaling molecules in human endometrial cancer of varying grades, and endometrium from postmenopausal women and IL11 signalling mechanisms in endometrial cancer cell lines. Methods IL11 levels in uterine lavage were measured by ELISA. IL11, IL11 receptor(R) ?, phosphorylated (p) STAT3 and SOCS3 were examined by immunohistochemistry in endometrial carcinomas and in control endometrium from postmenopausal women and normal cycling women. The effect of IL11 on pSTAT3/STAT3 and SOCS3 protein abundance in endometrial cancer cell lines and non-cancer endometrial epithelial cells was determined by Western blot. Results IL11 was present in uterine flushings and was significantly higher in women with Grade 1 carcinomas compared to postmenopausal women (p Conclusions The present study suggests that IL11 in uterine washings may be useful as a diagnostic marker for early stage endometrial cancer. It indicates that IL11, along with its specific receptor, IL11R?, and downstream signalling molecules, STAT3 and SOCS3, are likely to play a role in the progression of endometrial carcinoma. The precise role of IL11 in endometrial cancer remains to be elucidated.

Yap Joanne; Salamonsen Lois A; Jobling Tom; Nicholls Peter K; Dimitriadis Evdokia

2010-01-01

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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

2008-01-01

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Diagnóstico ecográfico de mioma uterino en mujeres con síntomas ginecológicos Ultrasound diagnosis of uterine myoma in women with gynecological symptoms  

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Full Text Available Se realizó un estudio descriptivo y transversal de 76 pacientes atendidas en el Departamento de Ultrasonido del Hospital "Carlos Manuel de Céspedes" de Bayamo, Granma, desde junio de 2011 hasta enero de 2012, con vistas a describir las características ecográficas del mioma uterino en mujeres con síntomas ginecológicos. Entre las variables analizadas figuraron: edad, color de la piel, hallazgos ecográficos y correspondencia entre el diagnostico presuntivo y el ecográfico. En la serie prevalecieron las diagnosticadas con mioma uterino, el grupo etario de 15-45 años y las féminas de piel negra. Asimismo, predominaron los miomas múltiples y de localización intramural. Las complicaciones que primaron fueron la degeneración quística y las calcificaciones. No hubo total correspondencia entre las indicaciones médicas presuntivas de miomas y el diagnóstico ecográfico definitivo.A descriptive and cross-sectional study was conducted in 76 patients attended in the Ultrasound Department of "Carlos Manuel de Céspedes" Hospital in Bayamo, Granma, from June 2011 to January 2012, in order to describe the sonographic characteristics of the uterine myoma in women with gynecological symptoms. Among the analyzed variables were age, race, sonographic findings and correspondence between the presumptive and sonographic diagnosis. Those diagnosed with uterine myoma, age group of 15-45 years and black women prevailed in the series. Also, multiple myomas and those of intramural location prevailed. Cystic degeneration and calcifications were the prevailing complications. There was not total correspondence between the presumptive medical indications of myomas and the final ultrasound diagnosis.

Katia Ramírez Fajardo; Grisell Torres Alfes; Yuleydis K Frutos Ramírez

2012-01-01

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Comparison of laparoscopic myomectomy using in situ morcellation with and without uterine artery ligation for treatment of symptomatic myomas.  

UK PubMed Central (United Kingdom)

STUDY OBJECTIVE: To evaluate the efficacy of laparoscopic uterine artery ligation (LUAL) before in situ morcellation (ISM) compared with ISM alone. DESIGN: Prospective study (Canadian Task Force classification II-1). SETTING: University-affiliated hospital. PATIENTS: One hundred forty-four women with symptomatic uterine myomas, of whom 45 underwent LUAL and ISM and 99 underwent ISM only, from August 2007 through August 2009. INTERVENTIONS: Ligation or no ligation of the uterine arteries before ISM. MEASUREMENTS AND MAIN RESULTS: In the LUAL+ISM group compared with the ISM group, mean (SD) operative time was significantly longer (107 [34] minutes vs 93 [35] minutes; p = .03), and there was less intraoperative blood loss (84 [53] mL vs 137 [166] mL; p < .001). Eight patients in the ISM group (8.1%) required a blood transfusion, including 4 (4.0%) with excessive intraoperative bleeding and 4 (4.0%) with postoperative hematomas. Although myomas in the LUAL+ISM group weighed more (p < .001), none of the patients in that group had excessive intraoperative bleeding, postoperative hematomas, or required blood transfusion (p = .046). At 2 years of follow-up, in the LUAL+ISM group compared with the ISM group, the myoma recurrence rate was 7% vs 24%, and symptom improvement was reported by 98% of patients vs 86% (statistically significant). CONCLUSION: Laparoscopic myomectomy using an ISM technique with or without simultaneous LUAL may be used in the management of symptomatic uterine myomas; however, LUAL+ISM may result in a better surgical outcome.

Chang WC; Huang PS; Wang PH; Chang DY; Huang SC; Chen SY; Chou LY; Sheu BC

2012-11-01

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Reduction by 98% in uterine myoma volume associated with significant symptom relief after peripheral treatment with magnetic resonance imaging-guided focused ultrasound surgery.  

UK PubMed Central (United Kingdom)

Magnetic resonance imaging-guided focused ultrasound surgery is a noninvasive treatment for symptomatic uterine myomas. Previous studies have demonstrated a correlation between the treated volume of the myoma, improvement in symptoms, and lesion shrinkage. We report a case in which MRgFUS treatment only at the periphery of the myoma resulted in a 98% reduction in tumor volume at 8 months posttreatment, and at 12-month follow-up, only a small lesion was visible at magnetic resonance imaging. The patient's symptoms, as assessed using the Uterine Fibroids Symptom and Quality of life (UFS-QOL) questionnaire, were substantially improved at both 6 and 12 months posttreatment. We also provide a hypothesis to explain this dramatic reduction in myoma volume after only partial MRgFUS treatment of the lesion.

de Melo FC; Diacoyannis L; Moll A; Tovar-Moll F

2009-07-01

 
 
 
 
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[Myomas management, alternatives to hysterectomy and myomectomy: what can we propose?].  

UK PubMed Central (United Kingdom)

Second generation endometrial ablation techniques must be used preferably as they present less complications than first generation techniques. An efficient contraception is highly recommended after thermal ablation. Myolysis techniques are still investigational, focused ultrasound myolysis MR or ultrasound-guided is accessible to approximately 10% of uterine myomas with 70% of long-term symptom relief. Outcomes of laparoscopic uterine artery occlusion are similar to those of uterine artery embolization but with less long-term durability.

Ouldamer L; De Jesus I

2013-07-01

42

Thermal balloon endometrial ablation in dysfunctional uterine bleeding  

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Full Text Available Introduction: Dysfunctional uterine bleeding (DUB) affects a large number of women in the reproductive and perimenopausal age group. It significantly impairs the quality of life in otherwise healthy women. There are many different techniques for the conservative management of DUB. Medical management, LNG-IUD, hysteroscopic resection and various global ablation techniques. Materials and Methods: We did a retrospective analysis of 156 women with dysfunctional uterine bleeding who had completed childbearing and who underwent uterine balloon ablation therapy using the Thermachoice device. Majority of the women (72%) were done using short general anesthesia while in the others sedation or local anesthesia was used. Results: 49% women had amenorrhea while 41 % had oligomenorhoea or eumenorrhoea. 90% were satisfied with the procedure. There were no major complications during this study. Conclusions: Thermal balloon endometrial ablation is a simple, safe and effective technique for the permanent treatment of DUB in well selected cases.

Pai Rishma

2009-01-01

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Molecular markers of endometrial carcinoma detected in uterine aspirates.  

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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

2011-04-08

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Molecular diagnosis of endometrial cancer from uterine aspirates.  

Science.gov (United States)

Rapid and reliable diagnosis of endometrial cancer (EC) in uterine aspirates is highly desirable. Current sensitivity and failure rate of histological diagnosis limit the success of this method and subsequent hysteroscopy is often necessary. Using quantitative reverse transcriptase-polymerase chain reaction on RNA from uterine aspirates samples, we measured the expression level of 20 previously identified genes involved in EC pathology, created five algorithms based on combinations of five genes and evaluated their ability to diagnose EC. The algorithms were tested in a prospective, double-blind, multicenter study. We enlisted 514 patients who presented with abnormal uterine bleeding. EC was diagnosed in 60 of the 514 patients (12%). Molecular analysis was performed on the remnants of aspirates and results were compared to the final histological diagnoses obtained through biopsies acquired by aspiration or guided by hysteroscopy, or from the specimens resected by hysterectomy. Algorithm 5 was the best performing molecular diagnostic classifier in the case-control and validation study. The molecular test had a sensitivity of 81%, specificity of 96%, positive predictive value (PPV) of 75% and negative predictive value (NPV) of 97%. A combination of the molecular and histological diagnosis had a sensitivity of 91%, specificity of 97%, PPV of 79% and NPV of 99% and the cases that could be diagnosed on uterine aspirate rose from 76 to 93% when combined with the molecular test. Incorporation of the molecular diagnosis increases the reliability of a negative diagnosis, reduces the need for hysteroscopies and helps to identify additional cases. PMID:23649867

Perez-Sanchez, Cristina; Colas, Eva; Cabrera, Silvia; Falcon, Orlando; Sanchez-Del-Río, Angel; García, Enrique; Fernández-de-Castillo, Luis; Muruzabal, Juan Carlos; Alvarez, Elena; Fiol, Gabriel; González, Carmen; Torrejón, Rafael; Moral, Eloy; Campos, Miriam; Repollés, Manuel; Carreras, Ramon; Jiménez-López, Jesus; Xercavins, Jordi; Aibar, Elena; Perdones-Montero, Alvaro; Lalanne, Eric; Palicio, Marta; Maes, Tamara; Rosell-Vives, Elisabet; Nieto, Carlos; Ortega, Alicia; Pedrola, Nuria; Llauradó, Marta; Rigau, Marina; Doll, Andreas; Abal, Miguel; Ponce, Jordi; Gil-Moreno, Antonio; Reventós, Jaume

2013-06-21

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

UK PubMed Central (United Kingdom)

OBJECTIVE: 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 into 2 equal groups to take either Diphereline or Cabergoline. The first Group took 3.75 mg of Diphereline 4 times every 28 days and the second group took 0.5 mg of Cabergoline once a week for 6 weeks. RESULTS: The Cabergoline was well tolerated and fewer adverse effects were noted. The tumor regressed significantly and volume reduction rate of individual tumor nodule varied from 46-53%. The gonadotropin releasing hormone agonist group all responded to the treatment, and volume reduction rate of the individual tumor nodule varied from 21-97%. The extent of tumor shrinkage was positively correlated to the number of nodules (p=0.881, p<0.005 and 0.701, p<0.005). CONCLUSION: In light of therapeutic efficacy and few adverse effects, the dopamine agonists may hold promise as novel treatment modalities for leiomyoma. Further studies are warranted to determine the optimal strategy for the treatment of leiomyoma through these agents.

Melli MS; Farzadi L; Madarek EO

2007-03-01

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Quiste gigante de ovario y mioma uterino. Presentación de un caso Giant ovarian cyst and uterine myoma. A case report  

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Full Text Available Se presenta un caso de quiste gigante del ovario, en una paciente de 30 años de edad, que fue atendida por el Servicio de Ginecología del Hospital Provincial de Inhambane, en el año 2010, por un aumento de tamaño en el abdomen. Se realizaron los estudios clínicos y ultrasonográficos. Se confirmó a través de una laparotomía exploradora una tumoración quística gigante del ovario con dimensiones extraordinarias y un mioma uterino, lo que es poco frecuente en la actualidad. En el estudio anatomopatológico se comprobó el diagnóstico de cistoadenoma seroso del ovario.A 30-year old patient presenting a giant ovarian cyst was attended at Gynecology service in the Provincial Hospital of Inhambane in 2010, the patient complained of abdominal distension. Clinical and ultrasonographic studies were completed. An exploratory laparotomy confirmed a giant ovarian cyst having odd dimensions and uterine myoma, not frequently found in present times. Pathological studies proved a serous cystadenoma of the ovary.

Carlos Antonio Sánchez Portela; Adonis García Valladares; Carmen Juana Sánchez Portela

2012-01-01

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In Papanicolaou smears, benign appearing endometrial cells bear no significance in predicting uterine endometrial adenocarcinomas.  

UK PubMed Central (United Kingdom)

Reporting of benign appearing endometrial cells (BECs) in the Papanicolaou smears of women aging 40 years or older was mandated in the Bethesda System 2001 aiming at predicting the uterine pathology. The purpose of this study was to determine the clinical significance of the BECs in patients in our Medical Center. A two-arm study was designed in ?40-years-old women with BECs and without BECs in their Pap smears from January 2002 to December 2004. Of 21,965 patients, 882 had BECs in their Pap smears and the rest did not. Among the patients with BECs, 186 (study group) and among those without BECs, 2,064 (control group) had histopathologic follow-ups. There were 4 patients in the study and 47 in the control groups who had uterine adenocarcinoma. The Chi-square P-value for adenocarcinoma between the two groups was 0.91; indicating insignificant differences between the two groups. We conclude that presence of BECs in the Pap smears of ?40-years-old women signal no significance as a harbinger of endometrial adenocarcinoma.

Moatamed NA; Le LT; Levin MR; Govind R; Apple SK

2013-04-01

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Magnetic resonance imaging of endometrial cyst  

Energy Technology Data Exchange (ETDEWEB)

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.).

Akamatsu, Nobuo; Nishi, Mutsumasa; Sekiba, Kaoru; Joja, Ikuo

1987-07-01

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Goserelin acetate (Zoladex) plus endometrial ablation for dysfunctional uterine bleeding: a large randomized, double-blind study.  

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OBJECTIVE: To confirm the advantages of goserelin prior to endometrial ablation for the treatment of dysfunctional uterine bleeding. DESIGN: Multicenter, prospective, randomized, double-blind study. PATIENT(S): Cycling premenopausal women with dysfunctional uterine bleeding. TREATMENT: Patients were...

Donnez, Jacques; Vilos, G; Gannon, M J; Stampe-Sorensen, S; Klinte, I; Miller, R M

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

Directory of Open Access Journals (Sweden)

Full Text Available 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 pThe 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 transvaginal 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

2002-01-01

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Quiste gigante de ovario y mioma uterino. Presentación de un caso/ Giant ovarian cyst and uterine myoma. A case report  

Scientific Electronic Library Online (English)

Full Text Available Abstract in spanish Se presenta un caso de quiste gigante del ovario, en una paciente de 30 años de edad, que fue atendida por el Servicio de Ginecología del Hospital Provincial de Inhambane, en el año 2010, por un aumento de tamaño en el abdomen. Se realizaron los estudios clínicos y ultrasonográficos. Se confirmó a través de una laparotomía exploradora una tumoración quística gigante del ovario con dimensiones extraordinarias y un mioma uterino, lo que es poco frecuente en la actualidad. En el estudio anatomopatológico se comprobó el diagnóstico de cistoadenoma seroso del ovario. Abstract in english A 30-year old patient presenting a giant ovarian cyst was attended at Gynecology service in the Provincial Hospital of Inhambane in 2010, the patient complained of abdominal distension. Clinical and ultrasonographic studies were completed. An exploratory laparotomy confirmed a giant ovarian cyst having odd dimensions and uterine myoma, not frequently found in present times. Pathological studies proved a serous cystadenoma of the ovary.

Sánchez Portela, Carlos Antonio; García Valladares, Adonis; Sánchez Portela, Carmen Juana

2012-10-01

52

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

2013-08-30

53

An Incidentally Found Inflamed Uterine Myoma Causing Low Abdominal Pain, Using Tc-99m-Tektrotyd Single Photon Emission Computed Tomography-CT Hybrid Imaging.  

UK PubMed Central (United Kingdom)

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 S; Schütz M; Bernt R; Zwerina J; Haller J

2013-09-01

54

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.

Schutz, Matthias; Bernt, Reinhard; Zwerina, Jochen; Haller, Joerg

2013-01-01

55

The place of Zoladex in deferred surgery for uterine fibroids. Zoladex Myoma Study Group.  

UK PubMed Central (United Kingdom)

Two hundred and forty-seven patients with uterine fibroids were randomized to surgery alone or 3 months' Zoladex (Zeneca, Macclesfield, Ches., UK) followed by surgery. Zoladex significantly reduced uterine and fibroid volumes (p = 0.0001). There was a significantly (p = 0.002) greater mean rise in haemoglobin from entry to preoperation in the Zoladex group (1 g/dl) compared with the surgery-alone group (0.3 g/dl) as well as a tendency towards easier surgery, and reduced operative blood loss. Zoladex-treated patients had a significantly (p = 0.016) shorter hospital stay and pelvic pain and abdominal pressure symptoms were significantly (p < 0.0001) reduced in this group. Zoladex was well tolerated.

Gerris J; Degueldre M; Peters AA; Romao F; Stjernquist M; al-Taher H

1996-01-01

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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 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 abdomen y además, constipación, tenesmo vesical y sangrados abundantes, que le causaban anemia severa. Después del interrogatorio y examen físico se encontró una tumora (more) ción 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 were constipation, vesiacal tenesmus and profuse bleeding that caused severe anemia. After the patient’s interview application and the physical examination was done a giant (more) 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

Hiralda Martínez, Jorge Luís

2013-09-01

57

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

2003-01-01

58

Gene expression signatures differentiate uterine endometrial stromal sarcoma from leiomyosarcoma.  

UK PubMed Central (United Kingdom)

OBJECTIVE: Endometrial stromal sarcoma (ESS) and leiomyosarcoma (LMS) are the two most common uterine sarcomas, but both are rare tumors. The aim of the present study was to compare the global gene expression patterns of ESS and LMS. METHODS: Gene expression profiles of 7 ESS and 13 LMS were analyzed using the HumanRef-8 BeadChip from Illumina. Differentially expressed candidate genes were validated using quantitative real-time PCR and immunohistochemistry. RESULTS: Unsupervised hierarchical clustering using all 54,675 genes in the array separated ESS from LMS samples. We identified 549 unique probes that were significantly differentially expressed in the two malignancies by greater than 2-fold with 1% FDR cutoff using one-way ANOVA with Benjamini-Hochberg correction, of which 336 and 213 were overexpressed in ESS and LMS, respectively. Genes overexpressed in ESS included SLC7A10, EFNB3, CCND2, ECEL1, ITM2A, NPW, PLAG1 and GCGR. Genes overexpressed in LMS included CDKN2A, FABP3, TAGLN, JPH2, GEM, NAV2 and RAB23. The top 100 genes overexpressed in LMS included those coding for myosin light chain and caldesmon, but not the genes coding for desmin or actin. CD10 was not overexpressed in ESS. Results for selected genes were validated by quantitative real-time PCR and immunohistochemistry. CONCLUSIONS: We present the first study in which gene expression profiling was shown to distinguish between ESS and LMS. The molecular signatures unique to each of these malignancies may aid in expanding the diagnostic battery for their differentiation, and may provide a molecular basis for prognostic studies and therapeutic target discovery.

Davidson B; Abeler VM; Hellesylt E; Holth A; Shih IeM; Skeie-Jensen T; Chen L; Yang Y; Wang TL

2013-02-01

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A study of differential diagnosis of uterine endometrial pathologies with MR imaging in postmenopausal women  

International Nuclear Information System (INIS)

[en] In postmenopausal women, the usefulness of the thickness and the organic changes of the endometrium obtained in MRI were investigated in the diagnosis of uterine cancer. A total of 129 study subjects were selected from the postmenopausal women, consisting of 72 cases of control group (C-group) having no endometrial hyperplasia or uterine cancer, 12 cases of endometrial hyperplasia group (EH-group) and 45 cases of uterine body cancer group (Ca-group), which were confirmed by histological diagnosis during the period from 1996 to 2001. Women with submucous myomata or endometrial polyp were excluded form the subjects. With the T2-weighted MRI, the thickness and heterogeneity of the endometrium (evaluated by comparisons with heterogeneity in the signal of bladder content), and the intensity of endometrial signal (classified by rating ''high'', ''intermediate'' or ''low'' in comparison with intracystic signal intensity) were comparatively examined. To determine cut-off values for differentiation of disease-free from EH, and for that of EH from cancer, analyses with receiver-operating characteristic (ROC) curve were performed. The endometrial thickness (mm, M±SD) in the Ca-group (24.6±17.2) was significantly greater than that in the C-group (3.0±1.2) or EH-group (6.9±5.3). ROC curve analyses revealed cut-off value for differentiating EH from disease-free was 4 mm, and that for EH from cancer was 10 mm. The, endometrial thickness in the EH-group tended to increase compared to that in the C-group, while there were no significant differences in endometrial heterogeneity and signal intensity between these groups. In the Ca-group, there were significantly more cases (77.8%) showing endometrial heterogeneity compared to those in the C-group (0%) or EH-group (9.3%). The percentage of the cases showing a ''low'' endometrial signal intensity was found to be significantly higher in the Ca-group (48.9%) compared to those in the C-group (0%) or EH-group (0%), and the same was observed in any clinical stage in the Ca-group. The endometrial thickness in the Ca-group was examined at different clinical stages, showing an increasing trend with the progress of clinical stage, while significant differences in the endometrial heterogeneity and signal intensity between the Ca-group and C- or EH-group were observed from an early period of clinical stage. The present study revealed that there are qualitative and quantitative differences in MRI findings of endometrium and/or myometrium between in patients with uterine cancer and in those with endometrial hyperplasia or with uterine pathologies other than endometrial cancer. This suggests the usefulness of MRI for the differential diagnosis of endometrial disorders. Endometrium thickness over 10 mm, heterogeneity in endometrial signal intensity, and ''low'' signal intensity of endometrial tissue in T2 weighted MRI would be useful criteria for screening diagnosis of endometrial cancer in postmenopausal women. (authors)

2005-01-01

60

Endometrial exosomes/microvesicles in the uterine microenvironment: a new paradigm for embryo-endometrial cross talk at implantation.  

UK PubMed Central (United Kingdom)

Exosomes are nanoparticles (?100 nm diameter) released from cells, which can transfer small RNAs and mRNA via the extracellular environment to cells at distant sites. We hypothesised that exosomes or the slightly larger microvesicles (100-300 nm) are released from the endometrial epithelium into the uterine cavity, and that these contain specific micro (mi)RNA that could be transferred to either the trophectodermal cells of the blastocyst or to endometrial epithelial cells, to promote implantation. The aim of this study was to specifically identify and characterise exosomes/microvesicles (mv) released from endometrial epithelial cells and to determine whether exosomes/mv are present in uterine fluid. Immunostaining demonstrated that the tetraspanins, CD9 and CD63 used as cell surface markers of exosomes are present on the apical surfaces of endometrial epithelial cells in tissue sections taken across the menstrual cycle: CD63 showed cyclical regulation. Exosome/mv pellets were prepared from culture medium of endometrial epithelial cell (ECC1 cells) and from uterine fluid and its associated mucus by sequential ultracentifugation. Exosomes/mv were positively identified in all preparations by FACS and immunofluorescence staining following exosome binding to beads. Size particle analysis confirmed the predominance of particles of 50-150 nm in each of these fluids. MiRNA analysis of the ECC1 cells and their exosomes/mv demonstrated sorting of miRNA into exosomes/mv: 13 of the 227 miRNA were specific to exosomes/mv, while a further 5 were not present in these. The most abundant miRNA in exosomes/mv were hsa-miR-200c, hsa-miR-17 and hsa-miR-106a. Bioinformatic analysis showed that the exosome/mv-specific miRNAs have potential targets in biological pathways highly relevant for embryo implantation. Thus exosomes/mv containing specific miRNA are present in the microenvironment in which embryo implantation occurs and may contribute to the endometrial-embryo cross talk essential for this process.

Ng YH; Rome S; Jalabert A; Forterre A; Singh H; Hincks CL; Salamonsen LA

2013-01-01

 
 
 
 
61

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 endometrial MVD was reversible, its long-term effect on endometrial receptivity still needs further study

2013-01-01

62

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

UK PubMed Central (United Kingdom)

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

Christensen BW; Schlafer DH; Agnew DW; Wang C; Kozlowski C; Asa CS

2012-12-01

63

Spontaneous uterine perforation due to clostridial gas gangrene associated with endometrial carcinoma.  

Science.gov (United States)

Few cases of clostridial gas gangrene associated with uterine malignancy have been reported. We report on a 46-year-old woman with clostridial sepsis. On the day of admission due to severe abdominal pain, peritonitis was diagnosed, and computed tomography showed free air in the abdomen. At emergency laparotomy, perforation of the necrotic uterine wall was observed. During hysterectomy, septic shock developed, and life-saving therapy was performed in the intensive care unit after surgery. Pathological examination of the necrotic uterine wall showed grade III endometrial adenocarcinoma of the uterine endometrium (International Federation of Gynecology and Obstetrics stage IIIa) with gas gangrene due to Clostridium perfringens. This report aims to alert gynecologists to the possibility that clostridial gas gangrene of the uterus can occur in patients with peritonitis and intra-abdominal free air. Early recognition and aggressive therapy can save patients' lives. PMID:20610901

Kurashina, Ryuhei; Shimada, Hiromi; Matsushima, Takashi; Doi, Daisuke; Asakura, Hirobumi; Takeshita, Toshiyuki

2010-06-01

64

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.

2011-01-01

65

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

66

Simultaneous uterine leiomyoma and endometrial hiperplasia in a white-nosed monkey (cercopithecus nictitans). First case report Leiomioma uterino e hiperplasia endometrial simultáneos en un cercopiteco de nariz blanca (Cercopithecus nictitans). Primera descripción de un caso.  

Digital Repository Infrastructure Vision for European Research (DRIVER)

This paper describes histopathological and immunocytochemical features of a combined uterine leyomioma and a non atypical complex endometrial hyperplasia in a white-nosed monkey (Cercopithecus nictitans). Immunocytochemically, uterine leiomyoma was ?-actin positive, and negative for desmin. By the o...

Martínez, Carlos M.; Ibáñez, Carla; Corpa, Juan M.

67

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

Directory of Open Access Journals (Sweden)

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

Nisha Singh; Bharti Singh

2013-01-01

68

Uterine ultrasound findings after radiofrequency endometrial ablation: correlation with symptoms.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To determine pelvic ultrasound characteristics in women after radiofrequency endometrial ablation (EA) and evaluate the association of those characteristics with symptoms and the need for subsequent therapeutic intervention. METHODS: This retrospective cohort study evaluated patients who underwent transvaginal pelvic ultrasound after radiofrequency EA between July 3, 2006, and November 13, 2009. The presence or absence of postablation symptoms (pelvic pain or vaginal bleeding) at the time of ultrasound defined the 2 groups. Two radiologists evaluated 17 ultrasound parameters. Demographic, clinical, and ultrasound characteristics were compared between symptomatic and asymptomatic patients, and features were assessed for association with subsequent therapeutic interventions. RESULTS: Of the 91 patients who had radiofrequency EA and subsequent ultrasound, 63 patients (69.2%) were symptomatic on evaluation. Symptomatic patients were significantly more likely than asymptomatic patients to have an endometrial thickness of 3 mm or more, a heterogeneous endometrial echotexture, and leiomyomas (P = 0.004, P = 0.008, and P = 0.05, respectively). The most frequent finding in all patients was an indistinct endometrial border (66/79 [83.5%]). In addition, there was a tendency for patients with leiomyomas to have a subsequent intervention (P = 0.07). Although infrequent, all patients (7/91) with cornual hematometra or proximal hydrosalpinx had pain. CONCLUSIONS: Indistinct endometrial border is a common finding after radiofrequency EA and is unrelated to the presence or absence of symptoms. Patients who present with post-radiofrequency EA symptoms seem to have a few specific ultrasound characteristics that differentiate them from asymptomatic patients. The presence of leiomyomas on ultrasound is predictive of the need for therapeutic interventions.

Alhilli MM; Wall DJ; Brown DL; Weaver AL; Hopkins MR; Famuyide AO

2012-12-01

69

Inhibin-? subunit expression in uterine endometrioid adenocarcinomas and endometrial cancer cell lines: a potential prognostic factor.  

UK PubMed Central (United Kingdom)

Inhibins/activins are secreted polypeptides of the transforming growth factor-? superfamily, forming a family of dimeric, disulphide-linked proteins. Inhibins are composed of an ?-subunit and one of two possible ?-subunits. Both inhibins and activins have substantial roles in human reproduction and in endocrine-responsive tumors. However, the prognostic significance and clinical implications of the inhibin-? subunits in uterine endometrioid adenocarcinomas is still not clearly defined. A series of 231 uterine endometrioid adenocarcinomas of a previous well-characterized cohort were re-evaluated for the expression of the inhibin-? subunit and correlated with several clinicopathological characteristics and clinical outcome. Additionally, several endometrial epithelial cell lines (Ishikawa plus and minus, HEC-1A, HEC-1B and RL95-2) were analyzed for the expression of this subunit using immunohistochemical and molecular biological techniques. A significant association between the inhibin-? subunit and histological grade, surgical staging and myometrial invasion was demonstrated. Survival analysis demonstrated that inhibin-? immunoreactivity significantly affected progression-free, cause-specific and overall survival of patients with endometrioid adenocarcinomas. The analyzed endometrial cancer cell lines can also synthesize this subunit. Inhibin-? seems to have a substantial role in the carcinogenesis and pathology of uterine endometrioid carcinomas, and might be used as a marker to identify high-risk patients and may aid in the selection of patients for a more aggressive adjuvant therapy. Since uterine cancer cell lines express the inhibin-? subunit, they constitute adequate in vitro models for assessing its function in endometrial carcinogenesis. However, further research is warranted to elucidate the possible implications of inhibin-? in endometrial carcinogenesis.

Mylonas I

2011-03-01

70

Inhibin-? subunit expression in uterine endometrioid adenocarcinomas and endometrial cancer cell lines: a potential prognostic factor.  

Science.gov (United States)

Inhibins/activins are secreted polypeptides of the transforming growth factor-? superfamily, forming a family of dimeric, disulphide-linked proteins. Inhibins are composed of an ?-subunit and one of two possible ?-subunits. Both inhibins and activins have substantial roles in human reproduction and in endocrine-responsive tumors. However, the prognostic significance and clinical implications of the inhibin-? subunits in uterine endometrioid adenocarcinomas is still not clearly defined. A series of 231 uterine endometrioid adenocarcinomas of a previous well-characterized cohort were re-evaluated for the expression of the inhibin-? subunit and correlated with several clinicopathological characteristics and clinical outcome. Additionally, several endometrial epithelial cell lines (Ishikawa plus and minus, HEC-1A, HEC-1B and RL95-2) were analyzed for the expression of this subunit using immunohistochemical and molecular biological techniques. A significant association between the inhibin-? subunit and histological grade, surgical staging and myometrial invasion was demonstrated. Survival analysis demonstrated that inhibin-? immunoreactivity significantly affected progression-free, cause-specific and overall survival of patients with endometrioid adenocarcinomas. The analyzed endometrial cancer cell lines can also synthesize this subunit. Inhibin-? seems to have a substantial role in the carcinogenesis and pathology of uterine endometrioid carcinomas, and might be used as a marker to identify high-risk patients and may aid in the selection of patients for a more aggressive adjuvant therapy. Since uterine cancer cell lines express the inhibin-? subunit, they constitute adequate in vitro models for assessing its function in endometrial carcinogenesis. However, further research is warranted to elucidate the possible implications of inhibin-? in endometrial carcinogenesis. PMID:21174065

Mylonas, Ioannis

2010-12-21

71

Uterine malignant degeneration after low-dose endometrial irradiation  

International Nuclear Information System (INIS)

[en] 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)

1980-01-01

72

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

UK PubMed Central (United Kingdom)

OBJECTIVE: 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 receive Diphereline 3.75 mg, 4 times every 28 days (group I), and Cabergoline 0.5 mg, once a week for 6 weeks (group II), were included in this study. Clinical symptoms, feasibility of intra-operative dissection, intraoperative complications, sonographic, and pathologic characteristics of the tumor were evaluated. RESULTS: Thirteen patients from group I, and 10 patients from group II underwent surgery. There was a significant difference between the groups in the rate of lymphocyte infiltration (p=0.003), but not in other pathologic features. In both groups, the mitotic index was between 0-10. While there was no significant difference between the groups in the number (p=0.30), and volume of leiomyomas (p=0.65), however, changes in the uterine artery circulation was significant (p=0.001 [group I], p=0.026 [group II]). In addition, there was a significant difference between the groups for intra-operative hemorrhage and adhesion of leiomyomas to the uterine wall. CONCLUSION: 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.

Sayyah-Melli M; Tehrani-Gadim S; Dastranj-Tabrizi A; Gatrehsamani F; Morteza G; Ouladesahebmadarek E; Farzadi L; Kazemi-Shishvan M

2009-08-01

73

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

74

Reconstruction of endometrium in vitro via rabbit uterine endometrial cells expanded by sex steroid.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To culture rabbit endometrial cells by using sex steroids to provide adequate seeding cells for endometrium reconstruction and uterine tissue engineering. DESIGN: Prospective experimental study. SETTING: Beijing Institute of Basic Medical Sciences and Tissue Engineering Research Center, Academy of Military Medical Sciences. ANIMAL(S): New Zealand rabbit and Kunming white strain mice. INTERVENTION(S): Rabbits were primed with pregnant mare serum gonadotropin and hCG. Endometrial cells were cultured with E(2) and P(4) of different concentrations. The endometrium was reconstructed by using endometrial cells as seeding cells and collagen-basement membrane matrix as scaffolds. MAIN OUTCOME MEASURE(S): Assay with 93-(4,5-dimethylthiazol-2-yl)2,5-diphenyl tetrazolium bromide, immunofluorescence staining, flow cytometric analysis, hematoxylin and eosin and immunohistochemical staining, and developmental rate of embryos. RESULT(S): The expression patterns of estrogen receptor and P receptor of rabbit endometrium were different before and after treatment with pregnant mare serum gonadotropin-hCG. One hundred nanomolar E(2) with 10 nmol/L P(4) facilitated the proliferation of epithelial cells whereas 100 nmol/L P(4) facilitated that of stromal cells. The epithelial cells could be stable if cultured for seven or eight passages. Cells in the epithelial layer of the reconstructed endometrium were cytokeratin positive. Some showed columnar morphology akin to the luminal epithelium in vivo. Reconstructed endometrium could improve the developmental rate and quality of one-cell mice embryos. CONCLUSION(S): Rabbit endometrial cells could be cultured with a long-standing proliferation capability by sex steroids and applied in uterine tissue engineering. Reconstructed endometrium with proliferated endometrial cells was akin to native endometrium in structure and function.

Wang HB; Lü SH; Lin QX; Feng LX; Li DX; Duan CM; Li YL; Wang CY

2010-05-01

75

[Sensitivity and specificity of hysterosonography in endometrial abnormalities in asymptomatic postmenopausal women].  

UK PubMed Central (United Kingdom)

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.

Tamanaha S; Aldrighi JM; Santos RE; Prado RA

2004-10-01

76

Role of inhibitor of DNA binding-1 protein is related to angiogenesis in the tumor advancement of uterine endometrial cancers  

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The inhibitor of DNA binding (ID)-1 protein, an inhibitor of basic helix-loop-helix transcription factors, has been found to be involved in multiple cellular functions. In the present study, ID-1 histoscores and mRNA levels were both significantly (p<0.05) increased in uterine endometrial cancers ac...

MAW, MIN KHINE; FUJIMOTO, JIRO; TAMAYA, TERUHIKO

77

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 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 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-Whitne (more) y. 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: 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 i (more) n 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.

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

2011-08-01

78

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  

Directory of Open Access Journals (Sweden)

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

2011-01-01

79

Is uterine artery embolization for patients with large myomas safe and effective? A retrospective comparative study in 323 patients.  

UK PubMed Central (United Kingdom)

PURPOSE: To evaluate the effectiveness, safety, and complications of uterine artery embolization (UAE) in women with large fibroid tumors. MATERIALS AND METHODS: From January 2005 to February 2011, 323 patients underwent UAE for symptomatic uterine leiomyomas without adenomyosis and were included in this study. Patients were divided into two groups: those with a large tumor burden (group 1; n = 63), defined as a dominant tumor with a longest axis of at least 10 cm or a uterine volume of at least 700 cm(3); and the control group (group 2; n = 260). Tumor infarction and volume reduction were calculated based on magnetic resonance imaging findings. Symptom status was assessed with a visual analog scale. Postprocedure complications and repeat interventions were recorded. The data were analyzed with appropriate statistical tests. RESULTS: No significant differences were seen between the two groups in volume reduction of dominant tumors (46.5% in group 1 vs 52.0% in group 2; P = .082) or percentage volume reduction of the uterus (40.7% in group 1 vs 36.3% in group 2; P = .114). Also, no significant differences were seen between the two groups regarding satisfaction scores at immediate or midterm follow-up (P = .524 and P = .497) or in the presence of procedure-related complications (P = .193). CONCLUSIONS: UAE outcomes in large fibroid tumors were comparable to those in smaller tumors, without an increased risk of significant complications. Tumor size may not be a key factor in predicting successful outcomes of UAE.

Choi HJ; Jeon GS; Kim MD; Lee JT; Yoon JH

2013-06-01

80

Diagnostic accuracy of sonohysterography and transvaginal sonography as compared with hysteroscopy and endometrial biopsy: a prospective study.  

UK PubMed Central (United Kingdom)

AIM: The aim of the study was to compare the diagnostic accuracy between transvaginal sonography (TVS) and sonohysterography (SHG) versus hysteroscopy (Hys) plus endometrial biopsy (EB) to evaluate uterine cavity. METHODS: One hundred and sixteen patients were enrolled. These presented with infertility and/or abnormal uterine bleeding and/or suspicious uterine cavity pathology. Women consecutively underwent during the same day, to TVS, SHG and Hys plus EB by three different operators. RESULTS: TVS shows excellent specificity (95.7%) in uterine polyps detection, good sensitivity (85,7%) and specificity (89.2%) in investigating endometrial hyperplasia, and excellent NPV (92.2%) in the diagnosis of submucous myomas. Diagnostic accuracy of TVS for synechiae is not evaluable. SHG demonstrates high specificity (92.8%) in the detection of uterine polyps, and high sensitivity (92.9%) and specificity (96.8%) in the diagnosis of endometrial hyperplasia. In addition it shows high sensitivity (90%), specificity (99%), PPV (92.2%), and NPV (99%) for detection of submucous myomas. Finally, SHG shows high PPV (100%) and NPV (100%) for synechiae assessment. CONCLUSION: TVS could be used as first step investigation to exclude uterine pathologies. TVS could reduce the number of diagnostic Hys normally performed in women with normal uterine cavity. Furthermore SHG should be useful to diagnose the pathologies and to decide between operative Hys in-office or resectoscopic treatment.

La Sala GB; Blasi I; Gallinelli A; Debbi C; Lopopolo G; Vinci V; Villani MT; Iannotti F

2011-10-01

 
 
 
 
81

Treatment of uterine myoma with 5 or 10mg mifepristone daily during 6 months, post-treatment evolution over 12 months: double-blind randomised clinical trial.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To evaluate the efficacy and safety of 5 and 10mg doses of mifepristone for 6 months for the treatment of uterine fibroids and to check those results at 1 year post-treatment. STUDY DESIGN: Randomised double-blind clinical study carried out at the "Eusebio Hernández" Hospital, Havana, Cuba. One hundred and seventy-six women with symptomatic uterine fibroids received one daily capsule of 10mg mifepristone orally or one daily capsule of 5mg mifepristone orally, over 6 months. Up to two endometrial biopsies were performed. Reduction in fibroid volume was used to evaluate efficacy. RESULTS: The 5 and 10mg dose had a similar efficacy in reducing the fibroid volume, 48.1% and 39.1%, p=0.07, and that of the uterus, 30.3% and 27.2%, p=0.63, respectively. Twelve months after treatment the majority of the subjects were asymptomatic with symptom prevalence similar to that at the end of treatment, except for hypermenorrhea and metrorrhagia, although the intensity of hypermenorrhea was much less, p<0.01. CONCLUSIONS: (1) Both doses obtain similar results in reducing fibroid size. (2) Administering 6 months' treatment achieves symptomatic improvement lasting 1 year in a high percentage of cases. (3) More studies need to be carried out with longer treatment and follow-up periods.

Esteve JL; Acosta R; Pérez Y; Campos R; Hernández AV; Texidó CS

2012-04-01

82

Role of hysteroscopy and endometrial biopsy in women with unexplained infertility.  

UK PubMed Central (United Kingdom)

OBJECTIVES: This study was designed to evaluate the role of hysteroscopy and endometrial biopsy in women with unexplained infertility. PATIENTS AND METHODS: Women with unexplained infertility were included in this prospective study, evaluated with transvaginal sonography and diagnostic hysteroscopy. Diagnostic hysteroscopy was performed between the 7th and 11th day of the cycle. The criteria for hysteroscopic findings were based on the cervical canal, uterine cavity, endometrium, visualization of the ostium tubae and lesions of the utero-tubal junction. After the hysteroscopic examination, endometrial biopsy was performed using a Pipelle(®) endometrial suction curette. Patients were classified according to the hysteroscopy results into four groups: patients with no abnormality detected (14), patients with cervical abnormalities (six), patients with endometrial abnormalities (73) and patients with uterine abnormalities (seven). RESULTS: One hundred women with unexplained infertility were included. All patients underwent diagnostic hysteroscopy, except for seven patients: six patients had stenotic external or internal cervical ostium and one had inadequate visualization as the uterine cavity was filled with blood. Based on hysteroscopic findings, 31 patients were finally diagnosed with endometrial polyps; 14 endometritis; 15 endometrial hyperplasia; six submucous myomas; seven intrauterine synechiae (73 cases = endometrial abnormalities group); seven congenital uterine anomalies (uterine abnormalities group), six cervical stenosis (cervical abnormalities group) and 14 women without any uterine abnormalities (no abnormalities group). Analysis of samples obtained using the Pipelle(®) endometrial suction curette was non-diagnostic in 16 cases; the most common endometrial pathological feature detected by this analysis was endometritis (15 %). CONCLUSIONS: Routine hysteroscopy and endometrial biopsy should be used as a basic part of the work-up for women with unexplained infertility.

Makled AK; Farghali MM; Shenouda DS

2013-07-01

83

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

Science.gov (United States)

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)-?, progesterone receptor (PR) and Ki67 (MIB-1) were examined. The mean SXR HSCOREs of carcinosarcoma (CS) and leiomyosarcoma (LMS) were 9.13 and 23.6, respectively, and SXR-positive rates were 3 out of 24 (12.5%) and 4 out of 17 (23.5%), respectively. SXR was not detected in endometrial stromal sarcoma (ESS). In CS cases, significant differences were detected between the expression of SXR and age and disease stages. There was no significant correlation between SXR-positive status and either disease-free survival or overall survival. Our results support an association between SXR and malignant behavior. Our results show that overexpression of SXR may represent a useful marker to identify patients with advanced-stage CS. In addition, our results showed that SXR may aid in the diagnosis of uterine sarcomas.

YUE, XIAONI; UTSUNOMIYA, HIROKI; AKAHIRA, JUN-ICHI; SUZUKI, FUMIHIKO; ITO, KIYOSHI; NAGASE, SATORU; SASANO, HIRONOBU; YAEGASHI, NOBUO

2013-01-01

84

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

UK PubMed Central (United Kingdom)

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)-?, progesterone receptor (PR) and Ki67 (MIB-1) were examined. The mean SXR HSCOREs of carcinosarcoma (CS) and leiomyosarcoma (LMS) were 9.13 and 23.6, respectively, and SXR-positive rates were 3 out of 24 (12.5%) and 4 out of 17 (23.5%), respectively. SXR was not detected in endometrial stromal sarcoma (ESS). In CS cases, significant differences were detected between the expression of SXR and age and disease stages. There was no significant correlation between SXR-positive status and either disease-free survival or overall survival. Our results support an association between SXR and malignant behavior. Our results show that overexpression of SXR may represent a useful marker to identify patients with advanced-stage CS. In addition, our results showed that SXR may aid in the diagnosis of uterine sarcomas.

Yue X; Utsunomiya H; Akahira JI; Suzuki F; Ito K; Nagase S; Sasano H; Yaegashi N

2013-03-01

85

Factors Associated With Uterine Endometrial Hyperplasia and Pyometra in Wild Canids: Implications for Fertility.  

Science.gov (United States)

The ability to safely and effectively manage reproduction is central to the success of AZA captive-breeding programs. Although the AZA Wildlife Contraception Center routinely monitors contraceptive safety, there have been no studies that compare the effects of contraceptive use to separation of males from females, the other option for preventing reproduction. We used retrospective medical records and pathology reports submitted by AZA and related facilities for the seven AZA-managed canid species to assess rates of uterine pathology relative to female reproductive life histories. Our results showed that the prevalence of both pyometra and endometrial hyperplasia (EH) was associated not only with treatment with the two most common contraceptives (Suprelorin® and MGA implants) but also with the number of years barren (i.e., not producing a litter and not contracepted). Rates of pyometra and EH were especially high in African painted dogs and red wolves, but lowest in swift and fennec foxes. The number of years producing a litter had a low association, suggesting it could be protective against uterine pathology. A more recently developed Suprelorin® protocol using Ovaban® to prevent the initial stimulation phase, followed by implant removal when reversal is desired, may be a safer contraceptive option. These results concerning the relationship between reproductive management and uterine health have important implications for AZA-managed programs, since the unsustainability of many captive populations may be due at least in part to infertility. Managing a female's reproductive lifespan to optimize or maintain fertility will require a reconsideration of how breeding recommendations are formulated. Zoo Biol. XX:XX-XX, 2013. (c) 2013 Wiley Periodicals Inc. PMID:23553688

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

2013-04-01

86

Factors Associated With Uterine Endometrial Hyperplasia and Pyometra in Wild Canids: Implications for Fertility.  

UK PubMed Central (United Kingdom)

The ability to safely and effectively manage reproduction is central to the success of AZA captive-breeding programs. Although the AZA Wildlife Contraception Center routinely monitors contraceptive safety, there have been no studies that compare the effects of contraceptive use to separation of males from females, the other option for preventing reproduction. We used retrospective medical records and pathology reports submitted by AZA and related facilities for the seven AZA-managed canid species to assess rates of uterine pathology relative to female reproductive life histories. Our results showed that the prevalence of both pyometra and endometrial hyperplasia (EH) was associated not only with treatment with the two most common contraceptives (Suprelorin® and MGA implants) but also with the number of years barren (i.e., not producing a litter and not contracepted). Rates of pyometra and EH were especially high in African painted dogs and red wolves, but lowest in swift and fennec foxes. The number of years producing a litter had a low association, suggesting it could be protective against uterine pathology. A more recently developed Suprelorin® protocol using Ovaban® to prevent the initial stimulation phase, followed by implant removal when reversal is desired, may be a safer contraceptive option. These results concerning the relationship between reproductive management and uterine health have important implications for AZA-managed programs, since the unsustainability of many captive populations may be due at least in part to infertility. Managing a female's reproductive lifespan to optimize or maintain fertility will require a reconsideration of how breeding recommendations are formulated. Zoo Biol. XX:XX-XX, 2013. (c) 2013 Wiley Periodicals Inc.

Asa CS; Bauman KL; Devery S; Zordan M; Camilo GR; Boutelle S; Moresco A

2013-04-01

87

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

International Nuclear Information System (INIS)

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

2005-01-01

88

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

Directory of Open Access Journals (Sweden)

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.

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

2006-01-01

89

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

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

Fadare Oluwole; Wang Sa A; Renshaw Idris L

2008-01-01

90

The effects of the selective cyclooxygenase-2 inhibitor on endometrial cytological findings in uterine endometrial cancer patients.  

UK PubMed Central (United Kingdom)

OBJECTIVE: We previously reported that oral administration of the selective cyclooxygenase-2 (COX-2) inhibitor etodolac results in antitumor effects in endometrial cancer tissue. Herein, we investigated whether these antitumor effects could be assessed using endometrial cytological findings. STUDY DESIGN: Etodolac (400 mg b.i.d. for 2 weeks) was administered preoperatively to 21 endometrial cancer patients: 16 had COX-2-positive disease and 5 had COX-2-negative disease. Twenty-one pairs of pre- and post-etodolac-treatment endometrial cytological samples were collected to review changes in the cytological features. RESULTS: In the COX-2-positive patients, nuclear atypia was slightly decreased in 3 of the 16 cases, while the mitotic index was decreased in all cases. Cellular overlapping and tumor cell cluster outlines were somewhat affected in 6 and 8 cases, respectively. Nuclear/cytoplasmic ratio, anisokaryosis and hyperchromasia were also reduced in 6, 4, and 2 cases, respectively; however, tumor diathesis and nucleoli features were unchanged. In contrast, endometrial cytological features did not appear to be affected in the 5 COX-2-negative patients. CONCLUSIONS: We conclude that the antitumor effects observed in endometrial cancer tissues following oral administration of etodolac are reflected in and can be easily assessed by evaluating endometrial cytological features.

Hasegawa K; Kawamura K; Kato R; Komiyama S; Kaneko C; Udagawa Y

2012-01-01

91

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

International Nuclear Information System (INIS)

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

2012-01-01

92

Sequential MR images of uterus after Gd-DTPA injection; Studies of normal volunteers and uterine endometrial malignant tumors  

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To investigate the sequential changes in signal intensity (SI) of normal and abnormal uteri, T1-weighted images were taken repeatedly after the injection of Gd-diethylenetriaminepentaacetic acid (DTPA). Six volunteers and 19 patients with known uterine body malignancy (18 carcinomas, one carcinosarcoma) were examined. The results in volunteers were as follows. In the secretory phase, SI of the endometrium was stronger in the late images than in the early ones, whereas in the proliferative phase, SI was stronger in the early images. SI of the myometrium decreased rapidly and there were no differences in SI between menstrual phases. In 17 of 18 endometrial carcinomas, the tumors showed hypointensity relative to the myometrium, and the contrast between the tumor and the myometrium was better in the early images. In the remaining two cases, the tumor showed hyperintensity and the contrast was better in the late images. After the injection of Gd-DTPA, the endometrium appeared differently according to the menstrual cycle in normal volunteers, and the appearance of uterine structures and endometrial malignant tumors changed sequentially. These findings must be kept in mind when evaluating uterine diseases by Gd-DTPA enhanced MRI. (author).

Okada, Susumu; Kato, Tomoyasu; Yamada, Keiko; Sawano, Seishi; Yamashita, Takashi; Hirai, Yasuo; Hasumi, Katsuhiko (Japanese Foundation for Cancer Research, Tokyo (Japan). Hospital)

1993-03-01

93

Two kinds of endometrial neoplasia arising from different origins in the uterine corpus: comparison of p53 expression and sex steroid receptor status.  

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This study presents a case of endometrial clear cell adenocarcinoma complicated by complex atypical glandular hyperplasia surrounded by adenomyosis in the uterine myometrium. The former was immuno-negative for estrogen receptor (ER) and positive for p53, whereas both of the latter were immuno-positive for ER and negative for p53. Therefore, there were two kinds of neoplasia arising from different origins in the uterine corpus. PMID:12206933

Koshiyama, Masafumi; Ueta, Michio

2002-09-10

94

Two kinds of endometrial neoplasia arising from different origins in the uterine corpus: comparison of p53 expression and sex steroid receptor status.  

UK PubMed Central (United Kingdom)

This study presents a case of endometrial clear cell adenocarcinoma complicated by complex atypical glandular hyperplasia surrounded by adenomyosis in the uterine myometrium. The former was immuno-negative for estrogen receptor (ER) and positive for p53, whereas both of the latter were immuno-positive for ER and negative for p53. Therefore, there were two kinds of neoplasia arising from different origins in the uterine corpus.

Koshiyama M; Ueta M

2002-09-01

95

Effects of a selective COX-2 inhibitor in patients with uterine endometrial cancers.  

UK PubMed Central (United Kingdom)

PURPOSE: COX-2 is highly expressed in endometrial cancers, suggesting that a selective COX-2 inhibitor could be valuable for treating endometrial cancers that overexpress COX-2. In this study, we investigated the anti-tumor effects of the selective COX-2 inhibitor etodolac on endometrial cancer patients. METHODS: Etodolac (400 mg, bid, for 2 weeks) was administered preoperatively to 21 endometrial cancer patients who had provided informed consent. Using pre-treatment biopsies and post-treatment surgical specimens, the expression levels of COX-2, Ki-67, p53, p21, p27, and cyclin D1 were evaluated by immunohistochemistry and the apoptotic index (AI) was determined by TUNEL staining. Preoperative biopsies and surgical specimens from 32 patients with endometrial cancer not treated with etodolac served as controls. RESULTS: Surgical specimens from COX-2 positive endometrial cancer patients treated with etodolac had significantly reduced expression levels of COX-2, Ki-67, p53, p21, p27, and cyclin D1 as determined by immunohistochemistry, while AI was not affected. These markers were unchanged for COX-2 negative endometrial cancer patients treated with etodolac and the control group. CONCLUSIONS: The selective COX-2 inhibitor etodolac showed anti-proliferative effects by suppressing COX-2 and cell-cycle regulator protein expression in patients with endometrial cancer positive for COX-2 expression. This study demonstrates that a selective COX-2 inhibitor is a potentially beneficial treatment for COX-2 positive endometrial cancers.

Hasegawa K; Torii Y; Ishii R; Oe S; Kato R; Udagawa Y

2011-12-01

96

Association of seedling myomas with myometrial hyperplasia.  

UK PubMed Central (United Kingdom)

It is paradoxical that such a presumably quiescent tissue as myometrium, so sheltered from carcinogen exposure, has more neoplasms than any other internal tissue and that, in contrast to cervix and endometrium, pathology textbooks recognize no precursor. Although myometrial dysplasia has been described, it is rare. Myometrial hyperplasia (MMH) is a common structural variation characterized by irregular zones of increased myometrial cellularity, with increased nucleus-cell ratios; but to date, there has been only anecdotal evidence that it may give rise to myomas. We studied the relationship of seedling myomas to MMH in 50 consecutive hysterectomies and found that most seedling myomas (44/63, 70%) arose in MMH--35 in inframucosal MMH, 3 in subserosal MMH, and 6 from intramural MMH. Some seedling myomas were incompletely circumscribed, seeming to arise not only in but also from MMH. We suggest that even seedlings in normal myometrium may arise not from normal myometrial smooth muscle cells but rather from myometaplasia in intramural stromal emboli, with hyperplastic and then neoplastic transformation. These findings may explain the high frequency and multiplicity of uterine leiomyomas. Frequent mucosal injury with stromal repair reactions may release growth factors that promote the high frequency and multiplicity of uterine leiomyomas.

Cramer SF; Mann L; Calianese E; Daley J; Williamson K

2009-02-01

97

A novel pilot study of endometrial stromal cells and immune cell populations in sentinel uterine-draining lymph nodes during the menstrual cycle and in endometriosis.  

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Recent studies suggest that changes in certain uterine immune cell populations in endometrium of women with endometriosis are likely to precede changes at ectopic sites. This preliminary study is a first look into the function of uterine-draining lymph nodes (LNs) during the menstrual cycle and in the presence of endometriosis. Paraffin-embedded obturator LNs were obtained from women with (n = 7, mean age 44.3) and without (n = 9, mean age 38.4) endometriosis, who had undergone hysterectomy for cervical or ovarian cancer and in whom LN involvement was not detected. Immunohistochemical staining for endometrial stromal cells and a range of immune cell populations was performed. The CD10+ endometrial stromal cells were detected in uterine-draining LNs throughout the menstrual cycle with numbers peaking during menstruation. The inflammatory process of menstruation was also associated with increased numbers of CD3+, CD4+, Foxp3+, DC-Sign+, CD68+, CD20+, CD79+, and plasma cells. In endometriosis, CD10+ endometrial stromal cells were further increased in numbers, but CD3+, CD4+, DC-Lamp+, FoxP3+, and plasma cells were reduced. This study indicates that efficient immunological responses may be required to contain shed endometrial fragments within the draining uterine LNs thus preventing their further dissemination with establishment of ectopic lesions at distant sites. PMID:23719712

Berbic, Marina; Ng, Cecilia H M; Black, Kirsten; Markham, Robert; Russell, Peter; Basten, Anthony; Fraser, Ian S; Hey-Cunningham, Alison J

2013-05-29

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

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

Jelena Milosevic; Biljana Djordjevic; Marija Tasic

2008-01-01

99

A pilot study of Foley's catheter balloon for prevention of intrauterine adhesions following breach of uterine cavity in complex myoma surgery.  

UK PubMed Central (United Kingdom)

PURPOSE: During abdominal myomectomy for removal of multiple fibroids, the uterine cavity may be breached. Repair of the breach is associated with a risk of development of intrauterine adhesions. We conducted a pilot study to evaluate the effectiveness of temporary placement of a Foley's catheter balloon inflated with 30 ml normal saline into uterine cavity at the end of surgery to prevent this complication. METHODS: Retrospective cohort study. When the uterine cavity was breached during open myomectomy, it was repaired with a No. 2-0 vicryl suture. A Foley catheter balloon was inserted into the uterine cavity at the end of the procedure, and the balloon distended with 30 ml of normal saline. The balloon was removed on the fourth post-operative day. Follow-up hysteroscopy was performed after 6 months. RESULTS: At the time of follow-up hysteroscopy 6 months after the myomectomy, we found no intrauterine adhesions in 16 consecutive women treated with balloon, compared to 3 out of 10 (30 %) historical controls where the balloon was not used. CONCLUSION: A Foley catheter balloon inserted into the uterine cavity following breach and repair of the uterine cavity at open myomectomy appears to prevent the formation of intrauterine adhesions.

Gupta S; Talaulikar VS; Onwude J; Manyonda I

2013-10-01

100

HMMC-1, a human monoclonal antibody to fucosylated core 1 O-glycan, suppresses growth of uterine endometrial cancer cells.  

UK PubMed Central (United Kingdom)

HMMC-1 is a human monoclonal antibody that reacts with a fucosylated and extended core 1 O-glycan, Fuc?1-2Gal?1-4GlcNAc?1-3Gal?1-3GalNAc-Ser/Thr, as an epitope. In the present study, we examined the effects of HMMC-1 on cell proliferation of two human uterine endometrial cancer cell lines, HEC8 and HEC9, to investigate the role of glycoproteins bearing the HMMC-1 epitope in cancer progression. HEC9 cells expressed high levels of the HMMC-1 epitope, but HMMC-1 reactivity was hardly detected in HEC8 cells. In a mouse model of lymph node metastasis using orthotopic implantation, HEC8 and HEC9 showed low (10%) and high (80%) metastatic potency, respectively. Growth of HEC9, but not HEC8, was remarkably inhibited by addition of HMMC-1 to the culture medium. Cell cycle analysis and expression analysis showed that HMMC-1 treatment increased the G(1) phase population of HEC9 cells and induced cyclin-dependent kinase inhibitors p16 and p21. Two glycoproteins, 97 and 137 kDa, with a strong reactivity to HMMC-1 were purified, and the 97-kDa glycoprotein was identified as CD166, an immunoglobulin superfamily cell adhesion molecule assumed to be involved in cancer metastasis. CD166 gene-silencing dramatically reduced HMMC-1 epitope expression and growth in HEC9 cells, indicating that CD166 is the primary glycoprotein presenting the HMMC-1 epitope in HEC9 cells. Collectively, HMMC-1 might arrest the cell cycle in the G(1) phase by binding to O-glycans on the CD166 expressed in HEC9 cells, raising the possibility that HMMC-1 extensively inhibits invasive growth of HMMC-1 epitope-positive uterine endometrial cancer cells by targeting the cancer-associated form of CD166.

Oikawa F; Kojima-Aikawa K; Inoue F; Suzuki A; Tanaka K; Tominaga E; Aoki D

2013-01-01

 
 
 
 
101

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

2011-01-01

102

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

International Nuclear Information System (INIS)

[en] 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.

2010-01-01

103

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; Alev At?? Ayd?n; Osman Temizkan; ?lay Gözükara; Eda Ülkü Uluda?; Canan Acar; ?nci Davas

2013-01-01

104

[Hysteroresection of submucous myomas after treatment with zoladex].  

UK PubMed Central (United Kingdom)

UNLABELLED: The early and heavy clinical symptoms of the submucous myomas demand early surgical intervention. The new alternative to the classical abdominal operation is the transcervical hysteroresection which is miniinvasive and organ-preserving procedure. OBJECTIVE: to assess the effect of the preoperative treatment of the patients with Goserelin acetate (Zoladex) on the intraoperative measures (operation time, intraoperative complications, difficulty of the procedure). STUDY DESIGN: prospective. PATIENT(S) AND METHODS: Total of 50 women with submucous myomas underwent hysteroresection. Ten of them were treated with Zoladex for two months preoperatively. RESULTS: In the treated group a mean decrease of 10.16 mm of the myoma diameter was achieved. This is especially important for myomas above 30 mm in diameter because 10 mm decrease in diameter leads to significant reduction of the tissue volume which has to be resected. In the treated group the mean operation time was decreased by 17.08 min. and the operation was assessed as "easier" in 90% of the cases. The authors assessed that the positive effect of Zoladex consists not only of the decreasing of the myoma diameter but also of achieving an endometrial atrophy which significantly improves the conditions for performing the intrauterine operation. CONCLUSION: Hysteroscopic resection of submucous myomas after pretreatment with Zoladex is faster, easier and with less intraoperative complications.

Tiufekchieva E; Nikolov A

2006-01-01

105

Inhibin/activin betaE-subunit in uterine endometrioid adenocarcinoma and endometrial cancer cell lines: from immunohistochemistry to clinical testing?  

UK PubMed Central (United Kingdom)

OBJECTIVE: Inhibins and activins are important regulators of the female reproductive system and have also been described to be involved in gynecologic cancer development. A new inhibin/activin subunit betaE has been identified, but only limited data on its expression in human uterine adenocarcinomas and endometrial cancer cell lines exist. METHODS: A series of 223 uterine endometrial adenocarcinomas were immunohistochemically analyzed with a specific antibody against the inhibin betaE-subunit. In addition, established endometrial cancer cell lines were analyzed for the synthesis of the inhibin betaE subunit by immunofluorescence and RT-PCR analysis. RESULTS: In this analysis, the inhibin betaE staining intensity was associated with histological grading along with a significant decrease in cases with ovarian invasion. However, inhibin-betaE did not affect patient survival nor did it constitute an independent prognostic parameter in endometrial adenocarcinoma patients. Additionally, the inhibin/activin betaE-subunit was found to be expressed in the human endometrial carcinoma cell lines HEC1a, HEC1b, Ishikawa, and RL95-2, although the level of expression was found to be highly differing among the cancer cell lines tested. CONCLUSION: The isolated analysis of the inhibin betaE subunit might be of minor prognostic value in identifying high-risk patients. However, its differential expression in cancer of different histological differentiation and ovarian metastasis suggests a putative but yet undefined role in endometrial carcinogenesis. Whether this novel and not well studied inhibin subunit has a substantial function in the pathogenesis and malignant transformation of human endometrium is still under investigation.

Mylonas I; Matsingou C; Käufl SD; Brüning A

2011-07-01

106

Treatment of Uterine Myoma with 2.5 or 5?mg Mifepristone Daily during 3 Months with 9 Months Posttreatment Followup: Randomized Clinical Trial.  

UK PubMed Central (United Kingdom)

Objectives. To evaluate the efficacy, safety, and quality of life by using 2.5 and mifepristone 5?mg daily doses to treat uterine fibroids over 3 months with a 9-month followup period. Design. Randomized clinical trial. Place. "Eusebio Hernández" Hospital, Havana, Cuba. Subjects. 220 women with symptomatic uterine fibroids. Treatment. One-half (2.5?mg) or one-whole 5?mg mifepristone tablet. Variables to Evaluate Efficacy. Changes in fibroid and uterine volumes, in symptomatic prevalence and intensity, and in quality of life. Results. After 3-month treatment, fibroid volume decreased by 27.9% (CI 95% 20-35) and 45.5% (CI 95% 37-62), in the 2.5 and 5?mg groups, respectively, P = 0.003. There was no difference in the prevalence of symptoms at the end of treatment, unlike after 6- and 9-month followup when there was a difference. Amenorrhea was significantly higher in the 5?mg group, P = 0.001. There were no significant differences in mifepristone side effects between the groups. Both groups displayed a similar improvement in quality of life. Conclusions. The 2.5?mg dosage resulted in a lesser reduction in fibroid size but a similar improvement in quality of life when compared to the 5?mg dose. This trial is registered with ClinicalTrials.gov NCT01786226.

Carbonell JL; Acosta R; Pérez Y; Garcés R; Sánchez C; Tomasi G

2013-01-01

107

Treatment of Uterine Myoma with 2.5 or 5?mg Mifepristone Daily during 3 Months with 9 Months Posttreatment Followup: Randomized Clinical Trial.  

Science.gov (United States)

Objectives. To evaluate the efficacy, safety, and quality of life by using 2.5 and mifepristone 5?mg daily doses to treat uterine fibroids over 3 months with a 9-month followup period. Design. Randomized clinical trial. Place. "Eusebio Hernández" Hospital, Havana, Cuba. Subjects. 220 women with symptomatic uterine fibroids. Treatment. One-half (2.5?mg) or one-whole 5?mg mifepristone tablet. Variables to Evaluate Efficacy. Changes in fibroid and uterine volumes, in symptomatic prevalence and intensity, and in quality of life. Results. After 3-month treatment, fibroid volume decreased by 27.9% (CI 95% 20-35) and 45.5% (CI 95% 37-62), in the 2.5 and 5?mg groups, respectively, P = 0.003. There was no difference in the prevalence of symptoms at the end of treatment, unlike after 6- and 9-month followup when there was a difference. Amenorrhea was significantly higher in the 5?mg group, P = 0.001. There were no significant differences in mifepristone side effects between the groups. Both groups displayed a similar improvement in quality of life. Conclusions. The 2.5?mg dosage resulted in a lesser reduction in fibroid size but a similar improvement in quality of life when compared to the 5?mg dose. This trial is registered with ClinicalTrials.gov NCT01786226. PMID:23984082

Carbonell, Josep Lluis; Acosta, Rita; Pérez, Yasmirian; Garcés, Roberto; Sánchez, Carlos; Tomasi, Giuseppe

2013-07-29

108

Treatment of Uterine Myoma with 2.5 or 5 mg Mifepristone Daily during 3 Months with 9 Months Posttreatment Followup: Randomized Clinical Trial  

Science.gov (United States)

Objectives. To evaluate the efficacy, safety, and quality of life by using 2.5 and mifepristone 5?mg daily doses to treat uterine fibroids over 3 months with a 9-month followup period. Design. Randomized clinical trial. Place. “Eusebio Hernández” Hospital, Havana, Cuba. Subjects. 220 women with symptomatic uterine fibroids. Treatment. One-half (2.5?mg) or one-whole 5?mg mifepristone tablet. Variables to Evaluate Efficacy. Changes in fibroid and uterine volumes, in symptomatic prevalence and intensity, and in quality of life. Results. After 3-month treatment, fibroid volume decreased by 27.9% (CI 95% 20–35) and 45.5% (CI 95% 37–62), in the 2.5 and 5?mg groups, respectively, P = 0.003. There was no difference in the prevalence of symptoms at the end of treatment, unlike after 6- and 9-month followup when there was a difference. Amenorrhea was significantly higher in the 5?mg group, P = 0.001. There were no significant differences in mifepristone side effects between the groups. Both groups displayed a similar improvement in quality of life. Conclusions. The 2.5?mg dosage resulted in a lesser reduction in fibroid size but a similar improvement in quality of life when compared to the 5?mg dose. This trial is registered with ClinicalTrials.gov NCT01786226.

Carbonell, Josep Lluis; Acosta, Rita; Perez, Yasmirian; Garces, Roberto; Sanchez, Carlos; Tomasi, Giuseppe

2013-01-01

109

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

110

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 ...

111

Expression of leukemia inhibitory factor in the endometrium in abnormal uterine cavities during the implantation window.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To investigate the expression of the implantation factors leukemia inhibitory factor (LIF), interleukin-11 (IL-11), and IL-6ST/gp130 in the endometrium to examine the relationship between loss of implantation and abnormal uterine cavity. DESIGN: Case-control study. SETTING: Department of Obstetrics and Gynecology, Tokyo Medical University. PATIENT(S): Subjects comprised 41 patients in the abnormal uterine cavity group who underwent resection of a uterine submucosal myoma or an endometrial polyp by transcervical resectoscopy (TCR) and 18 patients in the control group who underwent laparoscopic surgery. INTERVENTION(S): In the abnormal uterine cavity group, endometrial tissue specimens were obtained before resection under hysteroscopy. In the control group, endometrial tissue specimens were obtained by curettage at the time of laparoscopic surgery. MAIN OUTCOME MEASUREMENT(S): We divided the patients into four groups according to menstrual cycle and measured the endometrial expression of LIF, IL-11, and IL-6ST/gp130 with the use of quantitative real-time reverse-transcription polymerase chain reaction. RESULT(S): Significant increases in LIF and IL-11 mRNA expression were recognized during the midsecretory phase of the menstrual cycle in the control group. However, no difference in IL-6ST/gp130 mRNA expression was observed in any phase during the menstrual cycle in either group. In terms of LIF and IL-11 mRNA expression at the midsecretory phase, the abnormal uterine cavity group showed a significantly decreased LIF mRNA expression compared with the control group. CONCLUSION(S): LIF mRNA expression was significantly decreased in abnormal uterine cavities during the midsecretory phase, indicating that endometrial cavity defects are a possible cause of poor reproductive outcomes.

Hasegawa E; Ito H; Hasegawa F; Hatano K; Kazuka M; Usuda S; Isaka K

2012-04-01

112

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.

Girling Jane E; Donoghue Jacqueline F; Lederman Fiona L; Cann Leonie M; Achen Marc G; Stacker Steven A; Rogers Peter AW

2010-01-01

113

Does Menstrual Bleeding Decrease After Ablation of Intramural Myomas? A Retrospective Study.  

UK PubMed Central (United Kingdom)

STUDY OBJECTIVE: To evaluate the effect of radiofrequency volumetric thermal ablation (RFVTA) on menstrual bleeding in patients with intramural myomas. DESIGN: Retrospective analysis of a recently completed prospective trial of laparoscopic ultrasound-guided RFVTA in which 135 subjects had objectively measured heavy menstrual bleeding (?160 to ?500 mL) and confirmed submucosal, intramural, and subserosal myomas. We analyzed the pretreatment monthly menstrual blood loss as well as the response to treatment based on the types of myomas, specifically those subjects with only intramural myomas versus those with only submucosal myomas or those with both (Canadian Task Force classification II-2). SETTING: Outpatient hospital and private surgery centers. PATIENTS: One hundred thirty-five premenopausal symptomatic women (mean age: 42.4 ± 4.5 years) with uterine myomas and heavy menstrual bleeding confirmed by alkaline hematin analysis. INTERVENTIONS: Laparoscopic ultrasound-guided RFVTA. MEASUREMENTS AND MAIN RESULTS: Menstrual blood loss (MBL) at baseline and at 12 months after the procedure was quantified in 122 subjects with intramural myomas (including those that abut the endometrium, those that are within the myometrium, and those that extend from the serosa into the myometrium) and/or submucous myomas. Although 91.8% (112/122) of these subjects had 1 or more intramural myomas, submucous myomas were present in fewer than half of the subjects ([48.4%]). We identified 10 subjects who had submucous but no intramural myomas. This group had a significant (-45.1%) posttreatment decrease in monthly bleeding (95% confidence interval [CI], -78.0% to -12.2%; p = .013). In this same study, there were 63 subjects with intramural myomas and no submucosal myomas, and their posttreatment decrease in MBL of -31.8% was also clinically and statistically significant (95% CI, -41.4% to -22.2%; p<.001). Of those 63 subjects was a subset with intramural myomas (n = 27) without myomas abutting the endometrium or submucous myomas; this third set also resulted in a clinically and statistically significant reduction in MBL (-25.0% and -65.22 mL; 95% CI, -38.8% to -11.2%; p = .001). CONCLUSION: Although it has been known that the treatment of submucous myomas results in a reduction of MBL, this is the first study to show that radiofrequency ablative therapy for intramural myomas without a submucosal component will also result in a significant reduction in menstrual blood loss.

Galen DI; Isaacson KB; Lee BB

2013-09-01

114

Successful treatment of isolated fibular bone metastasis in a uterine endometrial cancer of clear cell carcinoma.  

UK PubMed Central (United Kingdom)

Clear cell carcinoma of the endometrium is an uncommon histological subtype and isolated metastasis to bone is rare. The authors present a case of a 61-year-old woman who underwent laparoscopic staging surgery for clear cell carcinoma of uterine endometrium (FIGO Stage IB) and early recurrence with isolated fibular bone metastasis three months later. With salvage radiotherapy (RT), she remains disease-free after 46 months. Curative-intended treatment with RT is possible as in this case.

Chen CY; Huang KG; Abdullah NA; Ueng SH; Lee CL

2013-01-01

115

Myoma pseudocapsule: a distinct endocrino-anatomical entity in gynecological surgery.  

UK PubMed Central (United Kingdom)

BACKGROUND: The myoma pseudocapsule is a structure formed surrounding the uterine fibroid, that in the uterus separates the myoma from normal tissue; because literature is lack of detailed information concerning myoma pseudocapsule, the author reviewed this important topic. METHODS: An extensive literature review from 1980 to 2008 was performed on the myoma pseudocapsule, using: fibroid, myoma, myomectomy and reproductive outcome, as keywords. RESULTS: The fibroid removal should always be performed inside its pseudocapsule and with a careful stretching, to extract fibroid from the surrounding fibromuscular skeleton, breaking up the fibrous bridges; because the vascular network generally surrounds the myoma, detachment of the myoma occurring inside the pseudocapsule should cause less bleeding. The maintenance of myometrial integrity during myomectomy allows the facilitation of uterine healing and is of benefit for future reproductive outcome. CONCLUSION: The benefits of intracapsular myomectomy are evident, because it preserves myometrial integrity and allows for restoration of the uterine musculature. This correct myomectomy, if done by laparoscopy, confers significant advantages in less intraoperative blood loss, short duration of hospital stay, few therapeutic antibiotic administration and better future fertility.

Tinelli A; Malvasi A; Rahimi S; Negro R; Cavallotti C; Vergara D; Vittori G; Mettler L

2009-10-01

116

Endometrial ablation: postoperative complications.  

UK PubMed Central (United Kingdom)

Endometrial ablation as a treatment for abnormal uterine bleeding has evolved considerably over the past several decades. Postoperative complications include the following: (1) pregnancy after endometrial ablation; (2) pain-related obstructed menses (hematometra, postablation tubal sterilization syndrome); (3) failure to control menses (repeat ablation, hysterectomy); (4) risk from preexisting conditions (endometrial neoplasia, cesarean section); and (5) infection. Physicians performing endometrial ablation should be aware of postoperative complications and be able to diagnose and provide treatment for these conditions.

Sharp HT

2012-10-01

117

Endometrial ablation: postoperative complications.  

Science.gov (United States)

Endometrial ablation as a treatment for abnormal uterine bleeding has evolved considerably over the past several decades. Postoperative complications include the following: (1) pregnancy after endometrial ablation; (2) pain-related obstructed menses (hematometra, postablation tubal sterilization syndrome); (3) failure to control menses (repeat ablation, hysterectomy); (4) risk from preexisting conditions (endometrial neoplasia, cesarean section); and (5) infection. Physicians performing endometrial ablation should be aware of postoperative complications and be able to diagnose and provide treatment for these conditions. PMID:22541856

Sharp, Howard T

2012-04-06

118

Sensitivity of Myoma Imaging Using Laparoscopic Ultrasound Compared With Magnetic Resonance Imaging and Transvaginal Ultrasound.  

UK PubMed Central (United Kingdom)

STUDY OBJECTIVE: To determine the efficacy of laparoscopic ultrasound (LUS) as compared with contrast-enhanced magnetic resonance imaging (CE-MRI) and transvaginal ultrasound (TVUS) in detection of uterine myomas. DESIGN: Retrospective study of imaging methods used in a trial of LUS-guided radiofrequency volumetric thermal ablation in women with symptomatic myomas (Canadian Task Force classification II-2). SETTING: Eleven medical university or private outpatient surgery clinics in the United States (nine sites) and Latin America (two sites). PATIENTS: One hundred thirty-five women with symptomatic myomas and objectively confirmed moderate to severe heavy menstrual bleeding. INTERVENTIONS: LUS-guided radiofrequency volumetric thermal ablation of myomas. MEASUREMENTS AND MAIN RESULTS: Preoperative TVUS scans and CE-MRIs were read at each site, and all CE-MRIs were read by a central reader. LUS-guided scans were obtained intraoperatively by each surgeon by mapping the uterus just before radiofrequency volumetric thermal ablation. The imaging methods and their yields in terms of number of myomas found per subject were as follows: TVUS, 403 myomas (mean [SD] 3 [1.8]; range, 1-8); site CE-MRI, 562 myomas (4.2 [3.8]; range, 1-18); central reader, 619 myomas (4.6 [3.7]; range, 0-20); and LUS, 818 myomas (6.1 [4.9]; range, 1-29) (p < .001). LUS was superior to TVUS, CE-MRI, and the central reader for detection of small (?1 cm(3)) myomas. Most imaged myomas were intramural: 197 (50.9%) by TVUS, 298 (55.5%) by site CE-MRI, 290 (48.7%) by the central reader, and 386 (48.5%) by LUS. CONCLUSION: Compared with CE-MRI and TVUS, LUS demonstrates the most myomas, regardless of size or type.

Levine DJ; Berman JM; Harris M; Chudnoff SG; Whaley FS; Palmer SL

2013-09-01

119

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

120

Mioma uterino gigante Giant myoma uteri  

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Full Text Available 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 síntomas 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.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

2011-01-01

 
 
 
 
121

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.

1999-01-01

122

Laparoscopic management of large myomas.  

UK PubMed Central (United Kingdom)

The objective of this article is to review the different techniques that have been adopted for removal of large myomas laparoscopically. We have also quoted literature about the impact of myomas on Pregnancy and obstetrical outcome and the effect of laparoscopic myomectomy on the same. Technical modifications to remove large myomas have been described along with methods to reduce intraoperative bleeding. This comprehensive review describes all possibilities of laparoscopic myomectomy irrespective of size, site and number.

Sinha R; Sundaram M

2009-07-01

123

Spontaneous regression of metastatic endometrial stromal sarcoma.  

Science.gov (United States)

Spontaneous regression of malignancy is rare and there appear to be no reports of spontaneous regression of endometrial stromal sarcoma. We report a rare case of metastatic endometrial stromal sarcoma that regressed spontaneously. A 58-year-old woman was admitted to hospital in January 1996 when her chest radiograph showed multiple nodular shadows in the left lower lung field. Computed tomography of the chest revealed bilateral nodules. Segmentectomy of the left lower lobe was performed by thoracoscopy. She had a past history of uterine myoma with metrorrhagia for which she had undergone a hystero-oophorectomy 10 years earlier. She also had a vaginal polyp removed 1 year earlier. The lung pathology was studied and the surgical specimens of the uterus and vagina were re-examined. The diagnosis was endometrial stromal sarcoma primarily arising in the uterus. The vaginal polyp and the pulmonary nodules were considered to be metastases. Samples of lung and vaginal tissues were positive for both estrogen and progesterone receptors. The patient was discharged without treatment in February 1996 and followed up in the outpatient clinic. The tumor shadow measuring 2 mm in diameter on admission was enlarged to 4 mm in diameter 1 year later. Surprisingly, spontaneous regression of the lung disease occurred at 33 months, the tumor size decreasing to 2 mm in diameter and to 1 mm at 46 months. No evidence of tumor enlargement was detected at the last follow-up in July 2001. Although the precise mechanism of tumor regression is unknown, metastatic endometrial stromal sarcoma may spontaneously regress. PMID:11948233

Ota, Seisuke; Shinagawa, Katsuji; Ueoka, Hiroshi; Tada, Shinya; Tabata, Masahiro; Hamazaki, Shuji; Kondo, Eisaku; Kiura, Katsuyuki; Mannami, Tomohiko; Shibayama, Takuo; Niiya, Kenji; Harada, Mine

2002-02-01

124

Spontaneous regression of metastatic endometrial stromal sarcoma.  

UK PubMed Central (United Kingdom)

Spontaneous regression of malignancy is rare and there appear to be no reports of spontaneous regression of endometrial stromal sarcoma. We report a rare case of metastatic endometrial stromal sarcoma that regressed spontaneously. A 58-year-old woman was admitted to hospital in January 1996 when her chest radiograph showed multiple nodular shadows in the left lower lung field. Computed tomography of the chest revealed bilateral nodules. Segmentectomy of the left lower lobe was performed by thoracoscopy. She had a past history of uterine myoma with metrorrhagia for which she had undergone a hystero-oophorectomy 10 years earlier. She also had a vaginal polyp removed 1 year earlier. The lung pathology was studied and the surgical specimens of the uterus and vagina were re-examined. The diagnosis was endometrial stromal sarcoma primarily arising in the uterus. The vaginal polyp and the pulmonary nodules were considered to be metastases. Samples of lung and vaginal tissues were positive for both estrogen and progesterone receptors. The patient was discharged without treatment in February 1996 and followed up in the outpatient clinic. The tumor shadow measuring 2 mm in diameter on admission was enlarged to 4 mm in diameter 1 year later. Surprisingly, spontaneous regression of the lung disease occurred at 33 months, the tumor size decreasing to 2 mm in diameter and to 1 mm at 46 months. No evidence of tumor enlargement was detected at the last follow-up in July 2001. Although the precise mechanism of tumor regression is unknown, metastatic endometrial stromal sarcoma may spontaneously regress.

Ota S; Shinagawa K; Ueoka H; Tada S; Tabata M; Hamazaki S; Kondo E; Kiura K; Mannami T; Shibayama T; Niiya K; Harada M

2002-02-01

125

Endometrial polyps associated with endometrial hyperplasia in an obese bonnet monkey (Macaca radiata): a case report.  

UK PubMed Central (United Kingdom)

BACKGROUND: A 10-year-old, female bonnet monkey (Macaca radiata) showed abnormal menstrual cycle length with heavy menstrual bleeding for 6-8 days. METHODS: Uterine ultrasound and histological examinations of endometrium by endometrial biopsy. RESULTS: An ultrasound examination of the uterine cavity showed presence of an enlarged polypoid mass. Further endometrial histology confirmed the presence of simple endometrial hyperplasia. CONCLUSIONS: We report for the first time that endometrial polyp is associated with endometrial hyperplasia in obese bonnet monkey.

Chaudhari UK; Metkari SM; Sachdeva G; Katkam RR; Nimbkar-Joshi S; Manjaramkar DD; Mahajan A; Thakur MH; Kholkute SD

2013-06-01

126

[Uterine fibroids complicated by haematometra].  

UK PubMed Central (United Kingdom)

BACKGROUND: Uterine fibroids are common, benign tumours of the myometrium. The clinical symptoms include menorrhagia, abdominal pain and subfertility. CASE DESCRIPTION: A 37-year-old black woman known to have uterine fibroids presented at the gynaecology outpatient clinic with abdominal pain. Ultrasonography and an MRI scan revealed haematometra caused by an obstructive myoma, which was drained during a hysteroscopy. The patient was subsequently treated with gonadotrophin-releasing hormone (GnRH) agonist in order to reduce the myoma. Resection of the myoma will take place sometime in the future. CONCLUSION: Haematometra is an accumulation of blood in the uterine cavity. It is a rare complication of uterine fibroids and causes abdominal pain and enlargement of the uterus. Amenorrhoea is often a finding because an adequate outflow of menstrual blood is no longer possible. The primary treatment is to drain the haematometra; a subsequent myomectomy should be performed.

Driessen SR; Haans LC; Puylaert JB

2012-01-01

127

Psychosexual health 5 years after hysterectomy: population-based comparison with endometrial ablation for dysfunctional uterine bleeding.  

UK PubMed Central (United Kingdom)

BACKGROUND: We report a population-based comparison of psychosexual health 5 years after contrasting amounts of surgical treatments for heavy periods [dysfunctional uterine bleeding (DUB)]. Women's fears about sexual function after hysterectomy might not be unfounded. The psychosexual problems may return and/or develop with time. The removal of ovaries at the time of hysterectomy is associated with greater deterioration of self-reported sexual function. Surgical menopause significantly impairs sexual wellbeing. We failed to observe uniform beneficial effects of hormone replacement therapy (HRT) on reported psychosexual health. OBJECTIVE: To compare self-reported bothersome sexual function; loss of interest in sex, difficulty in becoming sexually excited and vaginal dryness 5 years after surgical management of DUB [transcervical endometrial resection/ablation (TCRE) or subtotal and total hysterectomy, with and without prophylactic bilateral oophorectomy (BO)]. DESIGN: Prospective cohort study up to 5 years post-surgery for DUB, TCRE or hysterectomy, with or without BO. SETTING: Over 400 NHS and private hospitals in England, Northern Ireland and Wales. COHORT: Of 11,325 women who responded to the 5-year questionnaire, over 9500 (84%) were valid cases, and over 8900 (94%) did complete the questions relating to psychosexual function. Most were between the ages of 39 and 45 years, married or cohabiting. MAIN OUTCOMES: Self-reported experience of bother, recorded as 'some', 'severe' and 'extreme', to questions on (1) libido loss, (2) difficulty with sexual arousal, and (3) vaginal dryness during the past 4 weeks, 5 years after surgery. RESULTS: Five years after surgery for DUB, the crude and adjusted prevalence of psychosexual problems was higher after hysterectomy than after TCRE. Amongst the women with concurrent BO, the age- and HRT-adjusted odds ratios for extreme psychosexual problems were increased by 80% (libido loss), 82% (difficult sex arousal) and 69% (vaginal dryness) compared with TCRE. CONCLUSIONS: Five years after hysterectomy more women reported having bothersome psychosexual function than did the women who had a less invasive operation. Hormone therapy, although related to surgical method, did not reduce this long-term detrimental effect. The odds were particularly high amongst women with concurrent BO. Women should be advised that they might be at higher risk of psychosexual problems following hysterectomy, compared with a less invasive procedure.

McPherson K; Herbert A; Judge A; Clarke A; Bridgman S; Maresh M; Overton C

2005-09-01

128

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 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 sangramento uterino anormal e anormalidades da cavidade uterina, diagnosticadas inicialmente pela ultra-sonografia transvaginal. Todas as pacientes se submeteram à histerossonogr (more) afia 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 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, (more) 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.

Diniz, Angélica Lemos Debs; Gonçalves, Elmar Gonzaga

2000-06-01

129

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  

Directory of Open Access Journals (Sweden)

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; Elmar Gonzaga Gonçalves

2000-01-01

130

Acute Renal Failure in the Postpartum due to Calcified Myoma: A Case Report.  

UK PubMed Central (United Kingdom)

BACKGROUND: It has been reported that delivery can be a cause of urine retention. This complication occurs especially in case which are associated with a pelvic mass like calcified uterine myoma. But this unusual aspect of myoma can make ultrasonographic traps. OBJECTIVE: To report an unusual case of calcified uterine myoma which was unnoticed during pregnancy and made so obstructive renal failure few days after the delivery. CASE REPORT: Seven days after delivery aTwenty-nine-year-old Senegalese woman was admitted at a private hospital for a slight alteration of consciousness(Glasgow Coma Scale at 12). Emergency check-up showed an acute obstructive renal failure. Biological investigations showed ascendancy of granulocytes, deterioration of renal function with creatinin in 78 mg / l and urea in 1.82 g/l. Ultrasonographic examination revealed bilateral dilatation of renal calyces and an interstitial calcified uterine myoma compressing the bladder. Management consisted on a urethral catheterization of bladder, correction of hydro-electrolytic troubles and antibiotherapy (ciprofloxacin).Global evolution leads to fast fully consciousness, with disappearance of biological and ultrasonographic disorders. CONCLUSION: Calcified myoma can look like cephalic pole during pregnancy. This unusual aspect can be sometimes source of acute obstructive renal failure requiring urinary drainage in emergency. Improvement of women's management during postpartum can prevent such complications.

Diop MM; Diao B; Toure PS; Leye MY; Tall A; Ka MM

2012-07-01

131

Comparison of the cytobrush, cottonswab, and low-volume uterine flush techniques to evaluate endometrial cytology for diagnosing endometritis in chronically infertile mares.  

Science.gov (United States)

Endometritis is the most important cause of infertility in barren mares. The quick method of endometrial cytology (EC) has a relatively high reliability in diagnosing endometrial inflammation in the mare. For reliable cytological results, a collection technique that yields many well-preserved cells representative of a large uterine surface area without causing harm to the reproductive tract is required. The aim of the study was to compare three usually employed techniques for collection of endometrial and inflammatory cells (guarded cotton swab, uterine lavage, and cytobrush) in chronically infertile mares. Twenty Standardbred mares were used. In each mare, samples for EC were collected, first by a cotton swab (DGS), then by a cytobrush (CB), and finally by low volume flush (LVF). The slides were stained using the Diff Quick stain. The following parameters were assessed for each tested technique: background content of the slides; quality of the cells harvested; total cellularity; neutrophils; ratio PMN/uterine epithelial cells; inflammatory cells; vaginal epithelium cells. Categorical variables were compared using contingency tables and Pearson Chi-square tests, whereas continuous variables were compared using one-way analysis of variance (ANOVA); PDGS and CB resulted easy and quick to perform via a single operator in all cases. LVF was performed easily, but required the presence of 2-3 players and took more time. The background content of the slides prepared by DGS appeared proteinaceous, slides prepared by LVF appeared contaminated by red blood cells or debris, whereas slides prepared by CB appeared clear. All smears showed a good total cellularity. The CB yielded significantly more cells (PDGS and LVF. The DGS produced significant more cells than LVF (PDGS produced significantly more (P=0.003) intact cells than CB and LVF. Distorted cells were significantly (P=0.001) more frequent in smears by LVF. The CB harvested significantly (P=0.009) more fragmented cells. CB and LVF produced significantly (PDGS. In smears collected by LVF the proportion of PMNs/uterine epithelial cells was significantly (P=0.0062; P=0.0023) higher than in smears by CB and DGS. CB collected a significantly higher (P=0.0011) proportion of PMNs than DGS. Acute endometritis was diagnosed in 50% (10/20) of the mares by DGS cytological samples, 25% (5/20) by CB, and 75% (15/20) by LVF. Inflammatory cells other than PMN (lymphocytes, macrophages, eosinophils) were collected exclusively by CB method. Epithelial cells from the vagina were only detected in LVF slides. The agreement of the diagnosis of endometritis between the three techniques of collection and between the different criteria adopted to evaluate smears obtained with the same technique was poor (k?0.3). In conclusion, results show that cytobrush and flush specimens were superior in all parameters to cotton swab smears. Even though the cytobrush technique requires specialized equipment, sample collection by this method was easier, more consistent, and quicker than the lavage method, indicating that the brush would be the preferred collection method for use on field in the mare. More studies are needed to establish criteria for interpretation of inflammation in the mare on cytobrush samples. PMID:21855980

Cocchia, Natascia; Paciello, Orlando; Auletta, Luigi; Uccello, Valeria; Silvestro, Laura; Mallardo, Karina; Paraggio, Gerardo; Pasolini, Maria Pia

2012-01-01

132

Comparison of the cytobrush, cottonswab, and low-volume uterine flush techniques to evaluate endometrial cytology for diagnosing endometritis in chronically infertile mares.  

UK PubMed Central (United Kingdom)

Endometritis is the most important cause of infertility in barren mares. The quick method of endometrial cytology (EC) has a relatively high reliability in diagnosing endometrial inflammation in the mare. For reliable cytological results, a collection technique that yields many well-preserved cells representative of a large uterine surface area without causing harm to the reproductive tract is required. The aim of the study was to compare three usually employed techniques for collection of endometrial and inflammatory cells (guarded cotton swab, uterine lavage, and cytobrush) in chronically infertile mares. Twenty Standardbred mares were used. In each mare, samples for EC were collected, first by a cotton swab (DGS), then by a cytobrush (CB), and finally by low volume flush (LVF). The slides were stained using the Diff Quick stain. The following parameters were assessed for each tested technique: background content of the slides; quality of the cells harvested; total cellularity; neutrophils; ratio PMN/uterine epithelial cells; inflammatory cells; vaginal epithelium cells. Categorical variables were compared using contingency tables and Pearson Chi-square tests, whereas continuous variables were compared using one-way analysis of variance (ANOVA); P<0.05 was considered significant. Samplings by DGS and CB resulted easy and quick to perform via a single operator in all cases. LVF was performed easily, but required the presence of 2-3 players and took more time. The background content of the slides prepared by DGS appeared proteinaceous, slides prepared by LVF appeared contaminated by red blood cells or debris, whereas slides prepared by CB appeared clear. All smears showed a good total cellularity. The CB yielded significantly more cells (P<0.0001) than DGS and LVF. The DGS produced significant more cells than LVF (P<0.0001). The DGS produced significantly more (P=0.003) intact cells than CB and LVF. Distorted cells were significantly (P=0.001) more frequent in smears by LVF. The CB harvested significantly (P=0.009) more fragmented cells. CB and LVF produced significantly (P<0.0001; P=0.02) more PMNs/HPF than DGS. In smears collected by LVF the proportion of PMNs/uterine epithelial cells was significantly (P=0.0062; P=0.0023) higher than in smears by CB and DGS. CB collected a significantly higher (P=0.0011) proportion of PMNs than DGS. Acute endometritis was diagnosed in 50% (10/20) of the mares by DGS cytological samples, 25% (5/20) by CB, and 75% (15/20) by LVF. Inflammatory cells other than PMN (lymphocytes, macrophages, eosinophils) were collected exclusively by CB method. Epithelial cells from the vagina were only detected in LVF slides. The agreement of the diagnosis of endometritis between the three techniques of collection and between the different criteria adopted to evaluate smears obtained with the same technique was poor (k?0.3). In conclusion, results show that cytobrush and flush specimens were superior in all parameters to cotton swab smears. Even though the cytobrush technique requires specialized equipment, sample collection by this method was easier, more consistent, and quicker than the lavage method, indicating that the brush would be the preferred collection method for use on field in the mare. More studies are needed to establish criteria for interpretation of inflammation in the mare on cytobrush samples.

Cocchia N; Paciello O; Auletta L; Uccello V; Silvestro L; Mallardo K; Paraggio G; Pasolini MP

2012-01-01

133

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

Directory of Open Access Journals (Sweden)

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

Ashraf-Ganjoei Tahereh; Behtash Nadereh; Shariat Mamak; Mosavi Asamosadat

2006-01-01

134

Hemoperitoneum caused by a bleeding myoma in pregnancy.  

UK PubMed Central (United Kingdom)

The prevalence of uterine myomas during pregnancy is estimated to range from 0.3% to 2.6%. Although leiomyomas usually remain asymptomatic, in one often cases they may be complicated. The management of uterine fibroids during pregnancy is largely conservative and surgical removal is generally delayed until post partum. A 37-year-old pregnant woman (15 weeks) with a history of gynecologic examination several hours before presented with lower abdominal pain and signs of acute abdomen. She was para-2, as she had delivered a healthy child 12 years before, and current pregnancy was uncomplicated until presentation. Intra-abdominal hemorrhage was suspected and she underwent immediate exploratory laparotomy, which revealed massive hemoperitoneum. A subserous uterine leiomyoma of 8.5x6.5 cm was found in the fundus area, with an actively bleeding ruptured vessel on its dome. Myomectomy was successfully performed and 1.5 liter of blood and blood clots were evacuated from the peritoneal cavity. The histology report showed sections of interlacing bundles of smooth muscles with areas of bleeding and necrotic degeneration. The postoperative course and subsequent antenatal period were uneventful. The woman went into spontaneous labor at 38 weeks and delivered vaginally a healthy male baby. This rare case ofintra-abdominal hemorrhage due to bleeding myoma supports other recent studies, which have demonstrated that myomectomy may be successfully performed during pregnancy in selected circumstances.

Kasum M

2010-06-01

135

[Ultrastructure and relations between cells in the myometrium and in myomas of the human uterus  

UK PubMed Central (United Kingdom)

The state of myocytes and their intercellular connections in an unaltered myometrium in the peripheral zone and in the central part of the myoma node has been studied electron microscopically. When analysing the peripheral zone of the uterine myoma, myocytes have resemblence with myometrial cells in the folliculine phase of the menstrual cycle. Simultaneously, certain changes are observed both in the intracellular components and in intercellular interrelations: myocytic nuclei swell, most part of chromatin is decondenced, cell cytoplasmic volume increases, in the prenuclear zone numerous agregates of ribosomes are revealed. The myocytes draw nearer and form specialized junctions, that ensure their cooperation.

Skopichev VG; Savitski? GA; Shelest VN

1987-06-01

136

Clinical application of virtual hysteroscopy by CO2-multidetector-row computed tomography to submucosal myomas  

International Nuclear Information System (INIS)

[en] We produced virtual hysteroscopy (VH) images from the images obtained alter expanding the uterine cavity of patients with submucosal myomas and performing Multidetector-row Computed Tomography (MDCT) scans, and assessed them in comparison to hysteroscopic imaging and in relation to the advantages of VH. Setting; Tokyo medical university hospital department of obstetrics and gynecology. Patients; 89 patients with submucosal myomas treated by endoscopic surgery. Measurements and main results; The expandability of the uterine cavity by CO2 gas was favorable in all 89 cases in which imaging was performed, and it was possible to obtain clear VH images. The sites of origin of the submucosal myomas were clearly visualized, their imaging was consistent with that the imaging by hysteroscopy, and as a method of establishing the orientation of the uterine cavity it was possible to obtain a greater amount of information than by hysteroscopy. Although the invasiveness of the exposure and contrast medium cannot be denied, the possibilities and indications of VH, which by expanding and visualizing the uterine cavity enables the acquisition of navigation images of the uterine cavity, which varies in morphology from patient to patient, are expected to continue to expand. (author)

2006-01-01

137

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

Directory of Open Access Journals (Sweden)

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

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

2002-01-01

138

Endometrial polyps in postmenopausal women  

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The malignancy risk of endometrial polyps in postmenopausal women was correlated with the presence or absence of abnormal uterine bleeding. Of 481 postmenopausal women who presented with endometrial polyps at diagnostic hysteroscopy between 2004 and 2007, 48.9% were asymptomatic and 51.1% had postme...

Domingues, AP; Lopes, H; Dias, I; Oliveira, CF

139

Uterine torsion in pregnancy.  

UK PubMed Central (United Kingdom)

Torsion of the pregnant uterus is defined as rotation more than 45 degrees around the long axis of the uterus. Uterine torsion is observed in all age groups of the reproductive period, in all parity groups, and at all stages of pregnancy. Torsion from 60 degrees to 720 degrees has been described. It is not possible to clarify why uterine torsion occurs, but numerous abnormalities have appeared with uterine torsion; most often, abnormal fetal presentation, myoma uteri and uterine malformations. The most usual symptoms of uterine torsion are birth obstruction, abdominal pain, vaginal bleeding, shock, and urinary and intestinal symptoms. Eleven percent are asymptomatic. The treatment in the earlier months of pregnancy is immediate laparotomy and detorsion of the uterus and, if practicable, adjunct surgery to eliminate the possible etiologic factors. Near term or during labor cesarean section is carried out, and elimination of the possible etiologic factors. The fetal and maternal mortality rates since 1976 are 12% and 0% respectively.

Jensen JG

1992-05-01

140

Uterine endometrial carcinoma: 10 years' experience with long-term follow-up at a single Korean institution.  

UK PubMed Central (United Kingdom)

AIM: To evaluate prognostic factors in Korean patients with endometrial cancer. METHODS: A retrospective analysis was conducted on 248 patients who were staged surgically at the Samsung Medical Center between 1995 and 2004. Survival data were analyzed using Kaplan-Meier estimates, and multivariate analysis was performed using the Cox regression method. RESULTS: The median age was 51 years (range 21-75), which was younger than in previous studies in Western patients, and the age of 50 years was the cutoff to predict survival. More than half (55.6%) were normal weight or underweight (BMI <25). Multivariate analysis revealed that age, Fédération Internationale de Gynécologie et d'Obstétrique (FIGO) stage, and histopathology were independent predictors of disease-free survival, and FIGO stage and p53 mutation were independent prognostic factors for disease-specific survival (DSS). The 5-year DSS for patients with stage I, II, III and IV disease was 95.6, 93.8, 69.8 and 50%, respectively. The 5-year DSS rate for patients with a p53 mutation was 84.4%, compared with 97.1% for patients without. CONCLUSIONS: Korean patients with endometrial cancer were younger and had a lower BMI than previously reported. Furthermore, age greater than 50 years was predictive of a poor outcome. Age, FIGO stage, histopathology and a p53 mutation were independent prognostic factors for survival.

Lee EJ; Kim TJ; Choi CH; Lee JW; Lee JH; Bae DS; Park HM; Kim BG

2012-01-01

 
 
 
 
141

Management of endometrial precancers.  

Science.gov (United States)

In the United States, endometrial cancer is the most commonly diagnosed cancer of the female reproductive system. Strategies to sensitively and accurately diagnose premalignant endometrial lesions are sorely needed. We reviewed studies pertaining to the diagnostic challenges of endometrial precancers, their predictive value, and evidence to support management strategies. Currently, two diagnostic schemas are in use: the four-class 1994 World Health Organization hyperplasia system, based on morphologic features of architectural complexity and nuclear atypia and, more recently, the two-class endometrial intraepithelial neoplasia system, which is quantitative. Diagnosis should use criteria and terminology that distinguish between clinicopathologic entities that can be managed differently. In some instances, such as for women with hereditary nonpolyposis colon cancer, biomarkers may aid in diagnosis, but the clinical utility of biomarkers has yet to be determined. Total hysterectomy is curative for atypical endometrial hyperplasia or endometrial intraepithelial neoplasia, and provides a definitive standard for assessment of a concurrent carcinoma, when clinically appropriate. If hysterectomy is performed for atypical endometrial hyperplasia or endometrial intraepithelial neoplasia, then intraoperative assessment of the uterine specimen for occult carcinoma is desirable, but optional. Nonsurgical management may be appropriate for patients who wish to preserve fertility or those for whom surgery is not a viable option. Treatment with progestin therapy may provide a safe alternative to hysterectomy; however, clinical trials of hormonal therapies for atypical endometrial hyperplasia or endometrial intraepithelial neoplasia have not yet established a standard regimen. Future studies will need to determine the optimal nonsurgical management of atypical endometrial hyperplasia or endometrial intraepithelial neoplasia, standardizing agent, dose, schedule, clinical outcomes, and appropriate follow-up. PMID:23090535

Trimble, Cornelia L; Method, Michael; Leitao, Mario; Lu, Karen; Ioffe, Olga; Hampton, Moss; Higgins, Robert; Zaino, Richard; Mutter, George L

2012-11-01

142

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

International Nuclear Information System (INIS)

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

2003-01-01

143

Inflammatory pathways in endometrial disorders.  

UK PubMed Central (United Kingdom)

Complex interactions between the endocrine and immune systems govern the key endometrial events of implantation and menstruation. In contrast to other tissue sites, cyclical endometrial inflammation is physiological. However, dysregulation of this inflammatory response can lead to endometrial disorders. This review examines the inflammatory processes occurring in the normal endometrium during menstruation and implantation, highlighting recent advances in our understanding and gaps in current knowledge. Subsequently, the role of inflammatory pathways in the pathology of various common endometrial conditions is discussed, including heavy menstrual bleeding, dysmenorrhoea (painful periods), uterine fibroids, endometriosis and recurrent miscarriage.

Maybin JA; Critchley HO; Jabbour HN

2011-03-01

144

Inflammatory pathways in endometrial disorders.  

Science.gov (United States)

Complex interactions between the endocrine and immune systems govern the key endometrial events of implantation and menstruation. In contrast to other tissue sites, cyclical endometrial inflammation is physiological. However, dysregulation of this inflammatory response can lead to endometrial disorders. This review examines the inflammatory processes occurring in the normal endometrium during menstruation and implantation, highlighting recent advances in our understanding and gaps in current knowledge. Subsequently, the role of inflammatory pathways in the pathology of various common endometrial conditions is discussed, including heavy menstrual bleeding, dysmenorrhoea (painful periods), uterine fibroids, endometriosis and recurrent miscarriage. PMID:20723578

Maybin, Jacqueline A; Critchley, Hilary O D; Jabbour, Henry N

2010-08-17

145

Elective uterine myomectomy in pregnant women.  

UK PubMed Central (United Kingdom)

One hundred and six pregnant women with uterine myomas were admitted to a clinical protocol for operative or conservative management of myomas. The criteria for decision to submit to surgery were: (i) recurrent pain; (ii) large or rapidly growing myomas; (iii) large or medium myomas located in the lower uterine segment or deforming the placental site. According to these criteria 18 patients underwent myomectomy (operative group) and 88 were conservatively treated (conservative group). Complications and fetoneonatal outcome were monitored. The data were also compared to a control group of 2463 normal pregnant women. No spontaneous abortion occurred in the operated group, while the conservative group had a 13.6% spontaneous abortion rate (control group: 9.3%). The operated group had the highest cesarean section rate (93.7%), but no post-cesarean hysterectomy. The conservative group had a higher cesarean section rate compared with the pregnant women without myomas (34% vs 16.3%, respectively); they also had a 4.5% post-cesarean hysterectomy rate compared with 0.12% in the control group. Fetoneonatal outcome was good both in the conservative and operated group. The only perinatal death regarded a patient with a large myoma who refused surgery and went into premature labour at 32 weeks of gestation. Therefore, our study demonstrates that myomectomy during pregnancy is of advantage when performed early on selected patients.

Mollica G; Pittini L; Minganti E; Perri G; Pansini F

1996-01-01

146

Comparison of DNA hypermethylation patterns in different types of uterine cancer: cervical squamous cell carcinoma, cervical adenocarcinoma and endometrial adenocarcinoma.  

UK PubMed Central (United Kingdom)

The incidence of cervical adenocarcinoma (CA) is rising, whereas the incidence of cervical squamous cell carcinoma (CSCC) continues to decrease. However, it is still unclear whether different molecular characteristics underlie these 2 types of cervical carcinoma. To better understand the epigenetic characteristics of cervical carcinoma, we investigated the DNA promoter hypermethylation profiles in CA and CSCC. In addition, we investigated whether DNA hypermethylation patterns might be used for the molecular diagnosis of CA and endometrial adenocarcinoma (EA). Using the bisulfite-modification technique and methylation-specific PCR, we examined the aberrant promoter hypermethylation patterns of 9 tumor suppressor genes (APC, DAPK, CDH1, HLTF, hMLH1, p16, RASSF1A, THBS1 and TIMP3) in 62 CSCCs, 30 CAs and 21 EAs. After Bonferroni correction adjustment (statistically significant at p < 0.0055), we found that the aberrant hypermethylations of CDH1 and DAPK were more frequent in CSCCs than in CAs (80.6% vs. 43.3%, p = 0.001; 77.4% vs. 46.7%, p = 0.005), whereas HLTF and TIMP3 were more frequently methylated in CAs (3.2% vs. 43.3%, p < 0.001; 8.1% vs. 53.3%, p = 0.001). The hypermethylations of RASSF1A and APC were more frequent in CAs than in CSCCs, but this was not significant (9.7% vs. 33.3%, p = 0.008; and 14.5% vs. 40.0%, respectively, p = 0.009). In addition, RASSF1A hypermethylation was significantly more frequent in EAs than in CAs (81.0% vs. 33.3%, p = 0.001). In conclusion, the existence of these unique methylation patterns in these cancers suggests that their tumorigenesis may involve different epigenetic mechanisms.

Kang S; Kim JW; Kang GH; Lee S; Park NH; Song YS; Park SY; Kang SB; Lee HP

2006-05-01

147

Enzymes of the AKR1B and AKR1C Subfamilies and Uterine Diseases.  

Science.gov (United States)

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 and 10-15% suffer from 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 PGF2?, which stimulates cell proliferation. AKR1C3 converts PGD2 to 9?,11?-PGF2, and thus counteracts the formation of 15-deoxy-PGJ2, which can activate pro-apoptotic peroxisome-proliferator-activated receptor ?. AKR1B10 catalyzes the reduction of retinal to retinol, and 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 an introduction to uterine diseases and AKR1B and AKR1C enzymes, 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 in the pathophysiologies are then discussed, followed by conclusions and future perspectives. PMID:22419909

Rižner, Tea Lanišnik

2012-03-13

148

Enzymes of the AKR1B and AKR1C Subfamilies and Uterine Diseases.  

UK PubMed Central (United Kingdom)

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 and 10-15% suffer from 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 PGF2?, which stimulates cell proliferation. AKR1C3 converts PGD2 to 9?,11?-PGF2, and thus counteracts the formation of 15-deoxy-PGJ2, which can activate pro-apoptotic peroxisome-proliferator-activated receptor ?. AKR1B10 catalyzes the reduction of retinal to retinol, and 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 an introduction to uterine diseases and AKR1B and AKR1C enzymes, 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 in the pathophysiologies are then discussed, followed by conclusions and future perspectives.

Rižner TL

2012-01-01

149

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

150

[Effects of levonorgestrel intrauterine system on endometrial tissue after endometrial polyps resection by hysteroscopy].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To explore the changes of endometrial tissues after the insertion of levonorgestrel intrauterine system (LNG-IUS). METHODS: The endometrial tissues were harvested from 21 cases after endometrial polyps resection by hysteroscopy. And the patients received a 1-year follow-up. The immunohistochemical stains for estrogen receptor (ER), progesterone receptor (PR), Ki-67, bcl-2 and bax were used for semi-quantitative analyses. The changes of endometrial thickness were monitored and uterine weight was observed with a 3-year follow-up. RESULTS: The endometrial thickness and uterine weight declined continuously after the insertion of LNG-IUS. The endometrial thickness decreased from the preoperative level of (9.8 ± 1.2) mm to (3.5 ± 1.0) mm while the uterine weight dropped from the preoperative level of (98.8 ± 8.6) g to (66.6 ± 9.8) g. The expressions of ER, PR and Ki-67 were significantly lower than those of the para-polyps endometrial tissue (P < 0.05). The expressions of bcl-2 and bax were significantly higher than those of the para-polyps endometrial tissue (P < 0.05). CONCLUSION: LNG-IUS may prevent the recurrence of uterine endometrial polyps through its inhibited expressions of ER, PR and Ki-67 and induced endometrial apoptosis.

Cai HL; Ding XC; Qian RR; Yu RF; Sun LM; Li Q

2012-01-01

151

Direct aspiration endometrial biopsy via flexible hysteroscopy.  

UK PubMed Central (United Kingdom)

STUDY OBJECTIVE: To determine feasibility and efficacy of direct aspiration endometrial biopsy via the fluid channel of a flexible diagnostic hysteroscope. DESIGN: Retrospective review (Canadian Task Force classification II-3). SETTING: Abnormal uterine bleeding clinic in a tertiary care center. PATIENTS: All women who underwent direct aspiration endometrial biopsy from January 2007 through August 2011 via a flexible diagnostic hysteroscope because traditional office-based endometrial biopsy using a suction piston device was not technically possible. INTERVENTIONS: Diagnostic hysteroscopy followed by direct aspiration endometrial biopsy, accomplished by applying suction to the fluid channel of a 3.1-mm flexible diagnostic hysteroscope via a 10-mL syringe. The hysteroscope tip was agitated within the uterine cavity to obtain a tissue sample. MEASUREMENTS AND MAIN RESULTS: The median age of the 32 identified patients was 50 years; 18 women (56%) were nulliparous, and 10 (31%) were postmenopausal. Thirty-one patients underwent hysteroscopy/direct aspiration biopsy because of abnormal uterine bleeding or postmenopausal bleeding. The vaginoscopic approach was used in 19 patients (59%). Indications for direct aspiration endometrial biopsy included cervical stenosis, inability to pass the endometrial biopsy instrument into the uterine cavity, and patient intolerance of endometrial biopsy. Adequate endometrial samples were obtained in 28 patients (87.5%). In 3 of 4 patients in whom direct aspiration endometrial biopsy did not provide sufficient tissue, hysteroscopy revealed an atrophic-appearing endometrium. The direct aspiration endometrial biopsy diagnosis was confirmed in 5 of 7 patients who subsequently underwent dilation and curettage or hysterectomy. CONCLUSION: Direct aspiration endometrial biopsy is a simple and effective endometrial sampling method when traditional office-based endometrial biopsy is not feasible. Further prospective studies including larger populations are needed to confirm these results.

Breitkopf DM; Hopkins MR; Laughlin-Tommaso SK; Creedon DJ; Famuyide AO

2012-07-01

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  

Directory of Open Access Journals (Sweden)

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; José Mendes Aldrighi; Roberto Euzébio dos Santos; Roberto Adelino Almeida Prado

2004-01-01

153

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 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 estudadas 50 mulheres assintomáticas após menopausa, todas tinham suspeita de afecções endometriais pela ultra-sonografia transvaginal e, por isso, complementaram av (more) aliação 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). METHODS: Fifty asymptomatic postmenopausal women that had a suspicion of endometrial abnormalities based upon transvaginal ultrasonography were studied. Hysterosonography, diagnost (more) ic 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.

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

2004-12-01

154

Uterine artery embolization for the treatment of uterine fibroids.  

UK PubMed Central (United Kingdom)

Uterine artery embolization can be regarded as a less invasive procedure for the treatment of fibroids compared with myomectomy, hysterectomy, and laparoscopic myolysis. The aim of this study was the evaluation of safety and efficacy of uterine artery embolization and of womens' opinion about this treatment. After gynecological examination sixty-nine premenopausal women underwent uterine artery embolization. All procedures but four were technically successful; three women underwent unilateral embolization because of vascular malformation and one of them had an allergic reaction to contrast medium. Of the 69 patients: 58 went home the day after embolization, and 11 within first week. The follow-up examinations after 3, 6 and 12 month showed a significant reduction of uterine and fibroid volume with significant improvement of bleeding. Therefore, according to this report, uterine artery embolization is a successful, minimal invasive treatment of myoma that preserves the uterus and requires shorter hospitalization and recovery times than surgery.

Strini? T; Vuli? M; Bukovi? D; Maskovi? J; Hauptman D; Jelinci? Z

2004-12-01

155

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

156

Uterine Inversion; A case report.  

UK PubMed Central (United Kingdom)

The puerperal uterine inversion is a rare and severe complication occurring in the third stage of labour. The mechanisms are not completely known. However, extrinsic factors such as oxytocic arrests after a prolonged labour, umbilical cord traction or abdominal expression are pointed. Other intrinsic factors such as primiparity, uterine hypotonia, various placental localizations, fundic myoma or short umbilical cord were also reported. The diagnosis of the uterine inversion is mainly supported by clinical symptoms. It is based on three elements: haemorrhage, shock and a strong pelvic pain. The immediate treatment of the uterine inversion is required. It is based on a medical reanimation associated with firstly a manual reduction then surgical treatment using various techniques. We report an observation of a 25 years old grand multiparous patient with a subacute uterine inversion after delivery at home.

Bouchikhi C; Saadi H; Fakhir B; Chaara H; Bouguern H; Banani A; Melhouf M

2008-01-01

157

Current concepts in the imaging of uterine sarcoma.  

UK PubMed Central (United Kingdom)

Recent advances in genetics and pathology have improved our understanding of diagnosis and staging of uterine sarcomas. The major types of uterine sarcomas include leiomyosarcoma, low-grade endometrial stromal sarcoma, undifferentiated endometrial sarcoma, adenosarcoma and carcinosarcoma. The distinctive biological behavior and poor overall survival of uterine sarcoma create challenges in the management of these tumors. We herein present a comprehensive review of taxonomy, epidemiology, pathology, imaging findings and natural history of a wide spectrum of uterine sarcomas.

Tirumani SH; Ojili V; Shanbhogue AK; Fasih N; Ryan JG; Reinhold C

2013-04-01

158

Current concepts in the imaging of uterine sarcoma.  

Science.gov (United States)

Recent advances in genetics and pathology have improved our understanding of diagnosis and staging of uterine sarcomas. The major types of uterine sarcomas include leiomyosarcoma, low-grade endometrial stromal sarcoma, undifferentiated endometrial sarcoma, adenosarcoma and carcinosarcoma. The distinctive biological behavior and poor overall survival of uterine sarcoma create challenges in the management of these tumors. We herein present a comprehensive review of taxonomy, epidemiology, pathology, imaging findings and natural history of a wide spectrum of uterine sarcomas. PMID:22699695

Tirumani, Sree Harsha; Ojili, Vijayanadh; Shanbhogue, Alampady Krishna Prasad; Fasih, Najla; Ryan, John G; Reinhold, Caroline

2013-04-01

159

Diffuse cystic endometrial hyperplasia and metastatic endometrial adenocarcinoma in a vietnamese pot-bellied pig (Sus scrofa).  

UK PubMed Central (United Kingdom)

A 16-year-old female Vietnamese pot-bellied pig was euthanized after a period of inappetence and weight loss. Diffuse cystic endometrial hyperplasia and endometrial adenocarcinoma with metastasis to lymph nodes, liver, and lung were diagnosed. This report follows the recent description of cystic endometrial hyperplasia and uterine leiomyomas in 3 aged female Vietnamese pot-bellied pigs. The findings in this report and previous reports suggest that pigs may develop some similar age-related uterine lesions as do women.

Harmon BG; Munday JS; Crane MM

2004-11-01

160

Role of emmprin in endometrial cancer  

Directory of Open Access Journals (Sweden)

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; Kodama Junichi; Hongo Atsushi; Hiramatsu Yuji

2012-01-01

 
 
 
 
161

The Value of Diagnostic Hysteroscopy before Operative Hysteroscopy for Suspected Abnormal Intra-uterine Findings.  

UK PubMed Central (United Kingdom)

STUDY OBJECTIVE: To evaluate the accuracy of diagnostic office hysteroscopy in the detection of abnormal uterine findings in symptomatic and asymptomatic patients and compare it to the accuracy of operative hysteroscopy. DESIGN: Retrospective analysis of all women after operative hysteroscopy between 2010 and 2012 in our institution. DESIGN CLASSIFICATION: II-2 SETTING: The department of gynecology in a tertiary referral medical center PATIENTS: 132 patients with a mean age of 48 years after diagnostic office hysteroscopy and subsequent operative hysteroscopy. INTERVENTIONS: Operative hysteroscopy. MATERIALS AND METHODS: We collected demographic and clinical data from patients' charts. The indications as well as findings of the previous diagnostic modality (transvaginal ultrasound - TVUS, diagnostic hysteroscopy) were gathered and compared to the final tissue diagnosis obtained via operative hysteroscopy. Positive predictive values in diagnostic hysteroscopy were calculated for common pathological intra-uterine findings. RESULTS: 48 patients (37%) were menopausal and 84 (63%) premenopausal. The indications for hysteroscopy were abnormal uterine bleeding in 46% of patients and suspected uterine finding in 44%. A TVUS preceded the diagnostic hysteroscopy in 105 women (80%). Older female age, menopausal status and abnormal intra-uterine findings larger than 15 mm were associated with significantly greater true positive rates on diagnostic hysteroscopy (i.e the suspected findings on diagnostic hysteroscopy were verified by final pathology). Uterine bleeding during the interval between procedures was marginally significant and associated with greater false positive results. Bleeding as opposed to routine evaluation of uterine cavity, interval between procedures, location of intra-uterine finding and HRT (hormone replacement therapy) were not associated with greater true positive values. CONCLUSIONS: While diagnostic hysteroscopy is superior to TVUS in the assessment of polyps, it contributes little to TVUS when myomas and endometrial hyperplasia are suspected. Therefore, it should not be used routinely as an interface between TVUS and operative hysteroscopy when such findings such are suspected. Furthermore, in pre-menopausal patients with abnormal uterine bleeding between diagnostic and operative procedures and when small (<15mm) polyps are suspected, it might be worthwhile to repeat a diagnostic procedure before operative hysteroscopy.

Shinar S; Bibi G; Barzilay L; Rubens P; Almog B; Levin I

2013-09-01

162

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

Energy Technology Data Exchange (ETDEWEB)

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

Lee, Eun Ju; Lee, Hyang Mi; Kwon, Hyuk Chan; Joo, Hee Jae [Ajou University College of Medicine, Suwon (Korea, Republic of)

1995-12-15

163

Transrectal Ultrasound-Guided Hysteroscopic Myomectomy of Submucosal Myomas With a Varying Degree of Myometrial Penetration.  

UK PubMed Central (United Kingdom)

STUDY OBJECTIVE: To predict the 1-step complete resection rate after transrectal ultrasound-guided hysteroscopic myomectomy and to determine the usefulness of intraoperative transrectal ultrasonography (TRUS) in monitoring hysteroscopic electroresection of submucosal myomas. DESIGN: Prospective cohort study (Canadian Task Force classification II-1). SETTING: University hospital. PATIENTS: One hundred twenty women with symptomatic (abnormal uterine bleeding or reproductive disorder), single, submucosal myomas underwent hysteroscopic electroresection. Groups 1 and 2 were monitored, respectively, with or without TRUS. Anatomical inclusion criteria were myoma ?5 cm and myometrial free margin ?3 mm above the myoma. INTERVENTIONS: Myomas were evaluated preoperatively via sonohysterograpy and were graded according to the guidelines outlined by the European Society of Hysteroscopy (ESH), including size and myometrial free margin, and according to the STEPW (size, topography, extension, penetration, and lateral wall) classification. On the basis of sonographic findings, patients with myomas >3 cm received gonadotropin-releasing hormone therapy for 1 to 3 months. Hysteroscopic myomectomy was performed with or without TRUS guidance. At 4 to 8 weeks after the initial procedure, postoperative transvaginal ultrasonography, sonohysterography, or second-look hysteroscopy was performed. MEASUREMENTS AND MAIN RESULTS: In the TRUS group, a significantly higher percentage of 1-step complete resections was observed than in the group without TRUS (91% vs 73%) (p = .02). This was associated with a statistically significant difference in the subgroups of myomas that were deeply penetrating into the myometrium (89% vs 55%) (p < .01). One-way logistic analysis of data for all treated patients indicated the use of TRUS, as well as the ESH and STEPW classifications, as significant factors influencing the 1-step complete resection. At multivariable logistic regression analysis, use of TRUS (odds ratio [OR], 2.74; p < .001), myomas graded 0 or 1 according to ESH (OR, 3.55; p < .001), and size <3 cm (OR, 2.35; p < .05) were significantly associated with 1-step complete resection (area under the curve, 0.80; p < .001). In the TRUS group there were two significant predictors: size <3 cm (OR = 5.21; p < .05) and myometrial free margin <5 mm (OR, 0.18; p < .05). CONCLUSION: Intraoperative use of TRUS during hysteroscopic myomectomy increases the chance of complete 1-step removal of submucosal myomas that deeply penetrate the myometrium.

Ludwin A; Ludwin I; Pity?ski K; Basta P; Basta A; Banas T; Jach R; Wieche? M; Grabowska R; Stangel-Wójcikiewicz K; Milewicz T; Nocu? A

2013-09-01

164

Ovarian function after uterine artery embolization and hysterectomy.  

UK PubMed Central (United Kingdom)

STUDY OBJECTIVE: To evaluate the effect of uterine artery embolization (UAE) and hysterectomy on ovarian function. DESIGN: Prospective case control study (Canadian Task Force classification II-2). SETTING: University teaching hospital. PATIENTS: Eighty-four healthy premenopausal women with symptomatic uterine myoma(s) undergoing UAE or hysterectomy. INTERVENTION: Patients had blood drawn to measure follicle-stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (E2) levels and underwent transvaginal ultrasound to measure volume of the myoma(s) and uterus on cycle day 3 before the procedures. These measurements were repeated 3 and 6 months after treatment. MEASUREMENTS AND MAIN RESULTS: The main outcome was the differences in serum FSH, LH, E2, and ultrasound findings before and after UAE or hysterectomy. Of the 68 patients who underwent UAE and 16 who underwent hysterectomy, 48 and 13 respectively, completed 6-month follow-up. The mean age of the patients in the UAE group was 44.9 +/- 3.8 years and 43.7 +/- 5.6 years in the hysterectomy group. There was no significant difference in serum FSH before (8.9 +/- 0.7 IU/L) and 6 months after UAE (9.9 +/- 1.0 lU/L), and between the baseline (10.4 +/- 1.8 lU/L) and 6 months posthysterectomy (7.8 +/- 1.8 lU/L). The uterine volume 6 months after UAE (361 +/- 50 mL) was significantly smaller than before UAE(538 +/- 38mL; p =.005, 95% CI 44-241). Compared with baseline (154 +/- 20 mL), the dominant myoma volume was smaller at 6 months after UAE (97 +/- 16 mL; p <.05, 95% CI 1.57-62). CONCLUSION: Uterine artery embolization is associated with a significant reduction in myoma and uterine volume. Ovarian function at 6 months, as indicated by day 3 FSH levels, is not affected by UAE or hysterectomy.

Healey S; Buzaglo K; Seti L; Valenti D; Tulandi T

2004-08-01

165

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  

Directory of Open Access Journals (Sweden)

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; Sebastião Piato; Paulo Ayrosa Galvão Ribeiro; Tsutomo Aoki; Ricardo da Fonseca Nadais; Roberto Adelino de Almeida Prado

2004-01-01

166

Ischemic uterine rupture and hysterectomy 3 months after uterine artery embolization.  

UK PubMed Central (United Kingdom)

The exact frequency and extent of complications after uterine artery embolization (UAE) have yet to be documented in the literature. Ischemic necrosis and rupture of the uterus is a theoretical concern of this procedure. Rupture of the uterus from any cause is a very serious gynecologic complication requiring immediate surgical intervention to prevent death. Ischemic necrosis and rupture of the uterus can occur months after UAE. In our patient they occurred 3 months after UAE for treatment of symptomatic uterine myomas, and required hysterectomy. To our knowledge, this is the first report of ischemic uterine rupture after UAE in the United States.

Shashoua AR; Stringer NH; Pearlman JB; Behmaram B; Stringer EA

2002-05-01

167

The Surgical Treatments Outcomes Project for Dysfunctional Uterine Bleeding: summary of an Agency for Health Research and Quality-sponsored randomized trial of endometrial ablation versus hysterectomy for women with heavy menstrual bleeding.  

UK PubMed Central (United Kingdom)

Surgical Treatments Outcomes Project for Dysfunctional Uterine Bleeding is an agency for the Healthcare Research and Quality project built around a multicenter randomized clinical trial comparing hysterectomy and endometrial ablation (EA) for the treatment of heavy menstrual bleeding unrelated to structural causes. For inclusion, women self-defined their complaint, and the endometrial cavity was evaluated to exclude structural lesions. The primary outcomes were bleeding and major problem "solved" at 24 months, with length of institutional stay, surgical complications, quality of life, and reoperation included as secondary outcomes. Also measured was the baseline economic impact of heavy menstrual bleeding. The randomized controlled trial enrolled 237 women. Institutional stay was longer, and perioperative adverse events were more common and severe for those randomized to hysterectomy. At 24 months, 94.4% and 84.9% of women randomized to hysterectomy and EA, respectively, considered their major problem to be solved; at 48 months, the numbers were similar at 98.0% and 85.1%. Postprocedure quality-of-life measures (SF-36, EuroQOL) improved similarly in both groups, but reoperation was more common for women undergoing EA (34, or 30.9%, at 60 mo), with most (32 of 34) selecting hysterectomy.At baseline, women reported missed work as well as activity and leisure limitations. Excess monetary costs were $306 per patient-year (95% CI, $30-$1,872). Excess work and home management loss costs were $2,152 (95% CI, $1,862-$2,479). It was estimated that successful treatment, regardless of the type of intervention, could result in a gain of 1.8 quality-adjusted life years. Future studies will examine and compare the impact of the study interventions on economic outcomes.

Munro MG; Dickersin K; Clark MA; Langenberg P; Scherer RW; Frick KD

2011-04-01

168

Laparoscopic myomectomy focusing on the myoma pseudocapsule: technical and outcome reports.  

UK PubMed Central (United Kingdom)

BACKGROUND: Our aim was to assess surgical complaints and reproductive outcomes of laparoscopic intracapsular myomectomies by a prospective observational study run in University affiliated hospitals. METHODS: Between 2005 and 2010, 235 women underwent subserous and intramural laparoscopic myomectomy of fibroids (4-10 cm in diameter) for indications of pelvic pain, menstrual disorders, a large growing myoma or infertility. The main outcome measures were post-surgical parameters, including complications, the need for subsequent surgery or symptomatic relief, resumption of normal life and reproductive outcome. RESULTS: Pelvic pain occurred in 27%, menorrhagia or metorrhagia in 21%, a large growing myoma in 10% and infertility in 42% of women. Single fibroids occurred in 51.9% of patients while 48.1% had multiple myomas. Of all patients, 58.2% had subserosal and 41.8% had intramural myomas. No laparoscopies were converted to laparotomy. In 3 years, 1.2% of patients had a second laparoscopic myomectomy for recurrent fibroids. The mean total operative laparoscopic time was 84 min (range 25-126 min), with mean blood loss of 118 ± 27.9 ml. By 48 h after surgery, 86.3% were discharged with no major post-operative complications. No late complications, such as bleeding, urinary tract infections or bowel lesions, occurred. Of the women who underwent myomectomy for infertility, 74% finally conceived. At term, 32.9% of patients underwent Caesarean section, 24.8% delivered by vacuum extractor and 42.2% had spontaneous deliveries. No case of uterine rupture occurred. CONCLUSIONS: Intracapsular subserous and intramural myomectomy saving the fibroid pseudocapsule showed few early and no late surgical complications, enhanced healing by preserving myometrial integrity and allowed a good fertility rate and delivery outcome. In young patients suffering fibroids, laparoscopic intracapsular myomectomy is a potential recommended surgical treatment.

Tinelli A; Hurst BS; Hudelist G; Tsin DA; Stark M; Mettler L; Guido M; Malvasi A

2012-02-01

169

Pathologic characteristics of hysterectomy specimens in women undergoing hysterectomy after global endometrial ablation.  

UK PubMed Central (United Kingdom)

STUDY OBJECTIVE: To describe uterine pathologic features in women who underwent hysterectomy because of failed global endometrial ablation (GEA). DESIGN: Retrospective cohort study from 1998 through 2005 (Canadian Task Force classification III). SETTING: Tertiary referral center. PATIENTS: Sixty-nine women who underwent hysterectomy because of GEA failure. INTERVENTIONS: Pathology reports were available for 67 patients. Descriptions of hysterectomy specimens after GEA were reviewed. MEASUREMENTS AND MAIN RESULTS: Rates of pathologic findings in hysterectomy specimens after failed GEA were determined. Reasons for hysterectomy in the 67 patients with available pathology reports were bleeding in 34 (51%), pain in 19 (28%), and bleeding and pain in 14 (21%). The pathology reports of these specimens showed leiomyomas in 33 specimens (49%); intramural myomas were present in 15 women (44%) who underwent hysterectomy because of bleeding and 8 women (42%) who underwent hysterectomy because of pain. Hematometra was identified in 7 pathologic specimens (10%). Specifically, hematometra was identified in specimens from 5 of 19 women who underwent hysterectomy because of pain (26%). CONCLUSION: Hematometra was a significant finding in women who underwent hysterectomy because of persistent pain after GEA. A possible pathologic predictor of GEA failure may be intramural leiomyomas.

Carey ET; El-Nashar SA; Hopkins MR; Creedon DJ; Cliby WA; Famuyide AO

2011-01-01

170

Exercise May Cut Endometrial Cancer Risk for Heavy Women  

Science.gov (United States)

... sharing features on this page, please enable JavaScript. Exercise may cut endometrial cancer risk for heavy women (* ... 2013) Thursday, August 15, 2013 Related MedlinePlus Pages Exercise and Physical Fitness Obesity Uterine Cancer By Anne ...

171

Randomized comparison of goserelin versus suction curettage prior to Thermachoice II balloon endometrial ablation: one-year results.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To evaluate the clinical outcomes following the use of goserelin and suction curettage prior to ThermaChoice II balloon endometrial ablation to treat menorrhagia. METHODS: Qualified patients (n = 105) were randomized to receive either goserelin 3.6 mg one month before or suction curettage immediately before undergoing thermal balloon endometrial ablation. All patients had negative Papanicolaou smears, normal endometrial histology, and normal findings on transvaginal sonography. Uterine bleeding was documented by menstrual diary scores at baseline (Higham score > 150), and at three, six, and 12 months after the procedure. Five patients withdrew prior to surgery and 50 patients were anaesthetized in each group. Two patients in the suction curettage group had their management converted to hysteroscopic ablation, one because of a large uterine cavity (> 12 mL) and one because of a submucous myoma. The ThermaChoice II system circulated the liquid within the silicone balloon for eight minutes at approximately 180 mmHg pressure and 87°C. RESULTS: Participants' mean age, weight, and duration of menorrhagia were not significantly different between the groups. No safety issues related to the device were noted. At one year after ablation, the median reduction in Higham score was from 286 to 10 (96.5%) in the goserelin group (n = 47), and from 272 to 14 (94.9%) in the curettage group (n = 45). The combined amenorrhea/hypomenorrhea rates (higham score 0 to 35), eumenorrhea rate (higham score 36 to 75) and menorrhagia rate (higham score > 75) were 85%, 9%, and 6% (goserelin), and 76%, 16%, 9% (curettage), respectively. Patients' reported self-assessment of dysmenorrhea was none (51%), mild (30%), moderate (10%), and severe (9%) in both groups. Patient satisfaction was 89% in the goserelin group and 95% in the curettage group. In the goserelin group, one patient had a hysterectomy for bleeding and two had repeat resectoscopic endometrial ablations, one for pain (hematometra) and one for pain and bleeding. In the curettage group, one patient had repeat resectoscopic ablation, one patient withdrew, and one requested hormone therapy. The overall success rates were 88% in the goserelin group and 89% in the curettage group. CONCLUSION: At one year after ThermaChoice II treatment, 88.5% of women had normal menstrual bleeding or less. There was a non-significant trend (a lower Higham score) towards superiority of goserelin therapy before ablation compared with curettage.

Vilos GA; Vilos AG; Abu-Rafea B

2010-10-01

172

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)

1987-01-01

173

Differential diagnosis of myoma uteri by computed tomography  

Energy Technology Data Exchange (ETDEWEB)

Although CT can be used as well as ultrasound in evaluating myoma uteri, some cases are difficult to differentiate from ovarian tumors. A total of 150 cases with myoma uteri and 250 cases with ovarian tumors are evaluated with CT and pathological diagnosis. Of these, 19 cases (4.8 %) are difficult to differentiate. 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.

Fujisawa, H.; Takeda, T.; Kumagai, H.; Hiramatsu, K.; Seki, T.

1987-04-01

174

The diagnostic value of alcohol dehydrogenase isoenzymes and aldehyde dehydrogenase measurement in the sera of patients with endometrial cancer.  

UK PubMed Central (United Kingdom)

UNLABELLED: Background/Aim: The aim of this study was to investigate the potential role of alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) as tumor markers for endometrial cancer. PATIENTS AND METHODS: Serum samples were obtained from 40 women with endometrial cancer, 52 with myoma uteri and 52 healthy individuals. Class III, IV of ADH and total ADH activity was measured by a photometric method and class I, II ADH and ALDH activity, by a fluorometric method. RESULTS: The total activity of ADH and ADH class I was significantly higher in the serum of patients with endometrial cancer than in healthy individuals and patients with myoma. The diagnostic sensitivity for ADH I was 69%, specificity 77%, positive predictive value and negative predictive value were 75% and 71% respectively. The area under curve for ADH I was 0.682 and for total ADH was 0.623. CONCLUSION: The results suggest a potential role of ADH I as a marker for endometrial cancer.

Orywal K; Jelski W; Zdrodowski M; Szmitkowski M

2013-09-01

175

Uterine arterial embolization for uterine leiomyoma: efficacy and clinical outcome  

Energy Technology Data Exchange (ETDEWEB)

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

176

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

Directory of Open Access Journals (Sweden)

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; Sadeghi-Bazargani H; Abdollahi H; Ehdaeiv; F

2011-01-01

177

PET in uterine malignancies  

Directory of Open Access Journals (Sweden)

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; Andrea Skanjeti; Ettore Pelosi

2010-01-01

178

Diffuse cystic endometrial hyperplasia and metastatic endometrial adenocarcinoma in a vietnamese pot-bellied pig (Sus scrofa).  

Science.gov (United States)

A 16-year-old female Vietnamese pot-bellied pig was euthanized after a period of inappetence and weight loss. Diffuse cystic endometrial hyperplasia and endometrial adenocarcinoma with metastasis to lymph nodes, liver, and lung were diagnosed. This report follows the recent description of cystic endometrial hyperplasia and uterine leiomyomas in 3 aged female Vietnamese pot-bellied pigs. The findings in this report and previous reports suggest that pigs may develop some similar age-related uterine lesions as do women. PMID:15586579

Harmon, B G; Munday, J S; Crane, M M

2004-11-01

179

Quantitative MRI of uterine leiomyomas during triptorelin treatment: reproducibility of volume assessment and predictability of treatment response.  

UK PubMed Central (United Kingdom)

Magnetic resonance (MR) imaging is increasingly applied for the quantitative evaluation of uterine leiomyomas. MR is thought to be more accurate in comparison to ultrasound (US) techniques. MR signal intensity (SI) may prove to be predictive of myoma response to GnRH agonist treatment. This study aimed to evaluate the precision of uterine volume assessment by a parallel planimetric MR method and the accuracy of the ellipsoid formula based calculations from MR and US images. It was also attempted to analyze the precision of MR leiomyoma volume measurements and examine the relation between pretreatment myoma SI patterns and the response to agonist therapy. Twenty-seven women with a myomatous uterus were scanned three times during GnRH agonist treatment for 6 months. T1- and T2-weighted, as well as T1 contrast-enhanced sequences of the uterus were obtained in the transverse and sagittal plane. Abdominal US of the uterus was performed with a conventional sector scanner. By the use of a software system for analysis of three-dimensional images obtained by MR, uterine volume was measured by a parallel planimetric method (MR-ROI) as well as the use of the ellipsoid formula (MR-ELL). Myoma volume was assessed by the MR-ROI method. SI of the myomas was estimated from selected tissue samples as well as from the integral myoma region of interest. By abdominal US, volume was assessed by the ellipsoid equation (US-ELL). Within- and between-observer and method reliability (Rw/Rb) was calculated from mean squares obtained by analysis of variance. For uterine volume assessment, reliability between observers and between methods when the MR-ROI and MR-ELL methods were analyzed was excellent. For the US-ELL measurements, the between-observer reliability was limited. Moreover, the reliability of the US-ELL was low when the MR-ROI method was used as the standard. Myoma volume assessment with the MR-ROI method showed high between-observer and between-method agreement. The myoma/fat SI ratio and the mean SI coefficient of variation failed to show a correlation with the degree of response to triptorelin treatment of individual myomas. In MR uterine volume assessment the MR-ELL method is very accurate compared with the more complicated MR-ROI method. The agreement between MR and US is limited. Therefore, the ellipsoid method on MR images is to be regarded as the method of choice for quantitative assessment of uterine volume response to hormonal treatment. Myoma SI patterns were shown to be of no value in the response prediction of myomas to treatment with GnRH agonists.

Broekmans FJ; Heitbrink MA; Hompes PG; Schoute E; Falke T; Schoemaker J

1996-01-01

180

Medical treatment of uterine leiomyoma.  

UK PubMed Central (United Kingdom)

Uterine leiomyomas (also called myomata or fibroids) are the most common gynecologic tumors in the United States. The prevalence of leiomyomas is at least 3 to 4 times higher among African American women than in white women. Pathologically, uterine leiomyomas are benign tumors that arise in any part of the uterus under the influence of local growth factors and sex hormones, such as estrogen and progesterone. These common tumors cause significant morbidity for women and they are considered to be the most common indication for hysterectomy in the world; they are also associated with a substantial economic impact on health care systems that amounts to approximately $2.2 billion/year in the United States alone. Uterine myomas cause several reproductive problems such as heavy or abnormal uterine bleeding, pelvic pressure, infertility, and several obstetrical complications including miscarriage and preterm labor. Surgery has traditionally been the gold standard for the treatment of uterine leiomyomas and has typically consisted of either hysterectomy or myomectomy. In recent years, a few clinical trials have evaluated the efficacy of orally administered medications for the management of leiomyoma-related symptoms. In the present review, we will discuss these promising medical treatments in further detail.

Sabry M; Al-Hendy A

2012-04-01

 
 
 
 
181

Pathology of the uterine body.  

UK PubMed Central (United Kingdom)

During the past year, evidence has compiled to suggest that uterine carcinosarcomas are, in fact, metaplastic carcinomas and that mitotic counts are of no value in distinguishing between high- and low-grade endometrial stromal sarcomas in stage I cases. The pathologic and biologic behaviour of uterine müllerian adenosarcomas has been comprehensively reviewed. Prognostic factors have been identified in a large series of surgically staged endometrioid adenocarcinomas of the endometrium, while the sinister nature of the serous papillary and clear cell carcinomas of the endometrium have been confirmed. It has been claimed that a papillary pattern of growth is an independent prognostic factor in endometrial neoplasia and shown that the accuracy of macroscopic estimation of depth of myometrial invasion decreases with increasing tumor grade. The value of peritoneal cytologic examination in early stage endometrial adenocarcinoma has been questioned, as has the value of DNA flow cytometry in endometrial neoplasia. The prognostic significance of steroid receptor status has been confirmed and studies of oncogene amplification are beginning to yield prognostically useful information. Evidence is also beginning to emerge concerning chromosomal abnormalities in many women with endometrial adenocarcinoma.

Fox H

1991-08-01

182

Detection of endometrial lesions by degree of linear polarization maps  

Science.gov (United States)

Endometriosis is one of the most common causes of chronic pelvic pain and infertility and is characterized by the presence of endometrial glands and stroma outside of the uterine cavity. A novel laparoscopic polarization imaging system was designed to detect endometriosis by imaging endometrial lesions. Linearly polarized light with varying incident polarization angles illuminated endometrial lesions. Degree of linear polarization image maps of endometrial lesions were constructed by using remitted polarized light. The image maps were compared with regular laparoscopy image. The degree of linear polarization map contributed to the detection of endometriosis by revealing structures inside the lesion. The utilization of rotating incident polarization angle (IPA) for the linearly polarized light provides extended understanding of endometrial lesions. The developed polarization system with varying IPA and the collected image maps could provide improved characterization of endometrial lesions via higher visibility of the structure of the lesions and thereby improve diagnosis of endometriosis.

Kim, Jihoon; Fazleabas, Asgerally; Walsh, Joseph T.

2010-02-01

183

Acute tissue effects during transcervical endometrial resection  

DEFF Research Database (Denmark)

The acute tissue effects of transcervical endometrial resection (TCRE) with a standard Iglesias resectoscope using glycine 1.5% for irrigation were studied in 8 women prior to hysterectomy. Combinations of 80 or 120 W cutting current with blend 1 or 2 were applied for endometrial resection, preceded by cornual endometrial coagulation with the roller ball electrode with a coagulation effect of 40 or 60 W. The temperature was measured at the uterine vessels, ovarian ligaments and serosal surface. The increase in temperature at the serosal surface was 2.0 degrees C during cornual coagulation and 0.3 degrees C during endometrial resection, independent of the current effect applied. The maximum depth of tissue damage was 1.7 mm. No change in temperature was found at the uterine vessels or ovarian ligaments. The tissue destruction and the increase in temperature of the uterine surface are minimal, and TCRE offers excellent histological material. Careful coagulation/resection in the cornual and isthmus regions is recommended.

Holm-Nielsen, P; Nyland, M H

1993-01-01

184

Microwave endometrial ablation for endometrial protection in women with breast cancer on adjuvant tamoxifen.  

UK PubMed Central (United Kingdom)

AIM: The purpose of the current study was to determine the effectiveness of microwave endometrial ablation (MEA) in inhibiting the proliferative response of the endometrium in women with breast cancer who are treated with tamoxifen. MATERIAL AND METHODS: In the before-after study, we treated 31 postmenopausal patients who had received adjuvant tamoxifen for 1 year or more with MEA, the endometrial changes were compared before and after MEA. RESULTS: After MEA, the thickness of the uterine lining was decreased significantly. No patient had recurrent endometrial polyps or abnormal vaginal bleeding during the follow-up period. CONCLUSION: MEA had a protective action against the uterine effects of tamoxifen for postmenopausal patients. MEA is a safe and effective minimally invasive treatment method for breast cancer patients treated with tamoxifen.

Zhu Y; Yang J

2013-09-01

185

[Lymphoreticular cells in the human endometrial stroma  

UK PubMed Central (United Kingdom)

The endometrium of 12 patients with a normal spontaneous uterine cycle was examined immunohistochemically with the indirect PAP-method using various monoclonal antibodies. Lymphoreticular cells, which are responsible for non-specific defense mechanisms and for the cell-mediated immune reactions were identified. In all phases of the normal cycle, high numbers of cells belonging to the mononuclear phagocyte system (MPS) and T-lymphocytes were detected in the endometrial stroma. The overwhelming majority of T-lymphocytes were found to be of the suppressor/cytotoxic cell type, while helper/inducer cells were seen only in comparably low numbers. B-lymphocytes were virtually absent from the endometrial stroma.

Buchholz F; Horny HP; Dietl J

1988-12-01

186

Spontaneous Uterine Rupture in a Twine Pregnancy at 25-26 Weeks Gestation in a Woman with Previous History of Laparoscopy Myomectomy  

Directory of Open Access Journals (Sweden)

Full Text Available Introduction: Uterine rupture in pregnancy is rare and often catastrophic with high incidence of fetal and maternal morbidity and mortality. The most common cause of uterine rupture is separation of previous cesarean hysterotomy scar. Other common predisposing factors to uterine rupture are previous traumatizing operations or manipulations such as curettage, perforation, myomectomy and excessive or inappropriate uterine stimulation with oxytocin.Case Report: In this case, spontaneous rupture of uterine at 25-26 weeks gestation (twin pregnancy) in a 36 year old woman has been reported(G5P2A2L1). She was hospitalized so that preeclampsia can be rule out for her. She underwent laparoscopic removal of myoma and 3 months later IVF was done for her because of secondary infertility. During hospitalization, suddenly she had mild vaginal bleeding and decreased fetal movement. Emergency sonography reported that the two fetuses died and severe oligohydramnius and myomatosis uterine with the biggest size was 90mm.Conclusion: Try of labor was done for her but she didn't respond to induction and the patient was qualified for cesarean section. During the operation, the rupture of the uterine wall was seen in the site of the previous myomectomy and the two dead fetuses were observed in the abdomen without myoma in the uterin. The myoma that was reported by the sonologist was hematoma and omentoma. Uterine wall was repaired.

N. Soofizadeh

2009-01-01

187

[Detection of endometrial stromal sarcoma using endometrial cytology. Apropos of a case  

UK PubMed Central (United Kingdom)

The authors report a case of endometrial stromal sarcoma which was detected by endometrial cytology. The tumour originates either in the stroma of the endometrium or in foci of myometrial adenomyosis. It occurs most frequently in patients who are more than 60 years of age. It appears as an intra-uterine polypoid mass and causes bleeding and pelvic pain. Its incidence is difficult to establish. Endometrial cytology is highly suggestive of stromal sarcoma when smears harbour numerous atypical sarcomatous cells mixed with regular endometrial cells. Biopsies of the endometrium show decidua-like arrangements of malignant cells. Stromal sarcoma constitutes the homologous form of mesenchymal tumours of the uterus. The prognosis depends on whether local recurrences occur and on the sites of metastases in which the sarcomatous component seems to be latent with lesions that resemble adenocarcinomata . The five years salvage rate is approximately 26 to 28%. Treatment is surgical with or without irradiation.

Phat VN; Houissa-Vuong S; Baviera E; Schoonaert MF; Thévenon-Gonguet AM

1984-01-01

188

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

UK PubMed Central (United Kingdom)

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

Lucena E; Moreno-Ortiz H

2013-01-01

189

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 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 dismutase (CuZnSOD) e hidroperóxidos lipídicos (LOOH)no sangue e tecido endometrial de pacientes diagnosticados com mioma uterino, pólipo endometrial, hiperplasia simp (more) lex, 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 adenoca (more) rcinoma 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.

Pejić , Sne?ana; Todorović , Ana; Stojiljković , Vesna; Cvetković , Dragana; Luč ić , Nenad; Radojič ić , Ratko M.; Saič ić , Zorica S.; Pajovic, Sne?ana B.

2008-09-01

190

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 (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.

Snežana Peji?; Ana Todorovi?; Vesna Stojiljkovi?; Dragana Cvetkovi?; Nenad Lu?i?; Ratko M. Radoji?i?; Zorica S. Sai?i?; Snežana B. Pajovic

2008-01-01

191

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  

Directory of Open Access Journals (Sweden)

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 com

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

2003-01-01

192

Endometrial intraepithelial carcinoma: A case report and brief review  

Directory of Open Access Journals (Sweden)

Full Text Available This case report describes the precursor lesion of uterine papillary serous carcinoma (UPSC). A 65-year-old post-menopausal female presented with prolapse and vaginal discharge and underwent a hysterectomy revealing an atrophic endometrium, highly atypical endometrial glands, the lining cells of which showed pseudostratification, hobnailing, a high nuclear to cytoplasmic ratio, and prominent nucleoli. A p53 immunoreactivity score of 8 and a MIB-1 index of 80% was obtained leading to a diagnosis of endometrial intraepithelial carcinoma (EIC). Since serous EIC is commonly associated with extra-uterine serous carcinoma, it is a uniquely aggressive precursor lesion. Molecular studies support the hypothesis that EIC is a precursor of both uterine and extra-uterine invasive serous carcinomas. This is why the treatment protocol for EIC cases is total abdominal hysterectomy (TAH), accompanied by a staging procedure. In our patient, EIC was limited to the endometrium; associated with an excellent clinical outcome.

Ram Manisha; Bharadwaj Minakshi; Yadav Rajbala

2008-01-01

193

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.

1989-01-01

194

Ultrasonographic findings of Myoma, H-mole and Missed abortion  

Energy Technology Data Exchange (ETDEWEB)

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

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

1982-12-15

195

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

1982-01-01

196

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

Energy Technology Data Exchange (ETDEWEB)

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

197

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 ...

198

[Assessment of endometrial morphology and histology in postmenopausal women].  

UK PubMed Central (United Kingdom)

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 hysteroscopic 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.

Wolff LP; Monte AA; Atti AC; Monteiro IM

2010-11-01

199

Endometrial stromal sarcoma of the uterus presenting as pulmonary metastasis.  

UK PubMed Central (United Kingdom)

Endometrial stromal sarcoma (ESS) is a rare uterine sarcoma. Compared with other uterine malignancies, it occurs at an earlier age (42-58 years) and about 10-25% of the patients are premenopausal. The tumours have an indolent growth, with a tendency for late recurrence. Metastases are rarely detected before the diagnosis of the primary lesion. We report a case of ESS with pulmonary metastasis as a prodromal manifestation.

Binesh F; Taghipour Zahir S; Akhavan A; Roshan Bovanlu T

2013-01-01

200

Doppler study of uterine hemodynamics in women with unexplained infertility.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate uterine artery blood flow using pulsed Doppler, and endometrial and subendometrial microvascularization using three-dimensional (3D) power Doppler, in women with unexplained infertility. STUDY DESIGN: In a prospective clinical trial at a university teaching hospital, 40 women with unexplained infertility were compared to 40 fertile parous controls. In the mid-luteal (peri-implantation) phase, the endometrial thickness and volume, uterine artery pulsatility index (PI) and resistance index (RI), endometrial and subendometrial 3D power Doppler vascularization index (VI), flow index (FI), and vascularization flow index (VFI), and serum estradiol and progesterone levels were measured in both groups. RESULTS: The uterine artery PI (P=0.003) and RI (P=0.007) were significantly increased and the endometrial VI (P=0.029), FI (P=0.031), and VFI (P=0.001) and subendometrial VI (P=0.032), FI (P=0.040), and VFI (P=0.005) were significantly decreased in the unexplained infertility group. The endometrial thickness and volume and serum estradiol and progesterone levels, however, were not significantly different between the two groups. CONCLUSION: Peri-implantation endometrial perfusion is impaired in women with unexplained infertility: Doppler study of uterine hemodynamics should therefore be considered in infertility work-up.

El-Mazny A; Abou-Salem N; Elshenoufy H

2013-08-01

 
 
 
 
201

Staging in local endometrial carcinoma  

International Nuclear Information System (INIS)

[en] 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.)

1989-01-01

202

Pólipos endometriais/ Endometrial polyps  

Scientific Electronic Library Online (English)

Full Text Available Abstract in portuguese 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 (more) 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. Abstract in english 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 ri (more) sk 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.

Nogueira, Antonio Alberto

2005-05-01

203

[Local hyperestradiolemia of the uterus in the pathogenesis of hyperplastic endometrial processes  

UK PubMed Central (United Kingdom)

The study of local blood flow in the uterus in 100 cases of uterine fibromyoma established increased blood levels of estradiol and progesteron. Blood estradiol level in the local flow of the uterus was relatively high in postmenopausal women, particularly, in those suffering uterine myoma. "Foreign" estradiol-dependent tissue substrates such as myoma and hyperplastic lesions of the endometrium were found to be responsible for potentiating local transfer and thus raising local concentration of ovarian hormones. Regulation of subovarian transfer and accumulation of hormones was shown to be to a large extent independent of levels of basic sex steroids in the general blood flow of the female body. Chronic local hyperestradiolemia in the uterus is the key factor for hyperplastic lesions development in the endometrium.

Savitski? GA

1991-01-01

204

Long-term outcome of hysteroscopic endometrial resection with or without myomectomy in patients with menorrhagia.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To evaluate the long-term outcomes and hysterectomy rates after hysteroscopic endometrial resection with or without myomectomy for menorrhagia. STUDY DESIGN: Fifty-three women who had submucous myomas with intramural extension of less than 50% and smaller than 5 cm in diameter underwent endometrial resection and concomitant hysteroscopic myomectomy. Each of them was matched with a patient who had no submucous myomas and who had been treated by endometrial resection only. These two groups were compared for operative outcomes, additional procedures, outcome of menstrual bleeding and for subsequent hysterectomy, which was the endpoint of this study. RESULTS: During the mean follow-up period of 6.5 years, 18 (34.6%) women with endometrial resection and myomectomy and 21 (39.6%) without myomectomy underwent at least one gynecological procedure. Hysterectomy was performed in 26.9% [95% confidence interval (CI) 16.8-40.3] of the patients with myomectomy and in 17.0% (95% CI 9.2-29.2) of the patients without myomectomy (P = 0.22). The main indications for hysterectomy were pain and spotting bleeding in seven out of 14 cases with myomectomy and in four out of nine with endometrial resection only. Leiomyomas were found in 12 out of the 14 women who had hysterectomy after hysteroscopic myomectomy and in four out of nine with hysterectomy after endometrial resection only (P = 0.06). Most (75.6%) of the 82 women who had not required hysterectomy had reached menopause. All the patients without hysterectomy in both groups reported amenorrhea or slight bleeding, and this response maintained for years after the treatment. CONCLUSION: Endometrial resection may be combined with hysteroscopic myomectomy without a significant increase or decrease in hysterectomy rates during a long-term follow-up.

Rovio PH; Helin R; Heinonen PK

2009-02-01

205

Sonohysterographic endometrial sampling and hysteroscopic endometrial biopsy: a comparative study.  

UK PubMed Central (United Kingdom)

OBJECTIVES: To compare the quantity and quality of endometrial tissue sampled at saline contrast sonohysterography (SCSH) with that obtained by directed endometrial biopsy by operative hysteroscopy in patients with diffusely thickened and/or inhomogeneous endometrium at SCSH. A secondary aim was a comparison of the extent of procedure-related pain. METHODS: One hundred and twenty-eight patients with diffusely thickened (> 4 mm) and/or inhomogeneous endometrium at SCSH were prospectively recruited. Endometrial sampling was performed at the end of SCSH using the same 4.7-mm intrauterine catheter that had been used for saline instillation. These samples were compared to directed endometrial biopsies obtained with the guidance of an office 5-mm hysteroscope. After hysteroscopy, an extended guided curettage was performed under general anesthesia, providing specimens that were considered the gold standard for histological diagnosis. Endometrial specimen area (mm(2)), histologic concordance and procedure related pain (10-cm VAS) were compared for the two techniques. RESULTS: The median age of 88 pre- and of 40 post-menopausal patients was 41 (interquartile range, 34-48) years and 57 (interquartile range, 52-67) years, respectively. The median area of endometrial specimen obtained by SCSH was 25.1 (interquartile range, 12.4-52.3) mm(2) and was not significantly different from that obtained by hysteroscopy (16.9 (interquartile range, 10.0-52.7) mm(2)). The K values of the two different techniques for typical hyperplasia (n = 61) and for premalignant and malignant lesions (n = 26) were 0.91 and 0.94, respectively. Procedure-related pain was not significantly different between pre- and postmenopausal patients for both sampling techniques. CONCLUSIONS: SCSH with sampling proved to be as good as and as tolerable as hysteroscopic biopsy in cases with diffusely thickened and/or inhomogeneous endometrium. Both these imaging and biopsy techniques should be considered a reliable outpatient procedure in the management of patients with abnormal uterine bleeding. Published by John Wiley & Sons, Ltd.

Leone FP; Carsana L; Lanzani C; Vago G; Ferrazzi E

2007-04-01

206

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

207

Suspecting malignancy in endometrial polyps: value of hysteroscopy.  

UK PubMed Central (United Kingdom)

AIMS AND BACKGROUND: Hysteroscopic polypectomy is the gold standard to treat endometrial polyps and obtain specimens for histological evaluation. There is continuing debate as to when to offer hysteroscopic polypectomy, especially in asymptomatic women with incidental lesions. The aims of this study were to assess the accuracy of hysteroscopy and Vabra sampling in diagnosing atypical hyperplasia and cancer growing on the surface of endometrial polyps and to investigate the association between atypical endometrial polyps and some potential clinical risk factors. METHODS AND STUDY DESIGN: This was a retrospective study. We assessed 1039 hysteroscopies and we identified 345 women with endometrial polyps. All patients with endometrial polyps underwent hysteroscopic polypectomy. Data about age, menopausal status, abnormal uterine bleeding (AUB), hormone replacement therapy and tamoxifen use were collected. Hysteroscopic, histological and clinical data were analyzed. RESULTS: The incidence of endometrial hyperplasia or cancer growing on the surface of endometrial polyps was significantly low (1.7%). Hysteroscopy correctly excluded (negative predictive value: 100%) and accurately predicted (positive predictive value: 85.7%) preneoplastic or neoplastic lesions growing within the epithelial layer of endometrial polyps. Vabra sampling was inadequate for the histological diagnosis in 38.5% of cases. Age over 60 years and postmenopausal AUB were associated with an 8.3-fold ( P = 0.022) and 8.8-fold (P = 0.020) increased risk, respectively, of preneoplastic and neoplastic lesions growing on the surface of endometrial polyps. CONCLUSIONS: Diagnostic hysteroscopy is a good tool to predict malignancy of the epithelial layer of endometrial polyps. Age over 60 years and AUB are associated with an increased risk of malignant polyps. Few suspicious endometrial polyps should undergo surgical resection.

Daniele A; Ferrero A; Maggiorotto F; Perrini G; Volpi E; Sismondi P

2013-03-01

208

Endometrial cancer  

International Nuclear Information System (INIS)

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

2010-01-01

209

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

UK PubMed Central (United Kingdom)

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

Freeman SL; Green MJ; England GC

2013-08-01

210

[Case of atypical polypoid adenomyoma of the uterine cevix].  

UK PubMed Central (United Kingdom)

Atypical polypoid adenomyoma (APA) is a rare benign polypoid tumor occuring in young reproductive age women. There are no specific clinical features of APA. Grossly the tumor presents as a small polypoid lession in the low uterin cavum segment and cervical canal, mimicring infiltative endocervical or endometrial carcinoma. Microscopicaly APA consists of irregular glands, as endometrial with mild cellular atypia and diffuse smooth-mussle stroma. We present a case of APA of the uterine cervix in a young woman in regard to the diagnostical and treatment obstacles usually accompaning this rare pathology.

Bachurska S; Yamakov K; Belovezdov V; Staykov D; Pehlivanov B

2013-01-01

211

Uterine morphology and peristalsis in women with polycystic ovary syndrome  

International Nuclear Information System (INIS)

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

2012-01-01

212

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

213

Integrated genomic characterization of endometrial carcinoma.  

UK PubMed Central (United Kingdom)

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.

Kandoth C; Schultz N; Cherniack AD; Akbani R; Liu Y; Shen H; Robertson AG; Pashtan I; Shen R; Benz CC; Yau C; Laird PW; Ding L; Zhang W; Mills GB; Kucherlapati R; Mardis ER; Levine DA

2013-05-01

214

[Prognostic factors uterine corpus cancer].  

UK PubMed Central (United Kingdom)

The accumulated clinico-pathological dates and recent molecular biological studies have identified several prognostic factors for endometrial cancers. FIGO staging has taken into consideration of the tumor expansion and is the most important predictor in evaluating patient outcome. Characteristics of tumor biology, such as morphology of tumor and depth of invasion are also important prognostic considerations. Molecular markers indicating genetic/molecular events in cancer biology appear to be the 3rd predictors in estimating the prognosis. Finally, treatment of uterine corpus cancer can be directly related to prognosis. Postoperative chemotherapy is gradually taking precedence over irradiation in considering evidence-based medicine.

Inoue M

2006-12-01

215

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 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 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 uterin (more) as. 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. 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 (more) 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.

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

2012-12-01

216

Genomic profile of endometrial tumors depends on morphological subtype, not on tamoxifen exposure.  

Science.gov (United States)

Tamoxifen has been a very effective treatment for breast cancer for several decades, however, at the same time increases the risk of endometrial cancer, especially after prolonged exposure. In addition, tamoxifen has been associated with a higher proportion of unfavorable uterine tumor subtypes (carcinosarcomas and serous adenocarcinomas) with worse survival. We investigated whether endometrial tumors, which developed after prolonged tamoxifen treatment for breast cancer, are genetically different from endometrial tumors without preceding tamoxifen exposure. Array CGH was used on archival formalin-fixed paraffin embedded endometrial tumors to determine genomic aberrations. We compared the genomic profiles of 52 endometrial tumors from breast cancer patients after long-term (>or=2 years) tamoxifen use (endometrioid adenocarcinomas, n = 26; carcinosarcomas, n = 14; and serous adenocarcinomas, n = 12) with endometrial tumors from unexposed breast cancer patients (n = 45). Genomic profiles were correlated with tamoxifen exposure, tumor subtypes, and histopathological characteristics of the endometrial tumors. The common uterine corpus cancers of the endometrioid subtype show few genomic aberrations. Tumors with many genomic aberrations were in general ER-negative. In contrast, carcinosarcomas and serous adenocarcinomas showed many aberrations; however, they were indistinguishable from each other. Tumors that developed after prolonged tamoxifen use did not show more or different aberrations than unexposed tumors. This was true for all tumor subtypes. Thus, endometrial carcinomas that develop after prolonged tamoxifen use cannot be distinguished from nonusers on basis of their tumor genomic profile. PMID:20544844

Fles, Renske; Hoogendoorn, Wilhelmina E; Platteel, Inge; Scheerman, Caroline E; de Leeuw-Mantel, Gerie; Mourits, Marian J E; Hollema, Harry; van Leeuwen, Flora E; van Boven, Hester H; Nederlof, Petra M

2010-08-01

217

Uterine Fibroids  

Medline Plus

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

218

Uterine Fibroids  

Medline Plus

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 ...

219

Uterine Fibroids  

Medline Plus

Full Text Available ... of the body. Uterine fibroids are made of nodules of smooth muscle cells and fibrous tissue that ... the uterus. Fibroids may grow as a single nodule or in clusters. They may range in size ...

220

Uterine Fibroids  

Medline Plus

Full Text Available Uterine Fibroids Introduction Fibroids are common, benign tumors of the uterus. They can cause significant pain, as well as abnormal bleeding. About 30% of all women may have fibroids. Most ...

 
 
 
 
221

Recent developments in uterine mesenchymal neoplasms.  

UK PubMed Central (United Kingdom)

Smooth muscle and endometrial stromal tumours represent the two most common uterine mesenchymal neoplasms that may present diagnostic dilemmas for the practising surgical pathologist. Recent changes in morphological and staging criteria, as well as the discovery of new immunohistochemical markers, have improved the diagnosis and classification of these tumours. We highlight the difficulty in distinguishing tumour cell necrosis from infarct-type necrosis and the limited utility of p16 immunohistochemical expression in the diagnosis of leiomyosarcoma. We also discuss the controversial use of mitotic activity and necrosis as prognostic factors in endometrial stromal sarcomas. Emerging genetic information has also greatly expanded our understanding of 'sarcomagenesis' in both tumour types and may provide insight into potential therapeutic targets for the treatment of leiomyosarcoma and endometrial stromal sarcomas, harboring MED12 (mediator complex subunit 12) mutations and recurrent gene rearrangements, respectively. In this review, we discuss the core updates in the diagnosis and classification of uterine leiomyosarcomas and endometrial stromal sarcomas, highlighting new and important molecular genetic findings that may drive pathogenesis.

Chiang S; Oliva E

2013-01-01

222

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 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 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 (more) 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 least one embryo transfer, who presented implantation failures. The patients were submitted to a sonohysterographic examination followed by a diagnostic hysteroscopic examination, (more) 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

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

2003-08-01

223

Application of saline infusion sonography in the diagnosis of endometrial polyps  

Directory of Open Access Journals (Sweden)

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

N. Ribi?; A. ?uri?; M. Ajanovi?; K. Drljevi?

2006-01-01

224

Miomatosis uterina gigante Giant uterine myomatosis  

Directory of Open Access Journals (Sweden)

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; Raúl Vasallo Prieto; Simeón Collera; Ysis M. Martínez Chang; Jorge Miguel Correa Padilla; Javier Rivero Ojeda; Joel Frigola Cartaya; Carlos Alfonso Sabatier

2009-01-01

225

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

Energy Technology Data Exchange (ETDEWEB)

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

226

Leiomyomatosis peritonealis disseminata with formation of endometrial cysts within tumors arising after supracervical laparoscopic hysterectomy.  

UK PubMed Central (United Kingdom)

BACKGROUND: Use of morcellation during laparoscopic hysterectomy may result in seeding of uterine tissue throughout the abdominal cavity and development of 'iatrogenic' leiomyomatosis peritonealis disseminata. CASE: Two years after a supracervical laparoscopic hysterectomy a 42-year-old parous women presented with abdominal pain and bloating. CT scans and subsequent surgical exploration reveled multiple solid tumors containing cysts filled with altered blood. Histologically the tumors had characteristic features of a benign leiomyoma with smooth muscle cells infiltrated by endometrial glands. CONCLUSION: Pieces of smooth muscle cell and endometrial uterine tissue lost in the abdominal cavity during morcellation may progress to leiomyomatosis peritonealis disseminata with unusual appearance.

Bogusiewicz M; Rosi?ska-Bogusiewicz K; Walczyna B; Drop A; Rechberger T

2013-01-01

227

Saline infusion sonohysterography versus hysteroscopy for uterine cavity evaluation  

Science.gov (United States)

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; Jamaat, Sadia; Al-Jaroudi, Dania

2011-01-01

228

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 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 informações 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 (more) 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 uterine 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 hysteroscop (more) y 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 useful for the management of abnormal ute

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

2001-08-01

229

Bilateral Endometrial Stromal Sarcoma Originating from Ovarian Endometriosis: A Case Report  

Directory of Open Access Journals (Sweden)

Full Text Available Endometrial stromal sarcomas usually develop in the uterine corpus and occasionally arise in various extrauterine sites. Endometriosis is one of the most common benign gynecologic conditions. Malignant transformation is a rare but well-documented complication of endometriosis, occurring in 0.7% to 1% of cases. It can be the cause of some rare malignant tumors like endometrial stromal sarcoma, which is extremely rare at various extrauterine sites. Herein, we describe a surgicaly-proven case of bilateral endometrial stromal sarcoma originating from ovarian endometriosis in a 57-year-old woman.

M Tahmasebi; M Cina

2009-01-01

230

CHARACTERIZATION OF UTERINE EPIDERMAL GROWTH FACTOR RECEPTOR EXPRESSION DURING THE ESTROUS CYCLE AND EARLY PREGNANCY IN PIGS  

Science.gov (United States)

Uterine capacity is a component contributing to litter size in swine. The epidermal growth factor (EGF) gene is located near a uterine capacity quantitative trait locus on chromosome 8. EGF has been reported to stimulate epithelial cell growth, and therefore may influence endometrial function. We ha...

231

Endometrial and ovarian cancer in women with Lynch syndrome: update in screening and prevention.  

UK PubMed Central (United Kingdom)

Women with Lynch syndrome have an additional need to address the substantial increased lifetime risk of endometrial and ovarian cancer. Endometrial or ovarian cancer can be the presenting cancer in individuals with Lynch syndrome, or can be a second cancer. Lifetime risk of endometrial cancer in women with MLH1 or MSH2 mutations is approximately 40 %, with a median age of 49. Women with MSH6 mutations have a similar risk of endometrial cancer but a later age of diagnosis. Lynch syndrome-associated endometrial cancers are primarily endometrioid, although non-endometrioid subtypes including clear cell, papillary serous and MMMT have been reported. In addition, endometrial cancers arising in the lower uterine segment, while rare in the general population, are enriched in women with Lynch syndrome. Ovarian cancer risk in women with Lynch syndrome is 6-8 %, and Lynch syndrome-associated ovarian cancers exhibit a variety of histopathological subtypes. Studies of endometrial cancer screening in Lynch syndrome have been small, and more recently have focused on the use of office endometrial biopsy to identify pre-malignant and early stage cancers. Prevention options include the use of oral contraceptives, which are known to be highly effective for decreasing risk of both endometrial and ovarian cancer in the general population, and prophylactic surgery to remove the uterus and ovaries.

Lu KH; Daniels M

2013-06-01

232

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

Scientific Electronic Library Online (English)

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

Barbosa, Caio Parente; Santos, Marcelo Ettruri; Napolitano, Ana Cristina; Tamanaka, Paula Harue; Cordts, Emerson Barchi

1998-08-01

233

Uterine hemangiopericytoma.  

UK PubMed Central (United Kingdom)

In a clinicopathologic analysis of previously unreported uterine hemangiopericytomas, malignant behavior was observed in four of 21 followed patients. Recurrent disease occurred in the pelvis, abdomen, and lungs. The role of chemotherapy in the treatment of recurrences was not substantiated. No specific histologic features could be identified that correlated with malignant potential.

Buscema J; Klein V; Rotmensch J; Rosenshein N; Woodruff JD

1987-01-01

234

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

Digital Repository Infrastructure Vision for European Research (DRIVER)

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 o...

Esteve Carbonell JL; Acosta R; Perez Y; Rodriguez B; Seigler I; Sanchez C; Tomasi G

235

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

Directory of Open Access Journals (Sweden)

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; Laura Cárdenas Mastrascusa; Diana Sandoval Martínez; Henry Mayorga Anaya

2010-01-01

236

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

237

CD5+ Epstein-Barr virus-positive intravascular large B-cell lymphoma in the uterus co-existing with huge myoma.  

UK PubMed Central (United Kingdom)

A 42-year-old female underwent hysterectomy because of a huge uterine mass. Histologically, she was diagnosed as having intravascular lymphoma co-existing with myoma uteri. Lymphoma cells were large in size and were positive for CD5, CD20, CD45, CD79a, lambda light chain, and EBV but were negative for CD3 and cyclin D1. No other organs except for the adjoining bilateral ovaries seemed to be affected by the lymphoma cells. She received the combination chemotherapy (cyclophosphamide, doxorubicin, vincristine, and prednisolone) together with rituximab and has been well without definite disease progression. So far, this is the first case of CD5+ EBV+ intravascular large B-cell lymphoma (CD5+ EBV+ IVLBL) in the uterus of a patient who was incidentally diagnosed and successfully treated.

Yamada N; Uchida R; Fuchida S; Okano A; Okamoto M; Ochiai N; Iwasa H; Shimazaki C

2005-03-01

238

Treatment Options for Endometrial Cancer by Stage  

Science.gov (United States)

... endometrial cancer Treatment options for endometrial cancer by stage Endometrial cancer is often diagnosed when a woman ... the uterus, a different surgery may be planned. Stage I An endometrial cancer is stage I if ...

239

Uterine evacuator  

UK PubMed Central (United Kingdom)

A system for achieving evacuation of tissue from within the uterine cavity. A rotating Archimedes screw within a narrow cylindrical sheath achieves mechanical tissue extraction. A vacuum source attached to the sheath removes the extracted tissue from the sheath by suction. A fiber-optic system integrated into the sheath allows the procedure to be performed under direct visual guidance. The narrow diameter of the sheath allows for performance of the procedure without the need for cervical dilation.

TUGENDREICH DANIEL; ZION BEN-RAFAEL

240

Bilateral Endometrial Stromal Sarcoma Originating from Ovarian Endometriosis: A Case Report  

Digital Repository Infrastructure Vision for European Research (DRIVER)

Endometrial stromal sarcomas usually develop in the uterine corpus and occasionally arise in various extrauterine sites. Endometriosis is one of the most common benign gynecologic conditions. Malignant transformation is a rare but well-documented complication of endometriosis, occurring in 0.7% to 1...

M Tahmasebi; M Cina

 
 
 
 
241

Cervical cytology in serous and endometrioid endometrial cancer.  

UK PubMed Central (United Kingdom)

The aim of this study was to determine the frequency of abnormal cervical cytology in preoperative cervical cytology of patients diagnosed with uterine papillary serous carcinoma (UPSC) and endometrioid endometrial carcinoma (EEC). In addition, associations between abnormal cervical cytology and clinicopathologic factors were evaluated. In this multicentre study, EEC patients diagnosed at two hospitals from 1999 to 2009 and UPSC patients diagnosed at five hospitals from 1992 to 2009, were included. Revision of the histologic slides was performed systematically and independently by 3 gynecopathologists. Cervical cytology within six months before histopathologic diagnosis of endometrial carcinoma was available for 267 EEC and 80 UPSC patients. Cervical cytology with atypical, malignant, or normal endometrial cells in postmenopausal women was considered as abnormal cytology, specific for endometrial pathology. Abnormal cervical cytology was found in 87.5% of UPSC patients, compared with 37.8% in EEC patients. In UPSC, abnormal cytology was associated with extrauterine spread of disease (P=0.043). In EEC, abnormal cytology was associated with cervical involvement (P=0.034). In both EEC and UPSC patients, abnormal cervical cytology was not associated with survival. In conclusion, abnormal cervical cytology was more frequently found in UPSC patients. It was associated with extrauterine disease in UPSC patients, and with cervical involvement in EEC patients. More prospective research should be performed to assess the true clinical value of preoperative cervical cytology in endometrial cancer patients.

Roelofsen T; Geels YP; Pijnenborg JM; van Ham MA; Zomer SF; van Tilburg JM; Snijders MP; Siebers AG; Bulten J; Massuger LF

2013-07-01

242

Cervical cytology in serous and endometrioid endometrial cancer.  

Science.gov (United States)

The aim of this study was to determine the frequency of abnormal cervical cytology in preoperative cervical cytology of patients diagnosed with uterine papillary serous carcinoma (UPSC) and endometrioid endometrial carcinoma (EEC). In addition, associations between abnormal cervical cytology and clinicopathologic factors were evaluated. In this multicentre study, EEC patients diagnosed at two hospitals from 1999 to 2009 and UPSC patients diagnosed at five hospitals from 1992 to 2009, were included. Revision of the histologic slides was performed systematically and independently by 3 gynecopathologists. Cervical cytology within six months before histopathologic diagnosis of endometrial carcinoma was available for 267 EEC and 80 UPSC patients. Cervical cytology with atypical, malignant, or normal endometrial cells in postmenopausal women was considered as abnormal cytology, specific for endometrial pathology. Abnormal cervical cytology was found in 87.5% of UPSC patients, compared with 37.8% in EEC patients. In UPSC, abnormal cytology was associated with extrauterine spread of disease (P=0.043). In EEC, abnormal cytology was associated with cervical involvement (P=0.034). In both EEC and UPSC patients, abnormal cervical cytology was not associated with survival. In conclusion, abnormal cervical cytology was more frequently found in UPSC patients. It was associated with extrauterine disease in UPSC patients, and with cervical involvement in EEC patients. More prospective research should be performed to assess the true clinical value of preoperative cervical cytology in endometrial cancer patients. PMID:23722512

Roelofsen, Thijs; Geels, Yvette P; Pijnenborg, Johanna M A; van Ham, Maaike A P C; Zomer, Saskia F; van Tilburg, Johanna M Wiersma; Snijders, Marc P M L; Siebers, Albert G; Bulten, Johan; Massuger, Leon F A G

2013-07-01

243

Cabozantinib-S-Malate in Treating Patients With Recurrent or Metastatic Endometrial Cancer  

Science.gov (United States)

Endometrial Adenosquamous Cell Carcinoma; Endometrial Clear Cell Carcinoma; Endometrial Papillary Serous Carcinoma; Recurrent Endometrial Carcinoma; Stage IVA Endometrial Carcinoma; Stage IVB Endometrial Carcinoma

2013-09-03

244

Curcumin inhibits endometriosis endometrial cells by reducing estradiol production  

Directory of Open Access Journals (Sweden)

Full Text Available Background: Endometriosis is a complex estrogen-dependent disease that is defined as the presence of endometrial gland and stroma outside the uterine cavity. Although the exact mechanism for the development of endometriosis remains unclear, there is a large body of research data and circumstantial evidence that suggests a crucial role of estrogen in the establishment and maintenance of this disease. Objective: This study is an attempt to assess the effect of curcumin on inhibiting endometriosis endometrial cells and to investigate whether such an effect is mediated by reducing estradiol production. Materials and Methods: Endometriotic stromal cells, normal endometrial stromal cells, endometriotic epithelial cells and normal endometrial epithelial cells were isolated and cultured. E2 value of cells and the effect of curcumin on cell proliferation were evaluated. Finally, effect of curcumin on E2 assay was detected. Results: Electrochemiluminescence immunoassay results showed that E2 value of endometriotic epithelial cells was higher than the endometriotic stromal cells (p=0.037), while the expression of E2 in normal endometrial stromal and epithelial cells was extremely low. WST-8 result showed, compared with endometrial stromal cells, ectopic endometriotic stromal cells had a higher growth rate. After intervene with curcumin (10?mol/L, 30?mol/L and 50?mol/L) for 0-96h, the number of endometriotic stromal cells was reduced and cells growth slowed, compared with 0?mol/L group. Compared with 0?mol/L group, E2 level was lower after treatment with curcumin, especially in 30?mol/L and 50?mol/L group. Conclusion: In summary, in this study we found that E2 is important in ectopic endometrium, and epithelial cell is in dominant position with E2 secretion. Curcumin was able to suppress the proliferation of endometrial cells by reducing the E2 value.

Ying Zhang; Hong Cao; Zheng Yu; Hai-Ying Peng; Chang-jun Zhang

2013-01-01

245

The success rate of pregnancy in IUI cycles following endometrial sampling. A randomized controlled study : endometrial sampling and pregnancy rates.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The aim of this work was to compare the pregnancy rates during IUI cycles with or without endometrial sampling. STUDY DESIGN: A prospective, randomized study. PATIENTS AND METHODS: 150 patients were recruited. They were classified into three groups. Each comprised 50 patients. Group 1 was considered the control group and underwent IUI with no endometrial sampling. Group 2 underwent Tao Brush endometrial sampling on day 8-9 of the uterine cycle that preceded the stimulation cycle, and finally, Group 3 underwent Tao Brush endometrial sampling on day 8-9 of the same IUI cycle OUTCOME OF THE STUDY: A positive pregnancy test. RESULTS: Pregnancy percentages were 18, 38, and 36 % for group 1, group 2, and group 3, respectively. The paired t test was used to compare each two individual group means. The results show a highly significant value for the paired t test of the control group and group 2 of the patients (p = 0.001), as well as a highly significant results (p = 0.002) for the group 3 and the control group. No significant value was present between the group 2 and 3 of patients (p = 0.322). CONCLUSION: Endometrial sampling significantly increases pregnancy rates in IUI procedures when it is done in the proliferative phase of the IUI cycle, or the cycle prior to IUI, than pregnancy rates with IUI alone.

Abdelhamid AM

2013-09-01

246

Grave outcome of granulocyte colony-stimulating factor-producing endometrial cancer: a case report and literature review.  

UK PubMed Central (United Kingdom)

Granulocyte colony-stimulating factor (G-CSF)-producing nonhematopoietic malignancies have been reported in various organs, and most of them have been associated with poor clinical outcome. However, because of the rarity of reported cases, information regarding G-CSF-producing gynecological malignancies, especially uterine corpus cancer, is limited. We report a case of G-CSF-producing endometrial cancer, which exhibited a grave clinical outcome. Our case strongly indicates the aggressive nature of G-CSF-producing endometrial cancer.

Yamamoto K; Mabuchi S; Yamasaki M; Yoshimura M; Murata Y

2013-05-01

247

[Myxoid mesenchymal tumors of uterus: endometrial stromal and smooth muscle tumors, myxoid variant].  

UK PubMed Central (United Kingdom)

Four myxoid variant of uterine mesenchymal tumors are reported. One was a low grade stromal sarcoma with infiltrative margins and the others were well circumscribed tumors corresponding to an endometrial stromal nodule and two leiomyomas. They were hypocellular neoplasms composed of stellated cells with an abundant Alcian Blue positive myxoid matrix. The myxoid nature of the neoplasms obscured their cellular nature and made the distinction between smooth muscle and endometrial stromal tumors difficult. Endometrial stromal tumors, showed very focal areas of small basophilic cells, characteristic of endometrial stroma. The diagnosis was based on the presence of a spiral arteriolar network, a CD10 positivity as well as the absence of h-caldesmon and desmin expression. The two myxoid leiomyomas showed more spindle cells and a desmin expression while h-caldesmon was negative and CD10 focally positive in both cases. Myxoid variant of endometrial stromal tumors does not necessarily exhibit the typical morphology of endometrial stroma. They may demonstrate morphological features of smooth muscle tumors in the uterus. Also, myxoid changes in uterin smooth muscle tumors may modify the classical immunoreactivity of smooth muscle markers in these tumors and make it difficult to distinguish between benign and malignant neoplasms. An immunohistochemical panel of antibodies including CD10, h-caldesmon and desmin may help in establishing the correct diagnosis.

Chesnais AL; Watkin E; Beurton D; Devouassoux-Shisheboran M

2011-06-01

248

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

Directory of Open Access Journals (Sweden)

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; Ana Maria Gomes Pereira; Gilberto Kendi Takeda; Daniela de Baptista Depes; Reginaldo Guedes Coelho Lopes

2011-01-01

249

Use of strict sonohysterographic methods for preoperative assessment of submucous myomas.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To assess the diagnostic accuracy of sonohysterography (SHG) and transvaginal sonography versus diagnostic hysteroscopy in preoperative assessment of submucous myomas. DESIGN: Prospective pilot study. SETTING: University hospital outpatient center. PATIENT(S): Forty-eight symptomatic (bleeding, infertility) premenopausal patients with submucous myomas. INTERVENTION(S): Preoperative grading of submucous myomas with a strict SHG methodology and standard transvaginal sonography compared with hysteroscopic grading of submucous myoma before hysteroscopic myomectomy. MAIN OUTCOME MEASURE(S): SHG and sonographic agreement with hysteroscopic findings. RESULT(S): Forty-eight patients were enrolled (mean age +/- SD = 41 years +/- 10.2). The median duration of SHG was 12 minutes (interquartile range, 9-16). The mean number of submucous myomas was 1 (range, 1-3) per woman. In all cases, a successful SHG was performed, with no, mild, or moderate pain in 38 (79%), 8 (17%), and 2 (4%) patients, respectively. No patients experienced severe pain or vasovagal reaction. All cases were correctly diagnosed by SHG compared with the final hysteroscopic diagnosis (kappa = 1.0; SE = 0.105). Simple transvaginal ultrasound was inaccurate in six cases (kappa = 0.81; SE = 0.103). CONCLUSION(S): Strict and reproducible SHG diagnostic procedures proved to be as effective as hysteroscopy and well tolerated in preoperative grading of submucous myomas.

Leone FP; Lanzani C; Ferrazzi E

2003-04-01

250

Evaluation of loop ligation of larger myoma pseudocapsule combined with vasopressin on laparoscopic myomectomy.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To study the effects of reducing hemorrhage by loop ligation of larger myoma pseudocapsules combined with vasopressin on laparoscopic myomectomy (LM). DESIGN: Prospective controlled clinical trial. SETTING: Sheng Jing Hospital, China Medical University. PATIENT(S): A total of 105 women with symptomatic single or multiple larger myomas (diameter 6-18 cm) in need of surgical intervention, who wished to retain their uteri, were randomly divided into three groups in our hospital from January 2006 to January 2008: A) loop ligation combined with vasopressin; B) vasopressin alone; and C) neither loop ligation nor vasopressin. All patients were treated by LM. Each group included 35 cases. INTERVENTION(S): Loop ligation of larger myoma (6-18 cm) pseudocapsule combined with vasopressin before thoroughly enucleating the myoma. MAIN OUTCOME MEASURE(S): Operating time, blood loss, blood transfusion, postoperative stay in hospital, symptom improvement. RESULT(S): Average blood loss, postoperative stay in hospital, number of conversions to laparotomy, and need for transfusion because of bleeding during operation in group A were significantly lower than in groups B and C. All patients in group A underwent technically successful laparoscopic operations. CONCLUSION(S): Loop ligation of larger myoma pseudocapsules combined with vasopressin is a safe, effective, and promising new method to reduce bleeding during laparoscopic myomectomy and makes the laparoscopic operations with larger myomas easier.

Zhao F; Jiao Y; Guo Z; Hou R; Wang M

2011-02-01

251

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

Directory of Open Access Journals (Sweden)

Full Text Available 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 exame 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.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

2010-01-01

252

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

Scientific Electronic Library Online (English)

Full Text Available 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 exame ultrassonográfico, histeroscópico e biópsias endometriais. RESULTADOS: Das 52 mulheres selecionadas 32 (61,5%) apresentaram ultrassonografia normal, cavidade uterina (more) 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 anal (more) yzed. 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.

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

2010-01-01

253

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

Directory of Open Access Journals (Sweden)

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

M.L. Schulman; L.A. Bolton

2012-01-01

254

Tracer injection sites and combinations for sentinel lymph node detection in patients with endometrial cancer.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The aim of the present study was to clarify the most effective combination of injected tracer types and injection sites in order to detect sentinel lymph nodes (SLNs) in early endometrial cancer. PATIENTS AND METHODS: The study included 100 consecutive patients with endometrial cancer treated at Tohoku University Hospital between June 2001 and December 2012. The procedure for SLN identification entailed either radioisotope (RI) injection into the endometrium during hysteroscopy (55 cases) or direct RI injection into the uterine cervix (45 cases). A combination of blue dye injected into the uterine cervix or uterine body intraoperatively in addition to preoperative RI injection occurred in 69 of 100 cases. All detected SLNs were recorded according to the individual tracer and the resultant staging from this method was compared to the final pathology of lymph node metastases including para-aortic nodes. RESULTS: SLN detection rate was highest (96%) by cervical RI injection; however, no SLNs were detected in para-aortic area. Para-aortic SLNs were detected only by hysteroscopic RI injection (56%). All cases with pelvic lymph node metastases were detected by pelvic SLN biopsy. Isolated positive para-aortic lymph nodes were detected in 3 patients. Bilateral SLN detection rate was high (96%; 26 of 27 cases) by cervical RI injection combined with dye. CONCLUSION: RI injection into the uterine cervix is highly sensitive in detection of SLN metastasis in early stage endometrial cancer. It is a useful and safe modality when combined with blue dye injection into the uterine body.

Niikura H; Kaiho-Sakuma M; Tokunaga H; Toyoshima M; Utsunomiya H; Nagase S; Takano T; Watanabe M; Ito K; Yaegashi N

2013-11-01

255

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

Scientific Electronic Library Online (English)

Full Text Available 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 tratadas con resección endometrial histeroscópica seguida de inserción de un dispositivo intrauterino que libera 20 microgramos diarios de levonorgestrel. Resultados: En 23 (more) 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 chr (more) onic 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

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

2007-01-01

256

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

Directory of Open Access Journals (Sweden)

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; Juan Rodríguez C; Tamara Briceño C; Julio Veas P

2007-01-01

257

Laparoscopic myomectomy with uterine artery ligation: review article and comparative analysis.  

UK PubMed Central (United Kingdom)

Uterine leiomyomas are one of the most common benign smooth muscle tumors in women, with a prevalence of 20 to 40% in women over the age of 35 years. Although many women are asymptomatic, problems such as bleeding, pelvic pain, and infertility may necessitate treatment. Laparoscopic myomectomy is one of the treatment options for myomas. The major concern of myomectomy either by open method or by laparoscopy is the bleeding encountered during the procedure. Most studies have aimed at ways of reducing blood loss during myomectomy. There are various ways in which bleeding during laparoscopic myomectomy can be reduced, the most reliable of which is ligation of the uterine vessels bilaterally. In this review we propose to discuss the benefits and possible disadvantages of ligating the uterine arteries bilaterally before performing laparoscopic myomectomy.

Sinha R; Sundaram M; Mahajan C; Raje S; Kadam P; Rao G

2011-01-01

258

Embolization of symptomatic myomas (UAE): technique, indication and results; Embolisation bei symptomatischen Uterus-Myomen (UAE): Technik, Indikationsstellung und Ergebnisse  

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Presentation of indication, technique and results of transarterial uterine artery embolization (UAE) for the treatment of symptomatic myomas. Technical requirements are presented like DSA, catheters, superselective catheterisation and the different embolization materials as polyvinylalcohol (PVA) or microspheres, as well as the follow-up after UAE. The technical success rate of UAE is documented to range between 98 to 100% and myomatous symptomatology disappears in 85 to 94% of the cases. A reduction in the size of the myomata after UAE is observed between 48 to 70%. A resolution of the hemorrhage disappears in 80 to 96% of the cases immediately. Particulate embolization of the uterine artery is a new minimally invasive therapy in the management of symptomatic leiomyomas with a high efficiency and low rate of major complications. Further studies may prove the longterm results after UAE, the influence on fertility and possible late complications. (orig.) [German] Vorstellung der Indikationsstellung, der Technik und der Ergebnisse der Uterusarterienembolisation (UAE) bei symptomatischen Myomen. Interventionstechnische Voraussetzungen werden dargestellt, wie der Einsatz der DSA, der superselektiven Katheterisierung und der unterschiedlichen Embolisationsmaterialien wie Polyvinylalkohol (PVA) oder Microsphaeren, sowie Nachkontrollen nach UAE. Die technischen Erfolgsraten der UAE betragen zwischen 98-100%. Die Ansprechraten liegen zwischen 85-94% mit einem deutlichen oder kompletten Verlust der durch die Myome verursachten Symptomatik. Es wird eine Groe paragraph enreduktion nach UAE von 48 bis zu 70% der groe paragraph ten Myome erzielt. Bei Symptomen aufgrund der Groe paragraph e der Myome erreicht man eine Besserung bei 85-96%. Frauen die aufgrund von Menorrhagien mit der UAE behandelt werden, zeigen ein Ansprechen von 80-96%. Die bisherigen Daten zur UAE belegen eine hohe Effektivitaet bei einer minimalen Komplikationsrate. Weitere Studien sind ausgerichtet auf die Langzeitergebnisse, den Einfluss auf die Fertilitaet und moegliche Spaetkomplikationen. (orig.)

Vogl, T.J.; Jacobi, V.; Zangos, S. [Inst. fuer Diagnostische und Interventionelle Radiologie J.-W.-Goethe-Univ. Frankfurt (Germany); Gaetje, R.; Siebzehnruebl, E. [Klinik fuer Gynaekologie und Geburtshilfe J.-W.-Goethe-Univ. Frankfurt am Main (Germany)

2003-08-01

259

[Transcervical myomectomy and uterine fibroids: report of ten cases].  

UK PubMed Central (United Kingdom)

BACKGROUND: Uterine fibroids are the most common tumors of the uterus, their distribution in anatomical layers and segments of it are very varied clinical manifestations are usually abnormal bleeding and known treatments, the surgery is the most accomplished, either myomectomy or hysterectomy by both endoscopy and laparotomy, transvaginal approach is less common, but consider it a right way and solving the problem in selected cases. OBJECTIVE: To present a well-defined study protocol in patients with abnormal uterine bleeding, and myomectomy as a surgical transcervical simple, safe and effective in patients with intracavitary myoma protruded through the cervical canal. MATERIAL AND METHODS: ten patients are presented with abnormal uterine bleeding and anemia of various degrees, studied over a period of two years, following a research protocol for clinical methods, cabinet and laboratory diagnosis was submucosal fibroids with single fibroid, pedunculated protruding a vagina, treatment was performed transcervical myomectomy. RESULTS: The surgical procedure was obtained by solving the problem, having found the ten patients in the subsequent revisions in the outpatient, asymptomatic and without tumor lesions in the uterus. CONCLUSIONS: This study shows that performing a notarization in patients with abnormal uterine bleeding and making appropriate surgical treatment, achieves the desired objectives.

Cano López H; Cano Aguilar HE; Cano Aguilar FD

2012-10-01

260

Implantation in assisted reproduction: a look at endometrial receptivity.  

UK PubMed Central (United Kingdom)

Implantation failure in assisted reproduction is thought to be mainly due to impaired uterine receptivity. With normal uterine anatomy, changes in endocrine profile during ovarian stimulation and medical conditions of the mother (i.e. thrombophilia and abnormal immunological response) could result in a non-receptive endometrium. High oestradiol concentrations during ovarian stimulation lead to premature progesterone elevation, causing endometrial advancement and hampering implantation, which can be overcome by a freeze-all approach and embryo transfer in natural cycles or by milder stimulation protocols. Patients with recurrent implantation failure (RIF) should be tested for inherited and acquired thrombophilias. Each patient should be individually assessed and counselled regarding therapy with low-molecular-weight heparin (LMWH). Empirical treatment with LMWH, aspirin or corticosteroids is not effective for women with RIF who have negative thrombophilic tests. If thrombophilic tests are normal, patients should be tested for immunological causes. If human leukocyte antigen dissimilarity is proven, treatment with intravenous immunoglobulin might be beneficial. Preliminary observational studies using intralipid infusion in the presence of increased natural killer cytotoxic activity are interesting but the proposed rationale is controversial and randomized controlled trials are needed. Hysteroscopy and/or endometrial scratching in the cycle preceding ovarian stimulation should become standard for patients with RIF. Implantation failure in assisted reproduction is thought to be mainly due to impaired uterine receptivity. In the presence of normal uterine anatomy, changes in endocrine profile and the medical conditions of the mother (i.e. thrombophilia and abnormal immunological response) could result in non receptive endometrium. Patients with recurrent implantation failures should be tested for inherited and acquired thrombophilias. Each patient should be individually assessed and counselled regarding therapy with low-molecular-weight heparin (LMWH). Empirical treatment with LMWH, aspirin or corticosteroids is not effective for women with RIF who have negative thrombophilic tests. Hysteroscopy and/or endometrial scratching in the cycle preceding ovarian stimulation should become a standard for patients with recurrent implantation failure.

Fatemi HM; Popovic-Todorovic B

2013-06-01

 
 
 
 
261

Isolated Uterine Metastasis of Invasive Ductal Carcinoma  

Science.gov (United States)

Introduction. Most common metastasis sites of breast cancer are the lungs, bones, liver, and brain, whereas uterine involvement by metastatic breast disease is rare. Metastatic carcinoma of the uterus usually originates from other genital sites, most commonly being from the ovaries. Invasive lobular carcinoma spreads to gynecologic organs more frequently than invasive ductal carcinoma. Case Report. A 57-year-old postmenopausal woman was diagnosed with breast carcinoma 2 years ago and modified radical mastectomy was performed. Pathological examination of tumor revealed invasive ductal carcinoma, stage IIIc. She presented with abdominal pain and distension. Diagnostic workup and gynecologic examination revealed lesions that caused diffuse thickening of the uterus wall. Endometrial sampling was performed for confirmation of the diagnosis. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy. Breast carcinoma metastases in endometrium and myometrium were confirmed histopathologically and immunohistochemically. Conclusion. We herein report the first case of isolated uterine patient who had invasive ductal carcinoma of breast.

Arslan, Deniz; Tural, Deniz; Tatl?, Ali Murat; Akar, Emre; Uysal, Mukremin; Erdogan, Gulgun

2013-01-01

262

Lymph Node Mapping in Patients With Newly Diagnosed Endometrial Cancer Undergoing Surgery  

Science.gov (United States)

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

2013-09-05

263

Changes in uterine blood flow following laparoscopic myomectomy with or without uterine artery ligation on two- and three-dimensional power Doppler ultrasound.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate differences in uterine perfusion following laparoscopic myomectomy with or without uterine artery ligation (UAL). METHODS: From November 2005 to July 2007, we enrolled prospectively 105 women with symptomatic myomas who were scheduled to undergo laparoscopic myomectomy (57 with UAL (study group) and 48 without (control group)). Power Doppler ultrasound was used to evaluate uterine artery resistance (RI) and pulsatility (PI) indices and peak systolic velocity (PSV) and three-dimensional (3D) power Doppler ultrasound was used to obtain vascularization (VI), flow (FI) and vascularization flow (VFI) indices of the uterine tissue, which were calculated by VOCAL (Virtual Organ Computer-aided AnaLysis) software. RESULTS: Characteristics of the myomas, operative time and duration of hospital stay were comparable between the two groups, whereas the median (range) of estimated blood loss (50 (50-200) vs. 100 (50-900) mL, P = 0.001) and the frequency of excessive bleeding of > 500 mL (0% vs. 10%, P = 0.018) were significantly lower in the study group. The RI, PI and PSV were comparable between the two groups preoperatively, significantly lower in the study group 1 week after surgery (0.69 vs. 0.74, 1.31 vs. 1.76, and 34.08 vs. 47.49, respectively, P < 0.05), and comparable again 3 months later. The myometrial VI and VFI decreased after surgery and all three 3D power Doppler indices of the study group were similar to those of the control group throughout the study period. CONCLUSION: Concurrent UAL during laparoscopic myom- ectomy reduces the intraoperative blood loss and frequency of excessive bleeding without permanently compromising uterine perfusion.

Chang WC; Huang SC; Sheu BC; Shih JC; Hsu WC; Chen SY; Chang DY

2009-02-01

264

Diagnosis of abnormal uterine bleeding with biopsy or hysteroscopy.  

UK PubMed Central (United Kingdom)

Abnormal uterine bleeding in women is a common cause for gynecologic consultation. Physicians must maintain a low threshold for endometrial assessment in abnormal uterine bleeding. Accurately determining the etiology of the bleeding permits appropriate treatment, minimizes unnecessary delays in therapy, and prevents needless worry in women. There are few national consensus guidelines, best practice guidelines, or treatment algorithms that provide gynecologists with scrupulous data to make concise decisions for the utilization of technology such as endometrial biopsy, transvaginal ultrasound, saline infusion sonography, or hysteroscopy in the evaluation of menstrual aberrations. Using technology that has a high sensitivity to detect a disease allows a physician to make concise decisions for proceeding with minimally invasive procedures or reliance on medical therapies that will probably be effective.

Bradley LD

2011-04-01

265

Preoperative embolization or ligature of the uterine arteries in preparation for conservative uterine fibroma surgery.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To compare the efficacy, feasibility and morbidity of two preparation techniques for conservative uterine myoma surgery: temporary embolization and temporary surgical ligature of the uterine arteries. DESIGN: Retrospective study. SETTING: Gynecological Surgery and Interventional Radiology departments, Centre Hospitalier Universitaire of Dijon, France. POPULATION: A total of 100 women undergoing myomectomy between 2000 and 2008. METHODS: Three groups were constituted: (1) no preparation (43 patients), (2) uterine artery embolization (UAE) (30 patients) and (3) temporary surgical ligature of the uterine arteries (SLUA) (27 patients). The choice of technique depended on the number, size and topography of the fibromas. MAIN OUTCOMES MEASURES: Quantification of peroperative blood loss, delta hemoglobin, complications, subsequent fertility. RESULTS: Blood loss and delta hemoglobin were both lower in group 2 (p = 0.026 and p = 0.0002) and in group 3 (p = 0.048 and p = 0.001), respectively, than in group 1. The two preparation techniques were efficient. SLUA increased the duration of the operation (p < 0.0001). Hospitalization was longer following UAE (p = 0.0001). The rate of complications was 16.3, 23.3 and 3.7%, and of synechiae 9.3, 13.3 and 0% for groups 1, 2 and 3, respectively. The number of pregnancies was 8, 5 and 6 after a mean postoperative period of 5.6, 4.3 and 3.9 years, respectively. CONCLUSION: Both UAE and SLUA for myomectomy are feasible, reproducible and effective techniques for reducing peroperative blood loss. Use of these techniques must be generalized in patients with a high risk of hemorrhage, but may be compatible with subsequent fertility.

Tixier H; Grevoul J; Loffroy R; Lauferon J; Guiu B; Mutamba W; Filipuzzi L; Cercueil JP; Douvier S; Krause D; Sagot P

2010-10-01

266

Ultrasound-guided Reoperative Hysteroscopy: Managing Endometrial Ablation Failures.  

UK PubMed Central (United Kingdom)

Endometrial ablation and hysteroscopic myomectomy and polypectomy are having an increasing impact on the care of women with abnormal uterine bleeding (AUB). The complications of these procedures include the late onset of recurrent vaginal bleeding, cyclic lower abdominal pain, hematometra and the inability to adequately sample the endometrium in women with postmenopausal bleeding. According to the 2007 ACOG Practice Bulletin, approximately 24% of women treated with endometrial ablation will undergo hysterectomy within 4 years.[1] By employing careful cervical dilation, a wide variety of gynecologic resectoscopes, and continuous sonographic guidance it is possible to explore the entire uterine cavity in order to locate areas of sequestered endometrium, adenomyosis, and occult hematometra. Sonographically guided reoperative hysteroscopy offers a minimally invasive technique to avoid hysterectomy in over 60% to 88% of women who experience endometrial ablation failures.[2,3] The procedure is adaptable to an office-based setting and offers a very low incidence of operative complications and morbidity. In addition, the technique provides a histologic specimen, which is essential in adequately evaluating the endometrium in postmenopausal women or women at high risk for the development of adenocarcinoma of the endometrium.

Wortman M

2012-12-01

267

Ultrasound-guided Reoperative Hysteroscopy: Managing Endometrial Ablation Failures.  

Science.gov (United States)

Endometrial ablation and hysteroscopic myomectomy and polypectomy are having an increasing impact on the care of women with abnormal uterine bleeding (AUB). The complications of these procedures include the late onset of recurrent vaginal bleeding, cyclic lower abdominal pain, hematometra and the inability to adequately sample the endometrium in women with postmenopausal bleeding. According to the 2007 ACOG Practice Bulletin, approximately 24% of women treated with endometrial ablation will undergo hysterectomy within 4 years.[1] By employing careful cervical dilation, a wide variety of gynecologic resectoscopes, and continuous sonographic guidance it is possible to explore the entire uterine cavity in order to locate areas of sequestered endometrium, adenomyosis, and occult hematometra. Sonographically guided reoperative hysteroscopy offers a minimally invasive technique to avoid hysterectomy in over 60% to 88% of women who experience endometrial ablation failures.[2,3] The procedure is adaptable to an office-based setting and offers a very low incidence of operative complications and morbidity. In addition, the technique provides a histologic specimen, which is essential in adequately evaluating the endometrium in postmenopausal women or women at high risk for the development of adenocarcinoma of the endometrium. PMID:23292675

Wortman, Morris

2012-12-01

268

Endometrial microcalcifications detected by ultrasonography: clinical associations, histopathology, and potential etiology.  

Science.gov (United States)

Endometrial microcalcifications are uncommon, with alleged clinical implications ranging from innocuous to ominous. We reviewed the histopathologic slides from 29 patients who had endometrial echogenic foci on pelvic ultrasound and found many endometrial microcalcifications. The extent of microcalcifications in each specimen was graded on a semiquantitative scale from 0 to 3. The mean patient age was 54 years (range, 34-81 years). The specimens included endometrial biopsies, curettages, and hysterectomies. Most of the patients had presented with abnormal vaginal bleeding. Fifteen patients (51.7%) were postmenopausal, 10 (34.5%) were premenopausal, and the rest were perimenopausal. The most frequent endometrial types were atrophic (39.5%), inactive (23.3%), and proliferative (14%). Six specimens (14%) showed benign endometrial polyps. One patient had well-differentiated endometrioid carcinoma of the endometrium without myometrial invasion. Specimens from 16 patients (55.2%) had microcalcifications. The patients with calcifications were older than those without calcifications (mean age, 60 vs. 47 years, respectively; P = 0.017). The extent of microcalcifications positively correlated with the presence of endometrial polyps (P = 0.00076), postmenopausal state (P = 0.004), atrophic endometrium (P = 0.002), and hormone replacement therapy (P = 0.013). The microcalcifications were concentric or amorphous, intraglandular or stromal. They were focally associated with minute papillary epithelial projections or with degenerated endometrial glands. Follow-up was available on 26 patients (89.7%). Except for the patient with endometrioid carcinoma, none has developed uterine, adnexal, or peritoneal malignancy. In summary, endometrial microcalcifications are histologically heterogeneous and are associated with older patient age, postmenopausal state, atrophic endometrium, and endometrial polyps. Those found incidentally by means of pelvic ultrasonography, in our experience, did not portend malignancy. PMID:18156977

Truskinovsky, Alexander M; Gerscovich, Eugenio O; Duffield, Curtis R; Vogt, Philip J

2008-01-01

269

Fibroids (uterine myomatosis, leiomyomas).  

UK PubMed Central (United Kingdom)

INTRODUCTION: Between 5% and 77% of women may have fibroids, depending on the method of diagnosis used. Fibroids may be asymptomatic, or may present with menorrhagia, pain, infertility, or recurrent pregnancy loss. Risk factors for fibroids include obesity, having no children, and no long-term use of the oral contraceptive pill. Fibroids tend to shrink or fibrose after the menopause. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of: medical treatment alone; preoperative medical treatments for women scheduled for surgery; and surgical treatments in women with fibroids? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). RESULTS: We found 54 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. CONCLUSIONS: In this systematic review we present information relating to the effectiveness and safety of the following interventions: gonadorelin analogues (with progestogen, raloxifene, tibolone, or combined oestrogen-progestogen), hysterectomy (plus oophorectomy), hysteroscopic resonance-focused ultrasound, laparoscopic myomectomy, laparoscopically assisted vaginal hysterectomy, rollerball endometrial ablation, thermal balloon ablation, thermal myolysis with laser, total abdominal hysterectomy, total abdominal myomectomy, total laparoscopic hysterectomy, total vaginal hysterectomy, and uterine artery embolisation.

Lethaby A; Vollenhoven B

2011-01-01

270

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

UK PubMed Central (United Kingdom)

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.

Gajewska M; Panek G

2013-03-01

271

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

Science.gov (United States)

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

272

Diagnosis and Treatment of Uterine Septum  

UK PubMed Central (United Kingdom)

We assessed the efficacy of different methods of diagnosing and correcting uterine septa in 80 women. Hysterosalpingography revealed a uterine malformation, but failed to specify its character, and ultrasound scan was performed to screen the malformations. In 74 women hysteroscopy combined with laparoscopy was performed to define the malformation, and estimate the volume of uterine cavity and extent of septum. Preoperatively the patients received danazol or decapeptyl depot; a few cases were performed in the early follicular phase. Forty-six uterine septa were managed by laparoscopic-controlled resectoscopy. The distending medium was polyglukin or 2.7% sorbitol and 0.54% mannitol. Operating time ranged from 10 to 60 minutes (average 30 min). There was no significant blood loss. Postoperative hospital stay was 1 to 3 days. Twenty-five patients underwent hysteroscopy with curettage 2 to 4 months later, and filmy synechiae were found in four (16%). Histology and electron microscopic examination of endometrial tissue revealed its complete restoration. Of 29 women followed for 3 to 17 months, 12 (41.4%) conceived and 9 had a full-term infant. In this series, resectoscopy was atraumatic, operating time was short, blood loss was insignificant, and hospital stay was brief.

Adamian LV; Kulakov VI VI; Kiselev SI; Zurabiana ZR; Khashukoeva AZ; Sorour EA

1996-08-01

273

Diagnosis and Treatment of Uterine Septum  

Science.gov (United States)

We assessed the efficacy of different methods of diagnosing and correcting uterine septa in 80 women. Hysterosalpingography revealed a uterine malformation, but failed to specify its character, and ultrasound scan was performed to screen the malformations. In 74 women hysteroscopy combined with laparoscopy was performed to define the malformation, and estimate the volume of uterine cavity and extent of septum. Preoperatively the patients received danazol or decapeptyl depot; a few cases were performed in the early follicular phase. Forty-six uterine septa were managed by laparoscopic-controlled resectoscopy. The distending medium was polyglukin or 2.7% sorbitol and 0.54% mannitol. Operating time ranged from 10 to 60 minutes (average 30 min). There was no significant blood loss. Postoperative hospital stay was 1 to 3 days. Twenty-five patients underwent hysteroscopy with curettage 2 to 4 months later, and filmy synechiae were found in four (16%). Histology and electron microscopic examination of endometrial tissue revealed its complete restoration. Of 29 women followed for 3 to 17 months, 12 (41.4%) conceived and 9 had a full-term infant. In this series, resectoscopy was atraumatic, operating time was short, blood loss was insignificant, and hospital stay was brief. PMID:9074072

Adamian; Kulakov; Kiselev; Zurabiana; Khashukoeva; Sorour

1996-08-01

274

Endometrial stem cells and reproduction.  

UK PubMed Central (United Kingdom)

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 and likely requires a population of stem cells in the endometrium. The purpose of this review is to provide an introduction to some of the newest concepts in endometrial stem cell biology.

Morelli SS; Yi P; Goldsmith LT

2012-01-01

275

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

UK PubMed Central (United Kingdom)

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.

Isphording A; Ali RH; Irving J; Goytain A; Nelnyk N; Hoang LN; Gilks CB; Huntsman DG; Nielsen TO; Nucci MR; Lee CH

2013-05-01

276

Saline infusion sonohysterography versus hysteroscopy for uterine cavity evaluation  

Directory of Open Access Journals (Sweden)

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; Jamaat Sadia; Al-Jaroudi Dania

2011-01-01

277

Second generation endometrial ablation techniques: an audit of clinical practice.  

UK PubMed Central (United Kingdom)

OBJECTIVE(S): To audit the practice and effectiveness of second generation endometrial ablation techniques (microwave and thermal balloon ablation). DESIGN AND METHODS: An audit of microwave and balloon endometrial ablation procedures was completed and performed during a 2-year period, in two district hospitals of Calderdale and Huddersfield NHS Trust, UK. Patients were followed up with for a maximum of 1 year postoperatively, or were referred again from their GPs, with symptoms. A questionnaire was also completed to evaluate patient satisfaction. RESULTS: About 136 and 59 women underwent balloon and microwave endometrial ablation, respectively (Total = 195), for heavy periods. By the end of year 1, 16% of patients were amenorrhoeic and 60% had lighter periods. About 15% of women did not have any relief of symptoms and needed a hysterectomy by 3 years. There were no statistically significant differences in the endometrial ablation techniques. There was no significant effect of age, body mass index, utero-cervical length, or the ablation technique on the results or the hysterectomy rates. A satisfaction survey showed that 75% of women felt better after the procedure and would recommend it to a close friend. CONCLUSIONS: Second generation ablation techniques are safe and effective methods of treating dysfunctional uterine bleeding, and are easy to use. They have reduced the incidence of hysterectomies and also have financial implications for healthcare providers.

Madhu CK; Nattey J; Naeem T

2009-10-01

278

Metaplasia óssea e esterilidade primária Endometrial osseous metaplasia and primary infertility  

Directory of Open Access Journals (Sweden)

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; Marcelo K. Murata; Marcelo G. Cequinel; César A. Cornel; Jorjan Cruz; Jean F. Francisco; Augusto F. Beduschi

2001-01-01

279

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

Scientific Electronic Library Online (English)

Full Text Available 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 endometrial em uma mulher de 31 anos, sem gravidez prévia ou história de aborto, apresentando dismenorréia e infertilidade. A ultra-sonografia pélvica most (more) rou 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 hyperec (more) hoic 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.

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

2001-03-01

280

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

Directory of Open Access Journals (Sweden)

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

Annamaria Maglione; Sergio Montanaro; Francesco Petruzzelli

2013-01-01

 
 
 
 
281

BIOPSIA ENDOMETRIAL AMBULATORIA: EXPERIENCIA PRELIMINAR  

Scientific Electronic Library Online (English)

Full Text Available 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 endometrial difusa. Resultados: Se logró realizar el procedimiento a 131 pacientes (91%), obteniéndose diagnóstico histológico satisfactorio en 110 casos (76,4%). De las 11 (more) 0 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%), 110 were appropriate for histological diagnosis (76.4%). We met 3 women with endometrial carcinoma (2.7%) and 1 with hyperplastic atypia. Conclusion: Endometrial ambulatory biop (more) sy is a sensitive, specific, efficient, safe and cheap procedure. This method improves the early diagnosis of endometrial carcinoma

Domínguez C, Claudio; Zamora F, Jessica; Barrera P, Sandra; Tacla F, Ximena

2006-01-01

282

Endometrium evaluation with high-field (3-Tesla) magnetic resonance imaging in patients submitted to uterine leiomyoma embolization.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate the endometrial alterations related to embolization of uterine arteries for the treatment of symptomatic uterine leiomyomatosis (pelvic pain and/or uterine bleeding) by means of high-field (3-Tesla) magnetic resonance. METHODS: This is a longitudinal and prospective study that included 94 patients with a clinical and imaging diagnosis of symptomatic uterine leiomyomatosis, all of them treated by embolization of the uterine arteries. The patients were submitted to evaluations by high-field magnetic resonance of the pelvis before and 6 months after the procedure. Specific evaluations were made of the endometrium on the T2-weighted sequences, and on the T1-weighted sequences before and after the intravenous dynamic infusion of the paramagnetic contrast. In face of these measures, statistical analyses were performed using Student's t test for comparison of the results obtained before and after the procedure. RESULTS: An average increase of 20.9% was noted in the endometrial signal on T2-weighted images obtained after the uterine artery embolization procedure when compared to the pre-procedure evaluation (p=0.0004). In the images obtained with the intravenous infusion of paramagnetic contrast, an average increase of 18.7% was noted in the post-embolization intensity of the endometrial signal, compared to the pre-embolization measure (p<0.035). CONCLUSION: After embolization of the uterine arteries, there was a significant increase of the endometrial signal on the T2-weighted images and on the post-contrast images, inferring possible edema and increased endometrial flow. Future studies are needed to assess the clinical impact of these findings.

Jacobs MA; Nasser F; Zlotnik E; Messina MD; Baroni RH

2013-03-01

283

Uterine artery embolization - discharge  

Science.gov (United States)

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

284

Alterations in Wnt-?-catenin and Pten signalling play distinct roles in endometrial cancer initiation and progression.  

UK PubMed Central (United Kingdom)

Endometrioid endometrial cancer arises through a gradual series of histological changes, each accompanied by specific alterations in gene expression and activity. Activation of the Wnt-?-catenin pathway and loss of PTEN activity are frequently observed in endometrial cancers. However, the specific roles played by alterations in these pathways in the initiation and progression of endometrial cancer are currently unclear. Here, we investigated the effects of loss of Pten and Apc gene function in the mouse endometrium by employing tissue-specific and inducible mutant alleles, followed by immunohistochemical (IHC) and loss of heterozygosity (LOH) analysis of their corresponding cancerous lesions. Loss of the Apc function in the endometrium leads to cytoplasmic and nuclear ?-catenin accumulation in association with uterine hyperplasia and squamous cell metaplasia, but without malignant transformation. Loss of Pten function also resulted in squamous metaplasia but, in contrast to loss of Apc function, it initiates endometrial cancer. On the other hand, loss of Apc function in the endometrium accelerates Pten-driven endometrial tumourigenesis. Analysis of compound heterozygous mice confirmed that somatic loss of the wild-type Pten allele represents the rate-limiting initiation step in endometrial cancer. Simultaneous loss of Pten and Apc resulted in endometrial cancer characterized by earlier onset and a more aggressive malignant behaviour. These observations are indicative of the synergistic action between the Wnt-?-catenin and Pten signalling pathways in endometrial cancer onset and progression.

van der Zee M; Jia Y; Wang Y; Heijmans-Antonissen C; Ewing PC; Franken P; DeMayo FJ; Lydon JP; Burger CW; Fodde R; Blok LJ

2013-05-01

285

Alterations in Wnt-?-catenin and Pten signalling play distinct roles in endometrial cancer initiation and progression.  

Science.gov (United States)

Endometrioid endometrial cancer arises through a gradual series of histological changes, each accompanied by specific alterations in gene expression and activity. Activation of the Wnt-?-catenin pathway and loss of PTEN activity are frequently observed in endometrial cancers. However, the specific roles played by alterations in these pathways in the initiation and progression of endometrial cancer are currently unclear. Here, we investigated the effects of loss of Pten and Apc gene function in the mouse endometrium by employing tissue-specific and inducible mutant alleles, followed by immunohistochemical (IHC) and loss of heterozygosity (LOH) analysis of their corresponding cancerous lesions. Loss of the Apc function in the endometrium leads to cytoplasmic and nuclear ?-catenin accumulation in association with uterine hyperplasia and squamous cell metaplasia, but without malignant transformation. Loss of Pten function also resulted in squamous metaplasia but, in contrast to loss of Apc function, it initiates endometrial cancer. On the other hand, loss of Apc function in the endometrium accelerates Pten-driven endometrial tumourigenesis. Analysis of compound heterozygous mice confirmed that somatic loss of the wild-type Pten allele represents the rate-limiting initiation step in endometrial cancer. Simultaneous loss of Pten and Apc resulted in endometrial cancer characterized by earlier onset and a more aggressive malignant behaviour. These observations are indicative of the synergistic action between the Wnt-?-catenin and Pten signalling pathways in endometrial cancer onset and progression. PMID:23288720

van der Zee, Marten; Jia, Yundan; Wang, Yongyi; Heijmans-Antonissen, Claudia; Ewing, Patricia C; Franken, Patrick; DeMayo, Francesco J; Lydon, John P; Burger, Curt W; Fodde, Riccardo; Blok, Leen J

2013-03-14

286

Optimized culture conditions for tissue explants of uterine leiomyoma.  

UK PubMed Central (United Kingdom)

BACKGROUND: Uterine leiomyomas are the most common benign tumours in women, which arise from smooth muscle cells of the uterine myometrium and usually are multicentric. In spite of their frequency pathogenesis is widely unknown, mainly due to the absence of a suitable model system. We describe the systematic optimization of culturing leiomyoma tissue explants in an economical and effective ex vivo system. METHODS: Different concentrations of oxygen, different media, sera, hormones, and growth factor supplements were tested. Immunohistochemical stainings with antibodies against hormone receptors as well as specifying proliferation and apoptotic indices and real-time PCR were performed. RESULTS: Main parameters for culturing myoma tissue explants were tested for finding an optimal protocol. Standard medium D-MEM-F12 in combination with the use of horse serum in a reduced concentration of 1% turned out to be optimal for these tissue cultures as well as the addition of estradiol and epidermal growth factor EGF to media. Reduced oxygen content in the incubator air showed no positive effect. CONCLUSIONS: For culturing tissue explants of uterine leiomyoma several conditions were optimized. The established tissue culture model allows examining the effects of known and potential therapeutic substances and the influence of immune competent cells in the process of tumour formation to find new targets for medical treatment.

Fiebitz A; Fritsch M; Reichelt U; Ruester C; Chiantera V; Vercellino GF; Darwish A; Schneider A; Mechsner S

2012-01-01

287

Endometrial pathological changes after Fallopian ring tubal ligation.  

UK PubMed Central (United Kingdom)

Endometrial biopsy was used to study the luteal phase in patients with Fallopian ring (Yoon ring) tubal ligation. Luteal phase insufficiency was found in 9.3% of patients in the study group and in 3.4% of patients in the control group. THe differences are statistically not significant (p = 0.5). The patients with histological evidence of poor luteal phase after tubal ligation presented with oligomenorrhea and dysfunctional uterine bleeding. These results exclude the possibility of some interference with the utero-ovarian circulatory system caused by Fallopian rings.

de Cristofaro D; Zancanari C; Fiaccavento S; Pezzoli C

1982-07-01

288

Endometrial cancer, cervical cancer, and the adnexal mass.  

UK PubMed Central (United Kingdom)

Cancers of the endometrium, cervix, and ovaries account for nearly 25,000 annual deaths among women in the United States. In recent years, better understanding of the causes and risk factors associated with gynecologic malignancies has contributed to more effective screening and early diagnosis. Abnormal uterine bleeding, a palpable adnexal mass, or vague abdominal complaints in women older than 40 can be signs of cancer. Regular pelvic examination, combined with appropriate use of the Papanicolaou's smear, endometrial biopsy, transvaginal sonography, and other tests, is recommended.

Fontaine P

1998-06-01

289

Ceftiofur derivates in serum and endometrial tissue after intramuscular administration in healthy mares.  

Science.gov (United States)

Endometritis is one of the major problems in the horse breeding industry. The use of antibiotics for treatment of endometritis in the mare is recommended as best practice. The intrauterine application of antibiotics, however, has been under discussion over the last years because of concerns about its efficacy. The systemic use of antibiotics has been considered more effective because of its better distribution within the uterus. The objective of the present study was to determine the concentration of ceftiofur derivates in serum and endometrial tissue after intramuscular administration. Specifically, the authors tested the hypothesis that ceftiofur concentrations in serum and endometrial tissue remain above the minimum inhibitory concentration (MIC) for common uterine pathogens for 24 h. Nine mares in estrus received a single dose of 2.2 mg/kg ceftiofur hydrochloride intramuscular per kg of body weight. Blood samples and endometrial tissue were obtained immediately before treatment (-1 h) and 2 h and 24 h after treatment. Endometrial tissue was collected with a Kevorkian biopsy punch. Additional blood samples were collected 4 h and 10 h after treatment from the jugular veins. For determination of ceftiofur derivates in serum and endometrial tissue a high performance liquid chromatography (HPLC) assay was used. Results in serum and uterine tissue revealed greatest concentration of ceftiofur at 2 h and lowest concentrations at 24 h after treatment. Concentrations of ceftiofur at 2 and 24 h after treatment were significantly greater in serum than in endometrial tissue, but remained above the reported MIC for Streptococcus equi zooepidemicus and Escherichia coli in both serum and endometrial tissue until 24 h after treatment. PMID:20494421

Witte, T S; Bergwerff, A A; Scherpenisse, P; Drillich, M; Heuwieser, W

2010-05-21

290

Ceftiofur derivates in serum and endometrial tissue after intramuscular administration in healthy mares.  

UK PubMed Central (United Kingdom)

Endometritis is one of the major problems in the horse breeding industry. The use of antibiotics for treatment of endometritis in the mare is recommended as best practice. The intrauterine application of antibiotics, however, has been under discussion over the last years because of concerns about its efficacy. The systemic use of antibiotics has been considered more effective because of its better distribution within the uterus. The objective of the present study was to determine the concentration of ceftiofur derivates in serum and endometrial tissue after intramuscular administration. Specifically, the authors tested the hypothesis that ceftiofur concentrations in serum and endometrial tissue remain above the minimum inhibitory concentration (MIC) for common uterine pathogens for 24 h. Nine mares in estrus received a single dose of 2.2 mg/kg ceftiofur hydrochloride intramuscular per kg of body weight. Blood samples and endometrial tissue were obtained immediately before treatment (-1 h) and 2 h and 24 h after treatment. Endometrial tissue was collected with a Kevorkian biopsy punch. Additional blood samples were collected 4 h and 10 h after treatment from the jugular veins. For determination of ceftiofur derivates in serum and endometrial tissue a high performance liquid chromatography (HPLC) assay was used. Results in serum and uterine tissue revealed greatest concentration of ceftiofur at 2 h and lowest concentrations at 24 h after treatment. Concentrations of ceftiofur at 2 and 24 h after treatment were significantly greater in serum than in endometrial tissue, but remained above the reported MIC for Streptococcus equi zooepidemicus and Escherichia coli in both serum and endometrial tissue until 24 h after treatment.

Witte TS; Bergwerff AA; Scherpenisse P; Drillich M; Heuwieser W

2010-08-01

291

Uterine rudiments in patients with Mayer-Rokitansky-Kuster-Hauser syndrome consist of typical uterine tissue types with predominantly basalis-like endometrium.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To analyze the histologic and immunohistochemical structure of uterine rudiments focusing on the endometrium in a representative group of patients with Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome compared with a control group. DESIGN: Prospective comparative study. SETTING: University hospital. PATIENT(S): Forty-two patients with MRKH syndrome and 13 control subjects. INTERVENTION(S): Representative biopsies or whole uterine rudiments were removed during surgery and processed by a standardized procedure including immunohistochemical staining and analysis. MAIN OUTCOME MEASURE(S): Histologic structure, tissue types, hormone receptor expression, endometrial proliferative capacity, and type in correlation with cycle phase. RESULT(S): Twenty-two of the uterine rudiments showed a duct-like structure or small cavity, 17 of which contained endometrial epithelium and CD10-positive stroma. All rudiments contained an intact myometrial layer. Tubal epithelium and stroma were found in three rudiment samples. No significant differences were observed with regard to estrogen receptor (ER) or progesterone receptor (PR) expression in endometrium or myometrium. Interestingly, patients showed predominantly basalis-like endometrium with specific lack of CD90 expression and significantly lower proliferation compared with controls. CONCLUSION(S): All typical uterine tissues can be found in uterine rudiments of patients with MRKH syndrome. Expression of hormonal receptors in the latter and controls did not differ significantly. Endometrium shows predominantly basalis-like features in uterine rudiments.

Rall K; Barresi G; Wallwiener D; Brucker SY; Staebler A

2013-04-01

292

Progesterone and estrogen control of the response of rat uterine lysosomal cathepsin D activity to a deciduogenic stimulus.  

Science.gov (United States)

Endometrial sensitization to deciduogenic stimuli and destruction of luminal epithelial cells during the uterine decidual reaction may depend upon the control of endometrial lysosome function by progesterone and estradiol. These experiments examined progesterone and estrogen control of the levels of uterine cathepsin D and the response of cathepsin D activity to a deciduogenic stimulus. The progestin medroxyprogesterone acetate increased rates of uterine cathepsin D synthesis, but these rates were not enhanced by estradiol pretreatment. The response of cathepsin D activity to a deciduogenic stimulus, however, required progestin pretreatment, followed by estrogen treatment. Decreases in cathepsin D activity after a deciduogenic stimulus required estrogen stimulation for approximately 12 h, and this estrogen effect could be suppressed by treatment with dexamethasone or inhibitors of prostanoid synthesis. These results indicate that destruction of luminal epithelial cells during the uterine decidual reaction involves the coordinated control of the cathepsin D content by progesterone and of intracellular lysosome activity by estradiol. PMID:6460609

Moulton, B C

1982-04-01

293

Progesterone and estrogen control of the response of rat uterine lysosomal cathepsin D activity to a deciduogenic stimulus.  

UK PubMed Central (United Kingdom)

Endometrial sensitization to deciduogenic stimuli and destruction of luminal epithelial cells during the uterine decidual reaction may depend upon the control of endometrial lysosome function by progesterone and estradiol. These experiments examined progesterone and estrogen control of the levels of uterine cathepsin D and the response of cathepsin D activity to a deciduogenic stimulus. The progestin medroxyprogesterone acetate increased rates of uterine cathepsin D synthesis, but these rates were not enhanced by estradiol pretreatment. The response of cathepsin D activity to a deciduogenic stimulus, however, required progestin pretreatment, followed by estrogen treatment. Decreases in cathepsin D activity after a deciduogenic stimulus required estrogen stimulation for approximately 12 h, and this estrogen effect could be suppressed by treatment with dexamethasone or inhibitors of prostanoid synthesis. These results indicate that destruction of luminal epithelial cells during the uterine decidual reaction involves the coordinated control of the cathepsin D content by progesterone and of intracellular lysosome activity by estradiol.

Moulton BC

1982-04-01

294

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 greater risk of intrauterine necrosis. Both methods have low rate of serious complications (except for a high abortion rate).

2012-01-01

295

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

Energy Technology Data Exchange (ETDEWEB)

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

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

2012-10-15

296

Accuracy of Doppler ultrasound in diagnosis of endometrial carcinoma.  

UK PubMed Central (United Kingdom)

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

Batool S; Manzur S; Raza S

2013-01-01

297

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

Science.gov (United States)

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

2013-04-24

298

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

UK PubMed Central (United Kingdom)

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 (P<0.0001) at each time point over the 24h of culture as compared to controls. Oxytocin failed (P<0.001) to elicit PGF2? release in explants cultured with either Atosiban 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.

Penrod LV; Allen RE; Rhoads ML; Limesand SW; Arns MJ

2013-06-01

299

N-acetyl-beta-D-glucosaminidase activity in bovine uterine fluid and blood serum during the postpartum period.  

UK PubMed Central (United Kingdom)

Uterine fluid and serum N-acetyl-beta-D-glucosaminidase (NAGase) was determined in cows during the first 32 d post partum following normal and abnormal parturitions. Both uterine fluid and serum NAGase activities were elevated after calving and then started to decline gradually toward the 32nd day after calving, when they reached their lowest concentrations. No significant differences were found between the mean NAGase concentrations in uterine fluid of the two groups, although significant differences were found between the mean values of the combined groups between days. With serum NAGase concentrations, significant differences (P<0.01) were found between the mean values of the normal and abnormal puerperium groups. The major part of the enzyme detected in postpartum uterine fluid is probably contributed by epithelial cells present in the fluid. Uterine leucocytes and endometrial cell damage caused by bacterial infection may also contribute to the total NAGase activity in uterine fluid.

Hussain AM; Daniel RC; O'boyle D

1989-09-01

300

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

UK PubMed Central (United Kingdom)

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 G; Dueholm M; Mathiesen O; Hansen ES; Lundorf E; Møller C; Marinovskij E; Petersen LK

2013-05-01

 
 
 
 
301

Inhibin/activin-betaC subunit does not represent a prognostic parameter in human endometrial cancer.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Inhibins, dimeric peptide hormones composed of an ? subunit and one of two possible ? subunits (betaA or betaB), exhibit substantial roles in human reproduction and in endocrine-responsive tumors. Recently, two novel inhibin-beta subunits, defined as betaC and betaE, have been identified in humans. However, the prognostic significance and clinical implications of the novel inhibin-betaC subunit in endometrial cancers is still quite unclear. MATERIALS AND METHODS: A series of 296 uterine endometrial carcinomas were immunohistochemically analyzed with specific antibody against the inhibin-betaC subunit. The staining reactions were correlated with several clinicopathological characteristics and the clinical outcome. RESULTS: Endometrial cancer tissue demonstrated an immunolabelling against the inhibin-betaC subunit. The inhibin-betaC expression in endometrial carcinoma samples revealed a significant association with hemangiosis. However, the expression of this inhibin subunit did not affect patients' progression-free, cause-specific and overall survival. CONCLUSION: Overall, inhibin-betaC subunit was demonstrated in endometrial cancer tissue. This novel betaC subunit demonstrated a significant association with hemangiosis although without any impact on the patients' survival. Moreover, the inhibin-betaC subunits did not constitute an independent prognostic parameter in endometrial cancer patients. Therefore, the isolated analysis of this subunit might be of minor prognostic value in identifying high-risk patients.

Käufl SD; Kuhn C; Kunze S; Shabani N; Brüning A; Friese K; Mylonas I

2011-07-01

302

Endometrial intraepithelial carcinoma in association with polyp: review of eight cases.  

UK PubMed Central (United Kingdom)

BACKGROUND: The uterine endometrial polyp (EMP) has a potential risk of developing malignant tumors especially in postmenopausal women. These malignancies include endometrial intraepithelial carcinoma (EIC). PATIENTS AND METHODS: Eight patients with EIC in the EMP, who were postmenopausal with ages ranging from 49 to 76 years (av. 62), were cytologically reviewed in comparison with histological findings. RESULTS: The endometrial cytological findings were summarized as follows: mucous and watery diathesis as a background lacking or with little necrotic inflammatory changes; micropapillary cluster formation; abrupt transition between carcinoma cells and normal cells; nuclear enlargement; high N/C ratio; and single or a few prominent nucleoli. Histologically, one case had EIC alone in the EMP; three cases had EIC with stromal invasion confined to the EMP; and four cases had EIC in the atrophic endometrium in addition to EIC in the EMP. Seven patients have taken a disease-free course after surgical resection, but one patient died 44 months following the initial diagnosis because of the massive tumor extending over her peritoneal cavity. CONCLUSIONS: Endometrial cytology may be helpful for the detection of early endometrial adenocarcinomas with serous features including EIC. Some early stage endometrial adenocarcinomas represented by EIC exceptionally take an aggressive clinical course irrespective of a lack of extrauterine lesions. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1651876760876449.

Yasuda M; Katoh T; Hori S; Suzuki K; Ohno K; Maruyama M; Matsui N; Miyazaki S; Ogane N; Kameda Y

2013-01-01

303

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; Nair Rajasekharan; Singh Swetha

2010-01-01

304

Tuberculosis endometrial polyp.  

UK PubMed Central (United Kingdom)

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.

Seror J; Faivre E; Prevot S; Deffieux X

2013-01-01

305

Advanced uterine manipulation technologies.  

UK PubMed Central (United Kingdom)

As the number of conventional laparoscopic and robot-assisted gynecologic surgeries continues to rise, efficient and safe uterine manipulation has become increasingly important. Currently described uterine manipulation techniques require constant manual manipulation by the surgeon or surgical assistant. This often necessitates extra operating room personnel, increases fatigue levels, and decreases efficiency. There are two new uterine manipulation devices that can improve these measures: the Uterine Positioning System® (UPS) (Cooper Surgical, Trumbull, CT) and the ViKY UP® "Vision Control for endoscopY" Uterine Positioner (EndoControl Medical, La Tronche, France). Both provide accurate and secure uterine positioning. The UPS can manipulate the uterus with minimal bedside involvement from the surgical team while the ViKY UP provides uterine manipulation through a robotic arm controlled by the surgeon remotely. These two devices can facilitate a multitude of conventional laparoscopic and robot-assisted gynecologic surgeries.

Swan K; Kim J; Advincula AP

2010-10-01

306

Advanced uterine manipulation technologies.  

Science.gov (United States)

As the number of conventional laparoscopic and robot-assisted gynecologic surgeries continues to rise, efficient and safe uterine manipulation has become increasingly important. Currently described uterine manipulation techniques require constant manual manipulation by the surgeon or surgical assistant. This often necessitates extra operating room personnel, increases fatigue levels, and decreases efficiency. There are two new uterine manipulation devices that can improve these measures: the Uterine Positioning System® (UPS) (Cooper Surgical, Trumbull, CT) and the ViKY UP® "Vision Control for endoscopY" Uterine Positioner (EndoControl Medical, La Tronche, France). Both provide accurate and secure uterine positioning. The UPS can manipulate the uterus with minimal bedside involvement from the surgical team while the ViKY UP provides uterine manipulation through a robotic arm controlled by the surgeon remotely. These two devices can facilitate a multitude of conventional laparoscopic and robot-assisted gynecologic surgeries. PMID:21082569

Swan, Kimberly; Kim, John; Advincula, Arnold P

2010-10-01

307

Uterine angiomyolipoma with metastasis in a woman with tuberous sclerosis: a case report.  

Science.gov (United States)

Extrarenal angiomyolipomas (AMLs) have been reported at various anatomical sites such as the liver, spleen, abdominal wall, retroperitoneum, oral cavity, penis, spermatic cord, skin, and lung but are infrequently described in gynecological regions. However, only a few cases of extrarenal AML in the uterus have been reported. The authors describe a case of uterine AML in a 41-year-old woman with evidence of tuberous sclerosis. Initial diagnosis concluded with myoma based on the interpretation of imaging and other pathological parameters. However, after successful laparoscopic surgical staging, AML was diagnosed. To date, the feasibility of laparoscopic surgical diagnosis and the risks associated with this technique have not been reported. The authors briefly review the implementation of laparoscopic surgical staging to diagnose uterine AML. PMID:24020143

Lee, S J; Yoo, J Y; Yoo, S H; Seo, Y H; Yoon, J H

2013-01-01

308

Uterine angiomyolipoma with metastasis in a woman with tuberous sclerosis: a case report.  

UK PubMed Central (United Kingdom)

Extrarenal angiomyolipomas (AMLs) have been reported at various anatomical sites such as the liver, spleen, abdominal wall, retroperitoneum, oral cavity, penis, spermatic cord, skin, and lung but are infrequently described in gynecological regions. However, only a few cases of extrarenal AML in the uterus have been reported. The authors describe a case of uterine AML in a 41-year-old woman with evidence of tuberous sclerosis. Initial diagnosis concluded with myoma based on the interpretation of imaging and other pathological parameters. However, after successful laparoscopic surgical staging, AML was diagnosed. To date, the feasibility of laparoscopic surgical diagnosis and the risks associated with this technique have not been reported. The authors briefly review the implementation of laparoscopic surgical staging to diagnose uterine AML.

Lee SJ; Yoo JY; Yoo SH; Seo YH; Yoon JH

2013-01-01

309

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 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.

1989-11-00

310

Treatment of endometrial cancer. Radiotherapy and endometrial cancer  

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The current status of radiotherapy of endometrial cancer was discussed based on the literature, and the radiotherapeutic technique performed at the authors' institution and its results were presented. The treatment of endometrial cancer is predicted to become increasingly important, since this cancer tends to gradually increase in number, particularly among the aged.

Noguchi, H. (Shinshu Univ., Matsumoto, Nagano (Japan). Faculty of Medicine)

1981-10-01

311

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

UK PubMed Central (United Kingdom)

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

Malvasi A; Cavallotti C; Nicolardi G; Pellegrino M; Vergara D; Greco M; Kosmas I; Mynbaev OA; Kumakiri J; Tinelli A

2013-11-01

312

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

UK PubMed Central (United Kingdom)

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

Malvasi A; Cavallotti C; Nicolardi G; Pellegrino M; Vergara D; Greco M; Kosmas I; Mynbaev OA; Kumakiri J; Tinelli A

2013-08-01

313

Efficacy of the levonorgestrel intrauterine system (LNG-IUS) in the prevention of the atypical endometrial hyperplasia and endometrial cancer: retrospective data from selected obese menopausal symptomatic women.  

UK PubMed Central (United Kingdom)

The aim of this retrospective study was to evaluate the efficacy of levonorgestrel intrauterine system-releasing (LNG-IUS) insertion in preventing atypical endometrial hyperplasia (AH) and endometrial cancer (EC) in symptomatic postmenopausal overweight/obese women. A total of 34 overweight/obese postmenopausal women, presenting abnormal uterine bleeding (AUB) and endometrial hyperplasia (EH), and who were submitted to LNG-IUS insertion, were identified from registry data. Endometrial histology at LNG-IUS insertion showed simple EH in 20 cases (58.8%), complex EH in 14 cases (41.2%). At 36 months, 91% of patients showed no recurrence of AUB and a significant reduction in the mean endometrial thickness (from 8.2?±?2.2 to 3.2?±?1.5?mm, p < 0.05) was observed. Histologic regression of EH was observed in 27 (79.4%) and 33 (97.5%) cases at 12 and 36 months, respectively. None of the women in which EH persisted, reported cellular atypia or cancer progression at 12 and 36 months of follow-up. LNG-IUS represents an effective treatment option to manage postmenopausal obese women affected by AUB and EH. The device seems to be able to prevent the onset of AH and EC in women at high risk. Further prospective controlled studies in a well selected group of women are needed.

Morelli M; Di Cello A; Venturella R; Mocciaro R; D'Alessandro P; Zullo F

2013-02-01

314

Efficacy of the levonorgestrel intrauterine system (LNG-IUS) in the prevention of the atypical endometrial hyperplasia and endometrial cancer: retrospective data from selected obese menopausal symptomatic women.  

Science.gov (United States)

The aim of this retrospective study was to evaluate the efficacy of levonorgestrel intrauterine system-releasing (LNG-IUS) insertion in preventing atypical endometrial hyperplasia (AH) and endometrial cancer (EC) in symptomatic postmenopausal overweight/obese women. A total of 34 overweight/obese postmenopausal women, presenting abnormal uterine bleeding (AUB) and endometrial hyperplasia (EH), and who were submitted to LNG-IUS insertion, were identified from registry data. Endometrial histology at LNG-IUS insertion showed simple EH in 20 cases (58.8%), complex EH in 14 cases (41.2%). At 36 months, 91% of patients showed no recurrence of AUB and a significant reduction in the mean endometrial thickness (from 8.2?±?2.2 to 3.2?±?1.5?mm, p LNG-IUS represents an effective treatment option to manage postmenopausal obese women affected by AUB and EH. The device seems to be able to prevent the onset of AH and EC in women at high risk. Further prospective controlled studies in a well selected group of women are needed. PMID:23134558

Morelli, Michele; Di Cello, Annalisa; Venturella, Roberta; Mocciaro, Rita; D'Alessandro, Pietro; Zullo, Fulvio

2012-11-07

315

Awareness of general and personal risk factors for uterine cancer among healthy women.  

Science.gov (United States)

Participation rates in gynaecological cancer screening are influenced by different factors. The knowledge of general and personal risk factors for uterine cancer among women might influence their interest in gynaecological cancer screening. Two thousand nine hundred women in 23 gynaecological outpatient services were invited to answer a structured questionnaire regarding general and personal risk factors for cervical and endometrial carcinoma; 2108 women participated. Women with a history of cancer were excluded from the study. It was found that levels of knowledge about uterine carcinoma were low. Only 47.4% of women knew the difference between the sites of origin of cervical and endometrial cancer. Seventy-seven per cent of participants assessed their knowledge about uterine malignancies as insufficient; 96.3% would appreciate more information about uterine cancer. Younger women were significantly less well informed than postmenopausal women. Known risk factors such as smoking or human papillomavirus (HPV) infection as factors for cervical cancer were underestimated; most women assessed genetic factors as most important for the development of uterine cancer. The level of information about risk factors as well as general facts about gynaecological cancer in women is low. Ameliorating this lack of information might influence the perception of uterine cancer and result in higher participation rates in gynaecological cancer screening. PMID:16284496

Ackermann, Sven; Renner, Stefan Peter; Fasching, Peter Anton; Poehls, Uwe; Bender, Hans Georg; Beckmann, Mathias Wilhelm

2005-12-01

316

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

International Nuclear Information System (INIS)

[en] 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

2004-01-01

317

Premature estrogen exposure alters endometrial gene expression to disrupt pregnancy in the pig.  

Science.gov (United States)

Establishment and maintenance of pregnancy in the pig involve intricate communication between the developing conceptuses and maternal endometrium. Conceptus synthesis and release of estrogen during trophoblastic elongation are essential factors involved with establishing conceptus-uterine communication. The present study identified endometrial changes in gene expression associated with implantation failure and complete pregnancy loss after premature exposure of pregnant gilts to exogenous estrogen. Gilts were treated with either 5 mg estradiol cypionate (EC) or corn oil on d-9 and -10 gestation, which was associated with complete conceptus degeneration by d-17 gestation. Microarray analysis of gene expression revealed that a total of eight, 32, and five genes were up-regulated in the EC endometrium, whereas one, 39, and 16 genes were down-regulated, on d 10, 13, and 15, respectively. Four endometrial genes altered by EC, aldose reductase (AKR1B1), secreted phosphoprotein 1 (SPP1), CD24 antigen (CD24), and neuromedin B (NMB), were evaluated using quantitative RT-PCR and in situ hybridization. In situ hybridization localized gene expression for NMB, CD24, AKR1B1, and SPP1 in the luminal epithelium, and confirmed the expression patterns from RT-PCR analysis. The aberrant expression patterns of endometrial AKR1B1, SPP1, CD24, and NMB 3-4 d after premature estrogen exposure to pregnant gilts may be involved with conceptus attachment failure to the uterine surface epithelium and induction of endometrial responses that disrupt the establishment of a viable pregnancy. PMID:17640989

Ross, Jason W; Ashworth, Morgan D; White, Frankie J; Johnson, Greg A; Ayoubi, Patricia J; DeSilva, Udaya; Whitworth, Kristin M; Prather, Randall S; Geisert, Rodney D

2007-07-19

318

Added value of 3-dimensional sonography for endometrial evaluation in early puerperium.  

UK PubMed Central (United Kingdom)

OBJECTIVES: The purpose of this study was to examine the uterine cavity within 48 hours of delivery using 2- and 3-dimensional sonography after normal vaginal deliveries, instrumental deliveries, exploration of the uterine cavity, and cesarean deliveries. METHODS: A prospective study was performed in puerperal women with normal clinical examination findings. Measurements of the uterine length and width were taken in the midsagittal and coronal planes. Midsagittal measurements of the endometrium using 2- and 3-dimensional sonography and virtual organ computer-aided analysis were performed. Comparisons were made between normal and surgical vaginal deliveries, cesarean deliveries, and after exploration of the uterine cavity. RESULTS: A total of 123 patients were examined. Seventy-seven patients had normal vaginal deliveries; 21 had assisted vaginal deliveries; and 25 had cesarean deliveries. Thirteen underwent exploration of the uterine cavity. The uterine volume increased significantly as the birth weight increased and after cesarean delivery (P < .05). No correlation was found between the endometrial volume and parity, birth weight, and mode of delivery, including no correlation with exploration. Five cases of placental residua were found in asymptomatic women. All delivered vaginally. None underwent exploration of the uterus. All had irregular echogenic masses in the uterine cavity with positive color Doppler findings. The endometrial thickness and volume were significantly higher in these patients. CONCLUSIONS: Sonography along with Doppler assessment has added value in the clinical evaluation of the puerperal women, being able to also show residua in asymptomatic women. Three-dimensional sonography did not show an advantage over 2-dimensional sonography in the estimation of the puerperal uterus or residua.

Weissmann-Brenner A; Haas J; Barzilay E; Gilboa Y; Gat I; Gindes L; Mashiach R; Achiron R; Dulitski M

2013-04-01

319

Disparities in uterine cancer epidemiology, treatment, and survival among African Americans in the United States.  

UK PubMed Central (United Kingdom)

OBJECTIVE: The objective of this article is to comprehensively review the scientific literature and summarize the available data regarding the outcome disparities of African American women with uterine cancer. METHODS: Literature on disparities in uterine cancer was systematically reviewed using the PubMed search engine. Articles from 1992 to 2012 written in English were reviewed. Search terms included endometrial cancer, uterine cancer, racial disparities, and African American. RESULTS: Twenty-four original research articles with a total of 366,299 cases of endometrial cancer (337,597 Caucasian and 28,702 African American) were included. Compared to Caucasian women, African American women comprise 7% of new endometrial cancer cases, while accounting for approximately 14% of endometrial cancer deaths. They are diagnosed with later stage, higher-grade disease, and poorer prognostic histologic types compared to their Caucasian counterparts. They also suffer worse outcomes at every stage, grade, and for every histologic type. The cause of increased mortality is multifactorial. African American and white women have varying incidence of comorbid conditions, genetic susceptibility to malignancy, access to care and health coverage, and socioeconomic status; however, the most consistent contributors to incidence and mortality disparities are histology and socioeconomics. More robust genetic and molecular profile studies are in development to further explain histologic differences. CONCLUSIONS: Current studies suggest that histologic and socioeconomic factors explain much of the disparity in endometrial cancer incidence and mortality between white and African American patients. Treatment factors likely contributed historically to differences in mortality; however, studies suggest most women now receive equal care. Molecular differences may be an important factor to explain the racial inequities. Coupled with a sustained commitment to increasing access to appropriate care, on-going research in biologic mechanisms underlying histopathologic differences will help address and reduce the number of African American women who disproportionately suffer and die from endometrial malignancy.

Long B; Liu FW; Bristow RE

2013-09-01

320

Diagnostic immunohistochemistry in uterine sarcomas: a study of 397 cases.  

UK PubMed Central (United Kingdom)

The purpose of this study was to evaluate the use of a broad panel of antibodies used as diagnostic markers for abdominal mesenchymal tumors in uterine sarcomas. The expression of vimentin, AE1/AE3, smooth muscle actin (SMA), desmin , h-caldesmon, actin, Myf4, CD10, CD31, CD68, CD117, factor VIII, HMB-45, and S-100 protein was studied in 397 uterine sarcomas. SMA was positive in 90% of the ordinary leiomyosarcomas and when combined with desmin or h-caldesmon, a positivity of 96% and 92%, respectively, was achieved. Actin and Myf4 were positive in 4 of 5 rhabdomyosarcomas. Endometrial stromal sarcomas reacted positive with CD10 in 62 of 84 tumors and negative with h-caldesmon in 75 of 84 tumors. CD10 was the most frequent positive marker in adenosarcoma. Most tumor markers stained negative in undifferentiated uterine sarcoma, but 12 of 21 tumors reacted positive for SMA. A few focally HMB-45-positive cells were found within all tumor groups, except in rhabdomyosarcomas and giant cell tumors. Endothelial markers, S-100 protein, and CD117 do not seem to be of any diagnostic value in uterine sarcomas. In conclusion, when immunohistochemistry is used diagnostically in uterine sarcomas, a broad panel of markers provides better information than reliance on a single antibody.

Abeler VM; Nenodovic M

2011-05-01

 
 
 
 
321

POSSIBILITIES OF PHARMACALOGIC THERAPY APPLIED IN ABNORMAL UTERINE BLEEDING  

Directory of Open Access Journals (Sweden)

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.

Srdjan Pesic; Milan Stefanovic; Valentina Nikolic

2006-01-01

322

[Hormone-dependent characteristics of the myocyte cell surface in the human myoma and myometrium cultured in diffusion chambers  

UK PubMed Central (United Kingdom)

The normal and the pathologically changed human myometrium was cultured in the diffusion chamber implanted in the subcutaneous cellular tissue of the rat. In the absence of hormonal influence the growth of myometrium culture is only insignificant, while no myoma cell growth was found at all. Estradiol stimulates the growth and development of the myometrium culture and the myoma. A combined action of estradiol and progesterone stimulates the collagen formation.

Skopichev VG; Arutiunian NA; Pro?mina FI; Savitski? GA

1988-01-01

323

[Explosive growth of uterine leiomyomas and carcinologic ovarian risk in a non-menopausal patient with BRCA1-BRCA2 mutation treated by tamoxifen].  

UK PubMed Central (United Kingdom)

OBJECTIVE: To report the case of significant growth of a myoma in a premenopausal woman with a suspicion of BRCA1 and BRCA2 mutation, treated by tamoxifen for a hormonodependent breast cancer and to point out the carcinologic ovarian risks with a mutation BRCA1-BRCA2 in this context. Case. Four months after surgical treatment, chemotherapy and the beginning of tamoxifen, an explosive growth of the abdomen justified pelvic echography and laparoscopy confirming the diagnosis of uterine myoma. A polymyomectomy by laparotomy was performed. CONCLUSION: Use of tamoxifen in premenopausal woman with subjacent gynecological pathologies, whether BRCA1-BRCA2 mutation is present or not can prove to be delicate. A regular clinical and echographic monitoring is necessary.

Doridot V; This P; Clough KB

2002-11-01

324

Neonatal uterine bleeding as antecedent of pelvic endometriosis.  

Science.gov (United States)

We elaborate on a new theory to explain pelvic endometriosis, including endometriosis in premenarcheal girls, based on the finding that the neonatal endometrium can display secretory activity immediately after birth and, in some cases, changes analogous to those seen at menstruation in adults. The neonatal uterus is therefore capable of shedding its endometrium. Indeed, occult vaginal bleeding occurs in a majority of neonates, although overt bleeding is estimated to occur in only 5% of neonates. This may be due to functional plugging of the endocervical canal in the neonate, which in turn would promote retrograde flux of endometrial cells contained in menstrual debris. Ectopic endometrial implantation in a newborn with hydrometrocolpos has been documented. These data, coupled with the observation of a significantly increased risk of endometriosis in adolescents with cervical outflow obstruction and patent Fallopian tubes, indicate that endometriosis, especially in children and young adolescents, may originate from retrograde uterine bleeding soon after birth. PMID:24048011

Brosens, Ivo; Brosens, Jan; Benagiano, Giuseppe

2013-09-17

325

Quantification of nucleolar channel systems: uniform presence throughout the upper endometrial cavity.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To determine the prevalence of nucleolar channel systems (NCSs) by uterine region, applying continuous quantification. DESIGN: Prospective clinical study. SETTING: Tertiary care academic medical center. PATIENT(S): Forty-two naturally cycling women who underwent hysterectomy for benign indications. INTERVENTION(S): NCS presence was quantified by a novel method in six uterine regions-fundus, left cornu, right cornu, anterior body, posterior body, and lower uterine segment (LUS)-with the use of indirect immunofluorescence. MAIN OUTCOME MEASURE(S): Percentage of endometrial epithelial cells (EECs) with NCSs per uterine region. RESULT(S): NCS quantification was observer independent (intraclass correlation coefficient 0.96) and its intrasample variability low (coefficient of variation 0.06). Eleven of 42 hysterectomy specimens were midluteal, ten of which were analyzable with nine containing >5% EECs with NCSs in at least one region. The percentage of EECs with NCSs varied significantly between the LUS (6.1%; interquartile range [IQR] 3.0-9.9) and the upper five regions (16.9%; IQR 12.7-23.4), with fewer NCSs in the basal layer of the endometrium (17 ± 6%) versus the middle (46 ± 9%) and luminal layers (38 ± 9%) of all six regions. CONCLUSION(S): NCS quantification during the midluteal phase demonstrates uniform presence throughout the endometrial cavity, excluding the LUS, with a preference for the functional luminal layers. Our quantitative NCS evaluation provides a benchmark for future studies and further supports NCS presence as a potential marker for the window of implantation.

Szmyga MJ; Rybak EA; Nejat EJ; Banks EH; Whitney KD; Polotsky AJ; Heller DS; Meier UT

2013-02-01

326

Studies on preoperative CT and endoscopic evaluation of the spread of endometrial carcinoma  

International Nuclear Information System (INIS)

To establish accurate diagnosis concerning the spread and metastasis of endometrial carcinoma preoperatively, the following studies were carried out; 1) a study of the relation between lymphnode metastasis, parametrial invasion and cervical involvement, and the depth of myometrial invasion in 120 cases; 2) a study of the relation between the CT image and the histopathologic depth of myometrial invasion in 39 cases; and 3) endoscopic observation of the endocervical canal in 23 cases. Results 1) Thirty-eight of 120 (31.7%) cancerous lesions away from the original site were investigated. The spread and metastasis of the showed a high correlation with the depth of lesion myometreal invasion and cervical involvement. 2) The low density area (LDA) in the CT image of the uterine body was investigated in 38 of 39. A good correlation was found in a) the ratio of the LDA to the total uterine body image, b) the maximum ratio of the distance between the center of the LDA to the external rim of the uterine body image and LDA, c) the minimum width of the uterine wall image and the depth of myometrial invasion. 3) Endoscopic diagnosis of cervical involvement corresponded accurately with the postoperative diagnosis. The results strongly suggest that CT analysis of the depth of myometrial invasion and endoscopic evaluation of cervical involvement is useful for accurate preoperative diagnosis of endometrial carcinoma. (author) 54 refs

1989-01-01

327

Endometrial Histology of Depomedroxyprogesterone Acetate Users: A Pilot Study  

Directory of Open Access Journals (Sweden)

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

Andrea Ries Thurman; David E. Soper

2006-01-01

328

Endometrial Histology of Depomedroxyprogesterone Acetate Users: A Pilot Study  

Directory of Open Access Journals (Sweden)

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

Andrea Ries Thurman; David E. Soper

2006-01-01

329

Serous endometrial intraepithelial carcinoma: a case series and literature review  

Science.gov (United States)

Background Minimal uterine serous cancer (MUSC) or serous endometrial intraepithelial carcinoma (EIC) has been described by many different names since 1998. There have been very few cases reported in literature since EIC/MUSC was recognized as a separate entity. The World health Organization (WHO) Classification favors the term serous EIC. Although serous EIC is confined to the uterine endometrium at initial histology diagnosis, a significant number of patients could have distal metastasis at diagnosis, without symptoms. Serous EIC is considered as being the precursor of uterine serous cancer (USC), but pure serous EIC also has an aggressive behavior similar to USC. It is therefore prudent to have an accurate diagnosis and appropriate surgical staging. There are very few published articles in literature that discuss the pure form of serous EIC. The aim of this series is to share our experience and review evidence for optimum management of serous EIC. Patients and methods We report a series of five women treated in our institute in the last 3 years. We reviewed the relevant literature on serous EIC and various management strategies, to recommend best clinical practice. Conclusion Pure serous EIC is a difficult histopathological diagnosis, which requires ancillary immunohistochemical staining. It can have an aggressive clinical behavior with early recurrence and poor survival. Optimum surgical staging, with appropriate adjuvant treatment, should be discussed when treating these patients.

Pathiraja, P; Dhar, S; Haldar, K

2013-01-01

330

Cortisol and interferon tau regulation of endometrial function and conceptus development in female sheep.  

UK PubMed Central (United Kingdom)

During early pregnancy in sheep, the elongating conceptus secretes interferon-? (IFNT) and the conceptus as well as endometrial epithelia produce prostaglandins (PG) via PG synthase 2 (PTGS2) and cortisol via hydroxysteroid (11-?) dehydrogenase 1 (HSD11B1). Ovarian progesterone induces and PG and IFNT stimulates endometrial HSD11B1 expression and keto-reductase activity as well as many epithelial genes that govern trophectoderm proliferation, migration, and attachment during elongation. The primary aim of these studies was to test the hypothesis that HSD11B1-derived cortisol has a biological role in endometrial function and conceptus development during early pregnancy in sheep. In study 1, cyclic ewes received vehicle, cortisol, PF 915275 (PF; a selective inhibitor of HSD11B1), cortisol and PF, meloxicam (a selective inhibitor of PTGS2), cortisol and meloxicam, recombinant ovine IFNT, or IFNT and PF into the uterus from day 10 to day14 after estrus. Cortisol and IFNT stimulated endometrial HSD11B1 expression and activity, increased endometrial PTGS2 activity and the amount of PG in the uterine lumen, and up-regulated many conceptus elongation-related genes in the endometrium. Some effects of cortisol and IFNT were mediated by PTGS2-derived PG. In study 2, bred ewes received PF 915275 or recombinant ovine IFNT and into the uterus from day 10 to day 14 after mating. Inhibition of HSD11B1 activity in utero prevented conceptus elongation, whereas IFNT rescued conceptus elongation in PF-infused ewes. These results suggest that HSD11B1-derived cortisol mediates, in part, actions of ovarian progesterone and the conceptus on endometrial function and support the hypothesis that IFNT, PG, and cortisol coordinately regulate endometrial functions important for conceptus elongation and implantation during early pregnancy in sheep.

Dorniak P; Welsh TH Jr; Bazer FW; Spencer TE

2013-02-01

331

Laparoscopic treatment of unicornuate uterus with noncommunicating rudimentary uterine horn  

Directory of Open Access Journals (Sweden)

Full Text Available Congenital anomalies of the Mullerian system, which are associated with fertility problems, are common uterine malformations. Unicornuate uteri with rudimentary horn containing an endometrial cavity is a rare Mullerian malformation. A 36-years-old woman with primary infertility presented with dysmenorrhonea which had been present since 1995; her symptoms had been relieved with medical management since then. During the routine work-up, unicornuate uterus, associated with the rudimentary horn, and haematosalpinx and endometrioma were found, and laparoscopic management was performed. The case was presented and the relevant literature reviewed.

Çetin ARIK; Ercan M. AYGEN; Bülent ÖZÇEL?K; Y?lmaz ?AH?N; Mustafa O. YILMAZ

2002-01-01

332

[Influence of tubal and uterine milieu in the embryonic development  

UK PubMed Central (United Kingdom)

Establishment of pregnancy in mammals is a process resulting of closely concerted events. The participation of the embryo through its development and secretory activity on the one hand, and on the other, the oviductal and endometrial tissues, by means of their secretions, give the optimal conditions to let the embryo establish creating a proper milieu for its nutrition and development. In this review, we analyze the influence of the oviductal and uterine secretions upon early embryonic development and differentiation and some transport systems of nutritional elements required in the early stages of the blastogenesis.

Loza Arredondo MC; Hicks JJ

1990-09-01

333

Uterine amulets and Greek uterine medicine.  

Science.gov (United States)

This article publishes for the first time a hematite uterine amulet in the author's possession. After a brief look at this amulet I offer a summary of previous scholarship on uterine amulets, and then focus on three specific aspects -the amulets' relation to Greek medical texts on gynecological topics; evidence for the use of perishable and non-perishable amulets by Greek women prior to the proliferation of the hematite examples in the Roman period (ca. II CE). I conclude with a discussion of the derivation and meaning of ororiouth, based on my correspondence with Dr. Roy Kotansky. PMID:11623421

Hanson, A E

1995-01-01

334

Uterine amulets and Greek uterine medicine.  

UK PubMed Central (United Kingdom)

This article publishes for the first time a hematite uterine amulet in the author's possession. After a brief look at this amulet I offer a summary of previous scholarship on uterine amulets, and then focus on three specific aspects -the amulets' relation to Greek medical texts on gynecological topics; evidence for the use of perishable and non-perishable amulets by Greek women prior to the proliferation of the hematite examples in the Roman period (ca. II CE). I conclude with a discussion of the derivation and meaning of ororiouth, based on my correspondence with Dr. Roy Kotansky.

Hanson AE

1995-01-01

335

MR staging of endometrial carcinoma  

International Nuclear Information System (INIS)

Endometrial cancer is the second most common gynaecological malignancy. The usual presentation with post-menopausal bleeding results in an early diagnosis in most cases and thus there is opportunity for cure. Magnetic resonance (MR) imaging is pivotal in the decision-making process regarding treatment options. We present a review of the magnetic resonance (MR) findings to illustrate its role in the staging of endometrial cancer.

2006-01-01

336

MR staging of endometrial carcinoma  

Energy Technology Data Exchange (ETDEWEB)

Endometrial cancer is the second most common gynaecological malignancy. The usual presentation with post-menopausal bleeding results in an early diagnosis in most cases and thus there is opportunity for cure. Magnetic resonance (MR) imaging is pivotal in the decision-making process regarding treatment options. We present a review of the magnetic resonance (MR) findings to illustrate its role in the staging of endometrial cancer.

Messiou, C. [St James' s University Hospital, Leeds, West Yorkshire (United Kingdom)]. E-mail: c_messiou@hotmail.com; Spencer, J.A. [St James' s University Hospital, Leeds, West Yorkshire (United Kingdom); Swift, S.E. [St James' s University Hospital, Leeds, West Yorkshire (United Kingdom)

2006-10-15

337

Hysteroscopy after uterine fibroid embolization: evaluation of intrauterine findings in 127 patients.  

UK PubMed Central (United Kingdom)

AIM: Several atypical hysteroscopy findings have been described in association with uterine artery embolization (UAE). The purpose of this study was to evaluate the types and frequency of these findings in the largest published series of patients. MATERIAL AND METHODS: Premenopausal patients after bilateral UAE for symptomatic intramural fibroid underwent subsequent hysteroscopic examination 3-9 months following UAE. The uterine cavity was examined with focus on specific post-embolization changes. Biopsy of endometrium was obtained and evaluated together with a biopsy of abnormal foci if present. RESULTS: UAE was performed in a total of 127 women with an average size of dominant fibroid 63.1 mm in diameter and an average patient age of 35.1 years. Even though the majority of patients were asymptomatic at the time of hysteroscopy (78.0%), the post-embolization hysteroscopic examination was normal in only 51 patients (40.2%). The most frequent abnormalities included tissue necrosis (52 women, 40.9%), intracavitary myoma protrusion (45 women, 35.4%), endometrium 'spots' (22.1%), intrauterine synechiae (10.2%) and 'fistula' between the uterine cavity and intramural fibroid (6.3%). Histopathological examination showed normal, secretory or proliferative endometrium in 83.5% patients. Necrosis and/or hyalinization prevailed in the results of biopsy of abnormal loci (45 cases, 35.4%). CONCLUSION: Frequency of abnormal hysteroscopic findings several months after UAE for primary intramural myomas is high. Alarmingly high is the percentage of patients with a histopathologically verified necrosis. Performing hysteroscopy in selected patients after UAE is necessary before eventual surgical re-intervention, especially in women with reproductive plans.

Mara M; Horak P; Kubinova K; Dundr P; Belsan T; Kuzel D

2012-05-01

338

Uterine didelphys with cervical incompetence  

Directory of Open Access Journals (Sweden)

Full Text Available Uterine didelphys represents a uterine malformation where the uterus is present as a paired organ. There is presence of double uterine bodies with two separate cervices, and often a double or septate vagina as well. We report a case of single pregnancy in the right sided uterine body of a didelphic uterus with cervical incompetence.

Aher Gautam S, Gavali Urmila G, Kulkarni Meghana

2013-01-01

339

Primary cervical and uterine corpus lymphoma; a case report and literature review.  

Science.gov (United States)

Primary lymphoma of the uterine corpus and cervix is rare. We present a case of primary non-Hodgkin follicular lymphoma isolated to uterine corpus and parametria with focal spread to ovaries and fallopian tubes, incidentally found on the background of endometrial malignancy. A summary of the published cases focusing on the presentation and prognosis as well as a review of current management are discussed. The rising incidence of extra-nodal lymphoma and recent changes in classification and therapeutic approach, require clinical vigilance. In the absence of prospective studies assessing the value of the available therapeutic options, data from retrospective series and scattered case reports are presented in this review. PMID:23641308

Anagnostopoulos, Antonios; Mouzakiti, Niki; Ruthven, Stuart; Herod, Jonathan; Kotsyfakis, Michail

2013-04-12

340

Primary cervical and uterine corpus lymphoma; a case report and literature review.  

UK PubMed Central (United Kingdom)

Primary lymphoma of the uterine corpus and cervix is rare. We present a case of primary non-Hodgkin follicular lymphoma isolated to uterine corpus and parametria with focal spread to ovaries and fallopian tubes, incidentally found on the background of endometrial malignancy. A summary of the published cases focusing on the presentation and prognosis as well as a review of current management are discussed. The rising incidence of extra-nodal lymphoma and recent changes in classification and therapeutic approach, require clinical vigilance. In the absence of prospective studies assessing the value of the available therapeutic options, data from retrospective series and scattered case reports are presented in this review.

Anagnostopoulos A; Mouzakiti N; Ruthven S; Herod J; Kotsyfakis M

2013-01-01

 
 
 
 
341

Recurrent uterine rupture after hysterescopic resection of the uterine septum.  

UK PubMed Central (United Kingdom)

INTRODUCTION: Uterine rupture after hysteroscopic septum resection is a rare complication, and its frequency is reported to be approximately 1-2.7%. Uterine perforation and monopolar resection during hysteroscopy are well-known risk factors for subsequent uterine rupture during pregnancy. PRESENTATION OF CASE: We present a case of recurrent uterine ruptures during consecutive pregnancies in a patient who had undergone hysteroscopic septum resection for recurrent pregnancy loss. DISCUSSION: Recurrent uterine rupture due to hysteroscopic septum resection in pregnancy is a very rare condition. In the present case we noted that the first two uterine ruptures resulted from uterine contractions; however, the third rupture occurred spontaneously and earlier in gestation. As each uterine rupture occurred earlier than the rupture in the previous gestation, a history of uterine rupture during pregnancy should raise provider suspicion about the possibility of earlier uterine rupture recurrence. CONCLUSION: Uterine rupture may occur in pregnancies after hysteroscopic resection of the uterine septum. However, if a patient has a history of uterine rupture during previous pregnancies, the risk of uterine rupture may increase for earlier gestational ages in subsequent pregnancies. The patient must be informed about both the risks of uterine rupture during pregnancy after hysteroscopic septum resection and that recurrent ruptures may occur at earlier gestational weeks than during previous pregnancies.

Ergenoglu M; Yeniel AO; Y?ld?r?m N; Akdemir A; Yucebilgin S

2013-01-01

342

Uterine endometrioid adenocarcinoma with extensive pilomatrixoma-like areas. A case report.  

UK PubMed Central (United Kingdom)

Shadow cells are typical features of pilomatrixoma, although they have been described in other benign cutaneous tumours with characteristics of differentiation toward the hair matrix. The finding of extensive shadow cell differentiation in visceral carcinomas is otherwise unusual. We report herein a case of uterine adenocarcinoma with extensive pilomatrixoma-like areas in a 74-year-old woman. The endometrial tumour showed an invasive poorly differentiated growth with squamous differentiation deeply extending into the myometrium intermixed with lobules of empty squamoid polyhedral cells with clear shadow like nuclei, focally exhibiting a 'ghost' appearance. The cervix, salpinges, ovaries and pelvic lymph nodes were free of disease and, taking all evidence into account, the tumour was diagnosed as poorly differentiated endometrial endometrioid adenocarcinoma (FIGO stage IB). The recognition of an extensive pilomatrixoma-like component in a high- grade endometrioid adenocarcinoma may be important to avoid diagnostic misinterpretation with uterine metastases of malignant cutaneous pilomatrical tumours, such as pilomatrix carcinomas.

Squillaci S; Marchione R; Piccolomini M; Chiudinelli M; Fiumanò E; Ungari M

2013-02-01

343

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

DEFF Research Database (Denmark)

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

Holm, Nina Sofie Lillegaard; Glintborg, Dorte

2012-01-01

344

Three-dimensional power Doppler study of endometrial and subendometrial microvascularization in women with intrauterine device-induced menorrhagia.  

UK PubMed Central (United Kingdom)

OBJECTIVE: To evaluate endometrial and subendometrial microvascularization, using three-dimensional (3D) power Doppler ultrasound, in women with intrauterine device (IUD)-induced menorrhagia; and whether those potential findings could predict the risk of bleeding before IUD insertion. DESIGN: Prospective clinical trial. SETTING: University teaching hospital. PATIENT(S): One hundred twenty women, who requested the insertion of a copper IUD for contraception. INTERVENTION(S): Endometrial thickness and volume, uterine artery pulsatility index and resistance index, and endometrial and subendometrial 3D power Doppler vascularization index, flow index, and vascularization flow index were measured twice: immediately before and 3 months after IUD insertion. MAIN OUTCOME MEASURE(S): Doppler indices before and after IUD insertion. RESULT(S): Before IUD insertion, no significant difference was detected in the clinical characteristics, endometrial thickness and volume, and Doppler indices between women who had IUD-induced menorrhagia (n = 47) and those without menorrhagia (n = 73). However, after IUD insertion, there was a significant increase in the endometrial and subendometrial vascularization index, flow index, and vascularization flow index in women with menorrhagia, whereas other parameters remained not significantly different between the two groups. CONCLUSION(S): Endometrial and subendometrial microvascularization increases in women with IUD-induced menorrhagia; however, this finding has no predictive value before IUD insertion.

El-Mazny A; Abou-Salem N; Elshenoufy H

2013-06-01

345

[Hysteroscopy clinic: diagnostic and therapeutic method in abnormal uterine bleeding].  

UK PubMed Central (United Kingdom)

BACKGROUND: Abnormal uterine bleeding is a public health problem prevalence exceeded only by abnormal vaginal discharge as a reason for medical consultation. OBJECTIVE: To describe the findings reported by the Hysteroscopy clinic of the Hospital GEA Gonzalez on patients with Abnormal Uterine bleeding diagnosis. MATERIAL AND METHOD: Retrospective, transversal, descriptive study. The total 2546 records of those patient that were evaluated by Office Hysteroscopic between January 2007 and December 2008 on the Hysteroscopy Clinic of Hospital Manuel GEA Gonzalez, then we selected the 1482 records of those patients that were sended because of an Abnormal Uterine bleeding condition. We descrive the frequencies of the diagnosis and its interrelation with the age of the patients. We also report the therapeutical interventions during office hysteroscopy. RESULTS: The mean age of the patients was 42.15 +/- 9.30 years (from 12 a 92 years); the age groups of patients that belonged to 40-44 years and 45-49 years are the most frequent patient and they represent the 25% y el 23.3% of the records. The abnormal findings occurred on the 66% de of the patients. Those patients of 65 years old and older do not have any report of normal cavities, all of then have abnormal findings. The leiomyoma (26.9%) and the endometrial polyps (27.3%) were the most frequent findings. The postmenopausal bleeding had a rate of 90.9% abnormal findings and in this group of patients the most frequent diagnosis was atrophic endometrium (32.2%) and polyps (24.3%). Besides that the office hysteroscopy show its therapeutical usefulness because of the 67% and 77.5% of polipectomy perform for endometrial and cervical polyps respectively CONCLUSIONS: The office Hysteroscopy is a well tolerated diagnosis and therapeutic method that is useful for any women with abnormal uterine bleeding condition and it is the ideal technique for the examination of abnormal uterine bleeding in postmenopausal women... The office hysteroscopy is a efficient cost-effective and cost-benefic method for the management for endometrial and cervical polyps.

Alanis Fuentes J; Obregón Zegarra EH

2012-12-01

346

Uterine leiomyoma: available medical treatments and new possible therapeutic options.  

UK PubMed Central (United Kingdom)

CONTEXT: Uterine leiomyomas (fibroids or myomas) are benign tumors of the uterus and are clinically apparent in up to 25% of reproductive-age women. Heavy or abnormal uterine bleeding, pelvic pain or pressure, infertility, and recurrent pregnancy loss are generally associated with leiomyoma. Although surgical and radiological therapies are frequently used for the management of this tumor, medical therapies are considered the first-line treatment of leiomyoma. EVIDENCE ACQUISITION AND SYNTHESIS: A review was conducted of electronic and print data comprising both original and review articles on pathophysiology and medical treatments of uterine leiomyoma retrieved from the PubMed or Google Scholar database up to June 2012. These resources were integrated with the authors' knowledge of the field. CONCLUSION: To date, several pathogenetic factors such as genetic factors, epigenetic factors, estrogens, progesterone, growth factors, cytokines, chemokines, and extracellular matrix components have been implicated in leiomyoma development and growth. On the basis of current hypotheses, several medical therapies have been investigated. GnRH agonist has been approved by US Food and Drug Administration for reducing fibroid volume and related symptoms. In addition, the FDA also approved an intrauterine device, levonorgestrel-releasing intrauterine system (Mirena), for additional use to treat heavy menstrual bleeding in intrauterine device users only. Currently, mifepristone, asoprisnil, ulipristal acetate, and epigallocatechin gallate have been shown to be effective for fibroid regression and symptomatic improvement which are all in clinical trial. In addition, some synthetic and natural compounds as well as growth factor inhibitors are now under laboratory investigation, and they could serve as future therapeutic options.

Islam MS; Protic O; Giannubilo SR; Toti P; Tranquilli AL; Petraglia F; Castellucci M; Ciarmela P

2013-03-01