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Sample records for uterine myoma endometrial

  1. [Case of carcinoid of the appendix in a patient with endometrial cancer and uterine myoma].

    Science.gov (United States)

    Surmacki, Piotr; Lasota, Janusz; Sporny, Stanis?aw

    2003-02-01

    Reports on coexistence of the three cancers: a carcinoid of the appendix, myoma of the uterus and adenoma of the uterine cavity occurring in a female patient are exceptionally rare. Such a case may occur with a frequency of 2 every 10,000 hysterectomies. The patient was subjected to hysterectomy, appendectomy and had her obturator and iliac lymph nodes removed. Postoperative treatment comprised radiotherapy. It is estimated that on overall chance of 5 year survival is close to 50%. The overall good state of the patient, 4 years after operation, speaks for recommending this kind of treatment. The authors suggest that the carcinoid does not necessarily must be an inductor of a cancer of the endometrium and they indicate that a cancer of the endometrium is not an inductor of the carcinoid. PMID:12715426

  2. Super selective uterine arterio-embolization in treating uterine myoma

    International Nuclear Information System (INIS)

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

  3. Comparison of Bipolar Electrocoagulation and Nd:YAG Laser Coagulation for Symptomatic Reduction of Uterine Myomas

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    Goldfarb

    1994-08-01

    In 1991 and 1992, we presented a review of our experience using Nd:YAG laser fiber and bipolar needles to coagulate uterine myomas laparoscopically. We now present a comparison study of the Nd:YAG laser vs. bipolar coagulation needles for laparoscopic reduction of symptomatic uterine myomas. Since October 1990, we have performed over 300 cases of laparoscopic coagulation of symptomatic uterine myomas. The technique includes reduction of uterine and myomata size using depot leuprolide for a three to four month period of time. Hysteroscopic examination and endometrial sampling is performed during this preoperative period. The Nd:YAG laser fiber is a 600 micron bare fiber combined with a 50 watt Nd:YAG laser. The bi-polar needle is made in 30 and 45 mm lengths. The needles measure 5 cm in length and are inserted through a 5.5-mm trocar. Coagulation effect is measured by a standard ammeter. Myoma shrinkage is measured by pre- and post-operative vaginal ultrasound examination. Results reveal additional shrinkage 50-70% beyond the leuprolide effect. No myoma regrowth has been noted in this 3 year period. Minimal follow-up was 12 months. For patients with significant uterine bleeding, endometrial ablation is carried out at the same time. PMID:9073687

  4. [The role of biogenic amines in the mechanism of uterine hemorrhage in uterine myoma].

    Science.gov (United States)

    Bel'skaia, G D

    1990-02-01

    Function of the adrenosympathetic system has been assessed in 103 patients with uterine myoma. Levels of biogenic amines (adrenaline, noradrenaline, histamin) were determined in uterine tissues using spectrofluorometry. It was found out that storage of vasoactive mediators in the uterine tissue represents a mechanism of uterine bleedings in patients with uterine myoma. Another determinant is stress experienced by patients with menometrorrhagia. PMID:2339756

  5. Selective artery embolization for treatment of uterine myoma

    International Nuclear Information System (INIS)

    Objective: To assess the clinical effects of selective embolization of uterine arteries in the treatment of uterine myomata. Methods: 15 cases with symptomatic uterine myomata were treated by Seldinger's selective uterine arteries embolization. After a percutaneous femoral arterial puncture, an artery catheter was selectively inserted into bilateral uterine arteries. The insertion silk of fragments and gel form were introduced through catheter to occlude the blood supply of myoma. Results: Arteriography showed that most uterine myomata were supplied by bilateral uterine arteries. When both uterine arteries were embolized, the blood supply of uterine myoma could be occluded. With a mean follow-up of 6 months the menorrhagia and menstrual cycles returned to normal and, pain resolved. Conclusions: Selective uterine artery embolization is a new method for treatment of uterine myomata with less trauma

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

    International Nuclear Information System (INIS)

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

  7. MRI evaluation for conservative treatment in endometriosis and uterine myoma

    International Nuclear Information System (INIS)

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

  8. Uterine myomas in pregnancy, childbirth and puerperium

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    Spari? Radmila

    2014-01-01

    Full Text Available Fibroids are the most common benign tumors of the genital organs of women in reproductive age. Achieving reproductive function later in life, with more frequent use of assisted reproductive technologies, leads to an increased number of pregnancies complicated with fibroids. Their size may change during pregnancy, but the changes are mostly individual. Most fibroids stop growing or decline during the puerperium. The effect of fibroids on pregnancy depends on their number, size and location. The mechanisms bringing about perinatal complications are not fully understood. Fibroids during pregnancy can cause many perinatal complications, such as bleeding in pregnancy, miscarriage, pain due to red degeneration, malpresentation, preterm labor, premature rupture of membranes, placental abruption and obstruction of delivery and are associated with higher incidence of cesarean section, operative vaginal delivery, uterine atony and postpartum hemorrhage. Postpartum hysterectomy in these women is also more likely than in general population. Postpartum infections are more common in patients with fibroids, and myomas may also cause retained placenta. The most common cause of neonatal morbidity is prematurity, due to pregnancy ending in an earlier gestational age. Monitoring of pregnancies complicated with fibroids is essentially indistinguishable from monitoring normal pregnancies. Therapy includes only bed rest and observation, symptomatic therapy in case of pain and intensive fetal surveillance, and surgery in the acute situations.

  9. Epidemiology of Uterine Myomas: A Review

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    Radmila Sparic

    2016-12-01

    Full Text Available Myomas are the most common benign tumors of the genital organs in women of childbearing age, causing significant morbidity and impairing their quality of life. In our investigation, we have reviewed the epidemiological data related to the development of myomas in order to homogenize the current data. Therefore, a MEDLINE and PubMed search, for the years 1990-2013, was conducted using a combination of keywords, such as "myoma," "leiomyoma," "fibroids," "myomectomy," "lifestyle," "cigarette," "alcohol," "vitamins," "diet," and "hysterectomy". Randomized controlled studies were selected based upon the authors’ estimation. Peer-reviewed articles examining myomas were sorted by their relevance and included in this research. Additional articles were also identified from the references of the retrieved papers and included according to authors’ estimation. Many epidemiologic factors are linked to the development of myomas; however, many are not yet fully understood. These factors include age, race, heritage, reproductive factors, sex hormones, obesity, lifestyle (diet, caffeine and alcohol consumption, smoking, physical activity and stress, environmental and other influences, such as hypertension and infection. Some of the epidemiological data is conflicting. Thus, more research is needed to understand all the risk factors that contribute to myoma formation and how they exactly influence their onset and growth.

  10. State and development of uterine myoma embolization in Germany

    International Nuclear Information System (INIS)

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

  11. Robot-Assisted Myomectomy for Large Uterine Myomas: A Single Center Experience

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    Gunnala, Vinay; Setton, Robert; Pereira, Nigel; Huang, Jian Qun

    2016-01-01

    Objective. To determine if robot-assisted myomectomy (RAM) is feasible for women with large uterine myomas. Methods. Retrospective review of one gynecologic surgeon's RAM cases between May 2010 and July 2013. Large uterine myomas, defined as the largest myoma ≥9 cm by preoperative magnetic resonance imaging, was age- and time-matched to controls with the largest myoma 900 gm, of which no major adverse outcomes were observed. All patients in the study cohort were discharged on the same day after surgery. Conclusion. RAM is a feasible surgical approach for patients with myomas ≥9 cm. Patients with large myomas undergoing RAM are also candidates for same-day discharge after surgery. PMID:27034828

  12. Uterine Artery Embolization as Nonsurgical Treatment of Uterine Myomas

    OpenAIRE

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

    2011-01-01

    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  μ 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 ana...

  13. Uterine Artery Embolization as Nonsurgical Treatment of Uterine Myomas

    Science.gov (United States)

    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

    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 μm 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. PMID:22191046

  14. Deep venous thrombosis due to massive compression by uterine myoma

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    Aleksandra Brucka

    2010-10-01

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

  15. Body weight gain during adulthood and uterine myomas: Pró-Saúde Study

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    Karine de Lima Sírio Boclin

    2015-01-01

    Full Text Available This study intended to investigate whether body weight gain during adulthood is associated with uterine myomas. 1,560 subjects were evaluated in a Pró-Saúde Study. Weight gain was evaluated in a continuous fashion and also in quintiles. Odds ratios and 95% confidence intervals were estimated through logistic regression models that were adjusted for education levels, color/race, body mass indices at age 20, age of menarche, parity, use of oral contraceptive methods, smoking, health insurance, and the Papanicolaou tests. No relevant differences were observed regarding the presence of uterine myomas among weight gain quintiles in that studied population.

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

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    Plewka, Danuta; Marczyński, Jacek; Morek, Michał; Bogunia, Edyta

    2014-01-01

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

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

    International Nuclear Information System (INIS)

    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

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

    International Nuclear Information System (INIS)

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

  19. REPRESENTATION OF DIFFERENT LYMPHOCYTES' POPULATIONS IN PERIPHERAL BLOOD OF PATIENTS WITH UTERINE MYOMA

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    Ye. E. Zueva

    2014-07-01

    Full Text Available Abstract. Uterine myoma is one of the most widespread gynecological pathology among reproductive women older than 30 years. It is known, that often progress of this pathology is associated with genetic and endocrinologic factors. The immune system is not evident still. The aim of this study was to analyze the state of patient's immune system using flow cytometry assessment of different subpopulations of lymphocytes in peripheral blood. We have examined 46 patients with simple and proliferating forms of the myoma, with different variants of clinical symptoms. Absolute and relative content of different subpopulations of lymphocytes was not differed from normal population's standard. Significant differences of B-lymphocytes and natural killers content were observed between groups with simple and proliferating forms of disease. It was shown that metrorrhagia is associated with high level of T-lymphocytes and T-killers. It was noted that decreasing of B-lymphocytes content took place in cases with large number of uterine nodes. Obtained data are not sufficient for complete understanding of the role of immune system in pathogenesis of this disease, but they confirm that using of immunomodulating therapy is expedient for complex treatment of uterine myoma.

  20. [Immunohistochemical characteristic of myoma tissue in patients with uterine leiomyoma after treatment with ulipristal acetate

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    Kuryk E.G.

    2015-09-01

    Full Text Available Background. Uterine leiomyoma is one of the most common benign tumors of the female genital organs. The main conservative treatment of leiomyoma is progesterone receptor blockers that suppress myoma growth and may lead to its regression. Objective. To study the immunohistochemical features of myoma tissue in patients with uterine leiomyoma after treatment with selective progesterone modulator - ulipristal acetate. Methods. Leiomyoma tissue obtained from 9 patients after ulipristal acetate treatment were investigated. Group for comparison - leiomyoma from patients without hormonal therapy. Immunohistochemical study of progesterone and estrogen receptors, proliferative activity marker Ki-67 and inhibitor of apoptosis Bcl-2 was performed. Results. In the group of patients without preoperative hormonal treatment progesterone receptors were expressed in 76,4±6,8% of the nuclei, estrogen receptors - in 32,8±2,6%. In the group of patients after treatment with ulipristal acetate there was a significant decrease of progesterone receptor expression – 36,8±1,28% (p 0,05 . Bcl-2 in the control group was found in 65,4±7,2% cells, in leiomyoma after treatment there was a significant decrease of bcl-2 – 42,6±3,2% (p <0, 05. In leiomyomas without hormonal treatment Ki-67 was determined in 11,8% of the nuclei of smooth muscle cells, and in leiomyomas after ulipristal acetate – in 7,2% leiomyoma cells. Conclusions. In patients after three months of ulipristal acetate treatment there was a significant decrease of expression of progesterone receptor, bcl-2, and Ki-67. Taken together these data evidence reduced action of progesterone on leiomyoma cells, induction of apoptosis and decreased proliferation processes that may cause involution of fibroids. Citation: Kuryk EG, Litvak EO, Chabrat BV, Lysenko BM. [Immunohistochemical characteristic of myoma tissue in patients with uterine leiomyoma after treatment with ulipristal acetate]. Morphologia. 2015;9(3:42-7. Russian

  1. Uncommon Complication of Uterine Artery Embolization: Expulsion of Infarcted Myoma and Uterine Sepsis

    OpenAIRE

    Juliana G. Martins; Gaudenti, Dawn; Crespo, Frank; Ganesh, Dervi; Verma, Usha

    2016-01-01

    Uterine leiomyomas are the most common benign tumors in young females and leading cause of hysterectomy. Uterine artery embolization is a safe option for women who wish to retain their uterus. Several complications have been reported including expulsion and sepsis. MRI is a useful pretreatment tool to predict results and outcomes. We report a case of a 44-year-old female with a history of uterine fibroids with the largest one being intracavitary. Patient underwent uterine artery embolization ...

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

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    Terzić Milan

    2008-01-01

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

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

    OpenAIRE

    Filipowska, Justyna; Łoziński, Tomasz

    2014-01-01

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

  4. Management of dysfunctional uterine bleeding based on endometrial thickness

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    Ozgul Muneyyirci-Delale

    2010-09-01

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

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

    International Nuclear Information System (INIS)

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

  6. Myomas: anatomy and related issues.

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    Tinelli, Andrea; Sparic, Radmila; Kadija, Saša; Babovic, Ivana; Tinelli, Raffaele; Mynbaev, Ospan A; Malvasi, Antonio

    2016-06-01

    Myomas are the most common disorder of the female genital organs, occurring more frequently throughout women's reproductive years. Myomas are a major health issue all over the world. They develop as a monoclonal tumor from cells influenced by ovarian steroids, and mediated by surrounding myometrial cells by paracrine mechanisms. During its growth, a myoma compresses the surrounding tissue, causing the formation of a pseudocapsule, encapsulating the myoma. The mechanical properties of myomas are a key factor which can contribute to their growth. While myomas are essentially rigid, their pseudocapsule is more elastic, and this allows uterine adaptation to the growing myoma. Hence, the pseudocapsule induces displacement on the myometrium, which is not destructive since the integrity and contractility of uterine structure is maintained. Extensive research conducted on the myoma and its pseudocapsule has produced important data. Scientific research is still trying to clarify some of the evidence regarding the influence of myomas on infertility, especially in the case of intramural myomas. During fertility-sparing myoma surgery, data suggest that during myoma removal the pseudocapsule should be preserved. However, unsolved issues still exist on the cesarean myomectomy technique, since the age of pregnancy has been increasing in the new millennium, so patients present with myomas which should be removed before and during the cesarean section, or prior to applying for medically-assisted reproduction. PMID:26785282

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2005-11-01

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

  8. Prevalence of endometrial polyps and abnormal uterine bleeding in a Danish population aged 20-74 years

    DEFF Research Database (Denmark)

    Dreisler, E; Stampe Sorensen, S; Ibsen, P H; Lose, G

    2009-01-01

    included (429 pre- and 257 postmenopausal). AUB was assessed by a validated questionnaire. The women underwent transvaginal sonography (TVS) and saline contrast sonohysterography (SCSH). Hysteroscopic resection was performed in cases with suspected focal intrauterine pathology. Full evaluation was...... endometrial polyps. RESULTS: On final diagnosis there were 48 women with polyps, eight with submucosal myomas, four with other benign findings and one with polypoidal growing endometrial cancer. Complex hyperplasia without atypia was diagnosed in two women with polyps. The prevalence of endometrial polyps was...

  9. Uterine carcinosarcoma, leiomyosarcoma and endometrial stromal sarcoma : Epidemiological, clinical and prognostic aspects

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    Koivisto-Korander, Riitta

    2012-01-01

    Uterine carcinosarcoma (CS), leiomyosarcoma (LMS) and endometrial stromal sarcoma (ESS) have historically been considered as main subtypes of uterine sarcomas (USs). Depending on the classification, 3% to 9% of malignancies of the uterine corpus and about 1% of all female genital tract malignancies are USs. However, it has been estimated that USs account for nearly one third of deaths from uterine malignancies. The aims of these studies were to assess clinical behavior, survival, prognos...

  10. CLINICAL STUDY OF ENDOMETRIAL PATTERN IN DYSFUNCTIO NAL UTERINE BLEEDING BY TRANSVAGINAL SONOGRAPHY AND IT’ S HISTOPATHOLOGICAL CORRELATION

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    Varsha; Yelikar; Medha,

    2013-01-01

    ABSTRACT: OBJECTIVE : To evaluate role of Transvaginal Sonography in Dys functional Uterine Bleeding, to correlate endometrial pattern on Trans vaginal Sonographic findings and Histopathological Examination Report Findings (HPER) in cases of Dysfunctional Uterine Bleeding, to assess sensitivity, specificity, positiv e predictive value and negative predictive value of Transvaginal Sonography for endometrial pattern i n cases of Dysfunctional Uterine Bleeding. M...

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

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

    2013-01-01

    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

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

    International Nuclear Information System (INIS)

    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.

  13. Cervical Myomas

    Science.gov (United States)

    ... infected, interfere with urinating, or cause pain during sexual intercourse. Doctors can see or feel most myomas during ... bleeding can cause anemia, with fatigue and weakness. Sexual intercourse may be painful. If myomas become infected, they ...

  14. Validity of pipelle endometrial sampling in patients with abnormal uterine bleeding

    OpenAIRE

    Fakhar Shazia; Saeed Gulshan; Khan Amir; Alam Ali

    2008-01-01

    Background and Objectives: We compared endometrial sampling by pipelle endometrial curette with Conventional dilatation and curettage (D&C) in patients with abnormal uterine bleeding. Methods: Endometrial sampling with pipelle curette was performed on 100 patients followed by formal D&C. Samples were labeled as A and B, respectively, and sent to a histopathologist who was blinded as to the method of sampling. The histopathology reports of both samples were compared, taking D&C as the gold ...

  15. Value of endometrial thickness measurement for diagnosing focal intrauterine pathology in women without abnormal uterine bleeding

    DEFF Research Database (Denmark)

    Dreisler, E; Sorensen, S Stampe; Ibsen, P H; Lose, G

    2009-01-01

    aged 20-74 years were invited to participate and 686 women were eligible and accepted inclusion (429 pre- and 257 postmenopausal). The women underwent TVS measurement of endometrial thickness and saline contrast sonohysterography (SCSH). Hysteroscopic resection with histopathology (gold standard) was...... myomas and one with polypoidal growing cancer). For premenopausal women, the area under the ROC curve (AUC) was 0.79 (95% CI, 0.68-0.89) and for postmenopausal women it was 0.84 (95% CI, 0.76-0.92). For premenopausal women, the best negative likelihood ratio (LR- = 0.11) was obtained at an endometrial...... thickness of 5.2 mm, with a negative predictive value (NPV) of 99% and a positive predictive value (PPV) of 10%. For postmenopausal women the best LR- (0.08) was obtained at an endometrial thickness of 2.8 mm, with a NPV of 99% and a PPV of 26%. CONCLUSIONS: In women without AUB, TVS measurement of...

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

    International Nuclear Information System (INIS)

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

  17. Parasitic myoma after supracervical laparoscopic histerectomy

    Directory of Open Access Journals (Sweden)

    Maurício Paulo Angelo Mieli

    2013-06-01

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

  18. Endometrial Ablation in Menopausal Women on Estrogen Replacement Therapy Complaining of Abnormal Uterine Bleeding

    Science.gov (United States)

    Phillips

    1994-08-01

    Since March 1986, 26 menopausal patients complaining of persistent, annoying uterine bleeding with estrogen replacement therapy underwent either a Nd:YAG laser or an electrosurgical endometrial ablation. All patients discontinued estrogen replacement therapy one month prior to the ablation and resumed one month after the surgical procedure. There were no intraoperative complications. All women became amenorrheic within 1 month of the procedure. Endometrial ablation is an effective alternative to discontinuing estrogen replacement therapy in postmenopausal women complaining of unwanted uterine bleeding. PMID:9073740

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

    International Nuclear Information System (INIS)

    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)

  20. 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)

    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

    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.

  1. 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

  2. Postpartum uterine involution in sheep: histoarchitecture and changes in endometrial gene expression.

    Science.gov (United States)

    Gray, C A; Stewart, M D; Johnson, G A; Spencer, T E

    2003-02-01

    After parturition, the uterus undergoes marked remodelling during involution; however, little is known of the hormonal, cellular and molecular mechanisms that regulate this process. The working hypothesis used in this study is that return of the ovine uterus to a non-pregnant state involves termination of a hormonal servomechanism that regulates endometrial gland morphogenesis and function during pregnancy. Suffolk ewes were ovariohysterectomized on postpartum days 1, 7, 14 or 28. Serum concentrations of oestradiol were high at parturition, declined to postpartum day 4, peaked on postpartum day 6, and then declined and remained low thereafter. Progesterone was undetectable in plasma from ewes post partum. Uterine wet mass and horn length decreased after postpartum day 1, but ovarian mass did not change. Residual placental cotyledons were present in the maternal caruncles on postpartum days 1 and 7 and were extruded by postpartum day 14 as plaques that were resorbed by postpartum day 28. The width of the total endometrium, stratum compactum, stratum spongiosum and myometrium, as well as endometrial gland density, decreased after parturition. Most apoptotic cells in the involuting uterus were large, vacuolated and located between the endometrial glandular epithelial cells on postpartum days 1 and 7. Immunofluorescence analyses identified both T and B cells within the glandular epithelium on postpartum day 1. Cell proliferation was detected in the luminal epithelium and glandular epithelium on postpartum days 1 and 7. On postpartum day 1, expression of oestrogen receptor alpha (ERalpha) was not detected in luminal epithelium and was low in glandular epithelium, but ERalpha was present in epithelia thereafter. Progesterone receptor (PR) protein was not detected in endometrial epithelia on postpartum day 1, but was detected in the glandular epithelium thereafter. Between postpartum days 1 and 7, ERalpha and PR protein increased substantially in the endometrial glandular epithelium. On postpartum days 1-28, abundant expression of oxytocin receptor mRNA was detected in endometrial luminal epithelium and superficial to the middle glandular epithelium. Prolactin receptor (PRLR) mRNA was detected in glandular epithelium on all postpartum days, whereas mRNA for uterine milk protein (UTMP), an index of secretory capacity of glandular epithelium, was present only on postpartum day 1. Collectively, these results indicate that uterine involution in ewes involves remodelling of both caruncular and intercaruncular areas of the uterine wall and termination of differentiated uterine gland functions characteristic of pregnancy. PMID:12578532

  3. Correlation of bleeding pattern with endometrial histopathologic results in perimenopausal women with abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Zehra Yilmaz

    2015-06-01

    Full Text Available Background: Abnormal Uterine Bleeding (AUB is referred as bleeding outside of normal menstruation pattern and it is the most common gynecological problem for women of all ages. This study was evaluated the correlation of menstrual bleeding patterns and endometrial histopathological findings in perimenopausal women. Methods: This study was done on perimenopausal aged women presented with AUB for the last 6 months at a gynecology clinic of a tertiary medical center. Only the patients with isolated endometrial causes of AUB were selected for study. A total of 313 cases were included in the study. Abnormal bleeding patterns of the patients were recorded and endometrial sampling was performed to all women. AUB was classified as menorrhagia, metrorrhagia, menometrorrhagia, polymenorrhea, intermenstrual bleeding, and histopathological findings were classified as Proliferative Endometrium (PE, Secretory Endometrium (SE, Disordered Proliferative Pattern (DPP, Endometrial Polyp (EP, Chronic Endometritis (CE, Endometrial Hyperplasia (EH, and Endometrial Adenocarcinoma (CA. Results: The most common bleeding pattern was menorrhagia (45.0% and the most common histopathological finding was PE+SE (52.0% in our study. PE+SE and endometrial hyperplasia without atypia were found more common in menorrhagia group. The most histopathological findings were found PE+SE in menometrorrhagia and polymenorrhea group (P 0.05. Conclusions: We concluded that although menometrorrhagia and polymenorrhea were significantly more associated with PE+SE, intermenstrual bleeding was significantly more associated with EP and CE. It is noteworthy that endometrial hyperplasia without atypia is significantly higher in patients with menorrhagia which is the most common abnormal bleeding pattern in perimenopausal aged women. [Int J Reprod Contracept Obstet Gynecol 2015; 4(3.000: 547-550

  4. Uterine malignant degeneration after low-dose endometrial irradiation

    International Nuclear Information System (INIS)

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

  5. Giant myoma and erythrocytosis syndrome.

    Science.gov (United States)

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

    1999-08-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

  7. Current approaches to the treatment of endometrial hyperplasia in women with uterine leiomyoma

    Directory of Open Access Journals (Sweden)

    Potapov V.A.

    2014-09-01

    Full Text Available The study involved 155 women, of which 30 healthy women were in the control group. 125 women with uterine leiomyomas and endometrial hyperplasia constituted the main groups. In all women with uterine leiomyoma myomectomy was performed. Further treatment included randomized study of a new regimen of GnRH agonists together with COCs after myomectomy using comparison techniques: monotherapy with a-GnRH, progestins (dydrogesterone or COCs. The treatment using different medication regimens of endometrial hyperplasia after myomectomy convincingly demonstrated significantly greater efficacy of GnRH-a and COCs com¬bination in reducing frequency of symptoms of these diseases, volume of menstrual blood loss and improvement quality of life through the entire observation period. Greater efficacy of COCs and a-GnRH combination, to our opinion, is associated with a greater degree of suppression of cell proliferation and angiogenesis as a result of local (COCs, and systemic effects (a-GnRH.Thus, the proposed method of adjuvant therapy after myomectomy for women with associated endometrial hyperplasia has significant clinical benefits with minimal impact on bone mineral density and other menopausal signs caused by a-GnRH monotherapy.

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

    Directory of Open Access Journals (Sweden)

    Katia Ramírez Fajardo

    2012-09-01

    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.

  9. Analysis of 258 cases of uterine endometrial carcinoma in 18 years

    International Nuclear Information System (INIS)

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

  10. Uterine blood flow evaluation in bitches suffering from cystic endometrial hyperplasia (CEH) and CEH-pyometra complex.

    Science.gov (United States)

    Batista, P R; Gobello, C; Rube, A; Corrada, Y A; Tórtora, M; Blanco, P G

    2016-04-15

    Doppler ultrasound is a useful diagnosis tool to evaluate uterine blood flow in different canine reproductive states. The aim of this study was to describe and compare uterine blood flow in bitches suffering from cystic endometrial hyperplasia (CEH) and CEH-pyometra complex (CEH-P). Ninety diestrous bitches were clinically, hematologically, and ultrasonographically classified into four groups: (1) clinical signs, leukocytosis, CEH, and uterine luminal contents (CEH-P, n = 31); (2) asymptomatic bitches with CEH and uterine contents (CEH-C, n = 15); (3) asymptomatic bitches with CEH without uterine contents (CEH, n = 16); and (4) normal diestrous bitches (ND, n = 28). The widest cross-sectional diameter and uterine wall thickness (W) of uterine horns were measured using two-dimensional ultrasound. Peak systolic velocity and end diastolic velocity of uterine arteries were measured by Doppler ultrasound in all the bitches. Peak systolic velocity and end diastolic velocity were higher in CEH-P than in CEH-C, CEH, and ND (P  0.1). Conversely, resistance index (RI) reported lower values in CEH-P than that in the other three groups (P  0.1). When all the bitches were considered, correlation between RI and cross-sectional diameter was r = -0.69 (P  0.1). It is concluded that the uterine artery blood flow velocity of bitches suffering from pyometra was higher, not only from normal bitches, but also from females with endometrial hyperplasia. Furthermore, endometrial hyperplasia, accompanied or not by luminal contents, had a higher blood flow velocity than normal uterus. Hemodynamic parameters appear as useful markers to differentiate uterine pathologic conditions. PMID:26810829

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

    Science.gov (United States)

    2016-02-09

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

  12. 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)

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

    Directory of Open Access Journals (Sweden)

    M Aghahoseini

    2008-12-01

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

  14. [Endometrial imaging].

    Science.gov (United States)

    Lemercier, E; Genevois, A; Dacher, J N; Benozio, M; Descargues, G; Marpeau, L

    2000-12-01

    The diagnostic value of endovaginal sonography in benign or malignant endometrial pathology is high, increased by sonohysterography. Sonohysterography is useful in the diagnosis of endometrial thickness and to determine further investigations. MRI is accurate in the uterine adenomyosis diagnosis and is the imaging modality of choice for the preoperative endometrial cancer staging. PMID:11173754

  15. 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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2012-09-15

    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.

  17. Cystic adenomyosis spreading into subserosal-peduncolated myoma: How to explain it?

    Directory of Open Access Journals (Sweden)

    Gloria Calagna

    2015-01-01

    Conclusions: In this case, the peculiar growth pattern of cystic adenomyosis in a myoma represents a singular condition rarely reported in the medical literature. We therefore support the pathogenetic theory that the disease might have been caused by direct proliferation of endometrial cells within a peduncolated- subserosal myoma.

  18. Is myomectomy safe during cesarean section in large myomas?

    OpenAIRE

    Senturk, Mehmet Baki; Budak, Mehmet Sukru; Cakmak, Yusuf; Turan, Kasim

    2015-01-01

    Objective: The rate of cesarean section, gravida and pregnancy age have been gradually increasing. Thus the rate of myoma have increased during cesarean. But it may difficult to make decision aboıut myomectomy during cesarean especially large myomas because of complications. Therefore, several obstetricians do not recommend cesarean myomectomy, except in cases of small and pedunculated uterine fibroids that do not result in complications.The aim of this study to evaluate safety of myomectomy ...

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

    Fraser, I.S.; McCarron, G.; Hutton, B.; Macey, D.

    1987-01-01

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

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

    OpenAIRE

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

    2013-01-01

    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 ch...

  2. Uterine NK cells regulate endometrial bleeding in women and are suppressed by the progesterone receptor modulator asoprisnil.

    Science.gov (United States)

    Wilkens, Julia; Male, Victoria; Ghazal, Peter; Forster, Thorsten; Gibson, Douglas A; Williams, Alistair R W; Brito-Mutunayagam, Savita L; Craigon, Marie; Lourenco, Paula; Cameron, Iain T; Chwalisz, Kristof; Moffett, Ashley; Critchley, Hilary O D

    2013-09-01

    Uterine NK cells (uNK) play a role in the regulation of placentation, but their functions in nonpregnant endometrium are not understood. We have previously reported suppression of endometrial bleeding and alteration of spiral artery morphology in women exposed to asoprisnil, a progesterone receptor modulator. We now compare global endometrial gene expression in asoprisnil-treated versus control women, and we demonstrate a statistically significant reduction of genes in the IL-15 pathway, known to play a key role in uNK development and function. Suppression of IL-15 by asoprisnil was also observed at mRNA level (p IL-15RA. Thus, the response of stromal cells to progesterone will be to increase IL-15 trans-presentation to uNK, supporting their expansion and differentiation. In asoprisnil-treated endometrium, there is a marked downregulation of stromal PR expression and virtual absence of uNK. These novel findings indicate that the IL-15 pathway provides a missing link in the complex interplay among endometrial stromal cells, uNK, and spiral arteries affecting physiologic and pathologic endometrial bleeding. PMID:23913972

  3. Uterine Natural Killer cells regulate endometrial bleeding in women and are suppressed by the progesterone receptor modulator asoprisnil

    Science.gov (United States)

    Wilkens, Julia; Male, Victoria; Ghazal, Peter; Forster, Thorsten; Gibson, Douglas A.; Williams, Alistair RW; Brito-Mutunayagam, Savita L; Craigon, Marie; Lourenco, Paula; Cameron, Iain T; Chwalisz, Kristof; Moffett, Ashley; Critchley, Hilary OD

    2013-01-01

    Uterine NK cells (uNK) play a role in the regulation of placentation but their functions in non-pregnant endometrium are not understood. We have previously reported suppression of endometrial bleeding and alteration of spiral artery morphology in women exposed to asoprisnil, a progesterone receptor modulator. We now compare global endometrial gene expression in asoprisnil-treated versus control women, and we demonstrate a statistically significant reduction of genes in the IL-15 pathway, known to play a key role in uNK development and function. Suppression of IL-15 by asoprisnil was also observed at mRNA level (pIL-15RA. Thus, the response of stromal cells to progesterone will be to increase IL-15 trans-presentation to uNK, supporting their expansion and differentiation. In asoprisnil-treated endometrium, there is a marked down-regulation of stromal PR expression and virtual absence of uNK. These novel findings indicate that the IL-15 pathway provides a missing link in the complex interplay between endometrial stromal cells, uNK and spiral arteries affecting physiological and pathological endometrial bleeding. PMID:23913972

  4. Antioxidant enzymes and lipid peroxidation in endometrium of patients with polyps, myoma, hyperplasia and adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Pajović Snežana B

    2009-12-01

    Full Text Available Abstract Background Oxidative stress and impaired antioxidant system have been proposed as a potential factors involved in the pathophysiology of diverse disease states, including carcinogenesis. In this study, we explored the lipid peroxidation levels and antioxidant enzyme activities in women diagnosed with different forms of gynecological diseases in order to evaluate the antioxidant status in endometrium of such patients. Methods Endometrial tissues of gynecological patients with different diagnoses were collected and subjected to assays for superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase and lipid hydroperoxides. Results Superoxide dismutase activity was significantly decreased (50% in average in hyperplastic and adenocarcinoma patients. Activities of both glutathione peroxidase and glutathione reductase were increased 60% and 100% on average, in hyperplastic patients, while in adenocarcinoma patients only glutathione reductase activity was elevated 100%. Catalase activity was significantly decreased in adenocarcinoma patients (47%. Lipid hydroperoxides level was negatively correlated to superoxide dismutase and catalase activities, and positively correlated to glutathione peroxidase and glutathione reductase activities. Conclusions This study provided the first comparison of antioxidant status and lipid peroxidation in endometrial tissues of patients with polyps, myoma, hyperplasia and adenocarcinoma. The results showed that patients with premalignant (hyperplastic and malignant (adenocarcinoma lesions had enhanced lipid peroxidation and altered uterine antioxidant enzyme activities than patients with benign uterine diseases, polyps and myoma, although the extent of disturbance varied with the diagnosis. Further investigation is needed to clarify the mechanisms responsible for the observed alterations and whether lipid hydroperoxide levels and antioxidant enzyme activities in uterus of gynecological patients might be used as additional parameter in clinical evaluation of gynecological disorders.

  5. Differences in progesterone concentrations and mRNA expressions of progesterone receptors in bovine endometrial tissue between the uterine horns ipsilateral and contralateral to the corpus luteum.

    Science.gov (United States)

    Takahashi, Hiroto; Haneda, Shingo; Kayano, Mitsunori; Matsui, Motozumi

    2016-05-01

    Because the establishment of pregnancy begins at the uterine horn ipsilateral to the corpus luteum (ipsi-horn) in cattle, levels of progesterone (P4) and receptor expression in the endometrial tissue, which regulate the intrauterine environment for embryo development, may differ between the ipsi-horn and the uterine horn contralateral to corpus luteum (contra-horn). The aim of the present study was to determine the endometrial tissue P4 concentrations and nuclear progesterone receptor (PGR), progesterone receptor membrane component 1 (PGRMC1) and PGRMC2 mRNA expressions in the cranial and middle parts of the uterine horns during the luteal phase. The results showed higher endometrial tissue P4 concentrations in the cranial part of the ipsi-horn than in that of the contra-horn (Pmiddle part, there were no changes in the endometrial tissue P4 concentrations and P4 receptor expressions during the luteal phase. In conclusion, the differences in dynamics of endometrial tissue P4 concentrations and P4 receptor expressions between the uterine horns ipsilateral and contralateral to the ovary containing a corpus luteum may cause differences in the intrauterine environment for both the ipsi- and contra-horns. PMID:26782011

  6. Managing cesarean section in a patient with rotated uterus due to a large myoma

    OpenAIRE

    Matsuzaki, Shinya; Kakigano, Aiko; KIMURA, TADASHI

    2015-01-01

    Key Clinical Message In pregnancies complicated by large myomas, obstetricians may face difficulties during cesarean section if they fail to notice the rotation of the uterus and could make an incorrect uterine incision. This error might cause massive intraoperative hemorrhage. Obstetricians must exercise extreme caution during cesarean sections complicated by large myomas.

  7. The Effects of Nitric Oxide Donors on Uterine Artery and Sub-endometrial Blood Flow in Patients with Unexplained Recurrent Abortion

    OpenAIRE

    Abdel-Razik, Mohamed; El-Berry, Seham; Mostafa, Ahmed

    2014-01-01

    Background Nitric oxide plays a major role in increasing uterine blood flow during the luteal phase and early pregnancy. This study was done to compare uterine artery and sub-endometrial blood flow indices during the luteal phase between patients with unexplained recurrent abortion and fertile women and also to evaluate the effects of nitric oxide donors on blood flow indices in the abortion group. Methods The study included a control group of 30 primiparae who had normal vaginal delivery and...

  8. Vaginal Myomectomy for Semipedunculated Cervical Myoma during Pregnancy

    Directory of Open Access Journals (Sweden)

    Mikitaka Obara

    2014-05-01

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

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

    Directory of Open Access Journals (Sweden)

    Fang Chia-Lang

    2012-09-01

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

  10. Gene expression profiling of the paracrine effects of uterine natural killer cells on human endometrial epithelial cells.

    Science.gov (United States)

    Gong, Xin; Chen, Zhenzhen; Liu, Yanxia; Lu, Qiudan; Jin, Zhe

    2014-01-01

    The endometrium contains a population of immune cells that undergo changes during implantation and pregnancy. The majority of these cells are uterine natural killer (uNK) cells; however, it is unclear how these cells interact with endometrial epithelial cells. Therefore, we investigated the paracrine effects of the uNK cell-secretion medium on the gene expression profile of endometrial epithelial cells in vitro through microarray analysis. Our results, which were verified by qRT-PCR and western blot, revealed that soluble factors from uNK cells alter the gene expression profiles of epithelial cells. The upregulated genes included interleukin-15 (IL-15) and interleukin-15 receptor alpha (IL-15RA), which result in a loop that stimulates uNK cell proliferation. In addition, vascular endothelial growth factor C (VEGF-C) and chemokine (C-X-C motif) ligand 10 (CXCL-10) were also determined to be upregulated in epithelial cells, which suggests that uNK cells work synergistically with epithelial cells to support implantation and pregnancy. In addition, oriental herbal medicines have been used to treat infertility since ancient times; however, we failed to find that Zi Dan Yin can regulate these endometrial paracrine effects. PMID:24790599

  11. Wnt antagonist DKK1 is a target of Kruppel-like factor 9 (KLF9) in endometrial stromal cells: Implications for uterine receptivity

    Science.gov (United States)

    A significant underlying cause of pregnancy loss in mammals is the inability of the uterine epithelium to enter a "state of receptivity" for embryo implantation, due partly to the dysfunctional response of endometrial cells to progesterone (P). We previously showed that mice null for the Sp1-related...

  12. Hysteroscopic findings in postmenopausal patients with ultrasonographic diagnosis of endometrial thickening

    Directory of Open Access Journals (Sweden)

    Hosana Karinne de Marathaoan Souza Martins e Castello Branco

    2008-09-01

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

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

    Science.gov (United States)

    2016-02-09

    Endometrial Adenocarcinoma; Endometrial Clear Cell Adenocarcinoma; Endometrial Serous Adenocarcinoma; Endometrial Undifferentiated Carcinoma; Recurrent Uterine Corpus Carcinoma; Stage IIIA Uterine Corpus Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Uterine Corpus Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer

  14. Temsirolimus With or Without Megestrol Acetate and Tamoxifen Citrate in Treating Patients With Advanced, Persistent, or Recurrent Endometrial Cancer

    Science.gov (United States)

    2016-01-27

    Endometrial Carcinoma; Recurrent Uterine Corpus Carcinoma; Stage IIIA Uterine Corpus Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC1 Uterine Corpus Cancer; Stage IIIC2 Uterine Corpus Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer

  15. Diffusion-weighted magnetic resonance imaging to detect synchronous uterine endometrial and endocervical adenocarcinoma

    Directory of Open Access Journals (Sweden)

    Filomena Marino Carvalho

    2012-01-01

    Full Text Available Synchronous endometrial and cervical cancer is a very rare condition. This report describes a case of a 46-year-old woman who presented with a cervical mass that measured 5.6 cm along its longest diameter, whose biopsy analysis revealed an endocervical mucinous adenocarcinoma. She was classified as having an IB2 cervical carcinoma and treated with concurrent chemoradiation plus hysterectomy. Pathological and immunohistochemical analysis of the surgical specimens revealed a synchronous endometrioid grade 2 adenocarcinoma in the endometrium, and a well-differentiated mucinous adenocarcinoma in the cervix. Magnetic resonance imaging (MRI studies performed prior to treatment were reviewed and apparent diffusion coefficient (ADC maps were generated. The ADC values demonstrated distinct signal intensity differences between the endometrial and endocervical tumors. In conclusion, diffusion-weighted MRI and ADC maps can help to distinguish the site of origin of synchronous tumors.

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

    OpenAIRE

    Petitbarat, M.; Rahmati, M.; Sérazin, V.; Dubanchet, S.; Morvan, C.; Wainer, R.; de Mazancourt, P.; Chaouat, G.; Foidart, Jean-Michel; Munaut, Carine; Lédée, N.

    2011-01-01

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

  17. 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 ...

  18. 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)

    André Bernardo

    2011-08-01

    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.

  19. Uterine pathologies to be considered before uterus-preserving surgery in cases of uterine prolapse

    Directory of Open Access Journals (Sweden)

    Fatma Eskicioğu

    2015-12-01

    Full Text Available Objective: Investigation of unpredictable risks due to abnormal uterine pathology after the choice of uterus-preserving reconstructive surgical procedure for women who have uterine prolapse and no other complaints was aimed. Methods: The data of 121 women (105 postmenopausal and 16 premenopausal who underwent vaginal hysterectomy due to pelvic organ prolapse was examined and the post-hysterectomy histopathology results were evaluated. Results: Senile cystic atrophy was the most common endometrial pathology result among postmenopausal women (63.5%. However, proliferative and secretory endometrium was the most common endometrial pathology finding among premenopausal women (81.3%. There were statistically significant differences between postmenopausal and perimenopausal women in terms of these pathology results (p0.05, myoma uteri was significantly more common in patients with perimenopause (p=0.01. Conclusion: The uterus must be evaluated in terms of endometrial pathologies in asymptomatic women with pelvic organ prolapse before uterus-preserving reconstructive surgical procedure, especially in postmenopausal period. J Clin Exp Invest 2015; 6 (4: 443-446

  20. Paclitaxel, Carboplatin, and Bevacizumab or Paclitaxel, Carboplatin, and Temsirolimus or Ixabepilone, Carboplatin, and Bevacizumab in Treating Patients With Stage III, Stage IV, or Recurrent Endometrial Cancer

    Science.gov (United States)

    2016-03-18

    Endometrial Adenocarcinoma; Endometrial Adenosquamous Carcinoma; Endometrial Clear Cell Adenocarcinoma; Endometrial Serous Adenocarcinoma; Recurrent Uterine Corpus Carcinoma; Stage IIIA Uterine Corpus Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Uterine Corpus Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer

  1. Dilatation and Curettage Effect on the Endometrial Thickness

    Science.gov (United States)

    Davar, Robab; Dehghani Firouzabadi, Razieh; Chaman Ara, Kefayat

    2013-01-01

    Background Endometrial receptivity is required for successful implantation and pregnancy. Despite the remaining controversy, many studies have shown that ultrasonographic endometrial thickness can be considered as an indicator of endometrial receptivity. Objective The study objective was to investigate the effect of dilatation and curettage on the endometrial thickness. Materials and Methods Enrolled in the study were 444 patients visited in Obstetrics & Gynecology clinic of Shahid Sadoughi hospital between Jan. 2011 to Sep. 2012. Only patients whose menstrual cycle was regular were included in study. Patients with myoma, adenomyosis, endometrial polyps or other uterine anomaly, those who smoked, whose BMI was greater than 30 and who were taking medications that could affect endometrial thickness were excluded. Endometrial thickness was measured one day before evolution (n = 444) and 5-7 days after it (n = 444) using transvaginal ultrasonography. The endometrial thicknesses were correlated to the patients’ history of dilatation and curettage. Data analysis was done through SPSS software version 16 and using descriptive statistics, independent T-test and Anova. Results Endometrial thickness in patients who had 0, 1, 2, 3 and 4 D&C were 10.00 ± 0.58, 9.83 ± 0.47, 8.90 ± 0.92, 7.42 ± 0.18 and 7.40 ± 0.07, respectively one day before ovulation (spearman’s correlation coefficient = -0.33) and 10.62 ± 0.68, 9.64 ± 0.49, 8.48 ± 0.96, 6.32 ± 0.15 and 6.90 ± 0.04, respectively, 5-7 days after ovulation (spearman’s correlation coefficient = -0.66) estradiol and progesterone levels, measured in the day of 2nd ultrasonography had not statistic relation with endometrial thickness (P = 0.27 and 0.31). The relation of endometrial thickness and age was not significant (P = 0.54 and 0.06). Conclusions Dilatation and curettage has a significant effect on the endometrial thinning. PMID:24083012

  2. Uterine lavage is efficient to recover endometrial cytology sample and does not interfere with fertility rate after artificial insemination in cows.

    Science.gov (United States)

    Thomé, Helder Esteves; de Arruda, Rubens Paes; de Oliveira, Bruna Marcele Martins; Maturana Filho, Milton; de Oliveira, Guilherme Cain; Guimarães, Carina de Fátima; de Carvalho Balieiro, Júlio César; Azedo, Milton Ricardo; Pogliani, Fábio Celidônio; Celeghini, Eneiva Carla Carvalho

    2016-06-01

    Productivity rates directly depend on the fertility of a herd, which in turn can be influenced by many factors. Semen deposited in the female reproductive tract is foreign to the body and, in response to this invasion, produces an inflammatory reaction, which is characterized by rapid infusion of polymorphonuclear (PMN) cells. Techniques to obtain an endometrial sample are usually invasive and can mask the true inflammatory response. Ultrasound is a noninvasive technique and can contribute to the diagnosis of postartificial insemination (AI) inflammatory response in cattle. The present study was divided into two experiments. The aim of experiment 1 was to compare two methods of endometrial cytology collection, uterine cytobrush (UC) and uterine lavage (UL), and their effects on uterine hemodynamics that provide information about blood flow. The two methods were evaluated by Doppler ultrasound using the spectral and color modes. For that purpose, 19 Nellore cows were synchronized for timed AI and subjected to UC (n = 9) or UL (n = 10). The techniques were performed 4 hours after AI. The results showed that both techniques allow collection of a good quality sample and with enough PMN cells to perform counting. More PMN cells were obtained by UL than UC. There was no difference in uterine blood flow between the UC and UL groups in any of the periods evaluated (34 hours before and 4, 24, and 48 hours after collection of uterine sample). On the basis of results of experiment 1, the effect of UL on fertility was studied in experiment 2. A total of 128 Nellore cows were synchronized for TAI; 35 cows were subjected to endometrial cytology by UL 4 hours after AI, and 93 were not submitted to any procedure (control). Pregnancy diagnosis was performed by transrectal ultrasound 30 days after AI. Pregnancy rates did not differ between UL (54.29%) and control (56.99%) groups. The results of this study showed that UL allows the collection of more representative cells of the surface of the uterus than UC technique and causes no damage to the reproductive tract. Moreover, UL did not affect pregnancy rate when performed 4 hours after AI. PMID:26850464

  3. Endometrial Imaging

    Directory of Open Access Journals (Sweden)

    Khadijeh Bakhtavar

    2009-01-01

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

  4. Optimal uterine anatomy and physiology necessary for normal implantation and placentation.

    Science.gov (United States)

    de Ziegler, Dominique; Pirtea, Paul; Galliano, Daniela; Cicinelli, Ettore; Meldrum, David

    2016-04-01

    The authors review aberrations of uterine anatomy and physiology affecting pregnancy outcomes with IVF. In the case of endometriosis and hydrosalpinx, pathologies outside of the uterus alter the uterine endometrium. In the case of endometriosis, Dominique de Ziegler outlines the numerous changes in gene expression and the central role of inflammation in causing progesterone resistance. With endometriosis, the absence of ovarian function inherent in deferred transfer, with or without a more lengthy suppression of ovarian function, appears to be sufficient to restore normal function of eutopic endometrium. Because laparoscopy is no longer routine in the evaluation of infertility, unrecognized endometriosis then becomes irrelevant in the context of assisted reproductive technology. With hydrosalpinx and submucus myomas, the implantation factor HOXA-10 is suppressed in the endometrium and, with myomas, even in areas of the uterus not directly affected. Daniela Galliano reviews various uterine pathologies, the most enigmatic being adenomyosis, where the endometrium also manifests many of the changes seen in endometriosis and deferred transfer with extended suppression appears to provide the best outcomes. Ettore Cicinelli's group has extensively studied the diagnosis and treatment of endometritis, and although more definitive diagnosis and care of this covert disorder may await techniques such as sequencing of the endometrial microbiome, it undoubtedly is an important factor in implantation failure, deserving our attention and treatment. PMID:26926252

  5. Laparoscopic Myomectomy for Large Myomas

    OpenAIRE

    Yoon, Hyo Jin; Kyung, Min Sun; Jung, Un Suk; Choi, Joong Sub

    2007-01-01

    The aim of this study was to assess the feasibility and efficacy of laparoscopic myomectomy (LM) for large myomas. A subpopulation of 51 patients with myomas 8 cm or larger in diameter was selected from 155 patients who underwent LM at Kangbuk Samsung Hospital from July 2003 to November 2006. The mean age of the patients was 34.9±5.6 yr, mean parity was 0.6±0.9, and 8 patients had a previous operative history. The most common operative indication was a palpable abdominal mass (24 patients, 47...

  6. 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)

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

    2012-01-01

    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); Pslides 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 (Pslides. 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

  7. Patient, Physician, and Nurse Factors Associated With Entry Onto Clinical Trials and Finishing Treatment in Patients With Primary or Recurrent Uterine, Endometrial, or Cervical Cancer

    Science.gov (United States)

    2016-02-09

    Recurrent Cervical Carcinoma; Recurrent Uterine Corpus Carcinoma; Recurrent Uterine Corpus Sarcoma; Stage I Uterine Corpus Cancer; Stage I Uterine Sarcoma; Stage IA Cervical Cancer; Stage IB Cervical Cancer; Stage II Uterine Corpus Cancer; Stage II Uterine Sarcoma; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Uterine Corpus Cancer; Stage III Uterine Sarcoma; Stage IV Uterine Corpus Cancer; Stage IV Uterine Sarcoma; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer

  8. Screening for uterine tumours.

    Science.gov (United States)

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

    2012-04-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2006-02-15

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

  10. Carboplatin and Paclitaxel With or Without Cisplatin and Radiation Therapy in Treating Patients With Stage I, Stage II, Stage III, or Stage IVA Endometrial Cancer

    Science.gov (United States)

    2016-02-09

    Endometrial Clear Cell Adenocarcinoma; Endometrial Serous Adenocarcinoma; Stage IA Uterine Corpus Cancer; Stage IB Uterine Corpus Cancer; Stage II Uterine Corpus Cancer; Stage IIIA Uterine Corpus Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Uterine Corpus Cancer; Stage IVA Uterine Corpus Cancer

  11. 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.)

  12. SUCCESSFUL PREGNANCY OUTCOME IN SUB-MUCOUS MYOMA: A CASE REPORT

    Directory of Open Access Journals (Sweden)

    Susmita

    2014-07-01

    Full Text Available Myomas are the most common benign tumors of the female genital tract and are associated with numerous clinical problems including a negative impact on fertility. Myomas that compress the uterine cavity like submucous myomas significantly reduce pregnancy rates. CASE: A 29 year old primi-gravida woman with term pregnancy (39 weeks 2days came to the out-patient department, of the department of Obstetrics and Gynecology with pain abdomen on 26th July, 2013 and got admitted. On per vaginal examination cephalo- pelvic disproportion was detected and emergency lower segment caesarean section was done under spinal anesthesia. A single live male baby weighing 3.9 kg was delivered by cephalic presentation. Interestingly, a retro-placental submucous myoma was found intra-operatively in the right fundal area measuring 5 cm * 5 cm. There was no intra-operative or post-operative complication. Patient got discharged on the 5th post-operative day with routine post-operative advice. CONCLUSION: Sub-mucous myomas prevent implantation and growth of the embryo and thereby cause infertility in most of the cases. Chance of progressing to term pregnancy with successful outcome is very rare. This type of cases should be managed with expertise obstetric guidance and care.

  13. Oxidative damage of DNA induced by X-irradiation decreases the uterine endometrial receptivity which involves mitochondrial and lysosomal dysfunction

    OpenAIRE

    Gao, Wei; Liang, Jin-Xiao; LIU, SHUAI; Liu, Chang; Liu, Xiao-fang; Wang, Xiao-Qi; Yan, Qiu

    2015-01-01

    X irradiation may lead to female infertility and the mechanism is still not clear. After X irradiation exposure, significantly morphological changes and functional decline in endometrial epithelial cells were observed. The mitochondrial and lysosomal dysfunction and oxidative DNA damage were noticed after X irradiation. In addition, pretreatment with NAC, NH4Cl or Pep A reduced the X irradiation induced damages. These studies demonstrate that the oxidative DNA damage which involved dysfunctio...

  14. ROLE OF MIFEPRISTONE IN MEDICAL MANAGEMENT OF UTERINE FIBROID

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    Shradha

    2015-10-01

    Full Text Available BACKGROUND: Uterine leiomyoma is the most common benign tumour of uterus affecting women of reproductive age group and accounting for most common indication of hysterectomy in India. Effective medical treatment option can prevent hysterectomy related morbidity. MATERIALS AND METHODS: A total of 50 women with symptomatic leiomyoma and asymptomatic with uterine volume >160cc and fibroid size >2.5cm were included in the study. 20mg/day mifepristone was given to them over period of 3 months. Follow up was done at 1, 3 and 6 months of starting treatment. At each visit patients were evaluated for symptomatic improvement of menorrhagia, dysmenorrhoea and ultrasound for myoma volume, haemogram was done. Endometrial biopsy was done at the beginning of therapy, 3rd month and at end of treatment. RESULTS: At the beginning of study, all patients had menorrhagia. At 3 months, 80% developed amenorrhea and 20% scanty menses. At 6 months, 56% had scanty menses and 38% had normal menses but none had menorrhagia. 50% of patients had dysmenorrhoea at the beginning of study with severe dysmenorrhoea in 36% of cases. Only 10% of patients at 3 months and 14% at 6 months had dysmenorrhoea. Improvement in haemoglobin percentage from 9.6 gram% to 10.8 gram% at 3 months of therapy. The reduction in mean uterine volume was 12.28%after 1 month, 26.95% after 3 months and 11.13% at end of 6 months, as compared to pre-treatment level. Fibroid volume decreased by 14.34% after 1 month ,29.8% after 3 months and 24.98% at end of 6 months, as compared to pre-treatment level. At the end of 3 months, 50% of patients experienced no side effect. Rest 50% experienced minor side effects like nausea (8%, hot flushes (4%, liver dysfunction as evidenced by mild increase in transaminase (8% and simple endometrial hyperplasia in 30%. Follow up of these patients at 6 month i.e., 3 months after stopping the drug does not show any evidence of persistence of these effects. CONCLUSION: 20mg mifepristone produces reduction in myoma size, uterine volume and improvement of symptoms like menorrhagia and dysmenorrhoea. It is administered orally, cost effective and is well tolerable with less side effects.

  15. Dysfunctional uterine bleeding (DUB).

    Science.gov (United States)

    Bulletti, C; Flamigni, C; Prefetto, R A; Polli, V; Giacomucci, E

    1994-09-30

    Cyclic or irregular uterine bleeding is common in perimenarchal and perimenopausal women with or without endometrial hyperplasia. The disturbance often requires surgical treatment because of its negative effects on both blood loss and abnormal endometrial growth including the development of endometrial cancer. The endometrium is often overstimulated during the perimenopausal period when estrogen/progesterone production is unbalanced. A therapeutical approach with gonadotropin-releasing hormone agonist (GnRHa) was proposed in a depot formulation (Zoladex) that induces a sustained and reversible ovarian suppression. To avoid the risk of osteoporosis and to obtain adequate endometrial proliferation and differentiation during ovarian suppression, transdermal 17-beta-estradiol and oral progestin were administered. Results of 20 cases versus 20 controls showed a reduction of metrorrhagia, a normalization of hemoglobin plasma concentration, and an adequate proliferation and secretory differentiation of the endometrium of patients with abnormal endometrial growth. Abnormal uterine bleeding is mainly due to uterine fibrosis and an inadequate estrogen and/or progesterone production or to a disordered estrogen transport from blood into the endometrium. In premenopausal women, endometrial hyperplasia may be part of a continuum that is ultimately manifested in the histological and biological pattern of endometrial carcinoma. The regression of endometrial hyperplasia obtained by using the therapeutic regimen mentioned above represents a preventive measure for endometrial cancer. Finally the normalization of blood loss offers a good medical alternative to surgery for patients with DUB. PMID:7978956

  16. Uterine Lesions

    Directory of Open Access Journals (Sweden)

    A. Kurjak

    2005-08-01

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

  17. Cost-Effectiveness of Global Endometrial Ablation vs. Hysterectomy for Treatment of Abnormal Uterine Bleeding: US Commercial and Medicaid Payer Perspectives

    Science.gov (United States)

    Lenhart, Gregory M.; Bonafede, Machaon M.; Lukes, Andrea S.; Laughlin-Tommaso, Shannon K.

    2015-01-01

    Abstract Cost-effectiveness modeling studies of global endometrial ablation (GEA) for treatment of abnormal uterine bleeding (AUB) from a US perspective are lacking. The objective of this study was to model the cost-effectiveness of GEA vs. hysterectomy for treatment of AUB in the United States from both commercial and Medicaid payer perspectives. The study team developed a 1-, 3-, and 5-year semi-Markov decision-analytic model to simulate 2 hypothetical patient cohorts of women with AUB—1 treated with GEA and the other with hysterectomy. Clinical and economic data (including treatment patterns, health care resource utilization, direct costs, and productivity costs) came from analyses of commercial and Medicaid claims databases. Analysis results show that cost savings with simultaneous reduction in treatment complications and fewer days lost from work are achieved with GEA versus hysterectomy over almost all time horizons and under both the commercial payer and Medicaid perspectives. Cost-effectiveness metrics also favor GEA over hysterectomy from both the commercial payer and Medicaid payer perspectives—evidence strongly supporting the clinical-economic value about GEA versus hysterectomy. Results will interest clinicians, health care payers, and self-insured employers striving for cost-effective AUB treatments. (Population Health Management 2015;18:373–382) PMID:25714906

  18. What Are the Risk Factors for Endometrial Cancer?

    Science.gov (United States)

    ... have gone through menopause, it can cause the uterine lining to grow, which increases the risk of endometrial cancer. The risk of developing endometrial cancer from tamoxifen is low (less than 1% per year). Women ...

  19. Microsomal epoxide hydrolase expression in the endometrial uterine corpus is regulated by progesterone during the menstrual cycle.

    Science.gov (United States)

    Popp, Simone L; Abele, Ina S; Buck, Miriam B; Stope, Matthias B; Blok, Leen J; Hanifi-Moghaddam, Payman; Burger, Curt W; Fritz, Peter; Knabbe, Cornelius

    2010-04-01

    We have shown previously that high expression levels of microsomal epoxide hydrolase (mEH) correlate with a poor prognosis of breast cancer patients receiving tamoxifen, suggesting that enhanced mEH expression could lead to antiestrogen resistance (Fritz et al. in J Clin Oncol 19:3-9, 2001). Thus, the purpose of this study was to gain insights into the role of mEH in hormone-responsive tissues. We analyzed biopsy samples of the endometrium by immunohistochemical staining, pointing to a regulation of mEH during the menstrual cycle: during the first half mEH expression was low, increased during the second half and reached highest levels during pregnancy. Additionally, the progesterone receptor (PR) positive human endometrial cell lines IKPRAB-36 (estrogene receptor alpha [ERalpha] negative) and ECC1-PRAB72 (ERalpha positive) were chosen to further investigate the hormonal regulation of mEH expression. Western Blot and quantitative RT-PCR analysis revealed an increase of mEH expression after treatment with medroxy-progesterone 17-acetate (MPA) in the ERalpha containing ECC1-PRAB72 cells. In contrast our results suggest that MPA had no influence on the mEH protein level in the ERalpha- IKPRAB-36 cells. In conclusion, mEH expression is regulated by progesterone in the presence of both PRs and ERalpha. PMID:20383792

  20. Enzymes of the AKR1B and AKR1C subfamilies and uterine diseases

    Directory of Open Access Journals (Sweden)

    TeaLanisnik Rizner

    2012-03-01

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

  1. Non-puerperal uterine inversion: a case report

    Directory of Open Access Journals (Sweden)

    Anitha G.S.

    2015-08-01

    The aim was to highlight a rare condition of chronic non-puerperal uterine inversion following the extrusion of a benign fundally located submucous uterine myoma. A high index of suspicion is required to make a prompt diagnosis. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 1223-1226

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

    International Nuclear Information System (INIS)

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

  3. Endometrial cancer

    Science.gov (United States)

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

  4. 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)

    Angélica Lemos Debs Diniz

    2000-06-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Luis Ernesto Pérez

    2008-12-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1995-12-15

    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

  7. Role of emmprin in endometrial cancer

    Directory of Open Access Journals (Sweden)

    Nakamura Keiichiro

    2012-05-01

    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.

  8. Endometrial Metastasis from Breast Cancer during Adjuvant Endocrine Therapy.

    Science.gov (United States)

    Hara, Fumikata; Kiyoto, Sachiko; Takabatake, Daisuke; Takashima, Seiki; Aogi, Kenjiro; Ohsumi, Shozo; Teramoto, Norihiro; Nishimura, Rieko; Takashima, Shigemitsu

    2010-01-01

    It is well-known that tamoxifen increases the risk of endometrial cancer. Although metastasis to the uterus from breast cancer is uncommon, there have been some case reports on uterine metastasis. If an endometrial abnormality is detected, the differential diagnosis of whether the uterine tumor is metastatic or primary is very important to determine the course of treatment. We herein report a case in which we detected a uterine tumor during follow-up after treatment with tamoxifen, and demonstrate that GCDFP-15 is useful in diagnosing metastatic uterine tumors arising from breast cancer. PMID:20740186

  9. Giant Intraabdominal Endometrial Cyst

    International Nuclear Information System (INIS)

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

  10. Operative and Conservative Treatment of Uterine Sarcomas.

    Science.gov (United States)

    Harter, P; El-Khalfaoui, K; Heitz, F; du Bois, A

    2014-03-01

    Uterine sarcomas are rare, aggressive mesenchymal tumours with a relatively poor prognosis. The term comprises various histological subtypes, such as leiomyosarcoma, endometrial stromal sarcomas as well as undifferentiated uterine sarcomas, which require different operative and systemic/radiation therapy strategies accordingly. The evidence on operative, adjuvant and palliative treatment currently available is presented here. PMID:24882876

  11. Uterine arterial embolization for uterine leiomyoma: efficacy and clinical outcome

    International Nuclear Information System (INIS)

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

  12. Uterine arterial embolization for uterine leiomyoma: efficacy and clinical outcome

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

  13. FDG PET/CT diagnostic criteria may need adjustment based on MRI to estimate the presurgical risk of extrapelvic infiltration in patients with uterine endometrial cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sudo, Satoko; Sakuragi, Noriaki [Hokkaido University Graduate School of Medicine, Department of Gynecology, Sapporo (Japan); Hattori, Naoya; Manabe, Osamu; Hirata, Kenji; Tamaki, Nagara [Hokkaido University Graduate School of Medicine, Department of Nuclear Medicine, Kitaku, Sapporo (Japan); Kato, Fumi; Mimura, Rie; Magota, Keiichi; Sugimori, Hiroyuki [Hokkaido University Graduate School of Medicine, Department of Diagnostic and Interventional Radiology, Sapporo (Japan)

    2015-04-01

    The staging of endometrial cancer requires surgery which carries the risk of morbidity. FDG PET/CT combined with anatomical imaging may reduce the number of unnecessary lymphadenectomies by demonstrating the risk of extrapelvic infiltration. The purpose of this study was to optimize FDG PET/CT diagnostic criteria for risk assessment in endometrial cancer after first-line risk triage with MRI. The study population comprised 37 patients who underwent curative surgery for the treatment of endometrial cancer. First, the risk of extrapelvic infiltration was triaged using MRI. Second, multiple glucose metabolic profiles of the primary lesion were assessed with FDG PET/CT, and these were correlated with the histopathological risk of extrapelvic infiltration including lymphovascular space invasion (LVSI) and high-grade malignancy (grades 2 and 3). The results of histological correlation were used to adjust FDG PET/CT diagnostic criteria. Presurgical assessment using MRI was positive for deep (>50 %) myometrial invasion in 17 patients. The optimal FDG PET/CT diagnostic criteria vary depending on the results of MRI. Specifically, SUVmax (≥16.0) was used to indicate LVSI risk with an overall diagnostic accuracy of 88.2 % in patients with MRI findings showing myometrial invasion. High-grade malignancy did not correlate with any of metabolic profiles in this patient group. In the remaining patients without myometrial invasion, lesion glycolysis (LG) or metabolic volume were better indicators of LVSI than SUVmax with the same diagnostic accuracy of 80.0 %. In addition, LG (≥26.9) predicted high-grade malignancy with an accuracy of 72.2 %. Using the optimized cut-off criteria for LVSI, glucose metabolic profiling of primary lesions correctly predicted lymph node metastasis with an accuracy of 73.0 %, which was comparable with the accuracy of visual assessment for lymph node metastasis using MRI and FDG PET/CT. FDG PET/CT diagnostic criteria may need adjustment based on the anatomical information provided by MRI. The optimized criteria can predict the risk of pathology-proven LVSI correctly in 83.8 % of patients before surgery, and thus would improve presurgical treatment planning. (orig.)

  14. Uterine fibroids

    Science.gov (United States)

    ... et al. Randomised comparison of uterine artery embolisation (UAE) with surgical treatment in patients with symptomatic uterine ... et+al.+Randomised+comparison+of+uterine+artery+embolisation+(UAE)+with+surgical+treatment+in+patients+with+symptomatic+uterine+ ...

  15. Development of endometrial fibrosis in the mare: factors involved in tissue remodelling and collagen deposition

    OpenAIRE

    Oddsdóttir, Charlotta

    2008-01-01

    Age-related degeneration of the equine endometrium is an established and important cause of fertility problems in thoroughbred mares, causing great loss to the industry. As a part of the age-related endometrial degeneration complex, an excessive deposition of collagen leading to endometrial fibrosis is particularly important due to the limitations it causes to uterine function. The consequences include reduced efficacy of uterine defence mechanisms and a decrease in the uterine...

  16. Vaginal Myomectomy for Semipedunculated Cervical Myoma during Pregnancy

    OpenAIRE

    Mikitaka Obara; Yuko Hatakeyama; Yasushi Shimizu

    2014-01-01

    Objective - Cases of prolapsed myoma in which pregnancy was carried to full term or near term after vaginal myomectomy are very rare. Previously, only two such cases have been reported. In addition, both those patients had a pedunculated leiomyoma, which could be treated by twisting or clamping. Here, we report a case of a patient who was able to carry her pregnancy to term despite vaginal myomectomy for semipedunculated myoma at 13 weeks of pregnancy. Study Design - This study is a case ...

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

    Directory of Open Access Journals (Sweden)

    João Paulo Elsen Saut

    2013-10-01

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

  18. Critical tumor suppressor function mediated by epithelial Mig-6 in endometrial cancer

    OpenAIRE

    Kim, Tae Hoon; Lee, Dong-Kee; Cho, Sung-Nam; Orvis, Grant D.; Behringer, Richard R; John P. Lydon; Ku, Bon Jeong; McCampbell, Adrienne S; Broaddus, Russell R.; Jeong, Jae-Wook

    2013-01-01

    Endometrial cancer is preceded by endometrial hyperplasia, unopposed estrogen exposure and genetic alterations, but the precise causes of endometrial cancer remain uncertain. Mig-6, mainly known as a negative regulator of the EGF receptor, is an important mediator of progesterone signaling in the uterus, where it mediates tumor suppression by modulating endometrial stromal-epithelial communications. In this study, we investigated the function of Mig-6 in the uterine epithelium using a tissue-...

  19. 21 CFR 884.1060 - Endometrial aspirator.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endometrial aspirator. 884.1060 Section 884.1060 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... endometrium, and (ii) Contraindications: Pregnancy, history of uterine perforation, or a recent...

  20. 21 CFR 884.1185 - Endometrial washer.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endometrial washer. 884.1185 Section 884.1185 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL...: Only to evaluate the endometrium, (ii) Contraindications: Pregnancy, history of uterine perforation,...

  1. 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

  2. Contrast enhancement versus vasculature of uterine tumors

    International Nuclear Information System (INIS)

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

  3. Predictive modes of action of pesticides in uterine adenocarcinoma development in rats

    OpenAIRE

    Yoshida, Midori; Inoue, Kaoru; Takahashi, Miwa

    2015-01-01

    Endometrial adenocarcinoma in the uterine corpus is a malignant cancer that occurs in menopausal women and aged rodents. Because of the similarities in pathogenesis and morphology of endometrial adenocarcinoma in rodents and humans, prediction of the modes of action (MOA) in uterine carcinogenesis is important for extrapolation of rodent data to humans. Three MOAs have been accepted as major pathways for uterine carcinogenesis in rodents: 1) estrogenic activity, 2) increased serum 17beta-estr...

  4. Endometrial adenocarcinoma in a 13-year-old girl.

    Science.gov (United States)

    Kim, Sung Mee; Shin, So Jin; Bae, Jin Gon; Kwon, Kun Young; Rhee, Jeong Ho

    2016-03-01

    Endometrial cancer is the third most common gynecologic cancer in the Korea and occurs mainly in menopausal women. Although it can develop in young premenopausal women cancer as well, an attack in the adolescent girl is very rare. A 13-year-old girl visited gynecology department with the complaint of abnormal uterine bleeding. An endometrial biopsy revealed FIGO (International Federation of Gynecology and Obstetrics) grade II endometrial adenocarcinoma. In the treatment of endometrial cancer, conservative management should be considered if the patient is nulliparous or wants the fertility preservation. Therefore, we decided to perform a hormonal therapy and a follow-up endometrial biopsy after progestin administration for eight months revealed no residual tumor. We report a case of endometrial cancer occurred in a 13-year-old girl with a brief review of the literature. PMID:27004208

  5. Endometrial stromal polyps in rodents: biology, etiology, and relevance to disease in women.

    Science.gov (United States)

    Davis, Barbara

    2012-04-01

    Endometrial stromal polyps (ESP) are a common spontaneous reproductive tract lesion in the female rat. However, there is limited information concerning the etiology, biology, and significance of these polyps as an end point in toxicology and carcinogenicity studies. This paper reviews relevant literature to address these aspects of ESP with respect to potential relevance to human uterine tumors. Endometrial stromal polyps in rodents appear as age-related lesions. There are only a few chemicals tested for carcinogenicity in rat and mouse cancer bioassays associated with increased incidence of ESP with no common characteristics or mechanism of action. Uterine endometrial polyps that occur in women and the uterine stromal polyps that occur in rodents have distinct characteristics, although both types of uterine lesions are common, benign, and noncancerous. Human endometrial polyps develop from both endometrial and stromal components, whereas rodent polyps develop from the stromal component of the uterus. Endometrial polyps in women are hormone sensitive, but there is no scientific or experimental evidence to date that suggests that uterine stromal polyps in rodents are hormone sensitive. Therefore, based on differences in their etiology and biology, endometrial stromal polyps observed in rodent toxicity and carcinogenicity studies appear to have limited relevance to human endometrial polyps occurring in women. PMID:22215514

  6. Torsion of the uterus with myomas in a postmenopausal woman – case study and review of the literature

    Directory of Open Access Journals (Sweden)

    Dobrosława Sikora-Szczęśniak

    2014-05-01

    Full Text Available Introduction : Torsion of the uterus is defined as a rotation of more than 45° around the long axis of the uterus; 2/3 of cases are dextrorotations. The extent of rotation usually ranges from 45° to 180°. Objective: The purpose of the article was to present a case study of a postmenopausal woman with uterine torsion and myomas and to review the articles discussing the problem of rotated non-pregnant uterus. Material and methods : The article analyses the course of an extremely uncommon pathology, i.e. uterine torsion in a 67-year-old patient. Laparotomy exposed the uterus with myomas and numerous hemorrhages, rotated by 180° to the right side, size of 350 × 300 × 200 mm and bilateral necrosis of the ovaries. Moreover, we present a review of articles discussing surgical management in case of rotated non-pregnant uterus. Results and discussion: The patient was operated on by a team of gynecologists and surgeons. The uterus was derotated and total hysterectomy with salpingoophorectomy was performed. A fragment of the hepatic oval ligament was excised and periumbilical hernioplasty was performed. The patient was released home on the 10th day following the operation. Conclusions : If women complain of pain located within the small pelvis and abdominal cavity it is necessary to remember that it might result from the torsion of reproductive organs which is an uncommon condition but poses a health or life threat to patients. Surgical treatment of uterine torsion is successful if promptly implemented; in certain cases it is even possible to spare the patient’s fertility.

  7. 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)

    N. Soofizadeh

    2009-07-01

    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.

  8. Genital Cancers in Women: Uterine Cancer.

    Science.gov (United States)

    Roett, Michelle A

    2015-11-01

    There are two main types of uterine cancer. Endometrial carcinoma, the most commonly diagnosed genital cancer in women, accounts for most cases (more than 95%) and sarcoma comprises the remainder. Endometrial cancer primarily occurs in postmenopausal women. Risk factors include exposure to high levels of endogenous estrogen (eg, obesity, nulliparity, late menopause) or exogenous estrogen (eg, hormone replacement therapy, tamoxifen) and pelvic radiation. Genetics are involved in a small percentage of cases, notably among women in families with hereditary nonpolyposis colorectal cancer (HNPCC). More than 80% of patients with endometrial cancers present with abnormal uterine bleeding. Endometrial biopsy and transvaginal ultrasound are the first-line tests to evaluate bleeding. If the endometrial lining is thickened on ultrasound, endometrial biopsy is indicated. If symptoms persist after negative biopsy results, or if biopsy results are inadequate, hysteroscopy is performed for tissue sampling. Most patients with endometrial cancer are diagnosed early, when cancer is confined to the uterus. Hysterectomy is the treatment of choice in such cases. Treatment of advanced disease involves radiotherapy and/or chemotherapy. Perimenopausal women should be informed that abnormal bleeding could be a sign of cancer and should be evaluated. However, no routine screening is recommended except for women with HNPCC. PMID:26569046

  9. Endometrial carcinoma located in the right septate uterus cavity: a case report

    Science.gov (United States)

    Boubess, Ikram; Mahdi, Youssef; Ramsiss, Hanan; Filali, Adib; Alami, Mohamad Hassan; El khannoussi, Basma; Hachi, Hafid

    2015-01-01

    Endometrial cancer in patients with uterine congenital malformations is exceptional and there are only a few rare cases published in the literature. We report the case of a 67 years-old patient with an endometrial cancer located in the right cavity of a complete septate uterus.

  10. Radiation therapy of the uterine cancer

    International Nuclear Information System (INIS)

    Cervical and endometrial cancer of the uterus, and ovarian cancer are three major malignant diseases in gynecology in Japan. These diagnosis and therapy are almost established. In uterine cervical cancer, radiation therapy and surgery of these diseases are two main treatment methods, and both treatment results are almost the same. And radiation therapy is also used as postoperative treatment to patients with high risk factors. In endometrial cancer, surgery is main therapy. Radiation therapy is undergone only to medically inoperable cases preoperative radiation is widely carried out in Europe and America, but almost none in Japan. Postoperative irradiation is adapted to the cases with high risk factors. But recent advance of chemotherapy changes the importance of radiation therapy in such patients. I review the literatures of radiation therapy of uterine cervical cancer and of endometrial cancer. (author)

  11. MRI appearances of benign uterine disease

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-10-15

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

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

    International Nuclear Information System (INIS)

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

  14. Pólipos endometriais Endometrial polyps

    Directory of Open Access Journals (Sweden)

    Antonio Alberto Nogueira

    2005-05-01

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

  15. Carcinosarcoma arising in uterine didelphys after tamoxifen therapy for breast cancer: a case report.

    Science.gov (United States)

    Suprasert, Prapaporn; Khunamornpong, Surapan

    2010-05-01

    The occurrence of uterine cancer in breast cancer patients who received tamoxifen treatment, is well described. 72 our knowledge, an association between uterine anomaly and uterine carcinosarcoma in these patients had not been reported. We present a case of uterine carcinosarcoma occurring in uterine didelphys of a 72-year-old breast cancer patient, who had been treated with tamoxifen for 5 years. The patient presented with large pelvic mass. The uterine anomaly was not recognized preoperatively. The patient died of disease 5 months after diagnosis. Postmenopausal women taking tamoxifen should be closely monitored for symptoms of endometrial lesions. PMID:20524448

  16. Committee Opinion No. 601: Tamoxifen and uterine cancer.

    Science.gov (United States)

    2014-06-01

    Tamoxifen, a nonsteroidal antiestrogen agent, is widely used as adjunctive therapy for women with breast cancer, and it has been approved by the U.S. Food and Drug Administration for adjuvant treatment of breast cancer, treatment of metastatic breast cancer, and reduction in breast cancer incidence in high-risk women. Tamoxifen use may be extended to 10 years based on new data demonstrating additional benefit. Women taking tamoxifen should be informed about the risks of endometrial proliferation, endometrial hyperplasia, endometrial cancer, and uterine sarcomas, and any abnormal vaginal bleeding, bloody vaginal discharge, staining, or spotting should be investigated. Postmenopausal women taking tamoxifen should be closely monitored for symptoms of endometrial hyperplasia or cancer. Premenopausal women treated with tamoxifen have no known increased risk of uterine cancer and require no additional monitoring beyond routine gynecologic care. Unless the patient has been identified to be at high risk of endometrial cancer, routine endometrial surveillance has not proved to be effective in increasing the early detection of endometrial cancer in women using tamoxifen and is not recommended. If atypical endometrial hyperplasia develops, appropriate gynecologic management should be instituted, and the use of tamoxifen should be reassessed. PMID:24848920

  17. Magnetic resonance imaging of the uterus after endometrial resection

    Energy Technology Data Exchange (ETDEWEB)

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

    1998-02-01

    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.)

  18. Endometrial LGR7 expression and implantation failure.

    Science.gov (United States)

    Campitiello, Maria Rosaria; Caprio, Francesca; Mele, Daniela; D'eufemia, Diletta; Colacurci, Nicola; De Franciscis, Pasquale

    2016-06-01

    Implantation failure is considered as a major cause of infertility in women with recurrent pregnancy loss (RPL) and in otherwise healthy women with unexplained infertility. Preliminary data in primates suggested that relaxin (RLX) is involved in endometrial preparation for implantation. In a prospective observational study, the endometrial RLX receptor (LGR7) expression was assessed in three groups of patients with regular ovulatory cycle and normal uterine cavity: 23 with RPL (Group A), 23 with unexplained infertility undergone at least three cycles of failed in vitro fertilization (IVF) reporting good oocyte and embryo quality (Group B), 23 with proven fertility (Group C). Assessment of LGR7 expression was performed with both polymerase chain reaction (PCR) analysis and immunohistochemistry on endometrial samples obtained with hysteroscopic biopsy performed in the secretory phase of the menstrual cycle. Endometrial LGR7 was less expressed in group A and B versus C, both by PCR analysis (p = 0.024) and immunohistochemistry. The decreased expression of the endometrial RLX receptor in women with implantation failures, both in vitro fertilization failure and recurrent pregnancy loss, suggests that RLX may play a crucial role in the structural and functional changes of the endometrium during the window of implantation. PMID:26761440

  19. Uterine peristalsis-induced stresses within the uterine wall may sprout adenomyosis.

    Science.gov (United States)

    Shaked, Sivan; Jaffa, Ariel J; Grisaru, Dan; Elad, David

    2015-06-01

    Adenomyosis is a disease in which ectopic endometrial glands and stromal cells appear in the uterine myometrium. This pathology is common among women of reproductive age, and in addition to chronic pelvic pain and heavy periods it may also cause infertility. The 'tissue injury and repair' mechanism in response to increased intrauterine pressures was proposed as the etiology for migration of fragments of basal endometrium into the myometrial wall. In order to investigate this mechanism, a conceptual two-dimensional model of the uterine wall subjected to intrauterine pressures was implemented using ADINA commercial software. The stress field within the uterine wall was examined for a variety of intrauterine sinusoidal pressure waves with varying frequencies. The results revealed that: (1) as the wavelength of the subjected pressure wave decreased, high concentration of stresses developed near the inner uterine cavity; (2) as the pressure wave frequency increased, high gradients of the stresses were obtained; (3) at menstrual phase, the highest stresses obtained at the endometrial-myometrial interface. Therefore, increased uterine activity results in high stresses which may lead to tissue lesions and detachment of endometrial cells. PMID:25217062

  20. 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)

    Adriana Bittencourt Campaner

    2004-02-01

    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.

  1. Bovine herpesvirus 4 (BoHV-4) is tropic for bovine endometrial cells and modulates endocrine function

    OpenAIRE

    Donofrio, Gaetano; Herath, Shan; SARTORI, CHIARA; Cavirani, Sandro; Flammini, Cesidio Filippo; Sheldon, Iain Martin

    2007-01-01

    Bovine postpartum uterine disease, metritis, affects about 40% of animals and is widely considered to have a bacterial aetiology. Although the gamma herpesvirus BoHV-4 has been isolated from several outbreaks of metritis or abortion, the role of viruses in endometrial pathology and the mechanisms of viral infection of uterine cells are often ignored. The objectives of the present study were to explore the interaction, tropism and outcomes of BoHV-4 challenge of endometrial stromal and epithel...

  2. 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)

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

    OpenAIRE

    Ryu, Jeong-Ah; Kim, Bohyun; Lee, Jongmee; Kim, Sooah; LEE, SANG HOON

    2004-01-01

    Objective To assess the utility of hysterosonography (HS) as a screening method in patients with abnormal uterine bleeding. Materials and Methods We retrospectively reviewed transvaginal ultrasonography (TVS) and HS for 105 patients whose diagnosis was confirmed pathologically. All 105 patients were initially evaluated on the same day with both TVS and HS. On TVS and HS examination, endometrial cavitary lesions were classified as diffuse hyperplasia, endometrial polyp, endometrial cancer, ute...

  4. Review literature on uterine carcinosarcoma.

    Science.gov (United States)

    Singh, Rajendra

    2014-01-01

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

  5. Review literature on uterine carcinosarcoma

    Directory of Open Access Journals (Sweden)

    Rajendra Singh

    2014-01-01

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

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

    LENUS (Irish Health Repository)

    McMenamin, Moya

    2012-09-01

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

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

    Science.gov (United States)

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

    2013-08-01

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

  8. Histopathological study of endometrium in cases of abnormal uterine bleeding

    Directory of Open Access Journals (Sweden)

    Saroj A. Bolde

    2014-08-01

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

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

    OpenAIRE

    Ronit Haimov-Kochman; Asher Shushan; Ernst Voss; Yaron Hamani

    2013-01-01

    A 42 years old woman suffering from repeated events of intensive vaginal bleeding during the week off birth control pills was referred for diagnostic hysteroscopy. The patient underwent hysterohy drosonoscopy, a 3-step procedure, including a transvaginal ultrasound scan, a diagnostic hysteroscopy and immediate hydrosonography. A3 cmintramural myoma was detected by the ultrasound scan without impinging onto the uterine cavity as visualized by diagnostic hysteroscopy. However, continuous hydro...

  10. Uterine morphology and peristalsis in women with polycystic ovary syndrome

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

  11. 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

  12. UTERINE DYDELPHYS WITH PREGNANCY IN RIGHT CORNU

    Directory of Open Access Journals (Sweden)

    Mandavi

    2014-06-01

    Full Text Available Uterus Didelphys is also known as duplicated uterus. It is an embryological abnormality resulting from complete failure of fusion of Mullerian ducts. There is presence of two uterine horns and two cervices with no communication between endometrial and endocervical cavities. We report the case in our institute of single viable pregnancy in right sided uterine body of didelphic uterus. She was an unbooked case and baby was delivered at twenty nine weeks of gestation by caesarean section as she reported to us with preterm labour with breech presentation. She had an uncomplicated post-operative period

  13. MRI of endometrial cancer

    International Nuclear Information System (INIS)

    This study was performed to clarify the signal characteristics of endometrial cancer especially on enhanced MRI. Authors selected 21 ceses of endometrial cancer and 16 cases of noncancerous endometrium who had Gd-DTPA enhanced MRI. We compared preoperative MRI reports with postsurgical-histological proof and measured signal intensity of endometrial cancer, noncancerous endometrium and myometrium using region-of-interest. The accuracy of preoperative MRI in diagnosis of endometrial cancer was 97%. There were 6 cases suspected as endometrial cancer without preoperative proof. Three cases of them, who had endometrial cancer, were diagnosed correctly on MRI. The other 3 cases, one with endometrial hyperplasia, one with atypical hyperplasia and one with normal endometrium, were diagnosed as having noncancerous endometrium on MRI. These facts indicate that MRI including enhanced study has good accuracy. On unenhanced T1 weighted image, the signal intensity of endometrial cancer was not different from myometrium and normal endometrium. But on enhanced MRI, endometrial cancer showed lower signal intensity than myometrium and normal endometrium (p<0.01). Endometrial cancer was less enhanced than myometrium and normal endometrium after administration of Gd-DTPA (p<0.01). We have to pay attention to signal intensity and enhancement effect of endometrial region on enhanced MRI. The less enhanced endometrium suggests abnormal endometrium including cancer. (author)

  14. Uterine sarcoma

    Science.gov (United States)

    ... cause is unknown, there's no way to prevent uterine sarcoma. If you have had radiation therapy in your pelvic area or have taken tamoxifen for breast cancer, ask your provider how often you should be ...

  15. Uterine transplantation.

    Science.gov (United States)

    Brännström, Mats; Racho El-Akouri, Randa; Wranning, Caiza Almén

    2003-08-15

    Uterine factor infertility is either due to congenital malformation or acquired. Most women with uterine factor infertility have no chance to become genetic mothers, except by the use of gestational surrogacy. The logical but radical approach for treatment would be replacement of the unfunctional or absent uterus. Uterine transplantation could allow these women to become both genetic and gestational mothers. The present work reviews the existing literature on the history and recent development around this topic. We also briefly describe a newly developed model for heterotopic uterine transplantation in the mouse, in which pregnancies have been accomplished. Some specific issues that are required to be solved prior any further attempts to transplant the uterus in humans are also addressed. PMID:12860325

  16. Endometrial carcinoma; Endometriumkarzinom

    Energy Technology Data Exchange (ETDEWEB)

    Engelhard, K. [Krankenhaus Martha-Maria, Nuernberg (Germany)

    2011-07-15

    Magnetic resonance imaging (MRI) is the method of choice in staging endometrial cancer. Using MRI early tumor invasion (stage IA) can be differentiated from a deep tumor growth (stage IB) of the myometrium with reported sensitivities of 85-95%.Tumor invasion of the uterine cervix can be depicted with a sensitivity of 80% and specificity of 96%. In demonstrating lymph node metastases MRI shows a sensitivity of 50%, a specificity of 95% and and accuracy of 90%. These diagnostic criteria are decisive for the choice of therapy procedures. So a simple hysterectomy will be performed in early stage IA disease while an extended surgical procedure with pelvic lymphadenectomy and radiotherapy will be considered in advanced stages IB and II disease. Vaginal ultrasound shows lower values in tumor staging with accuracies of 73-95%. Staging accuracies of computed tomography also show lower results with 61-76%. For planning radiotherapy and detection of cancer recurrence MRI is the most valuable tool. (orig.) [German] Fuer die Stadieneinteilung des Endometriumkarzinoms ist die Magnetresonanztomographie Methode der Wahl. Die Sensitivitaeten zur Differenzierung einer oberflaechlichen (Stadium IA) von einer tiefen myometrialen Invasion des Tumors (Stadium IB) liegen bei 85-95%, bei Spezifitaeten von 80-85%. Eine Infiltration der Zervix (Stadium II) kann mit Sensitivitaeten von 80% und Spezifitaeten von 96% nachgewiesen werden. Bei der Detektion von Lymphknotenmetastasen liegen die Sensitivitaeten der MRT bei 50%, bei Spezifitaeten von 95% und Treffsicherheiten von 90%. Die genannten diagnostischen Kriterien bestimmen das therapeutische Vorgehen. Werden fruehe Stadien mit einfacher Hysterektomie behandelt, erfordern die Stadien IB und II kombinierte erweiterte chirurgische Techniken und eine Radiotherapie. Die Treffsicherheiten des vaginalen Ultraschalls (73-93%) und der Computertomographie (61-76%) fuer die Stadieneinteilung des Tumors liegen deutlich niedriger als die Werte fuer die MRT. Die Planung einer Radiotherapie und die Rezidiverkennung sind Domaenen der MRT. (orig.)

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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.

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

    International Nuclear Information System (INIS)

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

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

    Science.gov (United States)

    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

    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

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

    DEFF Research Database (Denmark)

    Andersen, L F; Meinert, L; Junge, Jette; Prentø, P; Ottesen, B S; Rygaard, Carsten

    1998-01-01

    OBJECTIVES: Thermal balloon endometrial ablation is a new method for treating menorrhagia. The technique appears to be less difficult compared to standard hysteroscopic ablation techniques and to be significantly safer. The influence into the uterine wall of the thermal balloon ablation procedure...... was investigated with special reference to the ability of total destruction of the endometrium and the thermal action on the myometrium and the serosa. STUDY DESIGN: Temperatures were measured at the uterine serosal surface during thermal balloon endometrial ablation for 8-16 min in eight patients...... microscopy in all patients, with a maximum depth of 11.5 mm. By electron microscopy no influence of heat could be demonstrated beyond 15 mm from the endometrial surface. CONCLUSION: Up to 16 min of thermal balloon endometrial ablation therapy can destroy the endometrium and the submucosal layers. The...

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

    DEFF Research Database (Denmark)

    Andersen, L F; Meinert, L; Rygaard, Carsten; Junge, Jette; Prentø, P; Ottesen, B S

    1998-01-01

    OBJECTIVES: Thermal balloon endometrial ablation is a new method for treating menorrhagia. The technique appears to be less difficult compared to standard hysteroscopic ablation techniques and to be significantly safer. The influence into the uterine wall of the thermal balloon ablation procedure...... was investigated with special reference to the ability of total destruction of the endometrium and the thermal action on the myometrium and the serosa. STUDY DESIGN: Temperatures were measured at the uterine serosal surface during thermal balloon endometrial ablation for 8-16 min in eight patients...... microscopy in all patients, with a maximum depth of 11.5 mm. By electron microscopy no influence of heat could be demonstrated beyond 15 mm from the endometrial surface. CONCLUSION: Up to 16 min of thermal balloon endometrial ablation therapy can destroy the endometrium and the submucosal layers. The...

  2. Cystic endometrial hyperplasia and pyometra in three captive African hunting dogs (Lycaon pictus).

    Science.gov (United States)

    Jankowski, Gwen; Adkesson, Michael J; Langan, Jennifer N; Haskins, Samantha; Landolfi, Jamie

    2012-03-01

    Pyometra and cystic endometrial hyperplasia are common in domestic canids and are suspected to develop as a consequence of elevated progesterone levels. Reports of uterine pathology in exotic canids are limited, with some speculating of association with contraception. This report describes pyometra, cystic endometrial hyperplasia, and ovariohysterectomy in three African hunting dogs (Lycaon pictus). Ovarian corpora lutea were detected in two of the dogs, suggesting endogenous progesterone production. One dog had a uterine adenocarcinoma and two had ovarian granulosa cell tumors. Clinical signs included anorexia, lethargy, vulvar discharge, polyuria, polydipsia, and abdominal distention. Diagnosis was based on clinical signs, physical examination, bloodwork, radiography, and ultrasonography, with confirmation through histopathologic evaluation of tissues. Cystic endometrial hyperplasia, pyometra, and uterine neoplasia have rarely been diagnosed in exotic canids; however, they should be considered as differential diagnoses in intact bitches that present with suspected reproductive disease. PMID:22448515

  3. Successful Pregnancy after Treatment with Ulipristal Acetate for Uterine Fibroids

    Science.gov (United States)

    Monleón, Javier; Galliano, Daniela; Pellicer, Antonio

    2014-01-01

    This case report presents a clinical pregnancy after ulipristal acetate (UA) to decrease uterine fibroid size. A 37-year-old patient, gravida 1, abortus 1, with uterine fibroids was treated with 5 mg of UA daily for 13 weeks starting eight months after a multiple laparotomic myomectomy. Fibroid shrinkage and restoration of the morphology of endometrial cavity were evaluated in order to allow a subsequent pregnancy. A decrease of the uterine fibroids and a normal morphology of the endometrial cavity were noted by transvaginal ultrasound after treatment. An endometrial biopsy excluded histologic endometrial changes. Three months after the end of UA the patient reported amenorrhea for 5 weeks and a clinical pregnancy was confirmed with transvaginal ultrasound. She underwent a subsequent uneventful pregnancy. Thus, the spontaneous pregnancy after UA to reduce fibroid size may support the potential clinical utility of this selective progesterone receptor modulator in the management of women with pregnancy desire and uterine fibroids after a prior myomectomy. Patients who refuse a new surgical procedure and/or those who are going to undergo assisted reproductive techniques would benefit from UA. It effectively shrinks fibroids, avoids risks of a new surgical procedure, and allows an immediate attempt at conception after the end of treatment. PMID:25143845

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

    OpenAIRE

    Farzaneh Chobsaz; Rostam Ghorbani; Shiva Roshankhah; Mozafar Khazaei

    2011-01-01

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

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

    OpenAIRE

    Navid Esfandiari; Mozafar Khazaei; Jafar Ai; Zohreh Nazemian; Aaron Jolly; Casper, Robert F

    2008-01-01

    Background: Endometriosis is the presence of endometrial tissue outside of the uterine cavity andis the most common gynecologic disorder in women of reproductive age. We have preliminaryevidence that in the presence of a 3-dimensional (3-D) fibrin matrix, human endometrial glands,stroma, and neovascularization can develop in vitro, mimicking the earliest stages of endometriosis.The aim of the present study was to determine if angiogenesis can be developed in a 3-D culture ofhuman stromal cell...

  6. The Krüppel-like factor 9 (KLF9) network in HEC-1-A endometrial carcinoma cells suggests the carcinogenic potential of dys-regulated KLF9 expression

    OpenAIRE

    Zeng Zhaoyang; Xiao Rijin; Su Ying; Simmen Frank A; Simmen Rosalia CM

    2008-01-01

    Abstract Background Krüppel-like factor 9 (KLF9) is a transcriptional regulator of uterine endometrial cell proliferation, adhesion and differentiation; processes essential for pregnancy success and which are subverted during tumorigenesis. The network of endometrial genes controlled by KLF9 is largely unknown. Over-expression of KLF9 in the human endometrial cancer cell line HEC-1-A alters cell morphology, proliferative indices, and differentiation, when compared to KLF9 under-expressing HEC...

  7. Persistence of endometrial activity after radiation therapy for cervical carcinoma

    International Nuclear Information System (INIS)

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

  8. Effectiveness of Hysteroscopic Repair of Uterine Lesions in Reproductive Outcome

    Directory of Open Access Journals (Sweden)

    Atta Allah Ghahiry

    2014-07-01

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

  9. Quantitative proteome profiling of human myoma and myometrium tissue reveals kinase expression signatures with potential for therapeutic intervention.

    Science.gov (United States)

    Lemeer, Simone; Gholami, Amin Moghaddas; Wu, Zhixiang; Kuster, Bernhard

    2015-01-01

    Uterine leiomyomas are benign tumors affecting a large proportion of the female population. Despite the very high prevalence, the molecular basis for understanding the onset and development of the disease are still poorly understood. In this study, we profiled the proteomes and kinomes of leiomyoma as well as myometrium samples from patients to a depth of >7000 proteins including 200 kinases. Statistical analysis identified a number of molecular signatures distinguishing healthy from diseased tissue. Among these, nine kinases (ADCK4, CDK5, CSNK2B, DDR1, EPHB1, MAP2K2, PRKCB, PRKG1, and RPS6KA5) representing a number of cellular signaling pathways showed particularly strong discrimination potential. Preliminary statistical analysis by receiver operator characteristics plots revealed very good performance for individual kinases (area under the curve, AUC of 0.70-0.94) as well as binary combinations thereof (AUC 0.70-1.00) that might be used to assess the activity of signaling pathways in myomas. Of note, the receptor tyrosine kinase DDR1 holds future potential as a drug target owing to its strong links to collagen signaling and the excessive formation of extracellular matrix typical for leiomyomas in humans. PMID:25327614

  10. Usefulness of sonohysterography in differentiating endometrial cancer from endometrial hyperplasia

    International Nuclear Information System (INIS)

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

  11. Usefulness of sonohysterography in differentiating endometrial cancer from endometrial hyperplasia

    Energy Technology Data Exchange (ETDEWEB)

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

    1999-06-15

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

  12. 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...

  13. Uterine fibromyolipoma

    International Nuclear Information System (INIS)

    Lipomatous tumors of the uterus are uncommon. Because of the fatty nature of those tumors, digital imaging techniques may provide the preoperative diagnosis. A case of uterine fibromyolipoma is reported, documented by both ultrasound (US) and computed tomography (CT), in which the diagnosis was strongly suggested by the US and CT findings. (author). 8 refs.; 2 figs

  14. Uterine Fibroids

    Science.gov (United States)

    ... inside the uterine cavity. Hysterosalpingography is a special X-ray test. It may detect abnormal changes in the size and shape of ... deficiency, or lack of iron. Hysterosalpingography: A special X-ray ... and fallopian tubes to detect abnormal changes in their size and shape or ...

  15. Diagnostic double guarded low-volume uterine lavage in mares

    DEFF Research Database (Denmark)

    Christoffersen, Mette; Brandis, Louise; Samuelsson, Julia; Bojesen, Anders Miki; Troedsson, M.H.T.; Petersen, M. R.

    2014-01-01

    Endometritis constitutes a major problem in the management of broodmares; hence diagnostic tests with a high sensitivity and specificity are desired. We hypothesize that a double guarded uterine flush technique for bacterial culture and cytology is comparable to standard diagnostic tests, the...... endometrial biopsy and double guarded swab. Endometrial biopsies (n=199), swabs (n=199) and double guarded lavage samples (n=199) were obtained from 34 mares at six different time points in four estrous cycles, and were evaluated cytologically and bacteriologically. Endometrial biopsies from the first cycle...... associated with the presence of PMNs on histology (p=0.003). Using the presence of PMNs in the endometrial tissue as the gold standard for diagnosing endometritis, the sensitivity of double guarded lavage culture was 0.75, and 0.33 and 0.5 for the swab and biopsy, respectively. In conclusion, the double...

  16. Assessing the importance of endometrial biopsy prior to oocyte donation

    OpenAIRE

    Sauer, Mark V.; Paulson, Richard J.; Moyer, Dean L.

    1997-01-01

    The importance of performing an endometrial biopsy in women preparing for oocyte donation goes beyond confirming the histologic response to hormone replacement therapy. Additional information related to uterine architecture, ease of embryo transfer, status of the ovaries, and patient compliance is also gained. Finally, the return visit provides an opportunity to discuss plans for the upcoming cycle. Whereas this report does not specifically address the question as to how many pregnancies were...

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

    Energy Technology Data Exchange (ETDEWEB)

    Joshi, Ayesha; Ellenson, Lora Hedrick, E-mail: lora.ellenson@med.cornell.edu

    2011-07-01

    Pten is the most frequently mutated gene in uterine endometriod carcinoma (UEC) and its precursor complex atypical hyperplasia (CAH). Because the mutation frequency is similar in CAH and UEC, Pten mutations are thought to occur relatively early in endometrial tumorigenesis. Previous work from our laboratory using the Pten{sup +/-} mouse model has demonstrated somatic inactivation of the wild type allele of Pten in both CAH and UEC. In the present study, we injected adenoviruses expressing Cre into the uterine lumen of adult Pten floxed mice in an attempt to somatically delete both alleles of Pten specifically in the endometrium. Our results demonstrate that biallelic inactivation of Pten results in an increased incidence of carcinoma as compared to the Pten{sup +/-} mouse model. In addition, the carcinomas were more aggressive with extension beyond the uterus into adjacent tissues and were associated with decreased expression of nuclear ER{alpha} as compared to associated CAH. Primary cultures of epithelial and stromal cells were prepared from uteri of Pten floxed mice and Pten was deleted in vitro using Cre expressing adenovirus. Pten deletion was evident in both the epithelial and stromal cells and the treatment of the primary cultures with estrogen had different effects on Akt activation as well as Cyclin D3 expression in the two purified components. This study demonstrates that somatic biallelic inactivation of Pten in endometrial epithelium in vivo results in an increased incidence and aggressiveness of endometrial carcinoma compared to mice carrying a germline deletion of one allele and provides an important in vivo and in vitro model system for understanding the genetic underpinnings of endometrial carcinoma.

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

    International Nuclear Information System (INIS)

    Pten is the most frequently mutated gene in uterine endometriod carcinoma (UEC) and its precursor complex atypical hyperplasia (CAH). Because the mutation frequency is similar in CAH and UEC, Pten mutations are thought to occur relatively early in endometrial tumorigenesis. Previous work from our laboratory using the Pten+/- mouse model has demonstrated somatic inactivation of the wild type allele of Pten in both CAH and UEC. In the present study, we injected adenoviruses expressing Cre into the uterine lumen of adult Pten floxed mice in an attempt to somatically delete both alleles of Pten specifically in the endometrium. Our results demonstrate that biallelic inactivation of Pten results in an increased incidence of carcinoma as compared to the Pten+/- mouse model. In addition, the carcinomas were more aggressive with extension beyond the uterus into adjacent tissues and were associated with decreased expression of nuclear ERα as compared to associated CAH. Primary cultures of epithelial and stromal cells were prepared from uteri of Pten floxed mice and Pten was deleted in vitro using Cre expressing adenovirus. Pten deletion was evident in both the epithelial and stromal cells and the treatment of the primary cultures with estrogen had different effects on Akt activation as well as Cyclin D3 expression in the two purified components. This study demonstrates that somatic biallelic inactivation of Pten in endometrial epithelium in vivo results in an increased incidence and aggressiveness of endometrial carcinoma compared to mice carrying a germline deletion of one allele and provides an important in vivo and in vitro model system for understanding the genetic underpinnings of endometrial carcinoma.

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

    International Nuclear Information System (INIS)

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

  20. Hormones and endometrial carcinogenesis.

    Science.gov (United States)

    Kamal, Areege; Tempest, Nicola; Parkes, Christina; Alnafakh, Rafah; Makrydima, Sofia; Adishesh, Meera; Hapangama, Dharani K

    2016-02-01

    Endometrial cancer (EC) is the commonest gynaecological cancer in the Western World with an alarmingly increasing incidence related to longevity and obesity. Ovarian hormones regulate normal human endometrial cell proliferation, regeneration and function therefore are implicated in endometrial carcinogenesis directly or via influencing other hormones and metabolic pathways. Although the role of unopposed oestrogen in the pathogenesis of EC has received considerable attention, the emerging role of other hormones in this process, such as androgens and gonadotropin-releasing hormones (GnRH) is less well recognised. This review aims to consolidate the current knowledge of the involvement of the three main endogenous ovarian hormones (oestrogens, progesterone and androgens) as well as the other hormones in endometrial carcinogenesis, to identify important avenues for future research. PMID:26966933

  1. Progesterone-Regulated Endometrial Factors Controlling Implantation.

    Science.gov (United States)

    Bhurke, Arpita S; Bagchi, Indrani C; Bagchi, Milan K

    2016-03-01

    The steroid hormone progesterone (P), acting via the progesterone receptor (PR) isoforms, PR-A and PR-B, exerts a profound influence on uterine functions during early gestation. In recent years, chromatin immunoprecipitation-sequencing in combination with microarray-based gene expression profiling analyses have revealed that the PR isoforms control a substantially large cistrome and transcriptome during endometrial differentiation in the human and the mouse. Genetically engineered mouse models have established that several PR-regulated genes, such as Ihh, Bmp2, Hoxa10, and Hand2, are essential for implantation and decidualization. PR-A and PR-B also collaborate with other transcription factors, such as FOS, JUN, C/EBPβ and STAT3, to regulate the expression of many target genes that functions in concert to properly control uterine epithelial proliferation, stromal differentiation, angiogenesis, and local immune response to render the uterus 'receptive' and allow embryo implantation. This review article highlights recent work describing the key PR-regulated pathways that govern critical uterine functions during establishment of pregnancy. PMID:26804062

  2. Induction of Smad-dependent and -independent pathways by TGF-betas in human endometrial and endometriotic cells

    OpenAIRE

    Sui, Cong

    2012-01-01

    Endometriosis is a chronic pathological disorder in which endometrial-like cells are found outside the uterine cavity. TGF-betas were observed to be highly expressed in the peritoneal fluid of patients with endometriosis, as well as in endometriotic sites. Thus, TGF-beta;s may play an important role in the pathogenesis of endometriosis. In this study, our aim was to investigate the biological function and signal transduction of TGF-betas in endometrial and endometriotic cells in vitro. ...

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

    Directory of Open Access Journals (Sweden)

    Salete Yatabe

    2011-12-01

    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.

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

    International Nuclear Information System (INIS)

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

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

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    M.L. Schulman

    1997-07-01

    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.

  6. [Clinical significance of analysis of estrogen and progesterone receptors in human uterine tissues].

    Science.gov (United States)

    Maleeva, A; Milkov, V

    1991-05-01

    The action of steroid hormones in the target cell was found to be associated with the presence of specific receptors in the cytoplasm. Uterine, endometrial, and myometrial tissues obtained at hysterectomy for endometrial carcinomatosis and fibromyomas were used. In fibromyomas, the estrogen and progesterone receptors were found to be higher in the cytosol than in the normal myometrium. In endometrial carcinomatosis, the estrogen receptors were in varying quantities: normal, low, or nil in the cytosol, whereas the progesterone receptors were low or nil. PMID:1897675

  7. Three-dimension finite-element analyses of multiple electrodes bipolar RF global endometrial ablation

    Science.gov (United States)

    Hu, Tao; Panhao, Tang; Xiao, Jiahua

    2015-03-01

    Radio-frequency ablation (RFA) is a minimally invasive surgical procedure to thermally ablate the targeted diseased tissue. There have been many finite-element method (FEM) studies of cardiac and hepatic RFA, but hardly find any FEM study on endometrial ablation for abnormal uterine bleeding. In this paper, a FEM model was generated to analyze the temperature distribution of bipolar RF global endometrial ablation with three pairs of bipolar electrodes placed at the perimeter of the uterine cavity. COMSOL was utilized to calculate the RF electric fields and temperature fields by numerically solving the bioheat equation in the triangle uterine cavity range. The 55°C isothermal surfaces show the shape of the ablation dimensions (depth and width), which reasonably matched the experimental results.

  8. Physical Activity Behavioral Intervention in Obese Endometrial Cancer Survivors

    Science.gov (United States)

    2015-10-14

    Stage IA Uterine Corpus Cancer; Stage IB Uterine Corpus Cancer; Stage II Uterine Corpus Cancer; Stage IIIA Uterine Corpus Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Uterine Corpus Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer

  9. Uterine adenolipoleiomyoma: a tumor with potential of aggressive behavior.

    Science.gov (United States)

    Shaco-Levy, Ruthy; Piura, Benjamin

    2008-04-01

    An unusual uterine adenolipoleiomyoma forming intramural and subserosal masses and recurring within 16 months in the form of huge coalescent uterine masses is described. Histology showed the mass to be composed of benign-appearing smooth muscle, mature adipose tissue, and bland endocervical-type glands. The recurrent adenolipoleiomyoma contained, in addition, benign-appearing endometrial-type glands and stroma and showed small foci of atypically proliferating endocervical-type epithelium. This is the fourth report of adenolipoleiomyoma within the uterus, the second with an intramural location, and the first with an aggressive behavior in the form of massive local recurrence. PMID:18317215

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

    Directory of Open Access Journals (Sweden)

    Medvedev M.V.

    2011-01-01

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

  11. Interdisciplinary stratification of patients with myoma-related symptoms

    International Nuclear Information System (INIS)

    With the establishment of uterine artery embolization (UAE), the individualization of treatment of the symptomatic myomatous uterus showed a general progression. The concrete therapy decision is made in an interactive process between doctor and patient. A series of factors influence the choice of a suitable, operative or non-operative, therapeutic procedure. In the weighting of therapeutic options between surgery or UAE, in addition to current results of studies which compare both techniques,recommendations made by expert committees and guidelines are helpful for a competent counseling of patients and additionally supportive in decision processes such as interdisciplinary stratification. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Vera Lúcia Rodrigues Lobo

    2008-01-01

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

  13. Miomatosis uterina gigante Giant uterine myomatosis

    Directory of Open Access Journals (Sweden)

    Miguel Sarduy Nápoles

    2009-09-01

    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.

  14. What Is Endometrial Cancer?

    Science.gov (United States)

    ... They make up about 4% of uterine cancers. Cervical cancers Cancers that start in the cervix and ... More ACS Sites Bookstore ACS CAN Marketplace Cancer Atlas Global Health Finish the Fight Press Room Mobile ...

  15. Endometrial ablation in the treatment of menorrhagia.

    Science.gov (United States)

    Erian, J

    1994-07-01

    A prospective 5-year multicentre study, involving three UK gynaecology centres with a special interest in endoscopic laser surgery, was set up to determine the safety, acceptability, clinical effectiveness and complications of neodymium yttrium-aluminium-garnet laser ablation of the endometrium in the treatment of menorrhagia. A total of 2342 women with disabling menorrhagia that was unresponsive to medical therapy were involved. The main outcome measures were: preoperative endometrial preparation; duration of laser ablation, intra- and postoperative complications, amenorrhoea rate, oligomenorrhoea rate, and the women's subjective assessment of treatment. No major complications occurred in the 2342 treatments. Nine (0.4%) cases of transient fluid overload, 11 (0.5%) of infection and five (0.2%) of uterine perforation occurred. None of the women required a laparotomy. The mean duration of the laser ablation was 24 min. The post-surgery amenorrhoea rate was higher in women pretreated with danazol. Of the 1866 women followed up for at least 1 year after treatment, 1043 (56%) developed complete amenorrhoea, 701 (38%) reported continuing but satisfactorily reduced menstruation, and 122 (7%) patients failed to improve with the first treatment (57 of these 122 women responded to a second laser ablation). Overall, 1744 (93%) had a satisfactory response to laser ablation and only 33 (1.8%) required subsequent hysterectomy. In conclusion, this study showed that hysteroscopic endometrial laser ablation is an acceptable alternative to hysterectomy for the treatment of menorrhagia. PMID:8043557

  16. [The morphological features of the uterine body adenocarcinoma].

    Science.gov (United States)

    Dzhaparidze, N A; Chakvetatdze, L B; Dzhikia, I D

    2014-06-01

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

  17. Current and future options in the management and treatment of uterine sarcoma

    Science.gov (United States)

    du Bois, Andreas; Heitz, Florian; Kurzeder, Christian; Sehouli, Jalid; Harter, Philipp

    2014-01-01

    Uterine sarcomas are rare aggressive mesenchymal tumours with limited prognosis. They encompass various histological subtypes such leiomyosarcoma, endometrial stromal sarcoma and undifferentiated sarcomas with different surgical and medical strategies. Current evidence of surgery, adjuvant and palliative therapy is reported. PMID:24381658

  18. Activated mutant p110? causes endometrial carcinoma in the setting of biallelic Pten deletion.

    Science.gov (United States)

    Joshi, Ayesha; Miller, Christopher; Baker, Suzanne J; Ellenson, Lora H

    2015-04-01

    PTEN and PIK3CA mutations occur with high frequency in uterine endometrioid carcinoma (UEC). Although PTEN mutations are present in complex atypical hyperplasia and carcinoma, PIK3CA mutations are restricted to carcinoma. We generated mouse models harboring Pten loss and/or activated Pik3ca in the endometrial epithelium to investigate their respective roles in the pathogenesis of UEC. Presence of an activated mutant Pik3ca on the background of Pten loss led to aggressive disease, with 100% of mice exhibiting carcinoma. Expression of Pik3ca with E545K mutation alone was unable to cause hyperplasia or cancer in the uterus and did not activate Akt as effectively as Pten deletion in short-term cultures of mouse endometrial epithelium, likely explaining the lack of phenotype in vivo. We also report that nuclear localization of FOXO1 correlated with PTEN mutational status irrespective of the PIK3CA status in endometrial cancer cell lines. Furthermore, gene expression profiles resulting from Pten loss or activation of Pik3ca in primary mouse endometrial epithelial cells exhibit minimal overlap. Thus, Pten and Pik3ca have distinct consequences on the activation of the phosphatidylinositol 3-kinase pathway in endometrial epithelium and are likely to affect other nonoverlapping cellular mechanisms involved in the development and progression of the most common type of uterine cancer. PMID:25698082

  19. Apparent diffusion coefficient of diffusion weighted MRI in endometrial carcinoma—Relationship with local invasiveness

    International Nuclear Information System (INIS)

    Objective: To evaluate the relationship between apparent diffusion coefficient (ADC) value and the local invasiveness of endometrial carcinoma. Methods and materials: The MR imaging of seventy-three patients with endometrial carcinoma proved by post-operative pathology and sixty-four patients with healthy uteri were retrospectively reviewed. All MR examinations included axial T2WI and T1WI, sagittal T2WI and diffusion-weighted sequences (b = 0 and b = 1000 s/mm2). Tumor size, mean ADC value (ADCm) and quartile ADC (ADCq) were acquired on post-processing workstation using voxel-analysis software. Differences between the ADC values among three layers of normal uterine body and endometrial carcinomas were compared by ANOVA test. Groups were divided according to pathologic type, histologic grade, depth of myometrial infiltration, presence of cervical invasion and lymphovascular space invasion, and lymph node metastasis. Tumor size and ADC values were compared and analyzed. Results: ADC values were different in three zones of uterine body (P −3 mm2/s] and highest in outer myometrium [(1.496 ± 0.196) × 10−3 mm2/s]. Mean ADC value of endometrial carcinomas [(1.011 ± 0.121) × 10−3 mm2/s] was lower than the normal uterine body. Quartile ADC and tumor size were greater in groups with more invasive pathologic factors (P < 0.05). Deep myometrial infiltration, cervical invasion, lymphovascular space invasion and lymph node metastasis were more common as quartile ADC values and tumor sizes increased. Conclusion: Mean ADC value was lower in endometrial carcinoma was lower than the normal uterus. Quartile ADC, representing the intra-tumor heterogeneity of water movement, had a profound relationship with invasiveness of endometrial carcinomas, while mean ADC value did not. ADC values may serve as a quantitative indicator to complement routine sequences.

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

    Energy Technology Data Exchange (ETDEWEB)

    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

    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).

  1. 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).

  2. 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 ...

  3. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... women with uterine fibroids is heavy bleeding. In fact, some of our patients have such heavy bleeding ... contrast. We want to make sure that, in fact, it is the uterine artery, that we're ...

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

    Directory of Open Access Journals (Sweden)

    Luiz Gustavo Oliveira Brito

    2012-12-01

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

  5. Brain metastases from endometrial carcinoma.

    Science.gov (United States)

    Piura, Ettie; Piura, Benjamin

    2012-01-01

    This paper will focus on knowledge related to brain metastases from endometrial carcinoma. To date, 115 cases were documented in the literature with an incidence of 0.6% among endometrial carcinoma patients. The endometrial carcinoma was usually an advanced-stage and high-grade tumor. In most patients (~90%), brain metastasis was detected after diagnosis of endometrial carcinoma with a median interval from diagnosis of endometrial carcinoma to diagnosis of brain metastases of 17 months. Brain metastasis from endometrial carcinoma was either an isolated disease limited to the brain only (~50%) or part of a disseminated disease involving also other parts of the body (~50%). Most often, brain metastasis from endometrial carcinoma affected the cerebrum (~75%) and was solitary (~60%). The median survival after diagnosis of brain metastases from endometrial carcinoma was 5 months; however, a significantly better survival was achieved with multimodal therapy including surgical resection or stereotactic radiosurgery followed by whole brain radiotherapy (WBRT) and/or chemotherapy compared to WBRT alone. It is suggested that brain imaging studies should be considered in the routine follow up of patients with endometrial carcinoma and that the search for a primary source in females with brain metastases of unknown primary should include endometrial biopsy. PMID:22523707

  6. Dietary melatonin alters uterine artery hemodynamics in pregnant Holstein heifers.

    Science.gov (United States)

    Brockus, K E; Hart, C G; Gilfeather, C L; Fleming, B O; Lemley, C O

    2016-04-01

    The objective was to examine uterine artery hemodynamics and maternal serum profiles in pregnant heifers supplemented with dietary melatonin (MEL) or no supplementation (CON). In addition, melatonin receptor-mediated responses in steroid metabolism were examined using a bovine endometrial epithelial culture system. Twenty singleton pregnant Holstein heifers were supplemented with 20 mg of melatonin (n = 10) or no melatonin supplementation (control; n = 10) from days 190 to 262 of gestation. Maternal measurements were recorded on days 180 (baseline), 210, 240, and 262 of gestation. Total uterine blood flow was increased by 25% in the MEL-treated heifers compared with the CON. Concentrations of progesterone were decreased in MEL vs CON heifers. Total serum antioxidant capacity was increased by 43% in MEL-treated heifers when compared with CON. Activity of cytochrome P450 1A, 2C, and superoxide dismutase was increased in bovine endometrial epithelial cells treated with melatonin, whereas the melatonin receptor antagonist, luzindole, negated the increase in cytochrome P450 2C activity. Moreover, estradiol or progesterone treatment altered bovine uterine melatonin receptor expression, which could potentiate the melatonin-mediated responses during late gestation. The observed increase in total uterine blood flow during melatonin supplementation could be related to its antioxidant properties. Compromised pregnancies are typically accompanied by increased oxidative stress; therefore, melatonin could serve as a therapeutic supplementation strategy. This could lead to further fetal programming implications in conjunction with offspring growth and development postnatally. PMID:26641925

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

    Directory of Open Access Journals (Sweden)

    Zeeba S. Jairajpuri

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

  8. Cancer of the Uterus (Endometrial Cancer)

    Science.gov (United States)

    ... Management Education & Events Advocacy For Patients About ACOG Cancer of the Uterus [Endometrial Cancer] Home For Patients Search FAQs Cancer of the ... Uterus [Endometrial Cancer] FAQ097, May 2011 PDF Format Cancer of the Uterus [Endometrial Cancer] Gynecologic Problems What ...

  9. Safety of cesarean myomectomy with huge myoma compared with uncomplicated cesarean section in Indian scenario

    OpenAIRE

    Shyam Pyari Jaiswar; Prachi Srivastava; Apala Priyadarshini; Sujata Deo; Pushplata Shankhwar

    2015-01-01

    Background: Myomectomy with cesarean section has traditionally been discouraged due to risk of intractable hemorrhage and increased post-operative morbidity. In recent years, many studies have demonstrated safety of performing myomectomy with cesarean section even for large fibroids. The aim of this study was to find out the safety and clinical outcome of cesarean myomectomy in case of large myoma to encourage routine combination of both procedures. Methods: 15 term women undergoing cesare...

  10. Accuracy of doppler ultrasound in diagnosis of endometrial carcinoma

    International Nuclear Information System (INIS)

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

  11. Effects of sulpiride and ethylene glycol monomethyl ether on endometrial carcinogenicity in Donryu rats.

    Science.gov (United States)

    Taketa, Yoshikazu; Inoue, Kaoru; Takahashi, Miwa; Sakamoto, Yohei; Watanabe, Gen; Taya, Kazuyoshi; Yoshida, Midori

    2016-06-01

    Sulpiride and ethylene glycol monomethyl ether (EGME) are known ovarian toxicants that stimulate prolactin (PRL) secretion, resulting in hypertrophy of the corpora lutea and increased progesterone (P4) production. The purpose of the present study was to investigate how the PRL stimulatory agents affected uterine carcinogenesis and to clarify the effects of PRL on endometrial adenocarcinoma progression in rats. Ten-week-old female Donryu rats were treated once with N-ethyl-N'-nitro-N-nitrosoguanidine (20 mg kg(-1) ), followed by treatment with sulpiride (200 ppm) or EGME (1250 ppm) from 11 weeks of age to 12 months of age. Sulpiride treatment inhibited the incidence of uterine adenocarcinoma and precancerous lesions of atypical endometrial hyperplasia, whereas EGME had no effect on uterine carcinogenesis. Sulpiride markedly prevented the onset of persistent estrus throughout the study period, and EGME delayed and inhibited the onset of persistent estrus. Moreover, sulpiride-treated animals showed high PRL and P4 serum levels without changes in the levels of estradiol-17β, low uterine weights and histological luteal cell hypertrophy. EGME did not affect serum PRL and P4 levels. These results suggest that the prolonged low estradiol-17β to P4 ratio accompanied by persistent estrous cycle abnormalities secondary to the luteal stimulatory effects of PRL may explain the inhibitory effects of sulpiride on uterine carcinogenesis in rats. Copyright © 2015 John Wiley & Sons, Ltd. PMID:26178146

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

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    Ernesto García Ayala

    2010-01-01

    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.

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

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    Selda Uysal

    2012-09-01

    Full Text Available Objective: Uterine perfusion, particularly the endometrial blood flow, may have an important role in endometrial receptivity. In order to assess the contribution of sub endometrial blood flow in the etiopathogenesis of unexplained infertility mid luteal- peri-implantation period spiral artery transvaginal color Doppler parameters were measured and compared with fertile controls. Material and Methods: Forty-two consecutive patients admitted to Izmir Katip Celebi University Ataturk Training and Research Hospital, Department of Obstetric and Gynecology with the diagnosis of unexplained infertility after standard diagnostic work up constituted the study group and they were compared with a fertile control group admitted to hospital with non specific gynecological complaints or for check-up in the same period. Mid luteal transvaginal color Doppler ultrasonography was applied to each patient by the same radiologist who was blind to the diagnosis of the particular patient and, RI (resistance index and PI (pulsatility index values were calculated. Results: There were no significant differences between the two groups, in respect to age, body mass index, basal hormonal and mid luteal progesterone levels (p>0.05. For the fertile control group, mid luteal-peri-implantation phase endometrial spiral artery mean RI values were calculated as 0.48±0.08 SD and mean PI values as 0.65±0.18 SD. For the study group, mean RI values were calculated as 0.54±0.07 SD, PI values were calculated as 0.80±0.16 SD. The differences for RI (p=0.009 and PI (p=0.004 were statistically significant. Conclusion: According to Doppler parameters, unexplained infertility patients have high impedance blood flow in spiral arteries which means that peri-implantation blood flow in these patient is lower than fertile controls. These findings suggest that endometrial perfusion may have an important contribution to etiopathogenesis of unexplained infertility.

  14. Endometrial mullerian adenosarcoma after toremifene treatment in breast cancer patients: a case report.

    Science.gov (United States)

    Chung, Ye Won; Bae, Hyo Sook; Han, Song I; Song, Jae Yoon; Kim, In Sun; Kang, Jae Seong

    2010-12-30

    Toremifene is an anti-estrogen which has been shown to be effective in the treatment of breast cancer, and is thought to be a less uterotrophic agent than tamoxifen. The risk assessment concerning endometrial cancer has been inconclusive because of its rare use up to the mid-1990s. We report a case of an adenosarcoma, which is a very rare type of uterine malignancy, after toremifene treatment for 5 years in a breast cancer patient. After 1 year of toremifene use, the patient had a benign Mullerian adenofibroma. After an additional 4 years of toremifene treatment, the endometrial polypoid lesion was transformed into a Mullerian adenosarcoma. Although toremifene is a promising anti-estrogenic agent in the treatment of breast cancer patients, clinicians should not neglect the possibility of a uterine malignancy. PMID:21278890

  15. Temsirolimus and Bevacizumab in Treating Patients With Advanced Endometrial, Ovarian, Liver, Carcinoid, or Islet Cell Cancer

    Science.gov (United States)

    2016-01-12

    Adult Hepatocellular Carcinoma; Advanced Adult Hepatocellular Carcinoma; Endometrial Serous Adenocarcinoma; Localized Non-Resectable Adult Liver Carcinoma; Lung Carcinoid Tumor; Malignant Ovarian Mixed Epithelial Tumor; Malignant Pancreatic Gastrinoma; Malignant Pancreatic Glucagonoma; Malignant Pancreatic Insulinoma; Malignant Pancreatic Somatostatinoma; Metastatic Digestive System Neuroendocrine Tumor G1; Ovarian Carcinosarcoma; Ovarian Endometrioid Adenocarcinoma; Ovarian Serous Surface Papillary Adenocarcinoma; Pancreatic Alpha Cell Adenoma; Pancreatic Beta Cell Adenoma; Pancreatic Delta Cell Adenoma; Pancreatic G-Cell Adenoma; Pancreatic Polypeptide Tumor; Recurrent Adult Liver Carcinoma; Recurrent Digestive System Neuroendocrine Tumor G1; Recurrent Fallopian Tube Carcinoma; Recurrent Ovarian Carcinoma; Recurrent Pancreatic Neuroendocrine Carcinoma; Recurrent Primary Peritoneal Carcinoma; Recurrent Uterine Corpus Carcinoma; Regional Digestive System Neuroendocrine Tumor G1; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cancer; Stage IIIA Uterine Corpus Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cancer; Stage IIIC Uterine Corpus Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer; Uterine Carcinosarcoma

  16. Uterine artery embolization to treat uterine fibroids

    International Nuclear Information System (INIS)

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

  17. 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)

    Luis Paulo Galvao Wolff

    2010-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Navid Esfandiari

    2008-01-01

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

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

    Science.gov (United States)

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

    2013-08-01

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

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

    International Nuclear Information System (INIS)

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

  1. Cine MR imaging of uterine peristalsis in patients with endometriosis

    International Nuclear Information System (INIS)

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

  2. Cine MR imaging of uterine peristalsis in patients with endometriosis

    Energy Technology Data Exchange (ETDEWEB)

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

    2007-07-15

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

  3. NMR guided focused ultrasound for myoma therapy - results from the first radiology-gynecology expert meeting

    International Nuclear Information System (INIS)

    The contribution on the results from the first radiology-gynecology expert meeting concerning NMR guided focused ultrasound (MRgFUS) for myoma therapy covers the following topics: structural prerequisites for MRgFUS therapy; required examinations before MRgFUS therapy; indication for MRgFUS therapy; success criteria for the MRgFUS therapy; contraindications; MRgFUS therapy for patients that want to have children; side effects and complications of MRgFUS therapy; post-examination after MRgFUS therapy.

  4. Induction of epithelial cell apoptosis in the uterus by a mouse uterine ischemia-reperfusion model: possible involvement of tumor necrosis factor-alpha.

    Science.gov (United States)

    Okazaki, Mitsuo; Matsuyama, Toshifumi; Kohno, Tomoko; Shindo, Hisakazu; Koji, Takehiko; Morimoto, Yoshiharu; Ishimaru, Tadayuki

    2005-05-01

    Menstruation in primates is preceded by a period of intense vasoconstriction, with resultant ischemia-reperfusion. Although apoptosis is involved in endometrial breakdown, the relationship between ischemia-reperfusion and apoptosis in the female genital tract has not been determined. To investigate the relationship between ischemia-reperfusion and apoptosis in the uterus, we analyzed a uterine ischemia-reperfusion model using BDF1 and C57BL/6 mice. Ischemia was induced by clamping the uterine horn and uterine artery for 5 to 30 min, followed by 6, 12, 24, or 48 h of reperfusion (n = 4 for each group). The number of TUNEL-positive endometrial cells increased with the duration of ischemia and reached a maximum at 24 h of reperfusion, but then tended to decrease at 48 h. Transmission electron micrographs of endometrial cells revealed a typical nuclear condensation, confirming the occurrence of apoptosis. The mRNA expression level of the proinflammatory cytokine tumor necrosis factor-alpha (TNFalpha) in the uterus increased after reperfusion. Ischemia-reperfusion-induced endometrial apoptosis was markedly decreased in TNF-R p55-deficient mice, confirming the essential role of TNFalpha in the induction of apoptosis by ischemia-reperfusion (n = 4). Our results suggest that ischemia-reperfusion and subsequent TNFalpha expression may be critical factors in inducing endometrial cell apoptosis. Our mouse model could be suitable for investigating ischemia-related uterine injury in humans, particularly in menstruation. PMID:15673605

  5. Adrenal Metastasis from Uterine Papillary Serous Carcinoma.

    Science.gov (United States)

    Singh Lubana, Sandeep; Singh, Navdeep; Tuli, Sandeep S; Seligman, Barbara

    2016-01-01

    BACKGROUND Uterine papillary serous carcinoma (UPSC) is a highly malignant form of endometrial cancer with a high propensity for metastases and recurrences even when there is minimal or no myometrial invasion. It usually metastasizes to the pelvis, retroperitoneal lymph nodes, upper abdomen, and peritoneum. However, adrenal metastases from UPSC is extremely rare. Here, we present a case of UPSC with adrenal metastasis that occurred 6 years after the initial diagnosis. CASE REPORT A 60-year-old woman previously diagnosed with uterine papillary serous carcinoma at an outside facility presented in September of 2006 with postmenopausal bleeding. She underwent comprehensive surgical staging with FIGO (International Federation of Gynecology and Obstetrics) stage 2. Post-operatively, the patient was treated with radiation and chemotherapy. The treatment was completed in April of 2007. The patient had no evidence of disease until July 2009 when she was found to have a mass highly suspicious for malignancy. Subsequently, she underwent right upper lobectomy. The morphology of the carcinoma was consistent with UPSC. She refused chemotherapy due to a previous history of chemotherapy-induced neuropathy. The patient was followed up with regular computed tomography (CT) scans. In October 2012 a new right adrenal nodule was seen on CT, which showed intense metabolic uptake on positron emission tomography (PET)/CT scan. The patient underwent right adrenalectomy. Pathology of the surgical specimen was consistent with UPSC. CONCLUSIONS UPSC is an aggressive variant of endometrial cancer associated with high recurrence rate and poor prognoses. Long-term follow-up is needed because there is a possibility of late metastases, as in this case. PMID:27117594

  6. What's New in Endometrial Cancer Research and Treatment?

    Science.gov (United States)

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

  7. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, Mineo (Keio Univ., Tokyo (Japan). School of Medicine)

    1989-05-01

    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.

  9. Endometrial Histology of Depomedroxyprogesterone Acetate Users: A Pilot Study

    Directory of Open Access Journals (Sweden)

    2006-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    Parvin Mostafa Gharabaghi

    2014-01-01

    Full Text Available Objectives: This is a preliminary study investigating the efficacy of aromatase inhibitor letrozol on endometrial histology in patients with disordered proliferative endometrium or simple hyperplasia. Materials and Methods: In a randomized clinical trial, 92 patients with abnormal uterine bleeding who had disordered proliferative endometrium or simple hyperplasia in endometrial biopsy, were randomized into case and control groups. patients received 2.5 mg of letrozole daily in case group (n=46 and 40 mg of megestrol acetate daily in control group (n=46 for 3 months. Endometrial biopsy was performed 3 to 4 weeks after completion of therapy to assess response. Results: After intervention in letrozole group, response to treatment was seen in 93% cases (including endometrial atrophy in 58.7% cases and weakly proliferative endometrium in 34.78% cases and in megestrol group response to treatment was seen in 85% cases (including endometrial atrophy in 41.3% cases and weakly proliferative endometrium in 43.47% cases. The difference between two groups was not statistically significant (P=0.31. Conclusion: The results of this study show that pre and post menopausal women with disordered proliferative endometrium or simple hyperplasia can be successfully treated with letrozole alone. However, due to the lack of significant difference between the two groups, further studies with larger sample size is recommended for better clearance of the topic.

  11. Equine endometrial vascular pattern changes during the estrous cycle examined by Narrow Band Imaging hysteroscopy.

    Science.gov (United States)

    Otzen, Henning; Sieme, Harald; Oldenhof, Harriëtte; Kassens, Ana; Ertmer, Franziska; Rode, Kristina; Müller, Kristin; Klose, Kristin; Rohn, Karl; Schoon, Heinz-Adolf; Meinecke, Burkhard

    2016-03-01

    The aim of this study was to evaluate the uterine blood supply and endometrial vessel architecture, during the equine estrous cycle. Narrow Band Imaging (NBI) hysteroscopy was used for evaluating changes in the endometrial vasculature during the estrous cycle [six mares, d 0 (representing the day of ovulation), d 6 and 11 in four locations]. In addition, endometrial biopsy samples were used for immunodetection of markers for angiogenesis (Vascular Endothelial Growth Factor A, its receptor 2, as well as angiopoietin-2 and its receptor-tyrosine-kinase Tie2) during the estrous cycle (three mares, d 0, 5 and 10; one biopsy per mare). Detailed analysis of hysteroscopic images revealed an increase in the vascular density from estrus towards diestrus. In contrast, microscopic specimens prepared from biopsies revealed no evidence for changes in the endometrial vessel number during the estrous cycle. Studies on expression of angiogenesis markers indicated that cyclic changes in the endometrial vascular density observed by NBI-hysteroscopy were not due to formation of new vessels. It is concluded that vessels are involved in blood supply of a smaller area during diestrus, facilitating better distribution of nutrients during this phase. PMID:26791330

  12. Giant Endometrial Polyp in a Postmenopausal Woman without Hormone/Drug Use and Vaginal Bleeding.

    Science.gov (United States)

    Unal, Betül; Do?an, Selen; Karaveli, Fatma ?eyda; Sim?ek, Tayup; Erdo?an, Gülgün; Candaner, I??l

    2014-01-01

    The objective of this study is to determine and discuss the causes of a giant endometrial polyp in a postmenopausal woman without hormone/drug use and to submit interesting clinical presentation. Here we report a seventy-year-old female patient who was admitted to our hospital with lower back pain. There were no other complaints from her. Physical examination was normal. For further examination, computed tomography was performed and a heterogeneous mass, with a diameter of 10 × 9 centimeters, was detected in the uterine cavity. Hysterectomy because of suspected endometrial cancer was performed. Histopathological examination showed us a giant endometrial polyp with edematous and focal fibrotic stroma, large thick walled blood vessels between normal sized and cystically dilated endometrial glands. To the best of our knowledge, this is the first report of a giant endometrial polyp which is unrelated to use of drugs such as tamoxifen and raloxifene; however, based on the history of the patient it may be associated with long-term consumption of thyme, which is a kind of phytoestrogen. PMID:25093134

  13. ANTEMORTEM DIAGNOSIS OF CYSTIC ENDOMETRIAL HYPERPLASIA AND SUCCESSFUL OVARIOHYSTERECTOMY IN AN AFRICAN WARTHOG (PHACOCHOERUS AFRICANUS).

    Science.gov (United States)

    Thompson, Kimberly A; Niehaus, Andrew; Shellabarger, Wynona; Depenbrock, Sarah; Agnew, Dalen

    2015-12-01

    During a routine geriatric examination on a 9-yr-old, nulliparous female African warthog (Phacochoerus africanus), a severely enlarged, mixed echogenicity uterus was discovered during transabdominal ultrasound. Ovariohysterectomy (OVH) was elected and performed due to concern for a potential neoplastic condition. Postoperatively, the warthog was treated prophylactically with metoclopramide and ranitidine to promote gastrointestinal motility and prevent postoperative ileus. The gross appearance and histopathology confirmed the presence of extensive widely disseminated cystic changes consistent with cystic endometrial hyperplasia (CEH) and multiple para-ovarian cysts. Uterine pathology, including CEH, is a common condition in domestic potbellied pigs (Sus scrofa), and as a result, it is recommended to perform an OVH at an early age. The advanced uterine changes may have accounted for this animal's history of infertility. This case provides evidence that nulliparity may be associated with the development of uterine pathology in warthogs. Increased knowledge of reproductive pathology will aid in improved management strategies for breeding nondomestic suids. PMID:26667548

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

    Directory of Open Access Journals (Sweden)

    Asselin Eric

    2006-10-01

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

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

    Science.gov (United States)

    Sexton, Émilie; Van Themsche, Céline; Leblanc, Kim; Parent, Sophie; Lemoine, Pascal; Asselin, Eric

    2006-01-01

    Background Endometrial cancer is the fourth most prominent cancer among all feminine cancers in the Western world. Resveratrol, a natural anti-oxidant found in red wine emerging as a novel anticancer agent, exerts antiproliferative and pro-apoptotic activity in various cancer cell types, but its effect on uterine cancer cells is poorly understood. At the molecular level, resveratrol has been reported to inhibit cyclooxygenase (COX) expression and/or activity; in endometrial cancer cells, COX-2 is overexpressed and confers cellular resistance to apoptosis. The aim of the present study was to determine if resveratrol could exert anti-proliferative and pro-apoptotic activity over uterine cancer cells upon inhibition of COX-2 expression and/or activity. Six different human uterine cancer cell lines were used as a model (HeLa, Hec-1A, KLE, RL95-2, Ishikawa and EN-1078D). Results and discussion High-dose of resveratrol triggered apoptosis in five out of six uterine cancer cell lines, as judged from Hoechst nuclear staining and effector caspase cleavage. In accordance, uterine cancer cell proliferation was decreased. Resveratrol also reduced cellular levels of the phosphorylated/active form of anti-apoptotic kinase AKT. Endogenous COX-2 protein levels were decreased, concomitant with a decrease in production of COX metabolites PGE2 and PGF2?, in each uterine cancer cell line expressing detectable levels of COX-1 and/or COX-2 in presence of resveratrol. Although COX expression was identified as a target of resveratrol in uterine cancer cells, inhibition of COX activity or exogenously added PGE2 did not modulate the effect of resveratrol on cellular proliferation. Conclusion High-dose of resveratrol exerts tumoricidal activity over uterine cancer cells and regulates COX expression. In these cells, resveratrol would not directly target COX activity, but possibly other enzymes involved in prostaglandin synthesis that act downstream of the COXs. PMID:17044934

  16. In Vitro Validation of Survivin as Target Tumor-associated Antigen for Immunotherapy in Uterine Cancer.

    Science.gov (United States)

    Vanderstraeten, Anke; Everaert, Tina; Van Bree, Rieta; Verbist, Godelieve; Luyten, Cathérine; Amant, Frederic; Tuyaerts, Sandra

    2015-01-01

    Survivin is an antiapoptotic protein, not expressed in terminally differentiated adult tissues, yet overexpressed in several tumors. Therefore, it is an interesting target for immunotherapeutic strategies. In addition to specific overexpression in tumors, tumor survival is mediated by survivin and hence, tumor survival can be tackled by targeting survivin. Survivin expression in uterine cancer was validated by quantitative real-time polymerase chain reaction and immunohistochemistry. In addition, we evaluated survivin immunogenicity by analyzing spontaneous B-cell and T-cell responses in patients. Survivin as a protein was expressed in only a minority of normal tissues, whereas it was being expressed in all of the currently analyzed uterine cancers, both endometrial carcinoma (n = 52) and uterine sarcoma (n = 52). Survivin RNA transcripts were overexpressed in more aggressive tumors and survivin protein was overexpressed in recurrent endometrial tumors compared with primary tumors. Spontaneous T-cell responses were seen in 10/39 endometrial cancer patients and 3/16 uterine sarcoma patients. In normal controls, T-cell responses were found only in 1 donor (n = 21). Although increased antibody titers were found in more aggressive and far-advanced tumors, no differences in B-cell responses were seen. Overall, when compared with normal controls, a B-cell response was only measured in 1/41 uterine sarcoma patients. In conclusion, we currently validated the presence of survivin in uterine cancer. In addition, spontaneous T-cell responses were found in 23.6% of the total patient population. These data indicate that a survivin-specific immune response may be induced spontaneously in patients, further fortifying the eligibility of survivin as an immunotherapeutic target. PMID:26049547

  17. A uterine tumor resembling ovarian sex cord tumor associated with tamoxifen treatment: a case report and literature review.

    Science.gov (United States)

    Gutierrez-Pecharroman, Ana; Tirado-Zambrana, Pernilla; Pascual, Alejandro; Rubio-Marin, Dolores; García-Cosío, Mónica; Moratalla-Bartolomé, Enrique; Palacios, José

    2014-03-01

    Uterine tumors resembling ovarian sex cord tumors are rare neoplasms of unknown etiology that are classified as distinct from endometrial stromal tumors on the basis of their morphologic, molecular, and behavioral characteristics. These neoplasms have a variable immunophenotype, sometimes coexpressing epithelial, myoid, and sex cord markers. To date, only 2 cases of uterine tumors resembling ovarian sex cord tumors associated with tamoxifen use have been reported. Here, we report the case of a 49-year-old woman who had been using tamoxifen for 5 years to treat breast cancer. The tumor was initially diagnosed by hysteroscopy biopsy on the basis of morphologic and immunohistochemical features. Hysterectomy revealed a polypoid mass measuring 20 mm. After an 18-month follow-up, the patient remains disease free. Here, we review the clinical, pathologic, and immunohistochemical features of uterine tumors resembling ovarian sex cord tumors and endometrial stromal tumors with a sex cord component associated with tamoxifen treatment. PMID:24487470

  18. Drugs Approved for Endometrial Cancer

    Science.gov (United States)

    This page lists cancer drugs approved by the Food and Drug Administration (FDA) for endometrial cancer. The list includes generic names and brand names. The drug names link to NCI's Cancer Drug Information summaries.

  19. Factors predicting recurrent endometrial cancer

    OpenAIRE

    Huijgens, A.N.J.; Mertens, H.J.M.M.

    2013-01-01

    Objectives: The aim of this study was to identify (prognostic) factors that may predict the development of recurrent endometrial cancer and may improve the choice of adjuvant therapy subsequently. Methods: Data of all patients, diagnosed with primary endometrial cancer in Orbis Medical Center Sittard between 2002 and 2010, were analyzed retrospectively. Cox regression analysis was performed for identification of independent prognostic factors; survival was calculated by using the Kaplan-Meier...

  20. Differentiation of the various lesions causing an abnormality of the endometrial cavity using MR imaging: emphasis on enhancement patterns on dynamic studies and late contrast-enhanced T1-weighted images

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byung Kwan; Kim, Bohyun; Park, Jong Min; Ryu, Jeong Ah [Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Radiology, Center for Imaging Science, Seoul (Korea); Kim, Mi Sung [Kwandong University College of Medicine, Department of Radiology, Myongji Hospital, Seoul (Korea); Bae, Duk Soo [Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Obstetrics and Gynecology, Seoul (Korea); Ahn, Geung Hwan [Samsung Medical Center, Sungkyunkwan University School of Medicine, Department of Pathology, Seoul (Korea)

    2006-07-15

    The objectives of this study were to determine the usefulness of magnetic resonance (MR) imaging in the differentiation of various lesions causing an abnormality of the endometrial cavity by evaluating the imaging features on dynamic contrast-enhanced study and late contrast-enhanced T1-weighted images (T1WI). Contrast-enhanced MR imaging of 59 pathologically proven lesions that showed an abnormality of the endometrial cavity, including 32 endometrial cancers, five sarcomas, nine hyperplastic polyps, nine submucosal myomas, three hyperplasia, and one adenomyoma, were retrospectively reviewed. The enhancement degree and patterns on dynamic contrast-enhanced study and late contrast-enhanced T1WI were compared among different pathologies. On dynamic contrast-enhanced study, 72% (23/32) of endometrial cancers showed early peak enhancement to be reached within 1 min following intravenous administration of contrast material. On late-contrast-enhanced T1WI, lesions showed weak enhancement with gradual washout. Ninety-five percent (21/22) of benign lesions and 100% (5/5) of sarcomas showed late peak enhancement to be reached in 2-3 min following intravenous administration of contrast material. On late contrast-enhanced T1WI, both of these lesions showed persistent strong enhancement. Different enhancement patterns on dynamic contrast-enhanced MR imaging and late contrast-enhanced T1WI can provide a useful clue in the differentiation of various lesions causing an abnormality of the endometrial cavity. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Gimpelson RJ

    2014-03-01

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

  2. Long-term efficiency and safety of trans-catheter uterine artery embolization by lipiodol-pingyingmycin emulsion for uterine fibroids

    International Nuclear Information System (INIS)

    Objective: To investigate the long-term efficiency and safety of trans-catheter uterine artery embolization using lipiodol-pingyingmycin emulsion (LPE-TUAE) for uterine fibroids. Methods: Two hundred and forty-three patients with uterine fibroids were treated by LPE-TUAE. Fourteen of them underwent hysterectomy or myomectomy 3 days to 6 months after LPE-TUAE. The specimens were studied pathologically. Another 229 patients were followed up for 1 to 4 years to observe the long-term outcomes. Results: Menorrhagia became normal or improved markedly in 96.0% (193/201). Lumbago and lower abdominal pain disappeared or relieved markedly in 949% (94/99). Bulk-related symptoms disappeared or lessened markedly in 96.0% (48/50). Ultrasound revealed that the average decreased rate in the largest fibroid volume were 60.7% at 1 year, 63.3% at 2 year, 65.6% at 3 year and 67.4% at 4 year after embolization, and the average decreased rate in the largest uterine volume were 49.6% at 1 year, 54.3% at 2 year, 55.2% at 3 year and 57.1% at 4 year after embolization. Reoccurrence rate of myoma was 10.8% 3-4 year after embolization. No significant difference was found in hormone level between pre- and post-embolization. Pathological studies of specimens showed that lipiodol was only accumulated in fibroids and was not seen in myometrium. Spotty necrosis 2 weeks after embolization and extensive patchy necrosis 3 weeks after embolization were occurred in fibroids. Necrosis was not showed in myometrium. No serious complications occurred. Conclusion: LPE-TUAE possesses a good long-term effectiveness for uterine fibroids, which doesn't cause the damage on ovarian function and normal myometrium or serious complications. (authors)

  3. Uterine Leiomyoma: Hysterosalpingographic Appearances

    Directory of Open Access Journals (Sweden)

    Firoozeh Ahmadi

    2008-01-01

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

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

    DEFF Research Database (Denmark)

    Holm, Nina Sofie Lillegaard; Glintborg, Dorte; Andersen, Marianne Skovsager; Schledermann, Doris; Ravn, Pernille

    2012-01-01

    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...

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

    International Nuclear Information System (INIS)

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

  6. Percutaneous laser-induced interstitial thermotherapy (LITT) for the treatment of very large uterine leiomyomas

    Science.gov (United States)

    Chapman, Roxana

    1997-05-01

    The success of treating tumors of the liver under local anaesthesia and ultrasound and computered tomography control by mens of the diode laser of 810 nm wavelength with fiber splitter and multiple fibers suggested this form of LITT might be suitable for the treatment of very large leiomyomas where laparoscopy was not possible. The immediate effect of LITT was to produce a large volume of coagulation within the myomas, to destroy the oestrogen receptors and to coagulate the surrounding blood vessels. After one month the coagulated volume had been converted into a jelly-like substance and the zone surrounding this had started to degenerate because of the destruction of its blood vessels which had resulted in local tissue anoxia. Three months later the central coagulum and surrounding zone had been partially absorbed and the whole volume of myoma treated had shrunk to a quarter of the original size. It has thus been shown that a minimally invasive method for the destruction of very large uterine leiomyomas can be safely performed, but further research is required before its general adoption.

  7. Pigment Epithelium-Derived Factor Alleviates Tamoxifen-Induced Endometrial Hyperplasia.

    Science.gov (United States)

    Goldberg, Keren; Bar-Joseph, Hadas; Grossman, Hadas; Hasky, Noa; Uri-Belapolsky, Shiri; Stemmer, Salomon M; Chuderland, Dana; Shalgi, Ruth; Ben-Aharon, Irit

    2015-12-01

    Tamoxifen is a cornerstone component of adjuvant endocrine therapy for patients with hormone-receptor-positive breast cancer. Its significant adverse effects include uterine hyperplasia, polyps, and increased risk of endometrial cancer. However, the underlying molecular mechanism remains unclear. Excessive angiogenesis, a hallmark of tumorigenesis, is a result of disrupted balance between pro- and anti-angiogenic factors. VEGF is a pro-angiogenic factor shown to be elevated by tamoxifen in the uterus. Pigment epithelium-derived factor (PEDF) is a potent anti-angiogenic factor that suppresses strong pro-angiogenic factors, such as VEGF. Our aim was to investigate whether angiogenic balance plays a role in tamoxifen-induced uterine pathologies, elucidate the molecular impairment in that network, and explore potential intervention to offset the proposed imbalance elicited by tamoxifen. Using in vivo mouse models, we demonstrated that tamoxifen induced a dose-dependent shift in endogenous uterine angiogenic balance favoring VEGF over PEDF. Treatment with recombinant PEDF (rPEDF) abrogated tamoxifen-induced uterine hyperplasia and VEGF elevation, resulting in reduction of blood vessels density. Exploring the molecular mechanism revealed that tamoxifen promoted survival and malignant transformation pathways, whereas rPEDF treatment prevents these changes. Activation of survival pathways was decreased, demonstrated by reduction in AKT phosphorylation concomitant with elevation in JNK phosphorylation. Estrogen receptor-? and c-Myc oncoprotein levels were reduced. Our findings provide novel insight into the molecular mechanisms tamoxifen induces in the uterus, which may become the precursor events of subsequent endometrial hyperplasia and cancer. We demonstrate that rPEDF may serve as a useful intervention to alleviate the risk of tamoxifen-induced endometrial pathologies. Mol Cancer Ther; 14(12); 2840-9. ©2015 AACR. PMID:26450919

  8. Ultrasonographic evaluation of abnormal uterine bleeding in postmenopausal women

    Directory of Open Access Journals (Sweden)

    Bindushree Kadakola

    2015-02-01

    Full Text Available Background: Objectives of current study were to diagnose causes of Abnormal Uterine Bleeding (AUB in postmenopausal women (PMW and to correlate it with curettage and histopathological findings, hysteroscopy and thereby minimizing unnecessary interventions in the form of operations and hysteroscopy where sonography depicts normal findings. Methods: After obtaining ethical clearance present prospective observational study was conducted from November 2010 to November 2012, to evaluate the endometrium in 50 postmenopausal women (PMW with bleeding per vagina referred to the department of Radio diagnosis by the department of gynaecology in Bangalore medical college and research institute. After applying inclusion and exclusion criterias the cases were evaluated with ultrasonography both transabdominal (TAS and transvaginal scan (TVS where ever necessary. Histopathological and hysteroscopic correlation was done in all cases. Results: 58% of the PMW with bleed were in the age group of 51-60 years. Most common cause of PMB was atrophic endometrium (44%, endometrial polyp (22%, followed by malignancy (14%, and hyperplastic endometrium (6%. At Endometrium thickness less than 4 mm there were nil chances of carcinoma. Conclusions: In women with AUB in postmenopausal age ultrasonography (USG can be considered as an initial imaging modality for diagnosing endometrial diseases. The sensitivity and specificity of USG for Atrophic endometrium is 100% and 84% respectively with accuracy of 100%, endometrial polyp the specificity is 100% with accuracy of 88%. For malignancy USG showed 100% specificity and accuracy of 100%. Hence USG is highly accurate for evaluating endometrial pathologies. Being noninvasive, less costly and good patient compliance USG should be considered as an initial imaging modality over invasive investigations like D and C, hysteroscopy in evaluating endometrial disorders. [Int J Reprod Contracept Obstet Gynecol 2015; 4(1.000: 229-234

  9. Can Endometrial Cancer Be Found Early?

    Science.gov (United States)

    ... Next Topic Signs and symptoms of endometrial cancer Can endometrial cancer be found early? In most cases, ... reach an advanced stage before signs and symptoms can be noticed. More information can be found in “ ...

  10. ROLE OF HYSTEROSCOPY IN ABNORMAL UTERINE BLEEDING I N PERIMENOPAUSAL AGE GROUP

    OpenAIRE

    Reethu; Sujatha M

    2013-01-01

    ABSTRACT: OBJECTIVE: The objectives included evaluation of the role of h ysteroscopy in the diagnosis of abnormal uterine bleeding in women of perimenopausal age group and to correlate the hysteroscopic findings with that of histopatholog y. METHODOLOGY: A total of fifty perimenopausal women were subjected to hysteroscopy fo llowed by endometrial sampling for histopathological examination. RESULTS: The age of the subjects ranged from 40 years to 53 ye...

  11. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... and Vascular Institute, we've performed almost 1,000 uterine fibroid embolizations. Fibroids are common, benign tumors ... really on the order of one in 10,000. And so, for all intents and purposes, it's ...

  12. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... parts of it can actually break off and fall into the cavity. And a small percentage of ... fibroid, instead of shrinking, may break off and fall into the uterine cavity, in which case we ...

  13. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... your fibroids will slowly shrink and become non-functional. So our goal is really to get 5 ... We don't want to treat people with history of cervical cancer or uterine cancer. We have ...

  14. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... We don't want to treat people with history of cervical cancer or uterine cancer. We have ... hopefully led to a much higher quality of life. The last bit of housekeeping that we have ...

  15. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... make sure that we're not going too fast, slowly inject, only going forward into the uterine ... blockage is relieved, we don't inject too fast. And so, typically it's a relatively low-pressure ...

  16. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... an excellent choice. Some women may not be candidates for this, and we'll get into that ... want to treat people with history of cervical cancer or uterine cancer. We have to make sure ...

  17. Uterine Fibroid Embolization

    Medline Plus

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

  18. Uterine changes during tamoxifen, toremifene, and other therapy for breast cancer. Evaluation with magnetic resonance imaging

    International Nuclear Information System (INIS)

    We have performed pelvic magnetic resonance imaging (MRI) in patients undergoing breast cancer surgery before and after adjuvant drug therapy. Our purpose was to detect any radiographic uterine changes induced by various types of adjuvant therapy on pre- and postmenopausal patients by evaluating prospectively performed MRI. Between September 2004 and December 2007, a total of 41 women with breast cancer (11 premenopausal, 30 postmenopausal) were enrolled. All underwent MRI of the pelvis before and after drug therapy, and uterine changes were evaluated. Postoperative drugs used were selective estrogen receptor modulators (SERMs) including tamoxifen and toremifene (n=18), aromatase inhibitors (n=13), and anticancer drugs (n=10). Only the postmenopausal patients receiving SERMs showed a significant increase in endometrial thickness: from 2.4±0.4 mm before therapy to 4.5±2.6 mm after therapy (P=0.0485). No statistically significant endometrial change was evident in postmenopausal patients treated with aromatase inhibitors (P=0.573) or anticancer drugs (P=0.754). Also, in premenopausal patients treated with SERMs or anticancer drugs, the change in endometrial thickness was not statistically significant (P=0.958, 0.370). This prospective study using MRI has demonstrated that uterine changes associated with adjuvant drugs for breast cancer occur exclusively in postmenopausal patients receiving SERMs. (author)

  19. Oncogene alterations in endometrial carcinosarcomas.

    Science.gov (United States)

    Biscuola, Michele; Van de Vijver, Koen; Castilla, María Ángeles; Romero-Pérez, Laura; López-García, María Ángeles; Díaz-Martín, Juan; Matias-Guiu, Xavier; Oliva, Esther; Palacios Calvo, José

    2013-05-01

    Endometrial carcinosarcomas are aggressive neoplasias composed of high-grade carcinomatous and sarcomatous elements. The pathogenesis and specific genetic alterations underlying these tumors are still not well known. We analyzed alterations in oncogenes involved in the pathogenesis of endometrial carcinomas that might represent predictive markers for specific therapies. Immunohistochemistry for HER2 (tyrosine kinase-type cell surface receptor HER2) and c-KIT (tyrosine-protein kinase Kit) and fluorescence in situ hybridization for EGFR (epidermal growth factor receptor) and ALK (anaplastic lymphoma receptor tyrosine kinase) were carried out for 76 endometrial carcinosarcoma samples on sequential tissue microarray sections. Analysis of 238 mutations across 19 common oncogenes was performed on 34 samples using the Sequenom OncoCarta Panel (Sequenom, Hamburg, Germany). We observed EGFR, HER2, and c-KIT expression in 71%, 1.5%, and 2.7% of tumors, respectively. EGFR amplification was detected in 11 of 76 endometrial carcinosarcomas (14.5%). Four samples showed both amplification and aneuploidy (5.2%). ALK amplification together with chromosome 2 polysomy was found in 1.3% of endometrial carcinosarcomas. In total, 23 mutations in 9 different oncogenes were detected in 15 (44.1%) of 34 endometrial carcinosarcomas. Five endometrial carcinosarcomas (14.7%) had 2 or more mutations. Eleven tumors (32.3%) had mutations affecting the PI3K (phosphoinositide-3-kinase)/AKT (v-akt murine thymoma viral oncogene homolog 1) (6 mutations in PIK3CA (PI3K catalytic alpha polypeptide) and 1 in AKT) and/or RAS/BRAF (serine/threonine-protein kinase B-raf) pathway (3 KRAS [kirsten RAS oncogene homolog], 2 NRAS [neuroblastoma RAS viral oncogene homolog], and 1 BRAF). Mutations in PDGFRA (platelet-derived growth factor receptor, alpha polypeptide) and/or KIT were found in 5 endometrial carcinosarcomas (14.7%). Finally, we found mutations in MET (met proto-oncogene [hepatocyte growth factor receptor]) in 2 tumors (5.9%) and in EGFR in one (2.9%). Our study evidences mutations in oncogenes in endometrial carcinosarcomas that are targets or modulators of response to specific therapies in other human cancers, with PI3K/AKT being the most frequently altered pathway. PMID:23199529

  20. Hysterectomy for dysfunctional uterine bleeding in the era of uterine conservation

    Directory of Open Access Journals (Sweden)

    Simar Kaur

    2015-08-01

    Full Text Available Background: Hysterectomy is one of the modalities to manage dysfunctional uterine bleeding (DUB where medical management fails or is contraindicated. Hysterectomy leads to guaranteed cure but does have a significant morbidity rate. In this era of popularization of various uterine conservation techniques there is a definite need to audit justification of causes which led to hysterectomy in DUB. Methods: Women with a diagnosis of DUB, based on clinical and ultrasound findings, which underwent endometrial sampling/curettage were recruited for the study. All these patients were followed up. Those who underwent hysterectomy for the sake of DUB were thoroughly studied. Information regarding the histopathology report of hysterectomy specimen was collected. Finally reason and justification of hysterectomy for these women was evaluated. Results: A total of 252 women were with DUB were included. In this group 76 women (30.2% underwent hysterectomy. Noncompliance to medical management was the most common indication (in 37.6% women, which led to hysterectomy in our study group. Significant result was seen with final histology of simple endometrial hyperplasia in which 19 out of 41 (46.4 % cases were missed on curettage. Similarly around 50% cases (21 out of 43 diagnosed as simple hyperplasia on curettage had normal endometrium on final histopathology. Contrary to this a 100% concordance was seen in complex hyperplasia (without atypia, with only two cases in our sample. More than three fourth (78% cases had a coincidental pathology in the myometrium. Conclusions: Thorough counseling for the benefits and side effects of medical management prior to starting it is imperative, as the most common indication for hysterectomy for DUB was non-compliance to medical management. If women with normal histopathology reports on curettage are not responding to medical management, further imaging and sampling is required. Women non responsive to medical management may have underlying/ co-existent myometrial pathology. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 1133-1136

  1. Cervical Myomas

    Science.gov (United States)

    ... Information Drug Information, Search Drug Names, Generic and Brand Natural Products, Search Drug Interactions Pill Identifier News & Commentary ALL NEWS > Resources First Aid Videos & Animations Figures Images Audio Pronunciations The One-Page Manual of Health ...

  2. Effects of catecholaminergic nerve lesion on endometrial development during early pregnancy in Mice.

    Science.gov (United States)

    Dong, Yulan; Liu, Guanhui; Wang, Zixu; Li, Jing; Cao, Jing; Chen, Yaoxing

    2016-04-01

    Maternal stress is common during pregnancy and the postnatal period. This stress typically activates the sympathetic nervous system which releases catecholamines. This study explored the influence of sympathectomy by using neurotoxin 6-hydroxydopamine (6-OHDA) on embryo implantation, and investigated the influence mechanism of sympathectomy on reconstruction of endometrial structure during early pregnancy. In the 6-OHDA-treated mice, uterine glands in the endometrium developed poorly, and the gland epithelia were arranged irregularly during early pregnancy. Furthermore, vacuoles, karyopykosis and plasmarrhexis appeared in some gland epithelia. The percentage of uterine glands and the density of proliferating cell nuclear antigen (PCNA) positivity were dramatically decreased, and Fas ligand (FasL) expression was decreased in cells from pregnancy days 5-9 (E5-9) in the treated group. Antioxidant enzyme activity levels in uteri were lower but the malondialdehyde (MDA) levels were higher in the 6-OHDA mice than those in the control mice at E5-9. Similarly, the number of inducible nitric oxide synthase (iNOS) positive cells was significantly increased during early pregnancy following treatment with 6-OHDA. Our results have indicated that peripheral catecholaminergic nerve lesions induced by 6-OHDA cause adverse pregnancy outcomes through disruption of endometrial gland development, which increases oxidative stress and iNOS expression in the endometrium. Thus, catecholaminergic nerves might favourably influence blastocyst implantation, foetal survival and development during early pregnancy by oxidative state regulation and endometrial gland reconstruction. PMID:26554516

  3. Uterine Healing after Therapeutic Intrauterine Administration of TachoSil (Hemostatic Fleece) in Cesarean Section with Postpartum Hemorrhage Caused by Placenta Previa

    DEFF Research Database (Denmark)

    Fuglsang, Katrine; Dueholm, Margit; Hansen, Estrid Stæhr; Petersen, Lone Kjeld

    2012-01-01

    due to placenta previa were enrolled. An evaluation of the cesarean section scar by transvaginal ultrasound, the uterine cavity and endometrium by hysteroscopy, and the endometrium by biopsy were made. The main outcome measures were intrauterine adhesions, recovery of endometrium at the site of Tacho......Sil application, visible remnants of TachoSil, and scar healing. Results. Eight patients had small remnants of TachoSil in the uterine cavity together with signs of resorption. All had a normal endometrial mucosa, and none had adhesions in the uterine cavity. All cesarean section scars were healed without defects...

  4. Implantation in the baboon: endometrial responses.

    Science.gov (United States)

    Fazleabas, A T; Kim, J J; Srinivasan, S; Donnelly, K M; Brudney, A; Jaffe, R C

    1999-01-01

    Blastocyst implantation in the baboon usually occurs between 8 and 10 days post ovulation. Changes that occur within this window of receptivity and immediately following implantation can be divided into three distinct phases. The first phase, regulated by estrogen and progesterone, is characterized primarily by changes in both the luminal and glandular epithelial cells in preparation for blastocyst apposition and attachment. The second phase is the further modulation of these steroid induced changes in both epithelial and stromal cells by embryonic signals. The final phase is associated with trophoblast invasion and the remodeling of the endometrial stromal compartment. During the initial phase, the actions of estrogen and progesterone are dependent on the presence of specific receptors. Estrogen up-regulates both its own receptor (ER) and the progesterone receptor (PR), while progesterone down-regulates this expression pattern. However, the pattern of progesterone-induced down-regulation of ER and PR is confined to the epithelial cells and demonstrates a gradient effect from the functionalis to the basalis. What is most intriguing is that the loss of epithelial PR is closely correlated with the establishment of uterine receptivity. Coincident with the changes in ER and PR expression, epithelial cells undergo alterations in their cytoskeletal architecture and secretory profile. These changes can be counteracted by PR antagonist treatment during the luteal phase. Although estrogen and progesterone play a critical role in establishing the initial phase of uterine receptivity, it is becoming increasingly evident that the embryo induces functional receptivity in ruminants and rodents. In our studies in the primate, we demonstrate that chorionic gonadotrophin when infused in a manner that mimics blastocyst transit, has physiological effects on the three major cell types in the uterine endometrium. The luminal epithelium undergoes endoreplication and distinct epithelial plaques are evident. The glandular epithelium responds by inducing transcriptional and post-translational modifications in the major secretory product, glycodelin. The stromal fibroblasts initiate their differentiation process into a decidual phenotype and are characterized by the expression of actin filaments. In phase three, blastocyst attachment to the surface epithelium and subsequent implantation is associated with local remodeling of the maternal stroma, smooth muscle, and endothelium of the blood vessels by the trophoblast. In addition, there is a gradual diminution of the epithelial plaques on the luminal surface although the glandular epithelium remains highly secretory. The most dramatic effect is on the stromal fibroblasts, which in response to embryonic stimuli, differentiate into decidual cells, the major cell type of the gestational endometrium. This differentiation is characterized by the expression of insulin-like growth factor binding protein-1 (IGFBP-1) in these cells. The cytokine IL-1 beta is one possible embryonic signal. COX-2 is the rate-limiting enzyme for prostaglandin biosynthesis and transcription of this enzyme in response to the embryonic stimulus (IL-1 beta) results in an increase in prostaglandin biosynthesis in stromal fibroblasts at the site of implantation. Prostaglandins and PGE2 in particular, binds to its specific receptor (EP2 or EP4) and activates adenyl cyclase. The resulting increase in intracellular levels of cAMP can now activate IGFBP-1 gene transcription at the site of implantation. In summary, our studies have demonstrated that chorionic gonadotrophin, when infused into non-pregnant baboons during the window of uterine receptivity can induce epithelial responses that are similar to those observed in a fertile cycle. Stromal differentiation is initiated; however, decidualization requires a signal from the conceptus. PMID:10797944

  5. Acute puerperal uterine inversion

    International Nuclear Information System (INIS)

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

  6. Rac1 Regulates Endometrial Secretory Function to Control Placental Development.

    Science.gov (United States)

    Davila, Juanmahel; Laws, Mary J; Kannan, Athilakshmi; Li, Quanxi; Taylor, Robert N; Bagchi, Milan K; Bagchi, Indrani C

    2015-08-01

    During placenta development, a succession of complex molecular and cellular interactions between the maternal endometrium and the developing embryo ensures reproductive success. The precise mechanisms regulating this maternal-fetal crosstalk remain unknown. Our study revealed that the expression of Rac1, a member of the Rho family of GTPases, is markedly elevated in mouse decidua on days 7 and 8 of gestation. To investigate its function in the uterus, we created mice bearing a conditional deletion of the Rac1 gene in uterine stromal cells. Ablation of Rac1 did not affect the formation of the decidua but led to fetal loss in mid gestation accompanied by extensive hemorrhage. To gain insights into the molecular pathways affected by the loss of Rac1, we performed gene expression profiling which revealed that Rac1 signaling regulates the expression of Rab27b, another GTPase that plays a key role in targeting vesicular trafficking. Consequently, the Rac1-null decidual cells failed to secrete vascular endothelial growth factor A, which is a critical regulator of decidual angiogenesis, and insulin-like growth factor binding protein 4, which regulates the bioavailability of insulin-like growth factors that promote proliferation and differentiation of trophoblast cell lineages in the ectoplacental cone. The lack of secretion of these key factors by Rac1-null decidua gave rise to impaired angiogenesis and dysregulated proliferation of trophoblast cells, which in turn results in overexpansion of the trophoblast giant cell lineage and disorganized placenta development. Further experiments revealed that RAC1, the human ortholog of Rac1, regulates the secretory activity of human endometrial stromal cells during decidualization, supporting the concept that this signaling G protein plays a central and conserved role in controlling endometrial secretory function. This study provides unique insights into the molecular mechanisms regulating endometrial secretions that mediate stromal-endothelial and stromal-trophoblast crosstalk critical for placenta development and establishment of pregnancy. PMID:26305333

  7. Pregnancy after uterine arterial embolization

    OpenAIRE

    Cláudio E. Bonduki; Paulo C. Feldner, Jr.; Juliana da Silva; Rodrigo de A. Castro; Sartori, Marair G F; Manoel J.B.C. Girão

    2011-01-01

    OBJECTIVE: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. METHODS: A retrospective study of 187 patients treated with uterine arterial embolization for symptomatic uterine fibroids between 2005-2008 was performed. Uterine arterial embolization was performed using polyvinyl alcohol particles (500-900 µm in diameter). Pregnancies were identified using screening questionnaires and the study database. RESULT...

  8. Uterine mesenchymal tumors

    Directory of Open Access Journals (Sweden)

    Nikhil A Sangle

    2011-01-01

    Full Text Available Uterine mesenchymal tumors are a heterogeneous group of neoplasms that can frequently be diagnostically challenging. Differentiation between the benign and malignant counterparts of mesenchymal tumors is significant due to differences in clinical outcome, and the role of the surgical pathologist in making this distinction (especially in the difficult cases cannot be underestimated. Although immunohistochemical stains are supportive toward establishing a final diagnosis, the morphologic features trump all the other ancillary techniques for this group of neoplasms. This review therefore emphasizes the key morphologic features required to diagnose and distinguish uterine mesenchymal tumors from their mimics, with a brief description of the relevant immunohistochemical features.

  9. Risk groups in pathologic stage III endometrial carcinoma

    International Nuclear Information System (INIS)

    Purpose: Pathologic stage III (pIII) endometrial carcinoma is a heterogeneous group ranging from patients (pts) with positive washings alone to those with involved lymph nodes and multiple extra-uterine disease sites. Patients are traditionally grouped into two subsets (A and C). This approach, however, may fail to differentiate between pt groups with markedly different prognoses. Our goal was to stratify pIII pts into prognostic groups based on sites of extrauterine disease and pathologic features in the surgical specimen. Methods/Materials: Seventy-six pIII (46 IIIA, 30 IIIC) endometrial carcinoma pts were treated between (6(80)) and (6(95)). Median age was 65 years (range, 25-83). Stage IIIA subsets included isolated washings, serosal or adnexal involvement in 14, 11 and 11 pts, respectively. Ten had multiple extrau-terine sites without nodal involvement. Most tumors were adenocarcinomas (ACA) (59%), were grades II-III (87%) and had deep myometrial invasion (71%). Patients underwent TAH-BSO with lymph node sampling (in 79%) and evaluation of washings (in 78%). Sixty-one (79%) received radiation therapy (RT), predominantly pelvic +/- para-aortic/intracavitary RT. Chemo- and hormonal therapy were given in 22% and 21%, respectively. After first stratifying pts into 3 prognostic groups (Low, Intermediate and High risk) based on sites of extrauterine disease (washings, adnexa, serosal involvement and lymph nodes), we evaluated the prognostic impact of pathologic features (grade, histology, cervical involvement, myometrial and lymphovascular invasion) within each risk group. Median followup (surviving pts) was 50 months (range, 5-157). Results: The 5-year actuarial disease-free (DFS) and cause-specific (CSS) survivals of the entire group were 49.1% and 62.3%, respectively. Low risk pts were identified to have either positive washings alone or adnexal involvement alone. Intermediate risk pts had either serosal involvement alone or synchronous positive washings and adnexal involvement. High risk pts included those with either involved lymph nodes or synchronous serosal involvement with either positive washings or adnexal involvement. The 5-yr DFS of the 3 risk groups were 74.8, 49.6 and 30.7% (p = 0.006) (See figure). No pathologic features were found to aid in the further delineation of prognostic risk groups. Conclusions: Extra-uterine disease sites allow stratification of stage III endometrial carcinoma pts into Low, Intermediate and High risk groups. The use of pathologic features in the hysterectomy specimen did not aid in further stratification of patients into the risk groups. This approach may offer more clinically useful prognostic information than the standard stage III subsets and allow better selection of optimal adjuvant therapy

  10. Predictive modes of action of pesticides in uterine adenocarcinoma development in rats.

    Science.gov (United States)

    Yoshida, Midori; Inoue, Kaoru; Takahashi, Miwa

    2015-10-01

    Endometrial adenocarcinoma in the uterine corpus is a malignant cancer that occurs in menopausal women and aged rodents. Because of the similarities in pathogenesis and morphology of endometrial adenocarcinoma in rodents and humans, prediction of the modes of action (MOA) in uterine carcinogenesis is important for extrapolation of rodent data to humans. Three MOAs have been accepted as major pathways for uterine carcinogenesis in rodents: 1) estrogenic activity, 2) increased serum 17beta-estradiiol (E2) to progesterone (P4) ratio and 3) modulation of estrogen metabolism to produce 4-hydroxyestradiol via P450 induction. Inhibition of estrogen excretion and increased aromatase in situ in the tumor are also a potential pathway. Here, chemicals showing uterine carcinogenicity were chosen from approximately 300 pesticides evaluated in Japan within the past decade, and their mechanisms were predicted using parameters from mechanistic and toxicity studies. Seven pesticides increased uterine tumor formation in rats, and the pathways of 4 pesticides could be predicted based on various mechanistic studies. The MOAs of cyenopyrafen and benthiavalicarb-isopropyl were predicted to be modulation of estrogen metabolism, while those of pyriminobac-methyl and spirodiclofen were predicted to be increased E2 to P4 ratio. The driven pathways of metazosulfuron and isopyrazam could not be predicted using several mechanistic studies. No mechanistic studies have been reported for sedaxane, which has a chemical structure and toxicological profile similar to isopyrazam. Our results indicated that appropriate mechanistic studies are useful for mechanism prediction in risk assessment. From this analysis, a flowchart showing a decision tree for predictive MOAs in uterine carcinogenesis was proposed. PMID:26538810

  11. Role of transvaginal ultrasonography in diagnosing endometrial hyperplasia in pre- and post-menopause women

    OpenAIRE

    Behrooz Shokouhi

    2015-01-01

    Background: Abnormal uterine bleeding (AUB) is the most common presenting symptom of endometrial hyperplasia (EH). Transvaginal ultrasonography (TVS) is a diagnostic tool in the evaluation of AUB and EH with various sensitivity and specificity. However, the exact accuracy of TVS in diagnosing EH had not been evaluated. In this study, we aim to evaluate the accuracy of TVS in detecting EH. Materials and Methods: In this retrospective study, 120 women (mean age of 48.64 ± 6.74 years) with AUB w...

  12. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... to make sure that we're not going too fast, slowly inject, only going forward into the uterine artery. You're watching on your monitor the whole time, right Alex? And that's exactly right. I'm not watching my hands. My eyes are focused on the TV monitor that we, of course, ...

  13. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... watch it as it flows. And basically the concept is to make sure that there's still some blood flow in that main uterine artery, but the little branches no longer have flow. So that's our first crude look. And when I think it's time to take amore detailed look, we'll acquire ...

  14. Uterine Cancer Statistics

    Science.gov (United States)

    ... Are the Symptoms? What Should I Know About Screening? How Is Ovarian Cancer Treated? Information for Health Care Providers Statistics Rates by Race and Ethnicity Rates by State Trends Related Links ... I Know About Screening? How Is Uterine Cancer Treated? Statistics Rates by ...

  15. Symptoms of Uterine Cancer

    Science.gov (United States)

    ... Are the Symptoms? What Should I Know About Screening? How Is Ovarian Cancer Treated? Information for Health Care Providers Statistics Rates by Race and Ethnicity Rates by State Trends Related Links ... I Know About Screening? How Is Uterine Cancer Treated? Statistics Rates by ...

  16. Uterine Fibroid Embolization

    Medline Plus

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

  17. Uterine Fibroid Embolization

    Medline Plus

    Full Text Available ... looking at. Again, a typical pattern of a woman with symptomatic uterine fibroids. And we're going to go ahead and, as we did on the left side already, we're going to block it off on this side here. Jim, back you. All right, so Alex, maybe as we come back to ...

  18. Outcome analysis in patients with uterine sarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Yu, To Sol; Kim, Hak Jae; Wu, Hong Gyun; Ha, Sung Whan; Song, Yong Sang; Park, Noh Hyun; Kim, Jae Won [Seoul National University College of Medicine, Seoul (Korea, Republic of)

    2015-03-15

    To analyze the prognostic factors for survivals and to evaluate the impact of postoperative whole pelvic radiotherapy (WPRT) on pelvic failure in patients with uterine sarcoma treated with radical surgery. We retrospectively analyzed 75 patients with uterine sarcoma who underwent radical surgery with (n = 22) or without (n = 53) radiotherapy between 1990 and 2010. There were 23 and 52 patients with carcinosarcoma and non-carcinosarcoma (leiomyosarcoma, 22; endometrial stromal sarcoma, 25; others, 5), respectively. The median follow-up period was 64 months (range, 17 to 269 months). The 5-year overall survival (OS) and pelvic failure-free survival (PFFS) of total patients was 64.2% and 83.4%, respectively. Multivariate analysis revealed that mitotic count (p = 0.006) was a significant predictor of OS. However, factors were not found to be associated with PFFS. On analyzing each of the histologic subtypes separately, postoperative WPRT significantly reduced pelvic failure in patients with carcinosarcoma (10.0% vs. 53.7%; p = 0.046), but not in patients with non-carcinosarcoma (12.5% vs. 9.9%; p = 0.866). Among the patients with carcinosarcoma, 4 patients (17%) had recurrence within the pelvis and 3 patients (13%) had recurrence in other sites as an initial failure, whereas among the patients with non-carcinosarcoma, 3 patients (6%) experienced pelvic failure and 13 patients (25%) experienced distant failure. The most significant predictor of OS was mitotic count. Based on the improved PFFS after postoperative WPRT only in patients with carcinosarcoma and the difference in patterns of failure between histologic subtypes, optimal adjuvant treatment options should be offered to patients based on the risk of recurrence patterns.

  19. Uterine sarcomas-Recent progress and future challenges

    Energy Technology Data Exchange (ETDEWEB)

    Seddon, Beatrice M., E-mail: beatrice.seddon@uclh.nhs.uk [London Sarcoma Service, Department of Oncology, University College Hospital, 1st Floor Central, 250 Euston Road, London, NW1 2PG (United Kingdom); Davda, Reena [London Sarcoma Service, Department of Oncology, University College Hospital, 1st Floor Central, 250 Euston Road, London, NW1 2PG (United Kingdom)

    2011-04-15

    Uterine sarcomas are a group of rare tumours that provide considerable challenges in their treatment. Radiological diagnosis prior to hysterectomy is difficult, with the diagnosis frequently made post-operatively. Current staging systems have been unsatisfactory, although a new FIGO staging system specifically for uterine sarcomas has now been introduced, and may allow better grouping of patients according to expected prognosis. While the mainstay of treatment of early disease is a total abdominal hysterectomy, it is less clear whether routine oophorectomy or lymphadenectomy is necessary. Adjuvant pelvic radiotherapy may improve local tumour control in high risk patients, but is not associated with an overall survival benefit. Similarly there is no good evidence for the routine use of adjuvant chemotherapy. For advanced leiomyosarcoma, newer chemotherapy agents including gemcitabine and docetaxel, and trabectedin, offer some promise, while hormonal therapies appear to be more useful in endometrial stromal sarcoma. Novel targeted agents are now being introduced for sarcomas, and uterine sarcomas, and show some indications of activity. Non-pharmacological treatments, including surgical metastatectomy, radiofrequency ablation, and CyberKnife radiotherapy, are important additions to systemic therapy for advanced metastatic disease.

  20. Microarray Analysis on Gene Regulation by Estrogen, Progesterone and Tamoxifen in Human Endometrial Stromal Cells

    Directory of Open Access Journals (Sweden)

    Chun-E Ren

    2015-03-01

    Full Text Available Epithelial stromal cells represent a major cellular component of human uterine endometrium that is subject to tight hormonal regulation. Through cell-cell contacts and/or paracrine mechanisms, stromal cells play a significant role in the malignant transformation of epithelial cells. We isolated stromal cells from normal human endometrium and investigated the morphological and transcriptional changes induced by estrogen, progesterone and tamoxifen. We demonstrated that stromal cells express appreciable levels of estrogen and progesterone receptors and undergo different morphological changes upon hormonal stimulation. Microarray analysis indicated that both estrogen and progesterone induced dramatic alterations in a variety of genes associated with cell structure, transcription, cell cycle, and signaling. However, divergent patterns of changes, and in some genes opposite effects, were observed for the two hormones. A large number of genes are identified as novel targets for hormonal regulation. These hormone-responsive genes may be involved in normal uterine function and the development of endometrial malignancies.

  1. Cystic adenomyosis spreading into subserosal-peduncolated myoma: How to explain it?

    OpenAIRE

    Gloria Calagna; Gaspare Cucinella; Gabriele Tonni; Roberto De Gregorio; Onofrio Triolo; Anna Martorana; Antonino Perino; Roberta Granese

    2015-01-01

    Introduction: Cystic adenomyosis is a rare variant of adenomyosis characterized by well- circumscribed cavitated endometrial gland and stroma located within the myometrium. The cysts usually measure ≥ 1 cm in diameter, contain a “chocolate-colored” fluid and do not open into the overlaying endometrium. Case presentation: We present a case of a peduncolated-subserosal cystic adenomyoma, namely cystic adenomyosis, correlated with pelvic MR imaging, laparoscopic surgery technique and histopat...

  2. Gene Tests May Improve Therapy for Endometrial Cancer

    Science.gov (United States)

    ... External link, please review our exit disclaimer . Subscribe Gene Tests May Improve Therapy for Endometrial Cancer By analyzing genes in hundreds of endometrial tumors, scientists identified details ...

  3. Molecular Pathogenesis of Endometrial and Ovarian Cancer

    OpenAIRE

    Merritt, Melissa A; Cramer, Daniel W.

    2010-01-01

    Pregnancy, breastfeeding, and oral contraceptive pill use interrupt menstrual cycles and reduce endometrial and ovarian cancer risk. This suggests the importance of turnover within Mullerian tissues, where the accumulation of mutations in p53 and PTEN has been correlated with number of cycles. The most common type of endometrial cancer (Type I) is endometrioid and molecular abnormalities include mutations in PTEN, KRAS and ?-catenin. The Type I precursor is Endometrial lntraepithelial Neoplas...

  4. Relationships between intrauterine infusion of N-acetylcysteine, equine endometrial pathology, neutrophil function, post-breeding therapy, and reproductive performance.

    Science.gov (United States)

    Gores-Lindholm, Alicia R; LeBlanc, Michelle M; Causey, Robert; Hitchborn, Anna; Fayrer-Hosken, Richard A; Kruger, Marius; Vandenplas, Michel L; Flores, Paty; Ahlschwede, Scott

    2013-08-01

    Persistent endometritis in the mare is associated with hypersecretion of mucus by endometrial epithelium and migration of neutrophils into the uterine lumen. This study examines the relationships between N-acetylcysteine (NAC), a mucolytic agent with anti-inflammatory properties, and endometrial architecture, serum neutrophil function, post-breeding therapy, and reproductive performance of NAC-treated mares in a clinical setting. In study 1, endometrial biopsies from mares receiving intrauterine saline (fertile-control, n = 6) or 3.3% NAC (fertile-treatment, n = 6; barren-treatment, n = 10) were evaluated by histology and image analysis. In study 2, phagocytic activity of serum-derived neutrophils was measured after adding 0.5% or 3% NAC. In study 3, pregnancy rates of repeat breeders (n = 44) receiving an intrauterine infusion of 3.3% NAC 24-36 hours before mating (group 1) was recorded, as was first cycle of the season pregnancy rates of reproductively normal mares (group 2, n = 85), and mares treated for bacterial endometritis the cycle before mating (group 3, n = 25). Intrauterine NAC did not adversely affect endometrial histology. Extracellular mucus thickness and staining intensity were reduced in fertile-treatment mares (P NAC solution, but not by 0.5% NAC (P NAC was not irritating and inhibited the oxidative burst of neutrophils. Repeat breeder mares, with evidence of mucus hypersecretion, but no uterine pathogens, when treated with NAC followed by post-mating uterine lavage and oxytocin (and in some cases intrauterine antibiotics), achieved a pregnancy rate of 77%. PMID:23623166

  5. Ulipristal acetate: a novel pharmacological approach for the treatment of uterine fibroids

    Directory of Open Access Journals (Sweden)

    Biglia N

    2014-02-01

    Full Text Available Nicoletta Biglia,1 Silvestro Carinelli,2 Antonio Maiorana,3 Marta D'Alonzo,1 Giuseppe Lo Monte,4 Roberto Marci4 1Department of Obstetrics and Gynaecology, Mauriziano "Umberto I" Hospital, University of Turin, Turin, 2Department of Pathology, European Institute of Oncology, Milan, 3Department of Obstetrics and Gynecology, ARNAS Civico Hospital, Palermo, 4Department of Morphology, Surgery and Experimental Medicine, Section of Obstetrics and Gynecology, Infertility Unit, University of Ferrara, Ferrara, Italy Abstract: Uterine fibroids are the most common benign tumors of the female genital tract. The management of symptomatic fibroids has traditionally been surgical; however, alternative pharmacological approaches have been proposed to control symptoms. To date, gonadotropin-releasing hormone analogs are the only available drugs for the preoperative treatment of fibroids. However, the US Food and Drug Administration recently authorized ulipristal acetate (UPA, an oral selective progesterone-receptor modulator, for the same indication. UPA is a new, effective, and well-tolerated option for the preoperative treatment of moderate and severe symptoms of uterine fibroids in women of reproductive age. According to clinical data, UPA shows several advantages: it is faster than leuprolide in reducing the fibroid-associated bleeding, it significantly improves hemoglobin and hematocrit levels in anemic patients, and it grants a significant reduction in the size of fibroids, which lasts for at least 6 months after the end of the treatment. Furthermore, UPA displays a better tolerability profile when compared to leuprolide; in fact, it keeps estradiol levels at mid follicular phase range, thereby reducing the incidence of hot flushes and exerting no impact on bone turnover. On the grounds of this evidence, the administration of 5 mg/day ulipristal acetate for 3 months is suggested for different patient categories and allows for planning a treatment strategy tailored to meet an individual patient's needs. Keywords: ulipristal acetate, uterine fibroids, myomas, selective progesterone-receptor modulator, medical treatment of uterine fibroids

  6. Endometrial biopsy findings in postmenopausal bleeding

    International Nuclear Information System (INIS)

    To study endometrial histopathology in women presenting with postmenopausal bleeding. A two-year study from January 2003 to December 2004 of 100 cases of postmenopausal bleeding was conducted at Combined Military Hospital, Sialkot. The histopathology of endometrial biopsy specimens was done to find out the causes of postmenopausal bleeding in these ladies. All these 100 patients had confirmed menopause and the average age was 55 years and above. The most common histopathological diagnosis was senile endometrial atrophy (27%), followed by simple cystic hyperplasia in (17%). Three cases of simple cystic hyperplasia had coexistent ovarian tumors. Glandular hyperplasia without atypia was seen in 6% and with atypia in 4%. Other causes were endometritis (13%), endometrial polyps (8%), proliferative phase endometrium (6%) and secretary phase endometrium (5%). Endometrial carcinoma was seen in (6%) cases, (8%) biopsy specimens were non-representative. Although senile endometrial atrophy was most commonly found in these ladies but a significant percentage of endometrial hyperplasia and endometrial cancer implies the need for investigating all cases of postmenopausal bleeding. Bimanual examination and pelvic ultrasonography should be combined with endometrial sampling so that rare pelvic pathologies may not be missed. (author)

  7. Endometrial aspiration cytology in gynecological disorders

    Directory of Open Access Journals (Sweden)

    Meenal V Jadhav

    2016-01-01

    Full Text Available Context: Endometrial aspiration is not a popular modality for the study of the endometrium despite its simplicity and potential utility. Aim: The present study was aimed at evaluating the utility of endometrial aspiration in various gynecological disorders. Materials and Methods: In this diagnostic accuracy study, 55 prospectively registered women with various gynecological disorders were evaluated clinically and subjected to endometrial aspiration cytology and study of endometrial histology. Endometrial aspiration was performed by infant feeding tube in 10 cases and intra cath cannula in 45 cases. The slides were stained with rapid Papanicolaou (PAP stain and Leishman stain. Results: Endometrial aspiration cytology showed 90% and 94.6% sampling adequacy with infant feeding tube and intra cath cannula, respectively. Intra cath cannula was very convenient to handle and superior to infant feeding tube in aspirating the endometrium. Of the two stains used, rapid PAP stain was less time-consuming and superior to Leishman stain in studying the nuclear details. Leishman stain was helpful in detecting cytoplasmic vacuoles of secretory endometrium. Overall diagnostic accuracy of endometrial cytology was 90.4% while that for morphological hormonal evaluation was 97.6%. It enjoyed a sensitivity of 91.66%, a specificity of 88.23%, positive predictive value of 94.28%, and negative predictive value of 83.33%. Conclusion: Intra cath cannula emerged as an inexpensive, effective, and convenient device for endometrial aspiration. Endometrial aspiration proved to be a fairly effective, simple, and informative diagnostic modality.

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

    International Nuclear Information System (INIS)

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

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

    Directory of Open Access Journals (Sweden)

    Oner H.

    2002-01-01

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

  10. Uterine adenocarcinoma with generalised metastasis in a bottlenose dolphin Tursiops truncatus from northern Patagonia, Argentina

    OpenAIRE

    SANCHEZ, J; Kuba, L.; Beron-Vera, B.; Dans, S.L.; Crespo, E.A.; Van Bressem, M.F.; Coscarella, M.A.; Garcia, N.A.; Alonso, M.K.; Pedraza, S. N.; Mariotti, P.A.

    2002-01-01

    An endometrial adenocarcinoma with areas of squamous differentiation and generalised metastasis was observed in a bottlenose dolphin Tursiops truncatus stranded in northern Patagonia in July 1997. This is the second report of a uterine adenocarcinoma in a free-living cetacean and the first in a Delphinidae. This neoplasm likely compromised reproduction for several years. In addition, the dolphin presented tattoo-like skin lesions and its digestive tract was infested by Anisakis simplex, Pseud...

  11. The Clinical Relevance of Rising CA-125 Levels Within the Normal Range in Patients With Uterine Papillary Serous Cancer

    OpenAIRE

    Frimer, Marina; Hou, June Y.; McAndrew, Thomas C.; Goldberg, Gary L; Shahabi, Shohreh

    2013-01-01

    The utility of cancer antigen 125 (CA-125) levels as an adjunct method of monitoring patients with uterine papillary serous carcinoma (UPSC) or endometrial serous carcinoma after surgery and adjuvant treatment has been reported. Our goal was to determine the significance of rising CA-125 levels within the normal range in these patients in the posttreatment surveillance setting. All patients with UPSC who underwent surgical staging and had preoperative CA-125 measurement from...

  12. An estrogen-induced endometrial hyperplasia mouse model recapitulating human disease progression and genetic aberrations

    International Nuclear Information System (INIS)

    Endometrial hyperplasia (EH) is a condition originating from uterine endometrial glands undergoing disordered proliferation including the risk to progress to endometrial adenocarcinoma. In recent years, a steady increase in EH cases among younger women of reproductive age accentuates the demand of therapeutic alternatives, which emphasizes that an improved disease model for therapeutic agents evaluation is concurrently desired. Here, a new hormone-induced EH mouse model was developed using a subcutaneous estradiol (E2)-sustained releasing pellet, which elevates the serum E2 level in mice, closely mimicking the effect known as estrogen dominance with underlying, pathological E2 levels in patients. The onset and progression of EH generated within this model recapitulate a clinically relevant, pathological transformation, beginning with disordered proliferation developing to simple EH, advancing to atypical EH, and then progressing to precancerous stages, all following a chronologic manner. Although a general increase in nuclear progesterone receptor (PR) expression occurred after E2 expression, a total loss in PR was noted in some endometrial glands as disease advanced to simple EH. Furthermore, estrogen receptor (ER) expression in the nucleus of endometrial cells was reduced in disordered proliferation and increased when EH progressed to atypical EH and precancerous stages. This EH model also resembles other pathological patterns found in human disease such as leukocytic infiltration, genetic aberrations in β-catenin, and joint phosphatase and tensin homolog/paired box gene 2 (PTEN/PAX2) silencing. In summary, this new and comprehensively characterized EH model is cost-effective, easily reproducible, and may serve as a tool for preclinical testing of therapeutic agents and facilitate further investigation of EH

  13. Endometrial safety: a key hurdle for selective estrogen receptor modulators in development.

    Science.gov (United States)

    Pinkerton, JoAnn V; Goldstein, Steven R

    2010-01-01

    Selective estrogen receptor modulators (SERMs) have the ability to provide mixed functional estrogen receptor (ER) agonist or antagonist activity, depending on the target tissue. Tamoxifen, the first SERM available for clinical use, is regarded as a highly effective agent for the prevention and treatment of breast cancer. However, tamoxifen exhibits ER agonist activity in the uterus and is associated with an increased risk of endometrial hyperplasia and malignancy. Endometrial safety has been an important consideration in the clinical development of SERMs, with improved benefit-risk profiles. Raloxifene, which is currently approved for the prevention and treatment of postmenopausal osteoporosis and for the prevention of breast cancer, seems to have neutral effects on the uterus. Promising results have been observed with the targeted development of newer and more tissue-specific SERMs, many of which are under investigation for postmenopausal osteoporosis. Of the newer SERMs in development, lasofoxifene has been shown to reduce fracture risk and decrease the incidence of breast cancer but has been associated with an increased incidence of vaginal bleeding, endometrial thickening, and endometrial polyps. Lasofoxifene and ospemifene have shown beneficial effects on the vaginal epithelium. Phase 3 clinical data have shown that bazedoxifene is effective in preventing and treating postmenopausal osteoporosis, without adverse effects on the endometrium or breast. Arzoxifene has been evaluated in phase 3 trials for postmenopausal osteoporosis and has been studied for the treatment of uterine malignancies but is no longer in clinical development. Further investigation of newer SERMs is warranted to more clearly define the endometrial safety of these agents. PMID:20107426

  14. MicroRNA-29b Inhibits Endometrial Fibrosis by Regulating the Sp1-TGF-?1/Smad-CTGF Axis in a Rat Model.

    Science.gov (United States)

    Li, Jingxiong; Du, Shaohua; Sheng, Xiujie; Liu, Juan; Cen, Bohong; Huang, Feng; He, Yuanli

    2016-03-01

    Intrauterine adhesions (IUAs), which are characterized by endometrial fibrosis, increase the risk of secondary infertility and recurrent miscarriage. MicroRNA-29 (miR-29) is a potent inhibitor of TGF-?1/Smad signaling. In this study, we investigated the therapeutic potential of agomir-29b, an miR-29b mimic, in endometrial fibrosis induced by dual injury (uterine curettage and lipopolysaccharide treatment) in a rat model of IUA and explored the underlying mechanism. We found that injured rats developed endometrial fibrosis characterized by increased COL1A1 and ?-smooth muscle actin expression and decreased E-cadherin expression, associated with a loss of miR-29b. Overexpression of miR-29b before injury prevented endometrial fibrosis including collagen accumulation and epithelial-mesenchymal transition. Delay of agomir-29b treatment until endometrial fibrosis was established on day 4 also halted the progression of disease. Further experiments indicated that miR-29b inhibited endometrial fibrosis via blockade of the Sp1-TGF-?1/Smad-CTGF pathway. In conclusion, agomir-29b may act as a novel and effective therapeutic agent against IUAs. PMID:26392347

  15. Endometrial Ablation: "Combination Procedure" (Nd:YAG Laser + Roller Ball Together)

    Science.gov (United States)

    Taylor

    1994-08-01

    Endometrial ablation is an effective treatment for intractable uterine bleeding. This can be accomplished using hysteroscopic electrosurgical rollerball, Nd:YAG laser, and with endomyometrial resection techniques. All ablations in this study were accomplished using the Nd:YAG laser and a "non-touch" technique on the ostiae, uterine fundus, and the upper 1/3 to 1/2 of the posterior uterine wall in combination with rollerball coagulation over the entire uterus after the 60 watt Nd:YAG application. The power source of the rollerball was set at 80 watts of pure coagulation current in most cases. Each patient was pre-treated with a GnRH agonist or an antiestrogenic compound. A total of 40 patients were treated beginning in November of 1990 until January 1994. Complete amenorrhea was achieved in 36 patients (90%). Two patients have slight monthly spotting requiring 1 to 2 mini-pads per month and two patients have light flow requiring 1 to 2 tampons for 1 to 3 days of the month. There were no failures. The complications were one uterine perforation with a dilator with no sequelae and one severe infection requiring hysterectomy. These promising results warrant further study of this "combination procedure." PMID:9073759

  16. Mesonephric Adenocarcinoma of the Uterine Corpus: A Case Report and Diagnostic Pitfall.

    Science.gov (United States)

    Kim, Sung Sun; Nam, Jong Hee; Kim, Ga-Eon; Choi, Yoo Duk; Choi, Chan; Park, Chang Soo

    2016-04-01

    Mesonephric adenocarcinoma is a rare tumor type that is usually found in areas where the Wolffian duct was present during the fetal period. We report a case of mesonephric adenocarcinoma of the uterine corpus in a 66-year-old woman who presented with vaginal bleeding. Pelvic magnetic resonance imaging revealed a 2.7-cm-sized irregular thickening and enhancement of the uterine body. The diagnosis following endometrial curettage biopsy was endometrioid adenocarcinoma, and the patient underwent a total hysterectomy with bilateral salpingo-oophorectomy. The tumor was composed of small tubular and ductal components, and a retiform appearance was also observed in the deeper areas. The tumor cells were immunopositive for cytokeratin, vimentin, CD10 with a luminal staining pattern, PAX2, and PAX8, and immunonegative for estrogen receptor and progesterone receptor, which was consistent with tumor of mesonephric origin. Mesonephric neoplasms reveal relatively low-grade nuclear feature, characteristic immunoprofiles (immunonegative for ER and PR, and immunopositive for CD10, PAX2, PAX8, and GATA3), and unique tumor location (myometrium), whereas Müllerian neoplasms such as endometrial adenocarcinoma show various morphology, immunopositivity for ER and PR, and primarily endometrial location. As described above, an integration of the clinical features, morphologic characteristics, and immunohistochemical profiles is needed to make a diagnosis. PMID:26510860

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

    International Nuclear Information System (INIS)

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

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

    International Nuclear Information System (INIS)

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

  19. Clinical utility of ulipristal acetate for the treatment of uterine fibroids: current evidence

    Science.gov (United States)

    Trefoux Bourdet, Alice; Luton, Dominique; Koskas, Martin

    2015-01-01

    Uterine myoma is the most common benign uterine tumor in women of reproductive age and occurs in 20%–25% of the worldwide population. No currently approved medical treatment is able to completely eliminate fibroids. Surgery, particularly hysterectomy, predominates as the treatment strategy of choice, even though it is associated with risks and complications and causes infertility. Until recently, gonadotropin-releasing hormone agonists were the only available drugs for the preoperative treatment of fibroids. However, ulipristal acetate (UPA), an oral selective progesterone receptor modulator, was recently licensed in Europe for the same indication. Recent studies have demonstrated the efficacy and safety of UPA in the medical management of fibroids before surgery, with a better tolerability profile than leuprolide acetate. Analyzing the literature, we identified new management strategies involving UPA and surgery, considering advantages of both medical and surgical therapy. The advent of UPA will undoubtedly modify the surgical approach to fibroids, but the heterogeneity of these possible indications now requires various original clinical studies to identify the optimal indications for UPA in patients with symptomatic fibroid(s). PMID:25848323

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

    Directory of Open Access Journals (Sweden)

    Sedigheh A. Fard

    2012-01-01

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

  1. A PROSPECTIVE STUDY ON ROLE OF HYSTEROSCOPY VS. TRANSVAGINAL SONOGRAPHY IN DIAGNOSIS OF ABNORMAL UTERINE BLEEDING

    Directory of Open Access Journals (Sweden)

    Padma

    2014-07-01

    Full Text Available AIMS AND OBJECTIVES: To study the demographic pattern of the patients and to evaluate causes of abnormal uterine bleeding in different menstrual phases using transvaginal sonography and diagnostic hysteroscopy. Evaluation of the validity of transvaginal sonography and hysteroscopy in various menstrual abnormalities and intrauterine pathologies. MATERIAL AND METHODS: Total 60 patients were selected with complaint of abnormal uterine bleeding who were in reproductive, premenopausal and postmenopausal phase of life and were grouped similarly. All patients were subjected for transvaginal sonography followed by hysteroscopy. RESULTS: Analysis of 60 cases were done, 21 (35% cases were normal and 39 (65% were having different uterine pathologies according to transvaginal sonography whereas 13 (21.66% were normal and 47 (78.34% were having uterine pathology as per hysteroscopy. In this study hysteroscopy was superior to TVS in detecting endometrial polyp and hyperplasia with sensitivity (100%, specificity (97.8%, positive predictive value (92.8% and negative predictive value (100% for polyp and 100%, 98.04%, 90% and 100% respectively for hyperplasia. Hysteroscopy shows 100% validity for submucous fibroid. TVS has better sensitivity (100%, specificity (98.2% and NPV (100% than hysteroscopy for detecting adenomyosis. TVS is superior to hysteroscopy in investigating endometrial carcinoma with 100%. Sensitivity, Specificity, PPV and NPV against hysteroscopic value of 66.6%, 100%, 100% and 98.2% respectively. Hysteroscopy has higher sensitivity (92.0% NPV (69.2% whereas TVS has higher specificity (100%, PPV (100% in diagnosis of AUB. CONCLUSION: Diagnostic hysteroscopy and transvaginal sonography are complimentary to each other in management of patients with abnormal uterine bleeding.

  2. Definition of Compartment Based Radical Surgery in Uterine Cancer—Part I: Therapeutic Pelvic and Periaortic Lymphadenectomy by Michael Höckel Translated to Robotic Surgery

    Science.gov (United States)

    Kimmig, Rainer; Iannaccone, Antonella; Buderath, Paul; Aktas, Bahriye; Wimberger, Pauline; Heubner, Martin

    2013-01-01

    Objective. To define compartment based therapeutic pelvic and periaortic lymphadenectomy in cervical and endometrial cancer. Compartment based oncologic surgery appears to be favorable for patients in terms of radicality as well as complication rates, and the same appears to be true for robotic surgery. We describe a method of robotically assisted compartment based lymphadenectomy step by step in uterine cancer and demonstrate feasibility data from 35 patients. Methods. Patients with the diagnosis of endometrial (n = 16) or cervical (n = 19) cancer were included. Patients were treated by rTMMR (robotic total mesometrial resection) or rPMMR (robotic peritoneal mesometrial resection) and pelvic or pelvic/periaortic rtLNE (robotic therapeutic lymphadenectomy) with cervical cancer FIGO IB-IIA or endometrial cancer FIGO I-III. Results. No transition to open surgery was necessary. Complication rates were 13% for endometrial cancer and 21% for cervical cancer. Within follow-up time median (22/20) month we noted 1 recurrence of cervical cancer and 2 endometrial cancer recurrences. Conclusions. We conclude that compartment based rtLNE is a feasible and safe technique for the treatment of uterine cancers and is favorable in aspects of radicality and complication rates. It should be analyzed in multicenter studies with extended followup on the basis of the described technique. PMID:23589777

  3. Definition of compartment based radical surgery in uterine cancer-part I: therapeutic pelvic and periaortic lymphadenectomy by Michael höckel translated to robotic surgery.

    Science.gov (United States)

    Kimmig, Rainer; Iannaccone, Antonella; Buderath, Paul; Aktas, Bahriye; Wimberger, Pauline; Heubner, Martin

    2013-01-01

    Objective. To define compartment based therapeutic pelvic and periaortic lymphadenectomy in cervical and endometrial cancer. Compartment based oncologic surgery appears to be favorable for patients in terms of radicality as well as complication rates, and the same appears to be true for robotic surgery. We describe a method of robotically assisted compartment based lymphadenectomy step by step in uterine cancer and demonstrate feasibility data from 35 patients. Methods. Patients with the diagnosis of endometrial (n = 16) or cervical (n = 19) cancer were included. Patients were treated by rTMMR (robotic total mesometrial resection) or rPMMR (robotic peritoneal mesometrial resection) and pelvic or pelvic/periaortic rtLNE (robotic therapeutic lymphadenectomy) with cervical cancer FIGO IB-IIA or endometrial cancer FIGO I-III. Results. No transition to open surgery was necessary. Complication rates were 13% for endometrial cancer and 21% for cervical cancer. Within follow-up time median (22/20) month we noted 1 recurrence of cervical cancer and 2 endometrial cancer recurrences. Conclusions. We conclude that compartment based rtLNE is a feasible and safe technique for the treatment of uterine cancers and is favorable in aspects of radicality and complication rates. It should be analyzed in multicenter studies with extended followup on the basis of the described technique. PMID:23589777

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

    International Nuclear Information System (INIS)

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

  5. Diagnosis and Management of Endometrial Cancer.

    Science.gov (United States)

    Braun, Michael M; Overbeek-Wager, Erika A; Grumbo, Robert J

    2016-03-15

    Endometrial cancer is the most common gynecologic malignancy. It is the fourth most common cancer in women in the United States after breast, lung, and colorectal cancers. Risk factors are related to excessive unopposed exposure of the endometrium to estrogen, including unopposed estrogen therapy, early menarche, late menopause, tamoxifen therapy, nulliparity, infertility or failure to ovulate, and polycystic ovary syndrome. Additional risk factors are increasing age, obesity, hypertension, diabetes mellitus, and hereditary nonpolyposis colorectal cancer. The most common presentation for endometrial cancer is postmenopausal bleeding. The American Cancer Society recommends that all women older than 65 years be informed of the risks and symptoms of endometrial cancer and advised to seek evaluation if symptoms occur. There is no evidence to support endometrial cancer screening in asymptomatic women. Evaluation of a patient with suspected disease should include a pregnancy test in women of childbearing age, complete blood count, and prothrombin time and partial thromboplastin time if bleeding is heavy. Most guidelines recommend either transvaginal ultrasonography or endometrial biopsy as the initial study. The mainstay of treatment for endometrial cancer is total hysterectomy with bilateral salpingo-oophorectomy. Radiation and chemotherapy can also play a role in treatment. Low- to medium-risk endometrial hyperplasia can be treated with nonsurgical options. Survival is generally defined by the stage of the disease and histology, with most patients at stage I and II having a favorable prognosis. Controlling risk factors such as obesity, diabetes, and hypertension could play a role in the prevention of endometrial cancer. PMID:26977831

  6. Effect of undernutrition on the uterine environment during maternal recognition of pregnancy in sheep.

    Science.gov (United States)

    Sosa, C; Abecia, J A; Carriquiry, M; Vázquez, M I; Fernández-Foren, A; Talmon, M; Forcada, F; Meikle, A

    2009-01-01

    The effects of pregnancy and undernutrition on endometrial gene expression were investigated in ewes fed all or half their maintenance requirements and killed on Day 14 of pregnancy or of the oestrous cycle. The endometrial expression of progesterone, oestrogen, oxytocin and interferon receptors (PR, ERalpha, OXTR and IFNAR, respectively), cyclo-oxygenase (COX)-2, proliferating cell nuclear antigen (PCNA), insulin-like growth factors (IGF)-I and -II, and IGF-1 receptor (IGF-1R) was studied by immunohistochemistry or real-time reverse transcription-polymerase chain reaction. The luminal epithelium of cyclic control ewes was devoid of PR staining and had relatively high levels of ERalpha, OXTR, COX-2 and IFNAR2. The presence of a conceptus decreased the in vitro uterine secretion of prostaglandin (PG) F(2alpha) and the expression of IFNAR2 in most cell types, and increased the gene expression of IGF-I and IGF-II. Undernutrition tended to increase ERalpha protein and gene, but decreased in vitro uterine secretion of PGE(2) and the gene expression of IFNAR2 in cyclic ewes. There was no effect of undernutrition on pregnancy rates or the number of conceptuses recovered. Consistent with this, undernutrition of pregnant ewes did not have any effect on uterine gene expression. Moreover, in cases where changes were observed in cyclic ewes, these changes were negated when a conceptus was present. PMID:19698291

  7. The Multifaceted Actions of Leukaemia Inhibitory Factor in Mediating Uterine Receptivity and Embryo Implantation.

    Science.gov (United States)

    Rosario, Gracy Xavier; Stewart, Colin L

    2016-03-01

    Embryo implantation is mediated by the combined actions of the ovarian hormones E2 and P4 on the uterus. In addition, the pro-inflammatory cytokine, leukaemia inhibitory factor (LIF), plays a pivotal role in regulating uterine receptivity. LIF is expressed in the endometrial glands and has a robust action on the uterine luminal epithelium (LE). In mice, LIF is induced by nidatory E2 and functions to convert the LE from a non-receptive to an embryo-responsive state. LIF mediates its actions by activating the JAK-STAT pathway specifically in the LE. Activation of JAK-STAT pathway results in the induction of many additional pathways, including some 40 +  transcription factors, many of which initiate a cascade of changes affecting epithelial polarity, epithelial-mesenchymal interactions, angiogenesis, stromal cell decidualization, and inhibiting cell proliferation. This review discusses the role of LIF and the recent analysis of its action on the uterine LE in regulating endometrial receptivity and implantation. PMID:26817565

  8. Chemoattraction of bone marrow-derived stem cells towards human endometrial stromal cells is mediated by estradiol regulated CXCL12 and CXCR4 expression

    OpenAIRE

    Xiuli Wang; Ramanaiah Mamillapalli; Levent Mutlu; Hongling Du; Taylor, Hugh S

    2015-01-01

    Bone marrow derived cells engraft to the uterine endometrium and contribute to endometriosis. The mechanism by which these cells are mobilized and directed to the endometrium has not been previously characterized. We demonstrate that human endometrial stromal cells (hESCs) produce the chemokine CXCL12 and that bone marrow cells (BMCs) express the CXCL12 receptor, CXCR4. Treatment with physiological levels of estradiol (E2) induced both CXCL12 and CXCR4 expression in hESCs and BMCs, respective...

  9. Implantation despite an extensive endometrial defect after hysteroscopic resection of symptom-free residual trophoblastic tissue 15 months after cesarean section.

    Science.gov (United States)

    Foth, Dolores; Nawroth, Frank; Isachenko, Eugenia; Valter, Markus; Mallmann, Peter; Schmidt, Torsten

    2002-11-01

    Successful implantation occurred after embryo transfer in the presence of an extensive endometrial defect after hysteroscopic resection of residual trophoblastic tissue 15 months after cesarean section. At the end of hysteroscopic surgery the anterior uterine wall seemed smooth, although ultimately no endometrium was left in that part and in parts of the fundus. Thus implantation is possible even with extensive endometrial defects. Interesting facts in this case were, first, the long symptom-free period with residual trophoblastic tissue in the uterus, and, second, successful implantation, pregnancy, and delivery despite at least 30% of endometrial surface being irreversibly destroyed. We suggest hysteroscopic resection as the method of choice for exact and minimally traumatic removal of especially older residual trophoblastic tissue. PMID:12386371

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

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    Mamaeva ?.?.

    2014-06-01

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

  11. Changes in endometrial transcription of TLR2, TLR4, and CD14 during the first-week postpartum in dairy cows with retained placenta.

    Science.gov (United States)

    Martins, Telma M; Muniz, Clarice S; Andrade, Virgílio B; Paixão, Tatiane A; Santos, Renato L; Borges, Álan M

    2016-04-15

    Changes in the endometrial transcription of pattern recognition receptors may increase the susceptibility to postpartum uterine infections in Holstein cows with retained placenta. To test this hypothesis, nine cows with retained placenta and ten cows without retained placenta were submitted to endometrial biopsies at the first and seventh days postpartum. Cows were monitored weekly with clinical and gynecological examinations until 42 days postpartum. Samples of the uterine contents were collected weekly for aerobic bacteria isolation. All cows had endometrial transcription of Toll-like receptors (TLRs) 1/6, 2, 4, 5, and 9; nucleotide-binding oligomerization domain (NOD)-like receptors 1 and 2; and the coreceptors cluster of differentiation 14 (CD14) and myeloid differentiation protein-2 (MD-2), as measured on the first and seventh days postpartum. Escherichia coli was the most common bacterium isolated from the uterine contents of cows with or without retained placenta until 21 days postpartum. Transcription levels of TLR2, TLR4, and CD14 in Holstein cows with retained placenta significantly decreased (P < 0.05) between the first and the seventh day postpartum. Conversely, cows without retained placenta did not have any significant changes in transcription levels between these time points. PMID:26777563

  12. Expression of Her-2/neu in endometrial carcinoma

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    Hanaa O Badr Eldin and **Wafaa H A Helmy

    2007-09-01

    Full Text Available Objective and background: Her-2/neu tyrosine kinase has been implicated in the development and progression of several human cancers and is target for therapeutic intervention. Smaller studies suggest that Her-2/neu may be involved in the tumerogenesis of endometrial adenocarcinoma. The aim of this study was to evaluate Her-2/neu expression in endometrial carcinoma (EC and its correlation with clinicopathological features in order to define the potential prognostic value of Her-2/neu overexpression in EC. Patients and methods: Nineteen patients with stage I-IV EC were included in this study. Demographic, clinical and pathologic information was obtained and recorded. Her-2/neu expression was evaluated by immunohistochemistry (IHC on paraffin embedded tissue sections with Her-2/neu antibody. Overexpression was defined as complete membrane staining in greater than 10% of cells. Results: The positive rate of Her-2/neu in EC was 42.1%. Her-2/neu was associated with surgical stage (p0.05. Conclusion: Our study provides evidence of Her-2/neu overexpression in a considerable proportion of the patients with uterine adenocarcinoma, thus suggesting the opportunity for the possible use of anti-Her-2/neu therapy in this malignancy by selective inhibition of Her-2/neu. The use of Herceptin, a monoclonal antibody directed against Her-2/neu, for therapy of patients harboring Her-2/neu positive EC may be beneficial. Her-2/neu overexpression is related to most of the prognostic variables of EC and may be incorporated into the criteria for determination of tumor aggressiveness as a prognostic marker.

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-07-15

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

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

    International Nuclear Information System (INIS)

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

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

    Energy Technology Data Exchange (ETDEWEB)

    MacLeod, C. [Royal Prince Alfred Hospital, Camperdown, NSW (Australia). Department of Radiation Oncology

    1998-08-01

    In the 1940s, 1950s and 1960s, low doses of radiotherapy were used to treat benign uterine bleeding. The cases of two women who received this form of therapy and later developed gynaecological malignancies and had high-dose pelvic radiotherapy are presented. A 76-year-old woman with an International Federation of Gynecology and Obstetrics (FIGO) stage-II B squamous cell carcinoma of the cervix received external beam radiotherapy and intra-uterine brachytherapy and a 77-year-old woman with a FIGO stage-I B endometrial adenocarcinoma received adjuvant postoperative pelvic radiotherapy. Both women had a significant past history of low-dose-rate intra-uterine irradiation for dysfunctional uterine bleeding. Therefore the theoretical question of carcinogenesis was raised, and also the practical questions of what dose had previously been given and what further dose could be safely given with regard to normal tissue tolerance. Copyright (1998) Blackwell Science Pty Ltd 20 refs.

  16. Radical radiotherapy for endometrial cancer and clinical evaluation of radiation dose for reference points

    International Nuclear Information System (INIS)

    Fifteen patients with endometrial cancer (Stage I [5], Stage II [4], Stage III [4], Stage IVa [2]) were treated by radiation therapy alone at Tokyo Women's Medical College during the 23-year period from 1969 to 1991. All patients were considered medically inoperable due to advanced age, hypertension, cardiovascular disease, diabetes mellitus, etc. Patient ages ranged from 46 to 82 years with a mean of 63 years (62.5±12.0). An external beam with a 10 MeV linear accelerator and low dose-rate intracavitary radiotherapy using a TAO applicator were administered to the patients with a total dose of 87.2±19.5 Gy at point A for cervical cancer. The complete response rate was 66.7% by clinical examination after treatment. Intrapelvic recurrence was seen in 1 patient and distant metastasis in 3. The 5-year cumulative survival rate for all patients was 59.3% and 100% for Stage I and II, respectively. Rectal complications were found in 4 cases, bladder in 2. In order to standardize the dose value for radiotherapy for endometrial cancer, we established three reference points (point I: fundus of the uterus, point II: bilateral uterotubal ostium, point III: bilateral mid portion of the lateral wall of the uterine body). These points were determined by measuring myometrial thickness of the uterine body by CT image at the time of treatment planning in each case. We make practical application of these points in radiation treatment and have found them to be useful for standardization and dose specification of intracavitary radiotherapy for endometrial cancer. (author)

  17. Intra-cavitary uterine pathology in women with abnormal uterine bleeding: a prospective study of 1220 women

    Science.gov (United States)

    Van den Bosch, T.; Ameye, L.; Van Schoubroeck, D.; Bourne, T.; Timmerman, D.

    2015-01-01

    Objectives: Our primary aim was to assess how patients’ characteristics, bleeding pattern, sonographic endometrial thickness (ET) and additional features at unenhanced ultrasound examination (UTVS) and at fluid instillation sonography (FIS) contribute to the diagnosis of intracavitary uterine pathology in women presenting with abnormal uterine bleeding (AUB). We further aimed to report the prevalence of pathology in women presenting with AUB. Methods: 1220 consecutive women presenting with AUB underwent UTVS, colour Doppler imaging (CDI) and FIS. Most women (n = 1042) had histological diagnosis. Results: Mean age was 50 years and 37% were postmenopausal. Of 1220 women 54% were normal, polyps were diagnosed in 26%, intracavitary fibroids in 11%, hyperplasia without atypia in 4% and cancer in 3%. All cancers were diagnosed in postmenopausal (7%) or perimenopausal (1%) women. ET had a low predictive value in premenopausal women (LR+ and LR- of 1.34 and 0.74, respectively), while FIS had a LR+ and LR- of 6.20 and 0.24, respectively. After menopause, ET outperformed all patient characteristics for the prediction of endometrial pathology (LR+ and LR- of 3.13 and 0.24). The corresponding LR+ and LR- were 10.85 and 0.71 for CDI and 8.23 and 0.26 for FIS. Conclusion: About half of the women presenting to a bleeding clinic will have pathology. In premenopausal women, benign lesions are often the cause of AUB. For the prediction of intracavitary pathology ET is of little value in premenopausal women. CDI and FIS substantially improve the diagnostic accuracy. PMID:25897368

  18. The effect of puerperal uterine disease on histopathologic findings and mRNA expression of proinflammatory cytokines of the endometrium in dairy cows.

    Science.gov (United States)

    Heppelmann, M; Weinert, M; Ulbrich, S E; Brömmling, A; Piechotta, M; Merbach, S; Schoon, H-A; Hoedemaker, M; Bollwein, H

    2016-04-15

    The aim of this study was to investigate the effect of puerperal uterine disease on histopathologic findings and gene expression of proinflammatory cytokines in the endometrium of postpuerperal dairy cows; 49 lactating Holstein-Friesian cows were divided into two groups, one without (UD-; n = 29) and one with uterine disease (UD+; n = 21), defined as retained fetal membranes and/or clinical metritis. General clinical examination, vaginoscopy, transrectal palpation, and transrectal B-mode sonography were conducted on days 8, 11, 18, and 25 and then every 10 days until Day 65 (Day 0 = day of calving). The first endometrial sampling (ES1; swab and biopsy) was done during estrus around Day 42 and the second endometrial sampling (ES2) during the estrus after synchronization (cloprostenol between days 55 and 60 and GnRH 2 days later). The prevalence of histopathologic evidence of endometritis, according to the categories used here, and positive bacteriologic cultures was not affected by group (P > 0.05), but cows with uterine disease had a higher prevalence of chronic purulent endometritis (ES1; P = 0.07) and angiosclerosis (ES2; P ≤ 0.05) than healthy cows. Endometrial gene expression of IL1α (ES2), IL1β (ES2), and TNFα (ES1 and ES2) was higher (P ≤ 0.05) in the UD+ group than in the UD- group. In conclusion, puerperal uterine disease had an effect on histopathologic parameters and on gene expression of proinflammatory cytokines in the endometrium of postpuerperal cows, indicating impaired clearance of uterine inflammation in cows with puerperal uterine disease. PMID:26810831

  19. Randomized comparative trial of cervical block protocols for pain management during hysteroscopic removal of polyps and myomas

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    Lukes AS

    2015-10-01

    Full Text Available Andrea S Lukes,1 Kelly H Roy,2 James B Presthus,3 Michael P Diamond,4 Jay M Berman,4 Kenneth A Konsker5 1Carolina Women’s Research and Wellness Center, Durham, NC, USA; 2Phoenix Gynecology Consultants, Phoenix, AZ, USA; 3Minnesota Gynecology and Surgery, Edina, MN, USA; 4Wayne State University, Detroit, MI, USA; 5Florida Woman Care, Boca Raton, FL, USA Purpose: To evaluate the efficacy of two cervical block protocols for pain management during hysteroscopic removal of intrauterine polyps and myomas using the MyoSure® device. Patients and methods: This was a randomized, comparative treatment trial conducted by five private Obstetrics and Gynecology practices in the USA. Forty premenopausal women aged 18 years and older were randomized to receive either a combination para/intracervical block protocol of 37 cc local anesthetic administered at six injections sites in association with the application of topic 1% lidocaine gel, or an intracervical block protocol of 22 cc local anesthetic administered at three injections sites without topical anesthetic, for pain management during hysteroscopic removal of intrauterine polyps and/or a single type 0 or type 1 submucosal myoma ?3 cm. The main outcomes were a composite measure of procedure-related pain and pain during the postoperative recovery period, assessed by the Wong-Baker Faces Rating Scale (0= no pain to 10= maximum pain. The lesion characteristics, procedure time, and adverse events were summarized. Results: A total of 17 polyps and eight myomas were removed in the para/intracervical block group, with diameters of 1.3±0.5 cm and 1.8±0.8 cm, respectively. In the intracervical block group, 25 polyps with a mean diameter of 1.2±0.7 cm and 7 myomas with a mean dia-meter of 1.9±0.9 cm were removed. The mean tissue resection time was 1.2±2.0 minutes and 1.2±1.4 minutes for the para/intracervical and intracervical block groups, respectively. The mean composite procedure-related pain score was low for both cervical block protocols, 1.3±1.4 in the para/intracervical block group vs 2.1±1.5 in the intracervical block group. During the postoperative recovery period, the mean pain scores were 0.3±0.7 vs 1.2±1.7 for the para/intracervical and intracervical block groups, respectively. There were no serious adverse events. Conclusion: The MyoSure procedure for removal of polyps and myomas was well tolerated, with low pain scores reported for both the para/intracervical and intracervical block protocols. Keywords: MyoSure, hysteroscopic morcellation, polypectomy, myomectomy

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-08-26

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

  1. CORRELACIÓN DE LA HISTEROSCOPIA Y BIOPSIA DIRIGIDA EN EL ESTUDIO DEL ENGROSAMIENTO ENDOMETRIAL PATOLÓGICO POR ULTRASONIDO

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    Macarena Socías T

    2007-01-01

    Full Text Available Objetivo: Correlacionar la histeroscopia con la biopsia dirigida en pacientes pre y postmenopáusicas con engrosamiento endometrial patológico al ultrasonido. Método: Estudio retrospectivo de 265 pacientes derivadas por engrosamiento endometrial patológico en la ecografía transvaginal y evaluadas mediante histeroscopia con biopsia dirigida. Resultados: 68,7% de las pacientes presentaron un aspecto histeroscópico benigno, 15,1% normal, 10,6% potencialmente maligno y 5,6% maligno. Los diagnósticos anátomo patológicos más frecuentes fueron: pólipo endometrial (n=92; 34,7%, endometrio proliferativo/secretor (n=84; 31,7% y mioma submucoso (n=38; 14,3%. Todos los cánceres endometriales (n=9 se presentaron en mujeres postmenopáusicas sin TRH y con endometrio 11 mm. La correlación entre histeroscopia y anatomía patológica para diagnóstico de patología benigna tuvo una sensibilidad y especificidad de 90,7% (95% IC 85,2 - 94,3 y 65,4% (95% IC 55,8 - 73,8; valor predictivo positivo y negativo fue de 80,2% (95% IC 73,8 - 85,4 y 82% (95% IC 72,3 - 88,7. Para diagnóstico de hiperplasia endometrial la sensibilidad y especificidad fue 60% (95% IC 31,3 - 83,2 y 91,4% (95% IC 87,3 - 94,2; el valor predictivo positivo y negativo fue de 21,4% (95% IC 10,7 - 39,5 y 98,3% (95% IC 95,7 - 99,3. Para diagnóstico de cáncer endometrial la sensibilidad y especificidad fue de 95% (95% IC 65,5 - 99,5 y 97,9% (95% IC 95,2 - 99; el valor predictivo positivo y negativo fue de 63,3% (95% IC 38,7 - 82,5 y 99,7% (95% IC 98,1 - 99,8. Conclusión: El 85% de las pacientes con engrosamiento endometrial presentaron una histeroscopia alterada (benigna, potencialmente maligna o maligna, confirmada en 80% de los casos por anatomía patológica. En un centro con experiencia la histeroscopia normal puede hacer innecesaria la biopsia. El aspecto potencialmente maligno a la histeroscopia puede ser un sobrediagnóstico, por lo que la anatomía patológica es imprescindible. Todos los cánceres endometriales fueron diagnosticados a la histeroscopiaObjective: Comparison of hysteroscopy with biopsy in pre- and post -menopausic patients with endometrial thickening on ultrasound. Methods: Retrospective study of 265 patients with pathologic endometrial thickening on transvaginal ultrasound and evaluated with hysteroscopy and biopsy. Results: 68.7% of the patients had benign hysteroscopy results, 15.1% were normal, 10.6% were potentially malignant, and 5.6% were malignant. The most frequent biopsy results were: endometrial polyp (n= 92, 34.7%, proliferate / secretor endometrium (n= 84, 31.7%, and submucosal myoma (n=38, 14.3%. All of the endometrial cancers (n= 9 were in post- menopausic women, with no history of hormone replacement therapy and with endometrial thickening 11mm. Sensitivity and specificity for hysteroscopy in comparison to biopsy for diagnosing benign pathology were 90.7% (95% CI 85.2 - 94.3 and 65.4% (95% CI 55.8 - 73.8, and the positive and negative predictive values were 80.2% (95% CI 73.8 - 85.4 and 81.9% (95% CI 72.3 - 88.7. Sensitivity and specificity for hysteroscopy in comparison to biopsy for diagnosing endometrial hyperplasia were 60% (95% CI 31.3 - 83.2 and 91.4% (95% CI 87.3 - 94.2, the positive and negative predictive values were 21.4% (95% CI 10.7 - 39.5 and 98.3% (95% CI 95.7 - 99.3. Sensitivity and specificity for hysteroscopy in comparison to biopsy for diagnosing endometrial cancer were 95% (95% CI 65.5 - 99.5 and 97.9% (95% CI 95.2 - 99, positive and negative predictive values were 63.3% (95% CI 38.7 - 82.5 and 99.7% (95% CI 98.1 - 99.8. Conclusion: 85% of the patients with endometrial thickening had an abnormal hysteroscopy result, which latter were confirmed in 80% of the cases with biopsy. In a center with experience, a normal hysteroscopy result can make biopsy unnecessary. Potentially malignant hysteroscopys tend to be over diagnosed, making biopsy fundamental. All endometrial cancers were detected by hysteroscopy in our study

  2. In vitro incorporation of 3H-leucine and 3H-uridine into endometrial cells of goat

    International Nuclear Information System (INIS)

    The interaction of uterine cellular components with ovarian progesterone and or oestrogen depends upon the quantity of hormones available to the cells and hormone receptors in the cells. The hormone induced alterations in the endometrium are pre-requisites to implantation because these are involved in preparing the endometrium for the implantation of the blastocyst. In the present study, an attempt was made to isolate the endometrial cells from goat, and then to elucidate the effect of different hormones such as progesterone and estradiol-17β, on protein and RNA synthesis in suspension cell culture. (author). 21 refs

  3. Sarcoma del estroma endometrial de grado alto

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    Mariuska Forteza Sáez

    2014-09-01

    Full Text Available El sarcoma del estroma endometrial es un tumor infrecuente, que comprende menos del 1 % de los tumores malignos ginecológicos. Presentamos el caso de una adolescente de 16 años con hemorragia uterina anormal a la que se le realizó histerectomía subtotal. Microscópicamente, la neoplasia estaba constituida por una proliferación maligna de células estromales del endometrio. El estudio inmuno-histoquímico mostró positividad para vimentina, desmina, CD10, CD117. El CD10 es un marcador inmuno-histoquímico del estroma endometrial normal y de los tumores del estroma endometrial, y es útil para el diagnóstico diferencial entre el sarcoma del estroma endometrial y el leiomioma celular o el leiomiosarcoma uterino. Las mejores opciones de tratamiento se obtienen con un enfoque multidisciplinario y en centros especializados.

  4. Uterine Artery Anatomy Relevant to Uterine Leiomyomata Embolization

    International Nuclear Information System (INIS)

    To categorize the anatomic variants of uterine arteries, and determine the incidence of menopausal symptoms where the tubo-ovarian branches were seen prior to embolization. Between July 1997 and June 2000, 257 (n = 257) uterine fibroid embolizations were performed at our institution. Arteriograms were retrospectively evaluated. Uterine arteries were classified into groups: type I (the uterine artery as first branch of the inferior gluteal artery), type II (the uterine artery as second or third branch of the inferior gluteal artery), type III (the uterine artery, the inferior gluteal and the superior gluteal arteries arising as a trifurcation), type IV (the uterine artery as first branch of the hypogastric artery), inconclusive, or not studied. Tubo-ovarian branches were recorded if visualized prior to and/or after embolization. Menopausal symptoms were recorded (n = 175 at 3 months, n = 139 at 6 months, n = 98 at 1 year, n = 22 at 2 years) using written questionnaires. Five hundred and fourteen uterine arteries (n = 514) were evaluated. There were 38% classifiable types, 23% inconclusive, and 39% not studied. Classification was as follows: type I, 45%; type II, 6%; type III, 43%; type IV, 6%. Among 256 patients, tubo-ovarian arteries were seen in 36 prior to embolization, but not afterwards. In this group, 25 patients reported transient menopausal symptoms (hot flashes, amenorrhea). Five patients did not report any menopausal symptoms. Six patients did not answer the questionnaires. Type I is the most common type of anatomy, followed by type III. The tubo-ovarian arteries may be visualized prior to and/or after embolization. The embolization was monitored to avoid embolization of the tubo-ovarian branches. Menopausal symptoms were transient all patients when the tubo-ovarian branches were seen prior to embolization

  5. Endometrioid endometrial adenocarcinoma recurring as carcinosarcoma.

    Science.gov (United States)

    Shaco-Levy, Ruthy; Piura, Benjamin

    2008-04-01

    Müllerian carcinosarcoma is currently regarded as a metaplastic (sarcomatous) carcinoma. Only five cases of pure ovarian adenocarcinoma recurring as carcinosarcoma have been documented in the literature. There are no documented cases of endometrial adenocarcinoma recurring as metaplastic carcinoma. We report of a case of endometrial adenocarcinoma, endometrioid type, recurring as metaplastic carcinoma showing sarcomatous differentiation. The tumor evolution in this case supports the prevailing opinion that Müllerian carcinosarcomas are derived from carcinomas and represent tumor progression. PMID:18412798

  6. Markers of the uterine innate immune response of the mare.

    Science.gov (United States)

    Nash, D M; Sheldon, I M; Herath, S; Lane, E A

    2010-05-01

    Reproductive efficiency in mares is low and persistent mating-induced endometritis (PMIE) is an important cause of subfertility. Mating-induced endometritis (MIE) an obligate precursor to PMIE, is a ubiquitous, transient inflammatory response to the presence of sperm, seminal components and pathogens. However, the specific inflammatory pathways that derive from MIE and that may also be precursors to PMIE are not clear. The ability to identify and measure robust, repeatable markers of inflammation integral to MIE may be key to understanding the progression to PMIE. The aim of the study was to (i) refine a protocol for inducing MIE and in doing so test a range of cellular and molecular parameters as valid markers of MIE to facilitate future studies of mares susceptible to PMIE (ii) concurrently identify those parameters with potential as inflammatory indicators during MIE to inform and enhance early treatment regimens in practice. Mating-induced endometritis was induced in pony mares using a stringent protocol; mares were treated intrauterine with frozen/thawed semen (n = 5; FTS) or frozen/thawed extender (n = 6: FTEx). The parameters tested were measured before treatment were compared to samples collected at strategic time points after treatment: uterine cytology using cytological (at 8, 16, 24, 48 and 72 h after treatment) or histological analysis (at 24 and 72 h); uterine bacteriology (at 24 and 72 h); secretion of prostaglandin F(2alpha) (PGF(2alpha); at 8, 16, 24, 48 and 72 h); peripheral concentrations of serum amyloid A (SAA; at 24h); endometrial mRNA gene expression, focussing upon IL8 and TLR4, as examples of genes pertinent to inflammation (at 24 h). Uterine neutrophil cell numbers in both treatment groups increased at 8 (P range of parameters tested, neutrophil cell numbers by cytological analysis and PGF(2alpha) were regarded as the most accurate markers of inflammation during MIE and important for use in practice. PMID:20022187

  7. Utility of the broccoli sign in the distinction of prolapsed uterine tumor from cervical tumor

    International Nuclear Information System (INIS)

    Objective: To describe the utility, histopathological basis, and clinical correlates of the broccoli sign. Methods: The committee on human research approved this HIPAA compliant study and waived written informed consent. Based on the records of the senior author and our multidisciplinary Gynecologic Oncology Tumor Board, we retrospectively identified thirteen women (mean age of 48.8 years; range, 34–74) with a cervical mass seen at MR imaging (n = 13) or CT (n = 5) that demonstrated the previously reported broccoli sign (i.e., a soft tissue stalk connecting the cervical mass to the uterine cavity) on one or other modality. All available clinical, imaging, and histopathological records were reviewed, with particular emphasis on initially suspected diagnosis, final proven diagnosis, and outcome. Results: Cervical cancer was the initial clinically suspected diagnosis in 6 of 13 patients. Surgical resection demonstrated prolapsed uterine tumor in all patients, consisting of endometrioid adenocarcinoma (n = 7), carcinosarcoma (n = 2), adenosarcoma (n = 1), and leiomyoma (n = 3). Excluding the three patients with leiomyomas, currently, 7 patients with malignant tumors are disease free after a mean interval of 15 months (range, 3–45) and 3 patients have been lost to follow-up. Conclusion: A stalk connecting an apparent cervical mass seen at CT or MR imaging to the endometrial cavity (“broccoli sign”) favors the diagnosis of a prolapsed uterine tumor; these prolapsed uterine tumors can often be malignant but appear to have a good prognosis.

  8. Utility of the broccoli sign in the distinction of prolapsed uterine tumor from cervical tumor

    Energy Technology Data Exchange (ETDEWEB)

    Jha, Priyanka; Chang, Stephanie T. [Department of Radiology, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143-0628 (United States); Rabban, Joseph T. [Department of Anatomic Pathology, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143-0628 (United States); Chen, Lee-may [Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143-0628 (United States); Yeh, Benjamin M. [Department of Radiology, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143-0628 (United States); Coakley, Fergus V., E-mail: Fergus.Coakley@radiology.ucsf.edu [Department of Radiology, University of California San Francisco, 505 Parnassus Avenue, San Francisco, CA 94143-0628 (United States)

    2012-08-15

    Objective: To describe the utility, histopathological basis, and clinical correlates of the broccoli sign. Methods: The committee on human research approved this HIPAA compliant study and waived written informed consent. Based on the records of the senior author and our multidisciplinary Gynecologic Oncology Tumor Board, we retrospectively identified thirteen women (mean age of 48.8 years; range, 34-74) with a cervical mass seen at MR imaging (n = 13) or CT (n = 5) that demonstrated the previously reported broccoli sign (i.e., a soft tissue stalk connecting the cervical mass to the uterine cavity) on one or other modality. All available clinical, imaging, and histopathological records were reviewed, with particular emphasis on initially suspected diagnosis, final proven diagnosis, and outcome. Results: Cervical cancer was the initial clinically suspected diagnosis in 6 of 13 patients. Surgical resection demonstrated prolapsed uterine tumor in all patients, consisting of endometrioid adenocarcinoma (n = 7), carcinosarcoma (n = 2), adenosarcoma (n = 1), and leiomyoma (n = 3). Excluding the three patients with leiomyomas, currently, 7 patients with malignant tumors are disease free after a mean interval of 15 months (range, 3-45) and 3 patients have been lost to follow-up. Conclusion: A stalk connecting an apparent cervical mass seen at CT or MR imaging to the endometrial cavity ('broccoli sign') favors the diagnosis of a prolapsed uterine tumor; these prolapsed uterine tumors can often be malignant but appear to have a good prognosis.

  9. Pregnancy recognition in cattle: effects of conceptus products on uterine prostaglandin production

    International Nuclear Information System (INIS)

    In cattle, continued progesterone (P4) production by the corpus luteum (CL) is required if pregnancy is to persist. Identification of putative conceptus-derived signals and evaluation of their biological roles relative to CL maintenance during early pregnancy were goals of this research endeavor. Using various chromatography systems, bovine conceptuses (days 19 to 23) exhibited extensive metabolism of tritiated P4 (90-98%), in vitro. A majority of conceptus metabolites were 5β-reduced pregnanes. A major conceptus metabolite was 5β-pregnan-3α-ol-20-one (5β-P). Conversely, endometrial explant cultures metabolized 40 to 50% of P4 substrate to primarily 5α-reduced steroid products. An in vivo test system to evaluate uterine PGF/sub 2α/ production capacity was characterized in experiment two. Exogenous estradiol-17β (E2; 3 mg I.V.) stimulated uterine blood flow, and PGF/sub 2α/ production and metabolism. In experiment three, CL function, interestrous interval, and spontaneous uterine PGF/sub 2α/ production were evaluated in cyclic cows following intrauterine administration of 5β-P, conceptus secretory proteins (CSP) or homologous serum proteins (Control). Results support a role for CSP in suppression of uterine PGF/sub 2α/ production during early pregnancy in cattle

  10. The Ultrasound and MRI Findings of Uterine Adenofibroma: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Hyun Jung; Rha, Sung Eun; Byun, Jae Young; Lee, Ah Won [Seoul St. Mary' s Hospital, College of Medicine, The Catholic University of Korea, Seoul (Korea, Republic of)

    2011-09-15

    Adenofibroma is an extremely rare benign m'ullerian mixed tumor composed of epithelium and mesenchymal cells. Most uterine adenofibromas occur in the endometrium, but they rarely protrude into the vagina. To date, only a few such cases with the imaging findings have been reported. Therefore, we report here on the sonographic and magnetic resonance (MR) imaging findings of a case of endometrial adenofibroma protruding into the vaginal cavity in a 28-year-old woman. The uterine adenofibroma appeared as a large intracavitary echogenic mass containing multiple small internal cysts, and it was distending the vaginal cavity on transrectal sonography. T2- weighted MR images showed a large intracavitary mass with heterogeneous high signal intensity protruding into the vaginal cavity. On gadolinium-enhanced T1-weighted MR images, heterogeneous septa-like enhancement was noted in the mass. Although uterine adenofibroma is extremely rare, adenofibroma can be suggested as a possible diagnosis when an intracavitary uterine mass, with multiple internal small cystic components and enhancing septa-like structures, is protruding into the vaginal cavity on imaging

  11. Uterine inhibitory effect of reticuline.

    Science.gov (United States)

    Martin, M L; Sagredo, J A; Morais, J M; Montero, M J; Sanchez, M T; San Roman, L

    1988-11-01

    Reticuline, the most abundant benzylisoquinoleic alkaloid of Laurobasidium lauri, exerts a uterine inhibitory effect mainly related to a decrease in the concentration of cytosolic calcium available for contraction. PMID:2907562

  12. Carcinoma of the uterine cervix

    International Nuclear Information System (INIS)

    There are few reports on uterine cancer in relation to radiation. This chapter discusses uterine cancer in A-bomb survivors, with special reference to the mortality rate, in a review of the literature. The Atomic Bomb Casualty Commission has first discovered 28 cases of uterine cancer among A-bomb survivors during the period 1953-1957. Since 1970, mortality rate from uterine cancer has been investigated statistically according to the T65D system. The Radiation Effect Research Foundation (RERF) has revealed 282 death cases from uterine cancer during the period 1950-1974. The RERF's data up to 1982 has revealed no radiation-dependent mortality from uterine cancer. More recent data (1950-1985) has revealed that mortality rate was increased by 22% in A-bomb survivors exposed to 1 Gy or more. When mortality of uterine cancer was investigated statistically using the 1968-1982 data for the population of the Research Institute for Nuclear Medicine and Biology, Hiroshima University, it was 1.2 times higher in the entire exposed group and 1.4 times higher in the group of proximally exposed A-bomb survivors (within 2 km from the hypocenter) than the non-exposed group, with statistically significant difference. It tended to be high in the group of distally exposed A-bomb survivors (who entered the city within 3 days after A-bombing) than the non-exposed group. When comparing the group of Hiroshima City with the group of Hiroshima Prefecture, mortality from uterine cancer was 1.3 times higher in the municipal group for proximally exposed A-bomb survivors and 1.3 times higher in the prefectural group for distally exposed A-bomb survivors and the others. Mortality rate was highest within one year after the acquisition of health handbook in the exposed group. (N.K.)

  13. What Should You Ask Your Doctor about Uterine Sarcoma?

    Science.gov (United States)

    ... for uterine sarcoma? What should you ask your doctor about uterine sarcoma? It is important for you ... and Staging Treating Uterine Sarcoma Talking With Your Doctor After Treatment What`s New in Uterine Sarcoma Research? ...

  14. DNA damage and apoptosis of endometrial cells cause loss of the early embryo in mice exposed to carbon disulfide

    International Nuclear Information System (INIS)

    Carbon disulfide (CS2) may lead to spontaneous abortion and very early pregnancy loss in women exposed in the workplace, but the mechanism remains unclear. We designed an animal model in which gestating Kunming strain mice were exposed to CS2 via i.p. on gestational day 4 (GD4). We found that the number of implanted blastocysts on GD8 was significantly reduced by each dose of 0.1 LD50 (157.85 mg/kg), 0.2 LD50 (315.7 mg/kg) and 0.4 LD50 (631.4 mg/kg). In addition, both the level of DNA damage and apoptosis rates of endometrial cells on GD4.5 were increased, showed definite dose–response relationships, and inversely related to the number of implanted blastocysts. The expressions of mRNA and protein for the Bax and caspase-3 genes in the uterine tissues on GD4.5 were up-regulated, while the expressions of mRNA and protein for the Bcl-2 gene were dose-dependently down-regulated. Our results indicated that DNA damage and apoptosis of endometrial cells were important reasons for the loss of implanted blastocysts induced by CS2. - Highlights: • We built an animal model of CS2 exposure during blastocyst implantation. • Endometrial cells were used in the comet assay to detect DNA damage. • CS2 exposure caused DNA damage and endometrial cell apoptosis. • DNA damage and endometrial cell apoptosis were responsible for embryo loss

  15. DNA damage and apoptosis of endometrial cells cause loss of the early embryo in mice exposed to carbon disulfide

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Bingzhen [Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan (China); Shen, Chunzi [Centers for Disease Control and Prevention, Zibo (China); Yang, Liu; Li, Chunhui; Yi, Anji [Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan (China); Wang, Zhiping, E-mail: zhipingw@sdu.edu.cn [Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, Jinan (China)

    2013-12-01

    Carbon disulfide (CS{sub 2}) may lead to spontaneous abortion and very early pregnancy loss in women exposed in the workplace, but the mechanism remains unclear. We designed an animal model in which gestating Kunming strain mice were exposed to CS{sub 2} via i.p. on gestational day 4 (GD4). We found that the number of implanted blastocysts on GD8 was significantly reduced by each dose of 0.1 LD{sub 50} (157.85 mg/kg), 0.2 LD{sub 50} (315.7 mg/kg) and 0.4 LD{sub 50} (631.4 mg/kg). In addition, both the level of DNA damage and apoptosis rates of endometrial cells on GD4.5 were increased, showed definite dose–response relationships, and inversely related to the number of implanted blastocysts. The expressions of mRNA and protein for the Bax and caspase-3 genes in the uterine tissues on GD4.5 were up-regulated, while the expressions of mRNA and protein for the Bcl-2 gene were dose-dependently down-regulated. Our results indicated that DNA damage and apoptosis of endometrial cells were important reasons for the loss of implanted blastocysts induced by CS{sub 2}. - Highlights: • We built an animal model of CS2 exposure during blastocyst implantation. • Endometrial cells were used in the comet assay to detect DNA damage. • CS2 exposure caused DNA damage and endometrial cell apoptosis. • DNA damage and endometrial cell apoptosis were responsible for embryo loss.

  16. Estudio del factor uterino como causa de infertilidad femenina Study of the uterine factor as a cause of female infertility

    Directory of Open Access Journals (Sweden)

    Marta Lucia Cutié Bressler

    2000-04-01

    Full Text Available Se realizó un estudio retrospectivo de 478 pacientes, durante el período 1968-1998, procedentes de la consulta de infertilidad del ISMM "Dr. Luis Díaz Soto", portadoras de factor uterino. Se encontró que el mioma predominó entre las causas (78 %, seguido del síndrome de Asherman (11 %, las malformaciones uterinas (10 % y los pólipos endometriales (0,8 %. Mencionamos las técnicas quirúrgicas más empleadas según enfermedades, obtuvimos normalización de las menstruaciones en el 97,2 %, así como un alto índice de embarazos (63,7 %.A retrospective study of 478 patients carriers of uterine factor that received attention at the Infertility Department of the "Dr. Luis Díaz Soto" Higer Institute of Military Medicine from l968 to l998 was conducted. It was found that myoma predominated among the causes (78 %, followed by Asherman's syndrome (11 %, uterine malformations (10 % and polyps (0.8 %. The most used surgical techniques according to diseases are mentioned here. A normalization of menstruations in 97.2 % of the cases, as well as a high index of pregnancies (63.7 % were obtained.

  17. MR imaging of bladder endometriosis and its relationship with the anterior uterine wall: Experience in a tertiary referral centre

    International Nuclear Information System (INIS)

    Objective: Both the intraperitoneal seeding and the uterine-vesical extension theory have been proposed to explain the pathogenesis of bladder endometriosis. The aim of this study was to describe MR imaging findings of bladder endometriosis and involvement of the anterior uterine wall in a tertiary referral centre for endometriosis in a effort to improve diagnosis and help clarify the pathogenesis. Methods: In a single-centre, retrospective study (2004–2009), 463 consecutive patients analysed for deep infiltrating endometriosis (DIE) were studied independently by two experienced readers for the presence of bladder endometriosis. MR studies revealing bladder endometriosis were then analysed in consensus for: location, size, signal intensity characteristics, uterine involvement, continuity with adenomyosis and presence of cysts. There was histopathologic correlation in 9 patients who had undergone partial bladder resection. Results: Bladder endometriosis was diagnosed in 32 patients on MR imaging (k = 0.85). Most lesions showed heterogeneous isointensity compared to that of muscle on T2-weighed imaging, containing foci of high signal intensity, suggesting cystic ectopic endometrial glands. On T1-weighted imaging lesions showed heterogeneous isointensity with foci or small cysts, demonstrating high signal intensity, indicating hemorrhage, was observed. Uterine involvement was found in 94% of the lesions, with either “continuous” or “hourglass” configurations. Presence of contiguous adenomyosis was found in only 4 lesions. Conclusions: With MR imaging, uterine involvement in bladder endometriosis is frequently found and in most cases located subserosally, suggesting extensive DIE, favouring the intraperitoneal seeding theory

  18. MR imaging of bladder endometriosis and its relationship with the anterior uterine wall: Experience in a tertiary referral centre

    Energy Technology Data Exchange (ETDEWEB)

    Busard, M.P.H., E-mail: m.busard@vumc.nl [VU University Medical Centre, Department of Radiology, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Mijatovic, V., E-mail: Mijatovic@vumc.nl [VU University Medical Centre, Department of Reproductive Medicine, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Lüchinger, A.B., E-mail: ab.luchinger@vumc.nl [VU University Medical Centre, Department of Reproductive Medicine, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Bleeker, M.C.G., E-mail: MCG.Bleeker@vumc.nl [VU University Medical Centre, Department of Pathology, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Pieters-van den Bos, I.C., E-mail: i.pieters@vumc.nl [VU University Medical Centre, Department of Radiology, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Schats, R., E-mail: r.schats@vumc.nl [VU University Medical Centre, Department of Reproductive Medicine, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Kuijk, C. van, E-mail: C.vanKuijk@vumc.nl [VU University Medical Centre, Department of Radiology, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Hompes, P.G.A., E-mail: p.hompes@vumc.nl [VU University Medical Centre, Department of Reproductive Medicine, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands); Waesberghe, J.H.T.M. van, E-mail: JHTM.vanwaesberghe@vumc.nl [VU University Medical Centre, Department of Radiology, De Boelelaan 1118, 1081 HZ Amsterdam (Netherlands)

    2012-09-15

    Objective: Both the intraperitoneal seeding and the uterine-vesical extension theory have been proposed to explain the pathogenesis of bladder endometriosis. The aim of this study was to describe MR imaging findings of bladder endometriosis and involvement of the anterior uterine wall in a tertiary referral centre for endometriosis in a effort to improve diagnosis and help clarify the pathogenesis. Methods: In a single-centre, retrospective study (2004–2009), 463 consecutive patients analysed for deep infiltrating endometriosis (DIE) were studied independently by two experienced readers for the presence of bladder endometriosis. MR studies revealing bladder endometriosis were then analysed in consensus for: location, size, signal intensity characteristics, uterine involvement, continuity with adenomyosis and presence of cysts. There was histopathologic correlation in 9 patients who had undergone partial bladder resection. Results: Bladder endometriosis was diagnosed in 32 patients on MR imaging (k = 0.85). Most lesions showed heterogeneous isointensity compared to that of muscle on T2-weighed imaging, containing foci of high signal intensity, suggesting cystic ectopic endometrial glands. On T1-weighted imaging lesions showed heterogeneous isointensity with foci or small cysts, demonstrating high signal intensity, indicating hemorrhage, was observed. Uterine involvement was found in 94% of the lesions, with either “continuous” or “hourglass” configurations. Presence of contiguous adenomyosis was found in only 4 lesions. Conclusions: With MR imaging, uterine involvement in bladder endometriosis is frequently found and in most cases located subserosally, suggesting extensive DIE, favouring the intraperitoneal seeding theory.

  19. Dilatation and Curettage Effect on the Endometrial Thickness

    OpenAIRE

    Davar, Robab; Dehghani Firouzabadi, Razieh; Chaman Ara, Kefayat

    2013-01-01

    Background Endometrial receptivity is required for successful implantation and pregnancy. Despite the remaining controversy, many studies have shown that ultrasonographic endometrial thickness can be considered as an indicator of endometrial receptivity. Objective The study objective was to investigate the effect of dilatation and curettage on the endometrial thickness. Materials and Methods Enrolled in the study were 444 patients visited in Obstetrics & Gynecology clinic of Shahid Sadoughi h...

  20. Rabdomiosarcoma Embrionario Uterino: Aspectos Morfológicos e Inmunohistoquímicos Embryonal Rhabdomyosarcoma of the Corpus Uterine: Morphological and Immunohistochemical Characteristics

    Directory of Open Access Journals (Sweden)

    Oscar Tapia E

    2011-12-01

    Full Text Available Los sarcomas uterinos son relativamente raros. El tipo histológico más frecuente es el leiomiosarcoma, seguido por el sarcoma del estroma endometrial. Los rabdomiosarcomas (RMS son neoplasias malignas con diferenciación muscular esquelética. El rabdomiosarcoma embrionario (RMSE tipo botrioide es el sarcoma más común de la infancia; con escasos reportes en adultos, afectando la región de cabeza y cuello, tracto genitourinario y extremidades más frecuentemente. En el tracto genitourinario, la vagina es la localización mas frecuente, comprometiendo en raras ocasiones el cuello o fondo uterino. Se presentan las características clínicas y morfológicas de un caso de RMSE uterino tipo botrioide diagnosticado en una paciente de 58 años en la Unidad de Anatomía Patológica del Hospital Hernán Henríquez Aravena de Temuco.Uterine sarcomas are relatively rare. The most common histological type is leiomyosarcoma, followed by endometrial stromal sarcoma. The rhabdomyosarcoma (RMS are malignant neoplasms with skeletal muscle differentiation. Embryonal rhabdomyosarcoma (RMSE type botryoides is the most common in childhood, with few reports in adults, affecting the head and neck region, genitourinary tract and extremities more frequently. In the genitourinary tract, the vagina is the most common location, rarely involving cervix and fundus uterine. Clinical and morphological characteristics are presented of a case of uterine RMSE diagnosed in a 58 year-old woman in the Pathology Unit of the Hernán Henríquez Aravena Hospital in Temuco.

  1. Predictive Value of Endometrial Thickness in Detecting Endometrial Malignancy in Patients with Postmenopausal Bleeding

    Directory of Open Access Journals (Sweden)

    Onur Kaya

    2014-09-01

    Full Text Available Aim: The aim of this study was to investigate the place of endometrial thickness in detecting endometrial malignancy in patients with postmenopausal vaginal bleeding. Methods: In this study, we retrospectively evaluated hospital records of 380 patients who had undergone endometrial biopsy with the diagnosis of postmenopausal bleeding in the Department of Obstetrics and Gynecology at Haseki Training and Research Hospital between January 2008 and January 2012. Results: Analysis of the biopsy specimens revealed benign or premalignant endometrium in 355 of the 380 patients who were histopathologically diagnosed with postmenopausal bleeding. The mean endometrial thickness in 25 patient with malign endometrium was 11.6±8.2 mm. In our study, when a endometrial thickness cut-off value of 10.8 mm was taken, the sensitivity, specificity, and negative predictive value was found to be 84%, 52%, and 96%, respectively. Conclusion: In our study, almost all patients (96% with endometrial thickness of less than 10.8 mm, were free from endometrial malignancy. (The Me­di­cal Bul­le­tin of Ha­se­ki 2014; 52:164-7

  2. Endometrial cancer arising from atypical complex hyperplasia: The significance in an endometrial biopsy and a diagnostic challenge

    OpenAIRE

    Byun, Jung Mi; Jeong, Dae Hoon; Kim, Young Nam; Cho, En Bee; Cha, Ju Eun; Sung, Moon Su; Lee, Kyung Bok; Kim, Ki Tae

    2015-01-01

    Objective We investigated the features of endometrial hyperplasia with concurrent endometrial cancer that had been diagnosed by endometrial sampling. Further, we attempted to identify an accurate differential diagnostic method. Methods We retrospectively studied 125 patients who underwent a diagnostic endometrial biopsy or were diagnosed after the surgical treatment of other gynecological lesions, such as leiomyoma or polyps. Patients were diagnosed between January 2005 and December 2013 at B...

  3. Pregnancy after uterine arterial embolization

    Directory of Open Access Journals (Sweden)

    Cláudio E. Bonduki

    2011-01-01

    Full Text Available OBJECTIVE: To evaluate pregnancy outcomes, complications and neonatal outcomes in women who had previously undergone uterine arterial embolization. METHODS: A retrospective study of 187 patients treated with uterine arterial embolization for symptomatic uterine fibroids between 2005-2008 was performed. Uterine arterial embolization was performed using polyvinyl alcohol particles (500-900 mm in diameter. Pregnancies were identified using screening questionnaires and the study database. RESULTS: There were 15 spontaneous pregnancies. Of these, 12.5% were miscarriages (n = 2, and 87.5% were successful live births (n = 14. The gestation time for the pregnancies with successful live births ranged from 36 to 39.2 weeks. The mean time between embolization and conception was 23.8 months (range, 5-54. One of the pregnancies resulted in twins. The newborn weights (n = 14 ranged from 2.260 to 3.605 kg (mean, 3.072 kg. One (7.1% was considered to have a low birth weight (2.260 kg. There were two cases of placenta accreta (12.5%, treated with hysterectomy in one case [6.3%], one case of premature rupture of the membranes (PRM (6.3%, and one case of preeclampsia (6.3%. All of the patients were delivered via Cesarean section. CONCLUSION: In this study, there was an increased risk of Cesarean delivery. There were no other major obstetric risks, suggesting that pregnancy after uterine arterial embolization is possible without significant morbidity or mortality.

  4. Uterine fibroid embolization with spheric micro-particles using flow guiding: safety, technical success and clinical results

    International Nuclear Information System (INIS)

    Materials and Methods: Twenty of the first 26 consecutive patients referred for potential UFE were enrolled in the study. Pre-interventional MRI was used to assess morphologic contraindication to UFE. The embolization procedures were performed from a unilateral femoral approach using 4F selective catheters in straight vessels, >2 mm in diameter, and micro-catheters in smaller and tortuous arteries. The endpoint of the 'flow guided' embolization was defined by reaching the angiography 'pruned tree' appearance and sluggish flow in the main stem of the uterine artery. Assessment of morphologic mid term success was done by MRI 10 days, 3 months, 6 months, 9 months and 1 year after UFE. The clinical mid term success was assessed by having questionaires completed for menstrual bleeding, retention of clinical (symptomatic) benefit and quality of life. Results: Technical success was 100%, with 8 minor (2 post-interventional collapses, 2 hematomas, 4 relevant post-embolizations syndromes, 1 spontaneous expulsion of a submucous myoma) and 3 major complications (1 hysterectomy because of vaginal bleeding for 5 weeks, 1 transient amenorrhea and 1 spontaneous expulsion of myoma with transient bleeding requiring admission). In 17 of 19 patients, MRI showed total fibroid devascularization throughout the entire follow-up. The average shrinkage of the dominant fibroid was 71.3% at one year. The menstrual bleeding record in the cohort group fell from an average of 501.6 before treatment to 76.2 points at one year. At the same time, the clinical symptoms significantly improved. The patient satisfaction with the applied therapy was >95% at 1 year. One patient with residual fibroid perfusion underwent a second procedure, which achieved complete devascularization and adequate clinical success at one year. The second patient with incomplete devascularization had a persistent clinical benefit. (orig.)

  5. Vascular invasion in uterine sarcomas and its significance. A multi-institutional study.

    Science.gov (United States)

    Roma, Andres A; Barbuto, Denise A; Samimi, Siavash Azadmanesh; Stolnicu, Simona; Alvarado-Cabrero, Isabel; Chanona-Vilchis, Jose; Aguilera-Barrantes, Irene; de Peralta-Venturina, Mariza; Malpica, Anais; Rutgers, Joanne K L; Silva, Elvio G

    2015-11-01

    Although metastases and high-mortality are frequent in high-grade endometrial sarcomas (HGSs), these findings are less commonly seen in low-grade endometrial stromal sarcomas (LGESSs), even in cases with lymphovascular invasion (LVI). We hypothesized that the "bulging plugs" of tumor characteristic of LVI in LGESS are fundamentally different from LVI seen in HGS. We reviewed 70 uterine sarcomas: 42 HGSs (high-grade endometrial stromal sarcomas, undifferentiated uterine sarcoma, and leiomyosarcoma) and 28 LGESSs. All cases had LVI documented on the histologic slides. Immunostains for CD31, ERG, and D2-40 were performed. LGESS harbored cohesive intravascular tumor foci with direct communication from the main tumor and attached to the vessel wall. The intravascular foci included tumor cells and small arteriole-type vessels and were surrounded by a thin fibrous band. Vascular markers confirmed the LVI and highlighted positively stained endothelial cells separating intravascular tumor foci from the blood itself. In contrast, intravascular tumor foci in HGS were composed of discohesive cells clusters, lacking the features described in LGESS. Only 8 (30.8%) patients with LGESS had recurrence/metastases (6 with lung metastasis); only 1 patient died of disease. Thirty (77%) patients with HGS had recurrence/metastases, 27 (69%) patients had lung metastases, and 22 (56.4%) patients died of disease. We propose that in most LGESSs, LVI represents vascular intrusion; manipulation or trauma is potentially responsible for tumor cell detachment into the circulation increasing the chances of recurrence/metastases. Classic LVI features were identified in HGS. This important distinction may allow for better management of patients and avoid unnecessary treatment in LGESS, reducing morbidity. PMID:26410057

  6. Uterine responses to feeding soy protein isolate and treatment with 17β-estradiol differ in ovariectomized female rats.

    Science.gov (United States)

    Ronis, Martin J; Gomez-Acevedo, Horacio; Blackburn, Michael L; Cleves, Mario A; Singhal, Rohit; Badger, Thomas M

    2016-04-15

    There are concerns regarding reproductive toxicity from consumption of soy foods, including an increased risk of endometriosis and endometrial cancer, as a result of phytoestrogen consumption. In this study, female rats were fed AIN-93G diets made with casein (CAS) or soy protein isolate (SPI) from postnatal day (PND) 30, ovariectomized on PND 50 and infused with 5μg/kg/d 17β-estradiol (E2) or vehicle. E2 increased uterine wet weight (P<0.05). RNAseq analysis revealed that E2 significantly altered expression of 1991 uterine genes (P<0.05). SPI feeding had no effect on uterine weight and altered expression of far fewer genes than E2 at 152 genes (P<0.05). Overlap between E2 and SPI genes was limited to 67 genes. Functional annotation analysis indicated significant differences in uterine biological processes affected by E2 and SPI and little evidence for recruitment of estrogen receptor (ER)α to the promoters of ER-responsive genes after SPI feeding. The major E2 up-regulated uterine pathways were carcinogenesis and extracellular matrix organization, whereas SPI feeding up-regulated uterine peroxisome proliferator activated receptor (PPAR) signaling and fatty acid metabolism. The combination of E2 and SPI resulted in significant regulation of 504 fewer genes relative to E2 alone. The ability of E2 to induce uterine proliferation in response to the carcinogen dimethybenz(a)anthracene (DMBA) as measured by expression of PCNA and Ki67 mRNA was suppressed by feeding SPI (P<0.05). These data suggest that SPI is a selective estrogen receptor modulator (SERM) interacting with a small sub-set of E2-regulated genes and is anti-estrogenic in the presence of endogenous estrogens. PMID:26945725

  7. Factors Influencing the Outcome after Endometrial Laser Ablation: A Review of 600 Cases

    Science.gov (United States)

    Garry; Shelley-Jones; Mooney

    1994-08-01

    A consecutive series of 524 patients who had undergone 600 endometrial laser ablations (ELA) were surveyed by mailed questionnaire to determine their response to the procedure. Five hundred one (96%) of the women replied. No major operative morbidity had occurred. The mean duration of follow-up was 15 months (range 6 to 42 months). The absolute amenorrhea rate was only 29%, but in 95% the volume of bleeding was significantly reduced. The frequency of menstruation was reduced in 37% of the patients and unaltered in the remainder. The majority (83%) expressed satisfaction with the medium term outcome. The principal reason for dissatisfaction was persistent menstrual pain. Reported success increased with increasing patient age but was not influenced by uterine size or operating time. ELA in correctly selected cases is a safe and effective treatment for menorrhagia. PMID:9073682

  8. Involvement of chromosome 6 in endometrial cancer.

    Science.gov (United States)

    Tibiletti, M. G.; Bernasconi, B.; Taborelli, M.; Furlan, D.; Fabbri, A.; Franchi, M.; Taramelli, R.; Trubia, M.; Capella, C.

    1997-01-01

    Cytogenetic investigation was performed on direct preparations of 15 endometrial cancers showing different histotypes. Clonal abnormalities were found in 11 out of 13 analysable cases. The modal chromosome number was near diploid in all cases. The abnormal karyotypes contained relatively simple numerical or structural aberrations in the majority of tumours. In contrast, two neoplasms with serous papillary and mixed mullerian morphological features shared multiple complex changes as well as cytogenetic evidence of intratumoral heterogeneity. The most frequent chromosome abnormality in our series of endometrial neoplasms was 6q deletion, which was detected in serous papillary, endometrioid and mixed mullerian tumours. The loss of the 6q region, which is also frequently involved in ovarian carcinoma, suggests a relationship between endometrial and ovarian cancers based on a common histogenesis. Images Figure 1 Figure 2 PMID:9192990

  9. Analysis of the relationship between temporary or permanent amenorrhea and ovarian function after uterine artery embolization

    International Nuclear Information System (INIS)

    Objective: To analyze the cases of amenorrhea after uterine artery embolization (UAE) and to find out the relationship with ovarian dysfunction or failure. Methods: Ten cases out of 287 patients with uterus myoma who underwent UAE were found amenorrhea. Six of them had temporary and 4 had permanent amenorrhea (38, 47, 48 and 48 years old). Preprocedural and postprocedural menstruations, blood FSH levels correlative factors including surgical operations, were observed and analyzed. Results: Menstruations of 6 cases with temporary amenorrhea were completely recovered without any significant changes in blood FSH levels, while 4 permanent amenorrhea cases demonstrated significant differences in blood FSH levels after the procedure. Their blood FSH were all > 20 u /L after UAE with one of them > 100 u /L 24 months later and another 38 year-old patient underwent surgical operation of ovaries bilaterally before UAE. Conclusions: Temporary amenorrhea may not mean ovarian dysfunction or failure. The probability of ovarian dysfunction or failure after UAE is low, which mainly occur in the peirmenopausal patients. Consideration of the probability of inducing early ovarian failure, caution should be taken for UAE on the patients having ovarian surgery before. (authors)

  10. Genes regulated by interferon-gamma in human uterine microvascular endothelial cells.

    Science.gov (United States)

    Kitaya, Kotaro; Yasuo, Tadahiro; Yamaguchi, Takeshi; Fushiki, Shinji; Honjo, Hideo

    2007-11-01

    Interferon (IFN)-gamma plays a critical role in murine uterine spiral artery remodeling for successful pregnancy. The effect of IFN-gamma on human uterine microvasculature, however, remains poorly understood. The aim of this study was to identify the genes regulated by IFN-gamma in human uterine microvascular endothelial cells. The effect of IFN-gamma on the gene expression profile in human uterine microvascular endothelial cells was evaluated by cDNA microarray analysis and quantitative real-time reverse transcriptase-polymerase chain reaction for the selected genes of interest. In vivo expression of the protein encoded by some of these genes in human uterine microvascular endothelial cells was evaluated by Western blotting and immunohistochemistry. Treatment with 10 ng/ml IFN-gamma for 4 h induced a significant > or =2-fold change in 29 genes in pooled human uterine microvascular endothelial cells; a total of 20 genes were up-regulated, whereas nine genes were down-regulated. The genes significantly up-regulated included chemokines (CXCL9, CXCL10, CCL8, IL15RA, and CCL5), enzymes (GBP5, TAP1, CYP27B1, SOD2, MX1, CASP1, and PTGES), and transcription factors (TFAP2C, IRF1, NFE2L3). The genes significantly down-regulated following IFN-gamma treatment included cytokines/cytokine receptors (CSF2, IL1R2, and SPP1), and insulin-like growth factor binding proteins (WISP2 and IGFBP3). The results of the cDNA microarray analysis were confirmed by quantitative real-time reverse transcriptase-polymerase chain reaction for the selected 17 genes of interest. The immunoreactivity for the proteins encoded by IL15RA, IFI30, and MX1 was detected in human uterine microvascular endothelial cells in vivo, whereas the immunoreactivity for CCNA1 and NQO1 was not detectable. These results suggest that IFN-gamma regulates the gene expression involved in natural killer cell recruitment, embryo and trophoblast migration, endometrial decidualization, angiogenesis, angiostasis, and anti-viral infection in human uterine microvascular endothelial cells. PMID:17912462

  11. Pregnancy history and risk of endometrial cancer

    Science.gov (United States)

    Pocobelli, Gaia; Doherty, Jennifer A.; Voigt, Lynda F.; Beresford, Shirley A.; Hill, Deirdre A.; Chen, Chu; Rossing, Mary Anne; Holmes, Rebecca S.; Noor, Zorawar S.; Weiss, Noel S.

    2011-01-01

    Background Epidemiologic studies are consistent in finding that women who have had at least one birth are less likely to develop endometrial cancer. Less clear is whether timing of pregnancies during reproductive life influences risk, and the degree to which incomplete pregnancies are associated with a reduced risk. Methods We evaluated pregnancy history in relation to endometrial cancer risk using data from a series of four population-based endometrial cancer case-control studies of women 45–74 years of age (1,712 cases and 2,134 controls) during 1985–2005 in western Washington State. Pregnancy history and information on other potential risk factors were collected by in-person interviews. Results Older age at first birth was associated with a reduced risk of endometrial cancer after adjustment for number of births and age at last birth (test for trend P = 0.004). The odds ratio comparing women at least 35 years of age at their first birth with those younger than 20 years was 0.34 (95% confidence interval = 0.14–0.84). Age at last birth was not associated with risk after adjustment for number of births and age at first birth (test for trend P = 0.830). Overall, a history of incomplete pregnancies was not associated with endometrial cancer risk to any appreciable degree. Conclusions In this study, older age at first birth was more strongly associated with endometrial cancer risk than was older age at last birth. To date, there remains some uncertainty in the literature on this issue. PMID:21691206

  12. Claudin7 and moesin in endometrial Adenocarcinoma; a retrospective study of 265 patients

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    Mhawech-Fauceglia Paulette

    2012-01-01

    Full Text Available Abstract Background Metastasis is the main cause of death in cancer and is a multistep process. Moesin (MSN, a member of the ezrin-rdixin-moesin family and Claudin7 (CLDN7, a tight junction protein, both play a role in tumor cell metastasis. Previously, we found an over-expression of MSN and under-expression of CLDN7 at the mRNA level in uterine serous carcinoma in comparison to uterine endometrioid adenocarcinoma. The purpose of this study is to determine the protein expression of MSN and CLDN7 in endometrial cancer (EC and to evaluate their prognostic value. Two hundred sixty-five patients with EC were retrieved from the archives. MSN and CLDN7 immunostaining were performed on the tissue paraffin sections. The expression of each antibody was reported and then correlated with clinicopathological prognostic factors including age, tumor grade, tumor stage, lympho-vascular involvement, depth of myometrial invasion, overall survival (OS, disease free survival (DFS and death of disease (DOD. Results MSN and CLDN were expressed in 46% and 52% of overall cases. We observed an association between MSN+ staining and tumor grade, and serous and clear cell carcinoma subtypes (p + staining and low tumor grade and endometrioid adenocarcinoma subtype (p Conclusion A significant prognostic value of MSN and CLDN7 in predicting disease outcomes in patients with EC was not demonstrated. Nevertheless, the high percentage of EC cases with MSN and CLDN7 immunoexpression, and their association with tumor grade and subtypes, suggests that these proteins might play a role in tumorigenesis of endometrial adenocarcinomas. Future studies are needed to shed light on their mechanistic properties in EC cells.

  13. Immunohistochemical (Ki-67) study of endometrial maturation in mice after use of phosphodiesterase type 5 inhibitor

    Science.gov (United States)

    Rashidi, Bahman; Rad, Jafar Soleimani; Rad, Leila Roshangar

    2015-01-01

    Background: Uterine receptivity for the implantation is a complicated process, that ovarian factors (hormonal), endometrium and embryo simultaneously are involved in this phenomenon. A successful implantation needs appropriate development of the endometrium. Furthermore, embryo must be capable of reacting with the endometrium and producing suitable adhesion molecules. This study aimed to examine one of endometrial maturation indices in mice before implantation, i.e., proliferation of stromal cells. Materials and Methods: A total of 40 adult female mice were divided into four groups: Control, gonadotropin, gonadotropin + progesterone, and gonadotropin + sildenafil citrate. The three experimental groups were first injected 7.5 IU of human chorionic gonadotropin (HCG) and then 7.5 IU of human menopausal gonadotropin (HMG). Then, every two female mice were placed in a cage with a male mouse for mating. Two groups were injected 1 mg of progesterone and 3 mg/kg of sildenafil citrate at intervals of 24, 48, and 72 h after injection of HMG. After 96 h, all the mice were killed, and their uterine samples subjected to tissue passage and prepared for analysis. Immunohistochemical method, Ki-67, and stromal mitotic cell count were used in this study. Results: Our observations in all groups showed changes in the luminal epithelium. ANOVA analysis Ki-67-positive stromal cells among all groups were not statistically significant. Conclusion: The results showed that administration of HMG and HCG following that of progesterone and sildenafil citrate could change the indices of endometrial maturation, and they were not involved in the phase immediately before implantation in stromal mitotic index. PMID:26380239

  14. Endometrial caspase 1 and interleukin-18 expression during the estrous cycle and peri-implantation period of porcine pregnancy and response to early exogenous estrogen administration

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    Stein Daniel R

    2010-04-01

    Full Text Available Abstract Background The role for endometrial secretion of cytokines during the establishment of pregnancy in a number of mammals is well established. The current study determined endometrial expression of caspase 1 (CASP1 and interleukin-18 (IL18 during the estrous cycle and early pregnancy, and following early estrogen administration, which induces conceptus loss during early development in pigs. Methods Gilts were hysterectomized on either D 0, 5, 10, 12, 15 and 18 of the estrous cycle, or D 10, 12, 15 or 18 of pregnancy. The abundance of endometrial CASP1 mRNA was unaffected by day of the estrous cycle, however there was a 6 and 10-fold increase in expression on D 15 and 18 of pregnancy. Endometrial expression of IL18 mRNA increased 5-fold between D 10 to 18 in cyclic and pregnant gilts. Total recoverable IL18 in uterine flushings was greater in pregnant compared to cyclic gilts on D 15 and 18. In the second experiment, mated gilts were treated with either corn oil (CO or estrogen (E on D 9 and 10 and hysterectomized on either D 10, 12, 13, 15 or 17 of pregnancy. The current study localizes the presence of CASP1 to the epithelial layer of the endometrium for the first time. Further, a day × treatment interaction was detected for endometrial CASP1 mRNA and protein abundance as E stimulated an earlier increase on D 13 compared to CO gilts. Although IL18 mRNA expression remained unaltered from the E treatment, protein abundance was significantly attenuated on D 15 and 18 in response to E treatment. Conclusions Endometrial expression of CASP1 and IL18 is associated with establishment of pregnancy in pigs. Alteration of CASP1 and IL18 following premature exposure of the uterus to estrogen during early pregnancy may contribute to conceptus loss between Days 15 to 18 of pregnancy.

  15. Effect of uterine lavage on neutrophil counts in postpartum dairy cows.

    Science.gov (United States)

    Dini, P; Farhoodi, M; Hostens, M; Van Eetvelde, M; Pascottini, O Bogado; Fazeli, M H; Opsomer, G

    2015-07-01

    Subclinical endometritis affects approximately 30% of lactating dairy cows, causing significant economic losses to the dairy industry. Yet, there is no efficient treatment available for this condition. The present study examines the effect of uterine lavage in clinically normal cows with sterile saline solution at 30 days in milk (DIM) on the percentage of polymorphonuclear cells (PMNs) detected with endometrial cytology as an indicator of subclinical endometritis. It was hypothesized uterine lavage would be a technique to reduce the number of PMNs in the uterus, and hence be beneficial for cows affected by subclinical endometritis. Cytology samples were taken by low-volume flushing from 50 Holstein Friesian cows on 30 and 40 DIM. On Day 30, cows were clinically examined and randomly assigned into a treatment and control group. In the treatment group, the cytology sampling on Day 30 was immediately followed by uterine lavage with 500-600 mL of sterile physiological saline (35-40°C). Cytology sampling was repeated in all cows at 40 DIM. Lactation numbers >2, peripheral progesterone concentrations >1 ng/mL and uterine lavage at 30 DIM all were significantly associated with lesser PMN percentages at 40 DIM (P=0.0041; 0.0187 and 0.0043, respectively). Uterine lavage might, therefore, be a useful and practical method to decrease the number of PMNs in the uterus of cattle. Results from the current study can be used as preliminary data for designing in depth therapeutic protocols for treatment of subclinical endometritis in cattle. PMID:25956200

  16. Uterine and ovarian disorders in old cats: A study by ultrasonography and radiography

    International Nuclear Information System (INIS)

    Aim of this study was to examine disorders of ovaries and uteri in old domestic cats, using ultrasonography and radiography. Six intact female domestic cats, 6-9 years old that had never received any hormonal contraception were used in the study. Serum samples were taken on days 2, 4 and 6 of oestrus and analysed for oestradiol-17 beta and progesterone concentrations. On day 4 of oestrus, ovarian and uterine appearance and diameters was determined, using ultrasonography. Hysterography was performed using an infusion of a contrast medium into the cranial vagina. The measurement of uterine diameter was done using the ultrasound and the hysterogram. Cystic endometrial hyperplasia (CEH) and cystic ovaries were common abnormal features. Ultrasound showed an ovarian diameter of 1.24+-0.48 cm and a follicle diameter of 0.3-0.4 cm at mid-oestrus. Cysts in the ovaries were observed with a diameter of 0.98-2.04 (3/6). Multiple cystic structures of 0.1-0.2 cm were found in the hyperplastic endometrium (5/6). Hysterography provided an overview of the uterine appearance, hyperplasia and the cystic changes in the endometrium. The diameter of the uterine horns, measured using the ultrasound and hysterogram, was 0.66+-0.22 and 0.68+-0.18 cm, respectively (p LT 0.05). The increase and the decline of oestradiol-17 beta, and the basal level of progesterone concentration, during oestrus, indicated that the cystic ovaries did not produce these hormones. The study demonstrated the abnormal changes in the ovaries and uteri of old cats, which is likely to be the cause infertility which is particularly important in endangered wild felids. It is valuable that ultrasound and hysterogram can now be used for diagnosing the pathology of ovaries and uterine disease in cats

  17. Effect of a povidone-iodine intrauterine infusion on progesterone levels and endometrial steroid receptor expression in mares

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    Talmon Marilina

    2010-12-01

    Full Text Available Abstract Background Intrauterine infusions have been widely used for the treatment of endometritis in the mare. Nevertheless, their consequences on endocrine and endometrial molecular aspects are unknown. We studied the effect of a 1% povidone-iodine solution intrauterine infusion on progesterone levels, endometrial histology and estrogen (ERα and progesterone (PR receptor distribution by immunohistochemistry. Methods Fourteen healthy mares were used in this study. Estruses were synchronized and seven mares were treated with intrauterine infusions at days 0 and 2 post ovulation of two consecutive estrous cycles. Uterine biopsy samples were taken on days 6 and 15 post ovulation. Results The treatment did not induce an inflammatory response indicating endometritis, neither affected the ERα. However, it reduced the percentage of PR positive cells (PPC on day 6 (deep glandular epithelium, control: 95.7 vs. infused: 61.5, P P = 0.07, and higher levels on day 15 compared with controls (4.4 ng/ml vs. 1.3 ng/ml, P = 0.07. Conclusion a 1% povidone-iodine infusion during days 0 and 2 post ovulation in healthy mares did not induce histological changes indicating endometritis, but altered progesterone concentrations and reduced the expression of endometrial PR at day 6 without affecting the ERα. These changes could reduce embryo survival.

  18. Prevalence of Human Papillomavirus in endometrial cancer

    DEFF Research Database (Denmark)

    Olesen, Tina Bech; Svahn, Malene Frøsig; Faber, Mette Tuxen; Duun-Henriksen, Anne Katrine; Junge, Jette; Norrild, Bodil; Kjaer, Susanne K

    2014-01-01

    HPV is a common sexually transmitted infection and is considered to be a necessary cause of cervical cancer. The anatomical proximity to the cervix has led researchers to investigate whether Human Papillomavirus (HPV) has a role in the etiology of endometrial cancer.......HPV is a common sexually transmitted infection and is considered to be a necessary cause of cervical cancer. The anatomical proximity to the cervix has led researchers to investigate whether Human Papillomavirus (HPV) has a role in the etiology of endometrial cancer....

  19. Detecting uterine glandular lesions: Role of cervical cytology

    Science.gov (United States)

    Bansal, Baneet; Gupta, Parikshaa; Gupta, Nalini; Rajwanshi, Arvind; Suri, Vanita

    2016-01-01

    Background: The sensitivity of cervical cytology for detection of glandular lesions is reported to be low. We conducted this study to assess the diagnostic accuracy of cervical Papanicolaou (Pap) smears for uterine glandular lesions and to compare the diagnostic utility of conventional and liquid-based cytology (LBC) smears for glandular lesions. Materials and Methods: Archived histopathology records of all cases reported as endocervical and endometrial adenocarcinoma in the study period were identified and the available corresponding Pap smears (in preceding 1 year) were retrieved. In addition, the Pap smears reported as glandular cell abnormalities (GCA) during the same study period were retrieved. The overall prevalence of GCA, sensitivity, and specificity of Pap smears for the detection of GCA was calculated. The diagnostic accuracy of conventional and LBC smears for the diagnosis of GCA was also compared. Results: The prevalence of GCA in our study was 0.32%. The overall specificity of Pap smears for the diagnosis of GCA was 60.8%, this was not significantly different between conventional and LBC smears (P = 0.4). The overall sensitivity of Pap smears for the detection of GCA was 41.8%; LBC smears had significantly better sensitivity as compared to conventional smears for the detection of endometrial as compared to endocervical adenocarcinoma (P Pap smears is low. The specificity of Pap smears, for diagnosis of GCA, was found to be moderate. However, the overall sensitivity of Pap smears for the detection of GCA was low, though better for LBC as compared to conventional smears. PMID:27014363

  20. Genomic instability influences the transcriptome and proteome in endometrial cancer subtypes

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    Habermann Jens K

    2011-10-01

    Full Text Available Abstract Background In addition to clinical characteristics, DNA aneuploidy has been identified as a prognostic factor in epithelial malignancies in general and in endometrial cancers in particular. We mapped ploidy-associated chromosomal aberrations and identified corresponding gene and protein expression changes in endometrial cancers of different prognostic subgroups. Methods DNA image cytometry classified 25 endometrioid cancers to be either diploid (n = 16 or aneuploid (n = 9, and all uterine papillary serous cancers (UPSC to be aneuploid (n = 8. All samples were subjected to comparative genomic hybridization and gene expression profiling. Identified genes were subjected to Ingenuity pathway analysis (IPA and were correlated to protein expression changes. Results Comparative genomic hybridization revealed ploidy-associated specific, recurrent genomic imbalances. Gene expression analysis identified 54 genes between diploid and aneuploid endometrioid carcinomas, 39 genes between aneuploid endometrioid cancer and UPSC, and 76 genes between diploid endometrioid and aneuploid UPSC to be differentially expressed. Protein profiling identified AKR7A2 and ANXA2 to show translational alterations consistent with the transcriptional changes. The majority of differentially expressed genes and proteins belonged to identical molecular functions, foremost Cancer, Cell Death, and Cellular Assembly and Organization. Conclusions We conclude that the grade of genomic instability rather than the histopathological subtype correlates with specific gene and protein expression changes. The identified genes and proteins might be useful as molecular targets for improved diagnostic and therapeutic intervention and merit prospective validation.

  1. Effects of Exogenous Ethinyl Estradiol on Endometrial Receptivity in Clomiphene Induced Cycles in Infertile Women with Polycystic Ovaries

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    Swasti, S. B. Khanna, U. Kaul

    2005-07-01

    Full Text Available To compare the effectiveness of clomiphene citrate used alone and in combination with ethinylestradiol on endometrial receptivity in infertile women with polycystic ovaries (PCO. Color dopplerultrasonographic evaluation of endometrial thickness (ET and pulsatility index (PI was done for 27infertile women with polycystic ovaries. These women were studied for one control unmedicatedcycle and randomized to receive clomiphene citrate (CC alone and CC with ethinyl estradiol (EE insubsequent 2 cycles. The total duration of follow up of patients was 77 months in which 2 womenconceived in control cycle and 1 conceived in CC+EE cycle. On day ofHCGinjection, mean ET was6.96 + 1.63mmin control cycle, 7.25 + 1.64mmin CC and 8.53 + 1.36mmin CC + EE cycle, whereas,the mean pulsatility index (PI of dominant uterine arteries was 4.09 + 0.97 in control cycle, 3.96 + 0.95 inCC cycle and 3.75 + 0.98 in CC + EE cycle. On day of HCG injection, mean PI of non-dominant uterinearteries was 4.06 + 1.01in control, 4.00 + 1.02 in CC and 3.71 + 0.95 in CC + EE cycles. A statisticallysignificant change (p< 0.05 was observed in ET and PI of dominant and non-dominant uterine arteries incontrol andCC+EEcycle and those inCCandCC+EEcycles. Addition of ethinyl estradiol to clomipheneinduced cycles produces a favorable endometrial response in infertile women with PCO.

  2. Radiation therapy for endometrial carcinoma

    International Nuclear Information System (INIS)

    Although pelvic irradiation has traditionally been employed as an adjunct to surgery, the role of radiation therapy as a definitive therapeutic modality continues to be controversial. One-hundred and twenty-one patients were treated for endometrial carcinoma between 1978 and 1985 at the Medical College of Virginia Hospital. These patients were divided into three groups with respect to their treatment. Group 1 consisted of 16 patients who had preoperative radiation therapy, group 2 consisted of 77 patients who had postoperative radiation therapy, and group 3 consisted of 28 patients who had radiation therapy alone. Ninety-three percent of the patients in groups 1 and 2 and 68% of patients in group 3 had stages I and II disease. In group 3, 32% of the patients had stages III and IV disease. Two-thirds of the patients in groups 1 and 2 had moderately differentiated tumor. One-third of patients in group 3 had poorly differentiated tumor. Sixty percent of the study's population in group 2 had deep myometrial invasion. The treatment doses utilized and local failures will be presented. All of the patients have been followed for a minimum period of 2 years. The observed actuarial 5-year survival was 85%, 80%, and 53%, respectively, for groups 1, 2, and 3. The overall survival of the entire patient population was 77%. There was 1 fatality secondary to small bowel complication in group 2 and another serious complication of rectovaginal fistula in group 1 requiring colostomy. Other side effects were skin reaction, diarrhea, and cystitis, which were treated symptomatically. Analysis of the authors' institution experience with adenocarcinoma of the endometrium and its management with radiation therapy is presented. Survival is correlated with stage, grade, and depth of myometrial invasion

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

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    Farzaneh Chobsaz

    2011-01-01

    Full Text Available Background: Sildenafil is a selective inhibitor of cyclic-guanosine monphosphat-specificphosphodiesterase type 5. It increases intracellular nitric oxide (NO production in some cells.There are reports on its positive effect on uterine circulation, endometrial thickness, and infertilityimprovement. Endometrial epithelial cells (EEC play an important role in embryo attachment andimplantation. The present work investigates the effect of sildenafil on human EEC and their NOsecretion in vitro.Materials and Methods: In this experimental in vitro study, endometrial biopsies (n=10 werewashed in a phosphate buffered solution (PBS and digested with collagenase I (2 mg/ml in DMEM/F12 medium at 37°C for 90 minutes. Epithelial glands were collected by sequential filtrationthrough nylon meshes (70 and 40 μm pores, respectively. Epithelial glands were then treated withtrypsin to obtain individual cells. The cells were counted and divided into four groups: control and1, 10, and 20 μM sildenafil concentrations. Cells were cultured for 15 days at 37ºC and 5% CO2; themedia were changed every 3 days, and their supernatants were collected for the NO assay. NO wasmeasured by standard Greiss methods. Data were analyzed by one way ANOVA.Results: There was no significant difference between groups in cell count and NO secretion, but thelevel of NO increased slightly in the experimental groups. The 10 μM dose showed the highest cellcount. EEC morphology changed into long spindle cells in the case groups.Conclusion: Sildenafil (1, 10, and 20 μM showed a mild proliferative effect on human EECnumbers, but no significant change was seen in NO production.

  4. Interest of uterine artery embolization with gelatin sponge particles prior to myomectomy for large and/or multiple fibroids

    International Nuclear Information System (INIS)

    Purpose: To evaluate the efficacy of pre-myomectomy uterine artery embolization with gelatin sponge particles to reduce operative blood loss and facilitate removal of fibroids. Materials and methods: This retrospective study included 33 women (mean age, 36 years; range, 24-45 years), of whom at least 18 wished to preserve fertility. They presented with at least one large myoma (mean diameter, 90 mm; range, 50-150 mm) and had undergone preoperative uterine artery embolization with resorbable gelatin sponge by unilateral femoral approach between December 2001 and November 2008. Clinical, radiological and surgical data were available for all patients. Mean haemoglobin levels before and after surgery were compared with Student's t-test. Results: No complication or technical failure of embolization occurred. The myomectomies were performed during laparotomy (25 cases) or laparoscopy (8 cases). Dissection of fibroids was easier (mean, 3 per patient; range, 1-11), with a mean operating time of 108 ± 50 min (range, 30-260 min). Bloodless surgery was the rule with a mean estimated peroperative blood loss of 147 ± 249 mL (range, 0-800 mL). Mean pre-(12.9 ± 1.3 g/dL) and post-therapeutic (11.4 ± 1.2 g/dL) haemoglobin levels were not statistically different (p > 0.05). There was no need for blood transfusion. None of the patients required hysterectomy. The mean duration of hospital stay was 7.5 ± 1.3 days (range, 3-12 days). Conclusion: Preoperative uterine artery embolization is effective in reducing intraoperative blood loss and improves the chances of performing conservative surgery. It should be considered a useful adjunct to myomectomy in women at high hemorrhagic risk or who refuse blood transfusion.

  5. Interest of uterine artery embolization with gelatin sponge particles prior to myomectomy for large and/or multiple fibroids

    Energy Technology Data Exchange (ETDEWEB)

    Butori, Noemie [Department of Vascular and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 bd du Marechal de Lattre de Tassigny, BP 77908, 21079 Dijon Cedex (France); Tixier, Herve; Filipuzzi, Laurence; Mutamba, William [Department of Gynecology and Obstetrics, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 bd du Marechal de Lattre de Tassigny, BP 77908, 21079 Dijon Cedex (France); Guiu, Boris; Cercueil, Jean-Pierre [Department of Vascular and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 bd du Marechal de Lattre de Tassigny, BP 77908, 21079 Dijon Cedex (France); Douvier, Serge; Sagot, Paul [Department of Gynecology and Obstetrics, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 bd du Marechal de Lattre de Tassigny, BP 77908, 21079 Dijon Cedex (France); Krause, Denis [Department of Vascular and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 bd du Marechal de Lattre de Tassigny, BP 77908, 21079 Dijon Cedex (France); Loffroy, Romaric, E-mail: romaric.loffroy@chu-dijon.fr [Department of Vascular and Interventional Radiology, University of Dijon School of Medicine, Bocage Teaching Hospital, 2 bd du Marechal de Lattre de Tassigny, BP 77908, 21079 Dijon Cedex (France)

    2011-07-15

    Purpose: To evaluate the efficacy of pre-myomectomy uterine artery embolization with gelatin sponge particles to reduce operative blood loss and facilitate removal of fibroids. Materials and methods: This retrospective study included 33 women (mean age, 36 years; range, 24-45 years), of whom at least 18 wished to preserve fertility. They presented with at least one large myoma (mean diameter, 90 mm; range, 50-150 mm) and had undergone preoperative uterine artery embolization with resorbable gelatin sponge by unilateral femoral approach between December 2001 and November 2008. Clinical, radiological and surgical data were available for all patients. Mean haemoglobin levels before and after surgery were compared with Student's t-test. Results: No complication or technical failure of embolization occurred. The myomectomies were performed during laparotomy (25 cases) or laparoscopy (8 cases). Dissection of fibroids was easier (mean, 3 per patient; range, 1-11), with a mean operating time of 108 {+-} 50 min (range, 30-260 min). Bloodless surgery was the rule with a mean estimated peroperative blood loss of 147 {+-} 249 mL (range, 0-800 mL). Mean pre-(12.9 {+-} 1.3 g/dL) and post-therapeutic (11.4 {+-} 1.2 g/dL) haemoglobin levels were not statistically different (p > 0.05). There was no need for blood transfusion. None of the patients required hysterectomy. The mean duration of hospital stay was 7.5 {+-} 1.3 days (range, 3-12 days). Conclusion: Preoperative uterine artery embolization is effective in reducing intraoperative blood loss and improves the chances of performing conservative surgery. It should be considered a useful adjunct to myomectomy in women at high hemorrhagic risk or who refuse blood transfusion.

  6. Chemoattraction of bone marrow-derived stem cells towards human endometrial stromal cells is mediated by estradiol regulated CXCL12 and CXCR4 expression

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    Xiuli Wang

    2015-07-01

    Full Text Available Bone marrow derived cells engraft to the uterine endometrium and contribute to endometriosis. The mechanism by which these cells are mobilized and directed to the endometrium has not been previously characterized. We demonstrate that human endometrial stromal cells (hESCs produce the chemokine CXCL12 and that bone marrow cells (BMCs express the CXCL12 receptor, CXCR4. Treatment with physiological levels of estradiol (E2 induced both CXCL12 and CXCR4 expression in hESCs and BMCs, respectively. BMCs migrated towards hESCs conditioned media; a CXCR4 antagonist blocked migration indicating that CXCL12 acting through its receptor, CXCR4, is necessary for chemoattraction of BM cells to human endometrial cells. E2 increased both CXCL12 expression in endometrial cells and CXCR4 expression in BM cells, further enhancing chemoattraction. E2 induced CXCL12/CXCR4 expression in endometrium and BM, respectively, drives migration of stem cells to the endometrium. The E2-CXCL12/CXCR4 signaling pathway may be useful in determining treatments for endometrial disorders, and may be antagonized to block stem cell migration to endometriosis.

  7. Characterisation of the human uterine microbiome in non-pregnant women through deep sequencing of the V1-2 region of the 16S rRNA gene

    Science.gov (United States)

    Vilchez-Vargas, Ramiro; Desimpel, Fabian; Jauregui, Ruy; Vankeirsbilck, Nele; Weyers, Steven; Verhelst, Rita; De Sutter, Petra; Pieper, Dietmar H.; Van De Wiele, Tom

    2016-01-01

    Background. It is widely assumed that the uterine cavity in non-pregnant women is physiologically sterile, also as a premise to the long-held view that human infants develop in a sterile uterine environment, though likely reflecting under-appraisal of the extent of the human bacterial metacommunity. In an exploratory study, we aimed to investigate the putative presence of a uterine microbiome in a selected series of non-pregnant women through deep sequencing of the V1-2 hypervariable region of the 16S ribosomal RNA (rRNA) gene. Methods. Nineteen women with various reproductive conditions, including subfertility, scheduled for hysteroscopy and not showing uterine anomalies were recruited. Subjects were highly diverse with regard to demographic and medical history and included nulliparous and parous women. Endometrial tissue and mucus harvesting was performed by use of a transcervical device designed to obtain endometrial biopsy, while avoiding cervicovaginal contamination. Bacteria were targeted by use of a barcoded Illumina MiSeq paired-end sequencing method targeting the 16S rRNA gene V1-2 region, yielding an average of 41,194 reads per sample after quality filtering. Taxonomic annotation was pursued by comparison with sequences available through the Ribosomal Database Project and the NCBI database. Results. Out of 183 unique 16S rRNA gene amplicon sequences, 15 phylotypes were present in all samples. In some 90% of the women included, community architecture was fairly similar inasmuch B. xylanisolvens, B. thetaiotaomicron, B. fragilis and an undetermined Pelomonas taxon constituted over one third of the endometrial bacterial community. On the singular phylotype level, six women showed predominance of L. crispatus or L. iners in the presence of the Bacteroides core. Two endometrial communities were highly dissimilar, largely lacking the Bacteroides core, one dominated by L. crispatus and another consisting of a highly diverse community, including Prevotella spp., Atopobium vaginae, and Mobiluncus curtisii. Discussion. Our findings are, albeit not necessarily generalizable, consistent with the presence of a unique microbiota dominated by Bacteroides residing on the endometrium of the human non-pregnant uterus. The transcervical sampling approach may be influenced to an unknown extent by endocervical microbiota, which remain uncharacterised, and therefore warrants further validation. Nonetheless, consistent with our understanding of the human microbiome, the uterine microbiota are likely to have a previously unrecognized role in uterine physiology and human reproduction. Further study is therefore warranted to document community ecology and dynamics of the uterine microbiota, as well as the role of the uterine microbiome in health and disease. PMID:26823997

  8. Characterisation of the human uterine microbiome in non-pregnant women through deep sequencing of the V1-2 region of the 16S rRNA gene.

    Science.gov (United States)

    Verstraelen, Hans; Vilchez-Vargas, Ramiro; Desimpel, Fabian; Jauregui, Ruy; Vankeirsbilck, Nele; Weyers, Steven; Verhelst, Rita; De Sutter, Petra; Pieper, Dietmar H; Van De Wiele, Tom

    2016-01-01

    Background. It is widely assumed that the uterine cavity in non-pregnant women is physiologically sterile, also as a premise to the long-held view that human infants develop in a sterile uterine environment, though likely reflecting under-appraisal of the extent of the human bacterial metacommunity. In an exploratory study, we aimed to investigate the putative presence of a uterine microbiome in a selected series of non-pregnant women through deep sequencing of the V1-2 hypervariable region of the 16S ribosomal RNA (rRNA) gene. Methods. Nineteen women with various reproductive conditions, including subfertility, scheduled for hysteroscopy and not showing uterine anomalies were recruited. Subjects were highly diverse with regard to demographic and medical history and included nulliparous and parous women. Endometrial tissue and mucus harvesting was performed by use of a transcervical device designed to obtain endometrial biopsy, while avoiding cervicovaginal contamination. Bacteria were targeted by use of a barcoded Illumina MiSeq paired-end sequencing method targeting the 16S rRNA gene V1-2 region, yielding an average of 41,194 reads per sample after quality filtering. Taxonomic annotation was pursued by comparison with sequences available through the Ribosomal Database Project and the NCBI database. Results. Out of 183 unique 16S rRNA gene amplicon sequences, 15 phylotypes were present in all samples. In some 90% of the women included, community architecture was fairly similar inasmuch B. xylanisolvens, B. thetaiotaomicron, B. fragilis and an undetermined Pelomonas taxon constituted over one third of the endometrial bacterial community. On the singular phylotype level, six women showed predominance of L. crispatus or L. iners in the presence of the Bacteroides core. Two endometrial communities were highly dissimilar, largely lacking the Bacteroides core, one dominated by L. crispatus and another consisting of a highly diverse community, including Prevotella spp., Atopobium vaginae, and Mobiluncus curtisii. Discussion. Our findings are, albeit not necessarily generalizable, consistent with the presence of a unique microbiota dominated by Bacteroides residing on the endometrium of the human non-pregnant uterus. The transcervical sampling approach may be influenced to an unknown extent by endocervical microbiota, which remain uncharacterised, and therefore warrants further validation. Nonetheless, consistent with our understanding of the human microbiome, the uterine microbiota are likely to have a previously unrecognized role in uterine physiology and human reproduction. Further study is therefore warranted to document community ecology and dynamics of the uterine microbiota, as well as the role of the uterine microbiome in health and disease. PMID:26823997

  9. Uterine fibromyolipoma; Uncommon imaging features

    Energy Technology Data Exchange (ETDEWEB)

    Soyer, P.; Masselot, J.; Vanel, D. (Centre de Lutte Contre le Cancer Gustave-Roussy, 94 - Villejuif (France)); Harry, G. (Centre Hospitalier General de Creil (France). Department of Radiology); Cazier, A. (Centre Hospitalier General de Creil (France). Department of Pathology)

    Lipomatous tumors of the uterus are uncommon. Because of the fatty nature of those tumors, digital imaging techniques may provide the preoperative diagnosis. A case of uterine fibromyolipoma is reported, documented by both ultrasound (US) and computed tomography (CT), in which the diagnosis was strongly suggested by the US and CT findings. (author). 8 refs.; 2 figs.

  10. Sterility of the uterine cavity

    DEFF Research Database (Denmark)

    Møller, Birger R.; Kristiansen, Frank V.; Thorsen, Poul; Frost, Lars; Mogensen, Søren C.

    1995-01-01

    trachomatis, yeasts and viruses were taken preoperatively from the apex of the vagina and cervical os. Immediately after hysterectomy the uterus was opened under sterile conditions and samples obtained from the isthmus and fundus of the uterine cavity for microbiological examination. Wet smears were taken...

  11. Micro-metastases into the uterine leiomyoma from invasive ductal breast cancer under adjuvant tamoxifen therapy: case report.

    Science.gov (United States)

    Dirican, A; Kucukzeybek, Y; Somali, I; Erten, C; Demir, L; Can, A; Bayoglu, I V; Yigit, S C; Unay, F C; Yetimalar, M H; Tarhan, M O

    2012-01-01

    Metastasis of breast cancer to the uterus is extremely rare. However, breast cancer is the leading tumor metastasizing from extragenital organs to the uterus. The most common signs of uterine metastasis are bleeding and mass effect. Tamoxifen use is known to increase risk of endometrial cancer. Immunohistochemical staining with GCDFP can be useful in differentiating primary uterine tumors from breast cancer metastasis. Metastasis to the uterus has been reported to worsen the prognosis. Although hysterectomy has been effective on survival, treatment modality to be used in the presence of other systemic metastases is not clear. Locoregional treatments can be used in oligometastatic cases. In addition, removal of solitary organ metastasis together with bone metastasis provides improvement in survival. PMID:23327065

  12. The genomics and genetics of endometrial cancer

    Directory of Open Access Journals (Sweden)

    Bell DW

    2012-03-01

    Full Text Available Andrea J O’Hara,  Daphne W Bell National Human Genome Research Institute, Cancer Genetics Branch, National Institutes of Health, Bethesda, MD, USAAbstract: Most sporadic endometrial cancers (ECs can be histologically classified as endometrioid, serous, or clear cell. Each histotype has a distinct natural history, clinical behavior, and genetic etiology. Endometrioid ECs have an overall favorable prognosis. They are typified by high frequency genomic alterations affecting PIK3CA, PIK3R1, PTEN, KRAS, FGFR2, ARID1A (BAF250a, and CTNNB1 (?-catenin, as well as epigenetic silencing of MLH1 resulting in microsatellite instability. Serous and clear cell ECs are clinically aggressive tumors that are rare at presentation but account for a disproportionate fraction of all endometrial cancer deaths. Serous ECs tend to be aneuploid and are typified by frequent genomic alterations affecting TP53 (p53, PPP2R1A, HER-2/ERBB2, PIK3CA, and PTEN; additionally, they display dysregulation of E-cadherin, p16, cyclin E, and BAF250a. The genetic etiology of clear cell ECs resembles that of serous ECs, but it remains relatively poorly defined. A detailed discussion of the characteristic patterns of genomic alterations that distinguish the three major histotypes of endometrial cancer is reviewed herein.Keywords: endometrial, cancer, genomics, genetics, sporadic

  13. 21 CFR 884.1100 - Endometrial brush.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Endometrial brush. 884.1100 Section 884.1100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL...) Indication: Only to evaluate the endometrium, and (ii) Contraindications: Pregnancy, history of...

  14. Genital tract burns during rollerball endometrial coagulation.

    Science.gov (United States)

    Vilos, G A; D'Souza, I; Huband, D

    1997-02-01

    Thermal injuries occurred in three women after hysteroscopic rollerball endometrial ablation. Possible mechanisms of injury included insulation failure of the rollerball to the sheath of the resectoscope, current division with the sheath acting as an alternate return electrode, and capacitative leakage of current from the active electrode to the sheath. PMID:9050741

  15. Oral contraception and risk of endometrial cancer

    Directory of Open Access Journals (Sweden)

    Mueck AO

    2011-10-01

    Full Text Available Alfred O Mueck1, Harald Seeger1, Xiangyan Ruan2 1Department of Endocrinology and Menopause, University Women's Hospital of Tuebingen, Tuebingen, Germany; 2Department of Gynecological Endocrinology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China Abstract: No placebo-controlled studies concerning hormonal contraception in general have been published, and only investigations on biological mechanisms and observational clinical studies are available. Thus, associations can be described but not their causality. Experimental studies strongly suggest protective effects of the progestagen component of hormonal contraception against development of estrogen-related (type 1 endometrial cancer. In light of this research, it seems biologically plausible that, in more than 20 published studies, a reduction in endometrial cancer risk was achieved in up to 50% of users of combined oral contraceptives (COC, compared with nonusers. Few data exist for progestin-only oral preparations. However, in view of the mechanisms involved, a reduction in cancer risk should also be expected. Whereas hormonal dose-dependency has been investigated in only a few studies, which showed a stronger risk reduction with increasing progestagenic potency, a decreased risk dependent on duration of use has been clearly demonstrated, and after stopping COC this effect has persisted for up to 20 years. Possible confounders, including family history, parity, and smoking, have been investigated in a few studies, with only a minor impact on hormonal effect of endometrial cancer risk, with the exception of obesity, which was a strong risk factor in most but not all studies. There are obvious differences in the incidence of endometrial cancer in women using COC when evaluated in absolute numbers for Western and Asian countries, being about 3–5-fold higher in the US than in Asia. Further research should include the noncontraceptive benefit of COC, especially in patients with a high risk of cancer, as in polycystic ovary disease, and should also include new contraceptive drugs using natural estradiol instead of ethinyl estradiol. Of importance is the question of the potency of hormonal intrauterine devices to protect against endometrial cancer. It can be concluded on the basis of biological plausibility and observational data that COC can strongly decrease the risk of estrogen-related endometrial cancer, with an effect persisting after withdrawal of the hormones, and a causal relationship for this protection against cancer seems reasonable. Keywords: hormonal contraceptives, endometrial cancer

  16. Endometrioid adenocarcinoma associated with endometrial stromal sarcoma: A rare, often unrecognized collision tumor

    Directory of Open Access Journals (Sweden)

    Grace Kim

    2015-08-01

    Full Text Available We are reporting 3 cases of the uterine corpus with collision of endometrioid adenocarcinoma (EAC with endometrial stromal sarcoma (ESS. The patients' ages ranged from 36 to 59 years old. The major clinical presentation was abnormal uterine bleeding. Microscopically, all 3 cases presented with 2 separate components, EAC Grade 1 and ESS (one low grade and two high grades. The EAC component ranged from 10% to 70%, and the ESS component ranged from 30% to 70% of total tumor volume. The EAC component was stage 1A in two cases and stage II in one case. The ESS component was stages IA, IIB, and IIIB. Adjuvant hormonal therapy was administrated to one patient while a second patient was treated with chemo/radiation therapy. Two patients were still alive with no evidence of disease at 4 years post-therapy. One patient was lost for follow-up. Collision tumor should be distinguished from carcinosarcoma due to its different treatment modality, outcome and, prognosis.

  17. Evaluation of Uterine Biophysical Profile and to Assess its Role in Predicting Conception among Unexplained Primary Infertility Patients

    Directory of Open Access Journals (Sweden)

    Pooja Gupta

    2014-12-01

    Full Text Available Introduction: Infertility is a devastating disease which affects its victims at a very basic level the ability to reproduce. This can be divisive to the couples involved, their relatives and friends. The influence of infertility can be immense. There are a lot of medical and social consequences of infertility and the psychological sequelae are one of them. Affected patients and their families suffer from loss of esteem, disappointment and depression. Considering the immense effect of infertility on the life of not only the affected couples but also on their families and relatives the present study was conducted with following objective. Objective: To evaluate the Uterine Biophysical Profile and to assess its role in predicting the conception outcome in spontaneous cycles in patients with unexplained primary infertility. Material &Methods: A prospective observational study was conducted in the Department of Obstetrics and Gynaecology, U.P. Rural Institute of Medical Sciences & Research, Saifaion 55 women with unexplained primary infertility after standard diagnostic work up. Ultrasound (TVS measurement of all patients was performed in their midcycle of spontaneous cycle. The Uterine Biophysical Profile (UBP i.e. certain sonographic qualities of the uterus were noted during the normal mid-cycle of these patients. These included 7 parameters: Endometrial thickness in greatest AP dimension of 7 mm or greater (full-thickness measurement, a layered ("5 line" appearance to the endometrium, myometrial contractions causing a wave like motion of the endometrium, homogeneous myometrial echogenicity, uterine artery blood flow (as measured by PI, less than 3.0, blood flow within zone 3 using color doppler technique, myometrial blood flow seen on gray-scale examination. The Uterine Scoring System for Reproduction ("USSR" was used to evaluate the total score. Results: Among 55 unexplained primary infertility patients 24 i.e. 43.63% conceived by serial ultrasonographic monitoring of spontaneous menstrual cycle and timed intercourse. According to USSR, with a ‘perfect score’ of 20, there was 80% conception rate. While 9 /15 patients (i.e 60% conceived with a score of 17-19.  With a score of 14-16, 10/23 patients conceived i.e. 43.37%.  Only 8.33% conception rate was seen with a low score of < or = 13.  Highest pregnancy rate (60% was seen with an endometrial thickness of 7-9mm while zone IV endometrial blood flow gave maximum conception rate of 66.66%. Conclusion: UBP can prove to be a simple, reliable, reproducible, rapid and non-invasive tool to predict uterine environment and hence conception outcome.

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

    Directory of Open Access Journals (Sweden)

    Sharma J

    2009-06-01

    Full Text Available Background : Office hysteroscopy with endometrial biopsy is usually the first investigation for abnormal uterine bleeding and other uterine diseases. Aims: To evaluate the effect of oral drotaverine with mefenamic acid on pain perception during hysteroscopy and endometrial biopsy and to compare it with that of paracervical block using 1% lignocaine and with that of intravenous sedation using diazepam with pentazocine. Settings and Design : Outpatient gynecological department and open randomized trial. Materials and Methods : One hundred twenty women undergoing hysteroscopy and endometrial biopsy were randomized into 3 groups. Group I received tablet containing drotaverine hydrochloride (80 mg + mefenamic acid (250 mg, group II received lignocaine paracervically and group III received intravenous diazepam. The intensity of pain during the procedure, 30 and 60 minutes later on visual analog scale (VAS was assessed. Statistical Analysis : Statistical analysis was performed using Kruskal-Wallis test, with the Bonferroni correction, the t test, and the χ2 test. Results: Groups were similar in age, parity, vaginal birth or relevant medical history. A statistically significant difference in pain scores was noted among the 3 groups during the procedure (group I, 4.13± 1.28; group II, 5.93± 1.26; group III, 5.58± 1.51, (P< 0.001; as well as 30 minutes later (group I, 1.78± 0.89; group II, 2.53± 0.81; group III, 2.23± 0.94, (P< 0.001 and 60 minutes later (group I, 1.2± 0.46; group II, 1.98± 0.83; group III, 1.68± 0.75, (P< 0.001. VAS at different time intervals among the groups was also statistically significant. No adverse effects were observed. Conclusions : Oral drotaverine with mefenamic acid is effective in women undergoing hysteroscopy and endometrial biopsy.

  19. Amniotic Membrane-Derived Mesenchymal Cells and Their Conditioned Media: Potential Candidates for Uterine Regenerative Therapy in the Horse

    Science.gov (United States)

    Corradetti, Bruna; Correani, Alessio; Romaldini, Alessio; Marini, Maria Giovanna; Bizzaro, Davide; Perrini, Claudia; Cremonesi, Fausto; Lange-Consiglio, Anna

    2014-01-01

    Amniotic membrane-derived mesenchymal cells (AMCs) are considered suitable candidates for a variety of cell-based applications. In view of cell therapy application in uterine pathologies, we studied AMCs in comparison to cells isolated from the endometrium of mares at diestrus (EDCs) being the endometrium during diestrus and early pregnancy similar from a hormonal standpoint. In particular, we demonstrated that amnion tissue fragments (AM) shares the same transcriptional profile with endometrial tissue fragments (ED), expressing genes involved in early pregnancy (AbdB-like Hoxa genes), pre-implantantion conceptus development (Erα, PR, PGRMC1 and mPR) and their regulators (Wnt7a, Wnt4a). Soon after the isolation, only AMCs express Wnt4a and Wnt7a. Interestingly, the expression levels of prostaglandin-endoperoxide synthase 2 (PTGS2) were found greater in AM and AMCs than their endometrial counterparts thus confirming the role of AMCs as mediators of inflammation. The expression of nuclear progesterone receptor (PR), membrane-bound intracellular progesterone receptor component 1 (PGRMC1) and membrane-bound intracellular progesterone receptor (mPR), known to lead to improved endometrial receptivity, was maintained in AMCs over 5 passages in vitro when the media was supplemented with progesterone. To further explore the potential of AMCs in endometrial regeneration, their capacity to support resident cell proliferation was assessed by co-culturing them with EDCs in a transwell system or culturing in the presence of AMC-conditioned medium (AMC-CM). A significant increase in EDC proliferation rate exhibited the crucial role of soluble factors as mediators of stem cells action. The present investigation revealed that AMCs, as well as their derived conditioned media, have the potential to improve endometrial cell replenishment when low proliferation is associated to pregnancy failure. These findings make AMCs suitable candidates for the treatment of endometrosis in mares. PMID:25360561

  20. Alterações endometriais após embolização de leiomiomas uterinos avaliadas por ressonância magnética de alto campo (3 Tesla) / Endometrium evaluation with high-field (3-Tesla) magnetic resonance imaging in patients submitted to uterine leiomyoma embolization

    Scientific Electronic Library Online (English)

    Monica Amadio Piazza, Jacobs; Felipe, Nasser; Eduardo, Zlotnik; Marcos de Lorenzo, Messina; Ronaldo Hueb, Baroni.

    2013-03-01

    Full Text Available OBJETIVO: Avaliar alterações endometriais relacionadas à embolização de artérias uterinas para tratamento da leiomiomatose uterina sintomática (dor pélvica e/ou sangramento uterino), por meio de ressonância magnética de alto campo (3 Tesla). MÉTODOS: Estudo longitudinal e prospectivo, no qual foram [...] incluídas 94 pacientes com diagnóstico clínico e por imagem de leiomiomatose uterina sintomática, todas tratadas por meio de procedimento de embolização das artérias uterinas. As pacientes foram submetidas a avaliações por ressonância magnética de alto campo da pelve antes e 6 meses após o procedimento. Foram realizadas avaliações específicas do endométrio nas sequências ponderadas em T2 e nas sequências ponderadas em T1, antes e após a infusão endovenosa dinâmica do meio de contraste paramagnético. Diante dos resultados dessas medidas, foram realizadas análises estatísticas por meio de teste t de Student para comparação dos resultados obtidos antes e após o procedimento. RESULTADOS: Observou-se um aumento médio de 20,9% no sinal endometrial nas imagens ponderadas em T2 obtidas após o procedimento de embolização das artérias uterinas, quando comparadas com a avaliação pré-procedimento (p=0,0004). Nas imagens obtidas com a infusão endovenosa do meio de contraste paramagnético, foi observado um aumento médio de 18,7% na intensidade de sinal endometrial pós-embolização de artérias uterinas, quando comparadas com a medida pré-embolização (p Abstract in english 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

  1. Murine Endometrial and Decidual NK1.1+ Natural Killer Cells Display a B220+CD11c+ Cell Surface Phenotype1

    OpenAIRE

    Mallidi, Thomas V.; Craig, Laura E.; Schloemann, Suzanne R.; Riley, Joan K

    2009-01-01

    Uterine natural killer (uNK) cells accumulate at the maternal-fetal interface during gestation and are thought to have an important role during pregnancy in both mice and humans. While the cell surface phenotype of human uNK cells is increasingly well defined, less is known regarding the cell surface expression profile of murine uNK cells both before and during gestation. Herein, we demonstrate that murine NK1.1+ (KLRB1C) endometrial NK (eNK) cells, derived from virgin mice, and NK1.1+ decidu...

  2. Inhibition of Transforming Growth Factor-β Receptor signaling promotes culture expansion of undifferentiated human Endometrial Mesenchymal Stem/stromal Cells

    OpenAIRE

    Shanti Gurung; Jerome A. Werkmeister; Gargett, Caroline E.

    2015-01-01

    Human endometrial MSC (eMSC) are a novel source of MSC easily harvested from the highly regenerative uterine lining. We have developed protocols for eMSC isolation from single cell suspensions using magnetic bead-sorting using a perivascular marker antibody to SUSD2 and culture expansion in serum free medium (SFM). Similar to other MSC, eMSC spontaneously differentiate into fibroblasts during culture expansion decreasing their purity and efficacy. The aim of this study was to determine if A83...

  3. Aerobes and Levels of Estradiol and Progesterone in Cystic Endometrial Hyperplasia-Pyometra Complex Bitches

    Directory of Open Access Journals (Sweden)

    Xiuli Peng

    2011-01-01

    Full Text Available To determine which aerobic bacteria exert a marked effect on Cystic Endometrial Hyperplasia-Pyometra complex (CEH-P and to determine from where these bacteria originate. About 48 privately owned bitches were diagnosed with CEH-P. Healthy vagina and uterine samples were obtained with cotton pledgets and cumulative uterine fluids from CEH-P cysts were collected with a syringe in utero to isolate and identify aerobic bacterial. A total of 99 isolates were identified and the primary aerobe in the CEH-P bitches was found to be Escherichia coli (33/99. The levels of estrode in bitches with endometritis and in bitches with pyometra and estrus were higher than the levels in diestrus bitches (p<0.01. When ranked according to the levels of progesterone in a descending order (i.e., from high to low levels, the ranking was bitches with pyometra, bitches with endometritis, bitches in estrus and bitches in diestrus. These results suggest that in addition to common pathogenic bacteria differential in every area, casual bacterial contamination invariably occurred in bitches with CEH-P and the primary infection ascended from the vagina when the cervix was open. The researchers also inferred that both estrode and progesterone levels in CEH-P bitches were increased relative to the levels in healthy bitches and were even higher than that of the levels observed in estrus bitches. Estrode and progesterone pretreatment and uterine mucosa damage were interpreted as the preconditions for bacterial infection. The hormone levels in CEH-P bitches were similar to the endocrinal characteristics of peripartum bitches.

  4. Uterine torsion in term pregnancy

    Directory of Open Access Journals (Sweden)

    Sparić Radmila

    2007-01-01

    Full Text Available Introduction Uterine torsion has been defined as a rotation of more than 45 degrees of the uterus around its long axis that occurs at the junction between the cervix and the corpus. The extent of the rotation is usually 180 degrees, although cases with torsion from 60 to 720 degrees have been reported. Aetiopathogenesis of this condition is still unclear. Establishing clinical diagnosis of this condition is difficult, but very important for reducing maternal and fetal morbidity and mortality. Clinical symptoms are either absent or nonspecific, and the diagnosis is usually made at laparotomy. Case outlineA 31-year old patient was admitted to the Institute of Gynecology and Obstetrics, Clinical Center of Serbia, Belgrade, as an emergency, seven days upon the established intrauterine fetal demise in the 40th gestation week. On uterine examination, the cervical length of 1.5 cm and dilatation of 3 cm were determined, as well as a palpable soft tissue formation, not resembling placenta praevia. Ultrasound examination confirmed fetal demise and exclusion of the presence of placenta praevia. The labor was completed by caesarean section. During surgery, uterine torsion of 180 degrees to the right was diagnosed. There was a stillborn male baby, and the cause of death was intrauterine asphyxia. A fibrosing and calcified accessory lobe 9x6x2.5 cm in size was observed on placental examination, which is a possible sign of initial gemellary pregnancy. Conclusion The clinical presentation of uterine torsion is variable and clinical examination and ultrasonographic scanning may be insufficient for diagnosis. The method of choice for establishing the diagnosis is magnetic resonance imaging. Once the diagnosis of uterine torsion in pregnancy is established, emergency laparotomy is indicated. Following caesarean delivery, it is necessary to surgically remove all the anatomical causes of torsion, and rotate the uterus back to its normal position. There are some authors who suggest bilateral plication of the round ligaments as a preventive procedure for repeated torsion in puerperium and following pregnancies. The effectiveness of this method requires further investigation. It is necessary to have in mind the possibility of uterine torsion in all cases of abdominal pain during pregnancy and dystocia.

  5. Endometrial carcinoma occuring from polycystic ovary disease : A case report

    International Nuclear Information System (INIS)

    Endometrial carcinoma usually occurs in postmenopausal women ; less than 5% occurs in women under the age of 40. Up to one quarter of endometrial carcinoma patients below this age have PCO(polycystic ovary disease, Stein-Leventhal syndrome). The increased incidence of endometrial carcinoma in patients with PCO is related to chronic estrogenic stimulation. We report MR imaging in one case of endometrial carcinoma occuring in a 23 year old woman with PCO and had complained of hypermenorrhea for about three years. On T2-weighted MR image the endometrial cavity was seen to be distended with protruded endometrial masses of intermediate signal intensity, and the junctional zone was disrupted beneath the masses. Both ovaries were best seen on T2-weighted MR imaging and showed multiple small peripheral cysts and low signal-intensity central stroma

  6. Induced soft tissue sarcomas following radiation treatment for uterine carcinomas

    International Nuclear Information System (INIS)

    Twenty-two cases of sarcomas arising from irradiated soft tissues were observed in 531 patients operated on for soft tissue sarcomas over 38 years in our Department. Eleven women were initially irradiated for cervical cancer (ce-ca), two for endometrial cancers. The remaining nine patients were irradiated for other lesions, malignant or benign. The median interval between the radiation for uterine cancer and the outcome of clinical symptoms of a sarcoma was 18 years. Sarcomas more frequently arose in the posterior fields (buttock or sacral region in nine patients) than in the anterior (pubis, hypogastrium-four patients). The infiltration of skin was almost always present (10/13), in seven cases with an ulceration (7/13). Histologically, four hemangiosarcomas, four fibrosarcomas, three malignant fibrous histiocytomas and two neurofibrosarcomas were found. The irradiation administered to ce-ca patients consisted of radium (22.0 mcd to 58.0 mcd) and an external radiation from X-ray units (except in one case) from two pairs of two anterior and posterior fields, with skin doses of 3200 cGy to 4200 cGy directly on one field plus several hundreds cGy from the opposite field. Three-year overall survival rate was low (30%) similar to that observed in patients with primary high-grade (G-3) sarcomas. We observed more cases subjected to radiotherapy for cervical cancer than might be expected. (author)

  7. Usefulness of MRI in diagnosis of endometrial carcinoma and endometrial hyperplasia

    International Nuclear Information System (INIS)

    The study was to assess the usefulness of T2-weighted and enhanced T1-weighted MR images in differentiating endometrial adenocarcinoma and hyperplasia. The subjects were 21 patients with endometrial hyperplasia (Group A), consisting of 15 with cystic glandular hyperplasia and 6 with atypical hyperplasia, and 7 with endometrial adenocarcinoma (Group B). Six other patients with no evidence of abnormal endometrial findings served as controls. In Group A, the endometrium had a high signal intensity on T2-weighted images, and was 10 mm or over in thickness before menopause and 6 mm after menopause. It was also a high or intermediate signal intensity on enhanced T1-weighted images. In patiemts with cystic glandular hyperplasia, the junctional zone was 10 mm or over on T2-weighted images. Similar findings were seen on enhanced T1-weighted images. In patients with atypical hyperplasia, the junctional zone disappeared or decreased on enhanced images compared with those on T2-weighted images. In group B, the endometrium had an intermediate or high signal intensity on T2-weighted images, with the junctional zone being 10 mm or more. Enhanced T1-weighted images showed lower signal intensities in the tumorous area than in the normal endometrium and muscular layer. These findings indicated that enhanced MR imaging may be useful in diagnosing endometrial lesions. (N.K.)

  8. Magnetic resonance imaging in the preoperative staging of endometrial carcinoma

    OpenAIRE

    Cabrita, S; Rodrigues, H.; Abreu, R; Martins, M; Teixeira, L.; C. Marques; Mota, F; Oliveira, CF

    2008-01-01

    PURPOSE OF INVESTIGATION: Magnetic resonance imaging (MRI) has emerged as an important imaging modality in the evaluation of the extension of endometrial carcinoma which is essential in planning treatment and predicting prognosis. This study aimed to assess the value of MRI in the preoperative staging of endometrial carcinoma. METHODS: We included in this study 162 patients with a histological diagnosis of endometrial carcinoma who underwent MRI pelvic imaging and surgical staging. MRI images...

  9. Potassium channels and uterine function

    OpenAIRE

    Brainard, Adam M.; Korovkina, Victoria P.; England, Sarah K.

    2007-01-01

    Ion channels are effector proteins that mediate uterine excitability throughout gestation. This review will focus primarily on the role of potassium channels in regulating myometrial tone in pregnancy and labor contractions. During gestation, potassium channels maintain the uterus in a state of quiescence by contributing to the resting membrane potential and counteracting contractile stimuli. This review summarizes the current knowledge about the significance of the potassium channels in main...

  10. True incidence of uterine adenomatoid tumors

    OpenAIRE

    Nakayama, Hirofumi; TERAMOTO, HIDEKI; TERAMOTO, MITSUE

    2013-01-01

    Uterine adenomatoid tumors (UATs) are benign tumors of the uterine serosa and myometrium that originate from the mesothelium and forming gland-like structures. This study was conducted in order to determine the true incidence of UATs, which are usually an incidental finding during uterine surgery performed for other causes. UATs may resemble pre-existing vessels and lymphatic ducts, as well as metastatic adenocarcinomas. A total of 199 consecutive surgical operations (134 hysterectomies and 6...

  11. A CASE REPORT ON UTERINE AV MALFORMATION IN LOWER UTERINE SEGMENT PLACENTAL IMPLANTATION

    Directory of Open Access Journals (Sweden)

    Hima

    2014-02-01

    Full Text Available Uterine Arterio - venous malformations (AVM are rare and potentially life threatening condition. AV malformations may be congenital or acquired. We report a case of acquired uterine AV malformation at the placental implantation site in the lower uterine segment which complicated the diagnosis

  12. Early second trimester uterine scar rupture

    OpenAIRE

    Bharatnur, Sunanda; Hebbar, Shripad; G, Shyamala

    2013-01-01

    Spontaneous uterine scar rupture can be lethal in pregnant women. A spontaneous uterine scar rupture in the early mid-trimester is rare and difficult to diagnose. This is a case of a 30-year-old woman (G2P1L1) at 19?weeks of gestation and having undergone a previous caesarean section presented with acute abdomen in shock. Laparotomy revealed a uterine scar rupture, which was resutured after evacuation of products of conception. This case merits that the uterine rupture should be considered as...

  13. [Chronic renal failure secondary to uterine prolapse].

    Science.gov (United States)

    Peces, R; Canora, J; Venegas, J L

    2005-01-01

    Acute and chronic renal failure secondary to bilateral severe hydroureteronephrosis is a rare sequela of uterine prolapse. We report a case of neglected complete uterine prolapse in a 72-year-old patient resulting in bilateral hydroureter, hydronephrosis, and chronic renal failure. In an attempt to diminish the ureteral obstruction a vaginal pessary was used to reduce the uterine prolapse. Finally, surgical repair of prolapse by means of a vaginal hysterectomy was performed. In conclusion, all patients presenting with complete uterine prolapse should be screened to exclude urinary tract obstruction. If present, obstructive uropathy should be relieved by the reduction or repair of the prolapse before irreversible renal damage occurs. PMID:15912657

  14. Human Endometrial Transcriptomics: Implications for Embryonic Implantation.

    Science.gov (United States)

    Gómez, Eva; Ruíz-Alonso, Maria; Miravet, Jose; Simón, Carlos

    2015-07-01

    Human endometrium has been extensively investigated in the search for markers capable of predicting its receptive status. The completion of the Human Genome Project has triggered a rapid development of new fields in molecular biology, the "transcriptomics" being a major turning point in the knowledge acquisition of endometrial receptivity. Based on this, a customized Endometrial Receptivity Array (ERA) has been developed, which is capable of identifying the genomic signature of receptivity. This diagnostic tool showed that the window of implantation (WOI) is displaced in one out of four patients with implantation failure, allowing the identification of their personalized WOI. This strategy allows performing a personalized embryo transfer (pET) on the day in which the endometrium is receptive. The combination of a systems biology approach and next-generation sequencing will overcome the limitations of microarrays, and will, in the future, allow elucidation of the mechanisms involved in embryo implantation. PMID:25818663

  15. Assessment of leukemia inhibitory factor and glycoprotein 130 expression in endometrium and uterine flushing: a possible diagnostic tool for impaired fertility

    Directory of Open Access Journals (Sweden)

    Tawfeek Manal A

    2012-04-01

    Full Text Available Abstract Background Uterine receptivity and implantation are complex processes requiring coordinated expression of molecules by zygote and uterus. Our objective was to evaluate the role of the endometrial expression of leukemia inhibitory factor (LIF and its glycoprotein 130 (gp130 receptor molecules and their secretion in uterine flushing during the window of implantation in cases of primary unexplained infertility Case presentation The study was conducted on 25 infertile women with unexplained infertility for at least two years and 10 normal fertile women as a control group . Endometrial tissue and uterine flushing were obtained. Each tissue specimen was divided into two pieces; one piece was used for histological dating of the endometrium and for immunostaining of progesterone receptors, and the second was used for RNA extraction and PCR assay of LIF and gp130 mRNA expression. Serum estrogen and progesterone were measured for all subjects. LIF mRNA was expressed in the endometrium of all normal fertile women but significantly decreased in infertile women. LIF was not detectable in 88% of infertile women while it was fairly detectable in 12% of them. Gp130 mRNA was hardly detectable in both fertile and infertile women with no difference between them. Infertile women secreted significantly less LIF and gp130 molecules in the uterine flushing compared with normal fertile women. Conclusions Expression of LIF mRNA in endometrium could be used as a molecular marker of unexplained infertility. Assessment of secreted LIF and gp130 molecules in uterine flushing could be another useful and safe method for predicting successful implantation as well as for diagnosing and eventually treating women with impaired fertility using recombinant human LIF.

  16. Large cell neuroendocrine carcinoma originating from the uterine endometrium: a report on magnetic resonance features of 2 cases with very rare and aggressive tumor

    Directory of Open Access Journals (Sweden)

    Natsuko Makihara

    2012-06-01

    Full Text Available Neuroendocrine carcinomas (NEC of the female genital tract are aggressive and uncommon tumors, which usually involve the uterine cervix and ovary, and are seen very rarely in the endometrium. Only less than 10 cases of large cell NEC (LCNEC of the endometrium have been reported in the literature and their radiological findings are not well described. We report here two cases of pathologically proven LCNEC of the uterine endometrium. In both cases, the uterine body was enlarged and the tumor occupied part of the uterine cavity. Endometrial mass exhibited heterogeneous high intensity on T2-weighted magnetic resonance (MR images, and diffusion-weighted MR images revealed high intensity throughout the tumor, consistent with malignancy. LCNEC is a highly malignant neoplasm without particular findings in terms of diagnostic imaging and pathology, so its preoperative definitive diagnosis is very difficult. However, when laboratory test, pathologic diagnosis and MR imaging suggest a poorly differentiated uterine malignancy, positron emission tomography-computed tomography scan should be performed as a general assessment to help with diagnosis.

  17. Effects of oral treatment with N-acetylcysteine on the viscosity of intrauterine mucus and endometrial function in estrous mares.

    Science.gov (United States)

    Witte, T S; Melkus, E; Walter, I; Senge, B; Schwab, S; Aurich, C; Heuwieser, W

    2012-10-01

    Persistent breeding-induced endometritis is ranked as the third most common medical problem in the adult mare and leads to enormous economic loss in horse breeding. In mares suffering from persistent breeding-induced endometritis, increased amounts of intrauterine (i.u.) fluid or viscous mucus in estrus or after breeding may act as a barrier for sperm and can contribute to low fertility. Current therapies of these mares aim to eliminate i.u. fluid and mucus by uterine lavage and/or administration of ecbolic drugs. Recently, i.u. administration of N-acetylcysteine (NAC) has been shown to support therapy in mares with endometritis. It was the objective of the present study to investigate effects of an oral administration of NAC on the viscosity of i.u. fluid in estrous mares. It was hypothesized that oral treatment with NAC reduces the viscosity of i.u. fluid and has a positive effect on the inflammatory response of the endometrium. Mares (n = 12) were included in the study as soon as estrus was detected (ovarian follicle >3.0 cm and endometrial edema), which was defined as Day 1. They were randomly assigned to a treatment (10 mg/kg NAC on Days 1-4) or a control group (no treatment). On days 1 and 5 i.u. mucus was collected and its rheologic properties were accessed. On Day 5, endometrial biopsies were obtained and evaluated for integrity of the luminal epithelium, number of polymorphonuclear neutrophils (PMN), staining for cyclooxygenase 2 (COX2), staining with Kiel 67 antigen (Ki-67), lectins and periodic acid Schiff (PAS). In the treatment group, viscosity of i.u. mucus increased significantly between Days 1 and 5 (P NAC treatment the mean number of PMN in endometrial biopsies was significantly lower compared to mares of the control group (1.9 ± 0.3 vs. 4.8 ± 0.4; P NAC treatment compared to control mares (P mucus in deep uterine glands differed significantly between groups (both P NAC treatment does not reduce viscosity of uterine mucus but has an antiinflammatory effect on the equine endometrium. PMID:22819282

  18. Feasibility investigation of allogeneic endometrial regenerative cells

    OpenAIRE

    Reid Michael; Woods Erik J; Min Wei-Ping; Wang Hao; Riordan Neil H; Ichim Thomas E; Patel Amit N; Zhong Zhaohui; Mansilla Eduardo; Marin Gustavo H; Drago Hugo; Murphy Michael P; Minev Boris

    2009-01-01

    Abstract Endometrial Regenerative Cells (ERC) are a population of mesenchymal-like stem cells having pluripotent differentiation activity and ability to induce neoangiogenesis. In vitro and animal studies suggest ERC are immune privileged and in certain situations actively suppress ongoing immune responses. In this paper we describe the production of clinical grade ERC and initial safety experiences in 4 patients with multiple sclerosis treated intravenously and intrathecally. The case with t...

  19. Endoplasmic Reticulum Stress in Endometrial Cancer

    OpenAIRE

    Ulianich, Luca; Insabato, Luigi

    2014-01-01

    Endometrial cancer (EC) is a common gynecologic malignancy often diagnosed at early stage. In spite of a huge advance in our understanding of EC biology, therapeutic modalities do not have significantly changed over the past 40?years. A restricted number of genes have been reported to be mutated in EC, mediating cell proliferation and invasiveness. However, besides these alterations, few other groups and ourselves recently identified the activation of the unfolded protein response (UPR) and G...

  20. Endometrial Scratch-Suction and Implantation Failure

    OpenAIRE

    Wael S. Nossair; Manal M. El Behery; Mohamed Al S. Farag

    2014-01-01

    Objective: The aim of this trial was to determine whether endometrial scratch-suction caused by insertion tube of (IUCD) with suction improved the probability of pregnancy in the subsequent IVF cycle in patients who had previous failed IVF outcome by removing small polyps and any hazardous materials. Design: Observational prospective cohort experimental study. Setting: Zagazig University Hospital, Obstetrics and Gynecology department. From period between September 20...

  1. The epidemiology of endometrial and ovarian cancer.

    Science.gov (United States)

    Cramer, Daniel W

    2012-02-01

    This review highlights similarities in the epidemiology of endometrial and ovarian cancer, including highly correlated incidence rates and similar risk factor profiles. Factors that decrease risk for both cancers include a late menarche, early age at first birth, giving birth and breastfeeding, and use of oral contraceptives. Short or irregular cycles and late menopause are associated with increased risk for both. Other risk factors that appear to operate in a similar direction include decreased risk associated with IUD use or a tubal ligation, and increased risk associated with obesity, lack of exercise, and use of talc powders in genital hygiene. Estrogen excess is proposed as the underlying mechanism for most endometrial cancers, whereas incessant ovulation has been suggested as the explanation for ovarian cancer. However, an increased number of estimated ovulatory cycles correlates directly with risk for both endometrial and ovarian cancer, suggesting that reproductive tissue turnover with an accumulation of PTEN or p53 mutations represents a possible common mechanism. An immune-based explanation involving mucin proteins represents another common mechanism that could explain additional risk factors. Maintenance of ideal weight, breastfeeding children, use of oral contraceptives, and avoidance of talc powders in genital hygiene are measures that could lower the risk for both types of cancer. Careful selection of patients for prophylactic oophorectomy for those women who are coming to hysterectomy for benign disease is an additional measure to consider for ovarian cancer. PMID:22244658

  2. Efficacy of transcatheter uterine artery embolization for treating emergency hemorrhage obstetrics and gynecology

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy of selective iliac artery embolization (TAE) or uterine artery embolization (UAE) for treatment of emergency hemorrhage in obstetrics and gynecology. Methods: Selective bilateral TAE or UAE were performed on 59 patients with acute cervical hemorrhage from postpartum hemorrhage (30), cervical cancer (16), endometrial cancer (8), and choriocarcinoma (5). Gelfoam particles were used in postpartum hemorrhage; chemotherapeutics and Iodipin suspension were used in malignancy. Results: Bleeding was stopped completely in all 59 patients with TAE or UAE procedure time of 30-50 minutes (mean: 42.17±4.78 minutes). There were no serious complications. Conclusion: TAE or UAE are effective for treating emergency hemorrhage in obstetrics and gynecology. (authors)

  3. Ly49 knockdown in mice results in aberrant uterine crypt formation and impaired blastocyst implantation.

    Science.gov (United States)

    Leon, Lucy; Felker, Allison M; Kay, Vanessa R; Tu, Megan M; Makrigiannis, Andrew P; Croy, B Anne

    2016-03-01

    Genetic knockdown (KD) of the mouse Ly49 receptor family is reported to result in infertility despite the presence of zona-enclosed blastocysts in the uterus. Ly49 receptors regulate leukocyte functions particularly Natural Killer (NK) cell functions and are analogous to human killer immunoglobulin-like receptors (KIRs). Histological analyses of gd3.5-4.5 B6.Ly49(KD) uteri identified hatched but retarded blastocysts with pyknotic nuclei, aberrant endometrial crypt formation and impaired uterine lumen closure accompanied by a lack of primary decidualization These data support peri-implantation roles for leukocytes expressing the Ly49 receptor repertoire and may give insight into KIR-based regulation of human infertility. PMID:26992687

  4. Uterine sarcoma incidental in infertile women: experience in a tropical hospital

    International Nuclear Information System (INIS)

    Uterine sarcoma is an uncommon gynaecological malignancy. Diagnosis in its early stage and management is challenging especially in a resource poor setting. The objective of the study is to evaluate the clinico-pathologic presentation of uterine sarcoma in 9 subfertile patients that underwent surgery for seemingly benign uterine diseases. Nine consecutive infertile women with intra-operative diagnosis of uterine sarcoma were reviewed over a period of 5.5 years. The nine patients were pre-operatively misdiagnosed with uterine fibroid in 7 (77.8%) patients and adenomyosis uteri in 2 (22.2%) patients. The patients mean age was 39.2 years with a range of 36 to 47 years. Parity ranged from para 0 to para 3. Of the nine patients, 7 (77.8%) presented with secondary infertility and two (22.2%) patients with primary infertility. Clinical presentations were mainly abdomino - pelvic mass (100%), pelvic pain (77.8%) and abnormal uterine bleeding in (77.8%) of patients. Three (33.3%) of the 9 patients had history of myomectomy. Pre-operative hysterosalpingogram revealed that six (66.7%) patients had bilateral tubal blockage, two (22.2%) patients had unilateral tubal blockage and one (11.1%) patient had bilateral patent fallopian tubes. Six (66.7%) patients had hydrosalpinges. Clinical staging of malignancy was stage Ic in seven patients, stage IIa and IIb in the remaining two patients. Histologic classifications were leiomyosarcoma in six patients and endometrial stromal sarcoma in three patients. Treatments offered were surgery alone in six (66.7%) patients, surgery with adjuvant chemotherapy for 2 (22.2%) patients and one (11.1%) patient had surgery with adjuvant radiotherapy. Case fatality was 77.8% with a year of diagnosis. In a resource constrained setting, due to limitations in making diagnosis in the early stage of the disease, a high index of suspicion is needed in all elderly infertile women presenting with seemingly benign abdomino pelvic mass. (author)

  5. Uterine rupture without previous caesarean delivery

    DEFF Research Database (Denmark)

    Thisted, Dorthe L A; Mortensen, Laust H; Krebs, Lone

    2015-01-01

    uterine rupture when adjusted for parity, epidural analgesia and augmentation by oxytocin. CONCLUSION: Although uterine rupture is rare, its association with epidural analgesia and augmentation of labour with oxytocin in multipara should be considered. Thus, vigilance should be exercised when labour is...

  6. Acute Renal Failure after Uterine Artery Embolization

    International Nuclear Information System (INIS)

    Renal failure is a potential complication of any endovascular procedure using iodinated contrast, including uterine artery embolization (UAE). In this report we present a case of acute renal failure (ARF) following UAE performed as a treatment for uterine fibroids. The likely causes of ARF in this patient are explored and the possible etiologies of renal failure in patients undergoing UAE are reviewed

  7. Sonohysterographic findings of endometrial abnormalities in women with polycystic ovarian disease

    International Nuclear Information System (INIS)

    To describe the sonohysterographic findings of endometrial abnormalities, and to determine the usefulness of sonohysterography (SH) for predicting endometrial abnormalities in women with polycystic ovarian disease(PCOD). 82 patients with PCOD who had vaginal bleeding or endometrial thickening and lesion mass on baseline transvaginal sonography were prospectively examined with SH. The SH findings were evaluated for endometrial thickness, the presence of endometrial thickening and lesion mass, echogenicity and surface contour, distensibility of the endometrial cavity, and disruption of endometrial-myometrial interface. These findings were compared with the pathologic findings and the diagnostic accuracy of SH for predicting endometrial abnormalities was assessed. Endometrial abnormalities were identified in 47 (57.3%) of 82 PCOD patients, and their pathologic diagnosis included endometrial carcinoma in 7 cases, hyperplasia in 19 cases (atypical hyperplasia, n=5), and polyp in 21 cases. Of the 35 patients who did not have endometrial abnormalities, there was disordered proliferative endometrium in 18 cases and normal proliferative or secretory endometrium in 17 cases. The SH findings of endometrial carcinoma were endometrial thickening in 5 cases, endometrial thickening and lesion mass in 2 cases, and the endometrial thickness ranged from 6 mm to 15 mm (mean 9.5 mm). They were characterized as a diffuse polyploid endometrial thickening or a sessile endometrial mass with irregular surface, homogeneous hyperechogenicity, and obliteration of the endometrial cavity. Endometrial hyperplasia appeared as endometrial thickening in 14 cases, endometrial lesion mass in 3 cases, and endometrial thickening and lesion mass in 2 cases, and the endometrial thickness was between 6.5-10.7 mm (mean 8.2 mm). They showed a diffuse uniform endometrial thickening or a polyploid endometrial lesion mass with homogeneous hyperechogenicity and a regular surface. Endometrial polyps appeared as endometrial mass in 19 cases, and focal endometrial thickening and endometrial thickening and lesion mass occurred in one case each, respectively. They had a homogeneously echogenic, polyploid endometrial mass with a regular surface. 16 cases with disordered proliferative endometrium had endometrial thickening, measuring between 5.5 to 9.2 mm (mean 6.8 mm) in thickness, which were homogeneously hyperechoic and smooth surfaced, and one case each had an endometrial mass and an endometrial thickening with mass. The endometrial thickness of endometrial carcinoma and hyperplasia was significantly higher than those of disordered proliferative endometrium (p=0.002). Endometrial abnormalities could be excluded hen the endometrial thickness was less than 6 mm. An endometrial thickness of 7 mm or greater was most useful parameter for the differentiation of endometrial carcinoma and hyperplasia from disordered proliferative endometrium with a sensitivity of 82.6%, a specificity of 82.4%, an accuracy of 82.5%, a positive predictive value of 76%, and a negative predictive value of 87.5%. Using endometrial thickening greater than 7 mm and the abnormal findings as the positive findings for predicting endometrial abnormalities in PCOD patients, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SH were 95.7%, 77.1%, 87.8%, 84.9%, and 93.1%, respectively. The SH findings were accurate and could be useful for predicting endometrial abnormalities for women with PCOD.

  8. Sonohysterographic findings of endometrial abnormalities in women with polycystic ovarian disease

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Ju [Ajou University School of Medicine, Suwon (Korea, Republic of)

    2004-06-15

    To describe the sonohysterographic findings of endometrial abnormalities, and to determine the usefulness of sonohysterography (SH) for predicting endometrial abnormalities in women with polycystic ovarian disease(PCOD). 82 patients with PCOD who had vaginal bleeding or endometrial thickening and lesion mass on baseline transvaginal sonography were prospectively examined with SH. The SH findings were evaluated for endometrial thickness, the presence of endometrial thickening and lesion mass, echogenicity and surface contour, distensibility of the endometrial cavity, and disruption of endometrial-myometrial interface. These findings were compared with the pathologic findings and the diagnostic accuracy of SH for predicting endometrial abnormalities was assessed. Endometrial abnormalities were identified in 47 (57.3%) of 82 PCOD patients, and their pathologic diagnosis included endometrial carcinoma in 7 cases, hyperplasia in 19 cases (atypical hyperplasia, n=5), and polyp in 21 cases. Of the 35 patients who did not have endometrial abnormalities, there was disordered proliferative endometrium in 18 cases and normal proliferative or secretory endometrium in 17 cases. The SH findings of endometrial carcinoma were endometrial thickening in 5 cases, endometrial thickening and lesion mass in 2 cases, and the endometrial thickness ranged from 6 mm to 15 mm (mean 9.5 mm). They were characterized as a diffuse polyploid endometrial thickening or a sessile endometrial mass with irregular surface, homogeneous hyperechogenicity, and obliteration of the endometrial cavity. Endometrial hyperplasia appeared as endometrial thickening in 14 cases, endometrial lesion mass in 3 cases, and endometrial thickening and lesion mass in 2 cases, and the endometrial thickness was between 6.5-10.7 mm (mean 8.2 mm). They showed a diffuse uniform endometrial thickening or a polyploid endometrial lesion mass with homogeneous hyperechogenicity and a regular surface. Endometrial polyps appeared as endometrial mass in 19 cases, and focal endometrial thickening and endometrial thickening and lesion mass occurred in one case each, respectively. They had a homogeneously echogenic, polyploid endometrial mass with a regular surface. 16 cases with disordered proliferative endometrium had endometrial thickening, measuring between 5.5 to 9.2 mm (mean 6.8 mm) in thickness, which were homogeneously hyperechoic and smooth surfaced, and one case each had an endometrial mass and an endometrial thickening with mass. The endometrial thickness of endometrial carcinoma and hyperplasia was significantly higher than those of disordered proliferative endometrium (p=0.002). Endometrial abnormalities could be excluded hen the endometrial thickness was less than 6 mm. An endometrial thickness of 7 mm or greater was most useful parameter for the differentiation of endometrial carcinoma and hyperplasia from disordered proliferative endometrium with a sensitivity of 82.6%, a specificity of 82.4%, an accuracy of 82.5%, a positive predictive value of 76%, and a negative predictive value of 87.5%. Using endometrial thickening greater than 7 mm and the abnormal findings as the positive findings for predicting endometrial abnormalities in PCOD patients, the sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of SH were 95.7%, 77.1%, 87.8%, 84.9%, and 93.1%, respectively. The SH findings were accurate and could be useful for predicting endometrial abnormalities for women with PCOD.

  9. Endometrial safety of ultra-low-dose estradiol vaginal tablets

    DEFF Research Database (Denmark)

    Simon, James; Nachtigall, Lila; Ulrich, Lian G; Eugster-Hausmann, Michaela; Gut, Robert

    2010-01-01

    To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17ß-estradiol vaginal tablets in postmenopausal women with vaginal atrophy.......To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17ß-estradiol vaginal tablets in postmenopausal women with vaginal atrophy....

  10. Endometrial safety of ultra-low-dose estradiol vaginal tablets

    DEFF Research Database (Denmark)

    Simon, James; Nachtigall, Lila; Ulrich, Lian G; Eugster-Hausmann, Michaela; Gut, Robert

    2010-01-01

    To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17β-estradiol vaginal tablets in postmenopausal women with vaginal atrophy.......To evaluate the endometrial hyperplasia and carcinoma rate after 52-week treatment with ultra-low-dose 10-microgram 17β-estradiol vaginal tablets in postmenopausal women with vaginal atrophy....

  11. Endometrial Adenocarcinoma Presenting in a Premenopausal Patient with Tuberous Sclerosis

    Science.gov (United States)

    Jaffe, J. S.; Chambers, J. T.

    2005-01-01

    Background: Endometrial adenocarcinoma is very uncommon in women under 40 years of age. Case: A 39-year-old woman with tuberous sclerosis and severe intellectual disability presented with irregular bleeding unresponsive to oral contraceptive therapy. She was subsequently found to have a deeply invasive endometrial adenocarcinoma. Conclusion:…

  12. Human Endometrial CD98 Is Essential for Blastocyst Adhesion

    Science.gov (United States)

    Domínguez, Francisco; Simón, Carlos; Quiñonero, Alicia; Ramírez, Miguel Ángel; González-Muñoz, Elena; Burghardt, Hans; Cervero, Ana; Martínez, Sebastián; Pellicer, Antonio; Palacín, Manuel; Sánchez-Madrid, Francisco; Yáñez-Mó, María

    2010-01-01

    Background Understanding the molecular basis of embryonic implantation is of great clinical and biological relevance. Little is currently known about the adhesion receptors that determine endometrial receptivity for embryonic implantation in humans. Methods and Principal Findings Using two human endometrial cell lines characterized by low and high receptivity, we identified the membrane receptor CD98 as a novel molecule selectively and significantly associated with the receptive phenotype. In human endometrial samples, CD98 was the only molecule studied whose expression was restricted to the implantation window in human endometrial tissue. CD98 expression was restricted to the apical surface and included in tetraspanin-enriched microdomains of primary endometrial epithelial cells, as demonstrated by the biochemical association between CD98 and tetraspanin CD9. CD98 expression was induced in vitro by treatment of primary endometrial epithelial cells with human chorionic gonadotropin, 17-?-estradiol, LIF or EGF. Endometrial overexpression of CD98 or tetraspanin CD9 greatly enhanced mouse blastocyst adhesion, while their siRNA-mediated depletion reduced the blastocyst adhesion rate. Conclusions These results indicate that CD98, a component of tetraspanin-enriched microdomains, appears to be an important determinant of human endometrial receptivity during the implantation window. PMID:20976164

  13. Failure of a single dose of medroxyprogesterone acetate to induce uterine infertility in postnatally treated domestic cats.

    Science.gov (United States)

    Lopez Merlo, M; Faya, M; Blanco, P G; Carransa, A; Barbeito, C; Gobello, C

    2016-03-01

    In mice and sheep, neonatal administration of progesterone or progestins inhibited development of uterine glands. The aims of the present study were (1) to describe uterine gland development on postnatal Days 6 to 8 and (2) to evaluate the effects of a single postnatal administration of a progestin on reproduction and adult uterine glands morphology and function in domestic cats. Necropsy was performed on three 1-week-old female cats which had died unrelated to this study. Ten female kittens were randomly assigned within the first 24 hours of birth to: medroxyprogesterone acetate 10 mg/animal subcutaneously (MPA; n = 6) or placebo (PLC; n = 4) and followed up until puberty when they were mated. Twenty-four days after the end of estrus, ovulation and pregnancy were diagnosed by serum progesterone measurement and ultrasonography, respectively. Then, all the cats were ovariohysterectomized. After necropsy or surgery, the excised organs were histologically evaluated. Seven queens ovulated (4 of 6 MPA and 3 of 4 PLC; P > 0.1) and were pregnant (P > 0.1). Four MPA cats presented endometrial hyperplasia and one of them developed a pyometra. The 1-week-old females presented uterine glands in the stage of budding and incipient penetration of the glandular epithelium into the underlying stroma. The MPA-treated queens revealed that the area occupied by uterine glands per square-micrometer (0.55 ± 0.2 vs. 0.49 ± 0.2; P > 0.1) and the height of the glandular epithelium (?m; 24.5 ± 6.7 vs. 24.4 ± 7.2; P > 0.1) did not differ from those of the PLC group. Neither significant gross nor microscopical differences were also found for ovaries (P > 0.1). It is concluded that 1-week-old kittens had an incipient stage of uterine gland development and that a single postnatal supraphysiological dose of MPA did not alter uterine adenogenesis in this species. Furthermore, this treatment seemed to predispose to uterine disease without prevention of fertility. PMID:26534826

  14. Early second trimester uterine scar rupture.

    Science.gov (United States)

    Bharatnur, Sunanda; Hebbar, Shripad; Shyamala, G

    2013-01-01

    Spontaneous uterine scar rupture can be lethal in pregnant women. A spontaneous uterine scar rupture in the early mid-trimester is rare and difficult to diagnose. This is a case of a 30-year-old woman (G2P1L1) at 19 weeks of gestation and having undergone a previous caesarean section presented with acute abdomen in shock. Laparotomy revealed a uterine scar rupture, which was resutured after evacuation of products of conception. This case merits that the uterine rupture should be considered as a differential diagnosis in pregnant women presenting with acute abdomen. In this case, although there was uterine rupture in the second trimester and a complete placental separation, fetus was alive which is quite unusual in patients presenting with rupture uterus. PMID:24326433

  15. Polyarteritis nodosa with uterine involvement

    International Nuclear Information System (INIS)

    Polyarteritis nodosa (PAN) is characterized by multisystem necrotizing vasculitis, primarily affecting small-to-medium-sized muscular arteries, and it is typically found in middle-aged men. PAN is rarely found in the female genital tract (including the uterus), and imaging of the uterus with PAN has not previously been reported. Reported is a case of a 78-year-old patient with uterus enlargement who was diagnosed with PAN through clinical findings and images. Computed tomography and magnetic resonance imaging findings of a uterus affected by PAN are presented and reviewed, and potential characteristic findings of the uterine with PAN are discussed

  16. Long-term results of symptomatic fibroids treated with uterine artery embolization: In conjunction with MR evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Man Deuk [Department of Diagnostic Radiology Bundang CHA General Hospital, Pochon CHA University (Korea, Republic of)], E-mail: mdkim@cha.ac.kr; Lee, Hyun Seok [Department of Diagnostic Radiology Bundang CHA General Hospital, Pochon CHA University (Korea, Republic of); Lee, Mee Hwa [Department of Obstetrics and Gynecology, Bundang CHA General Hospital, Pochon CHA University (Korea, Republic of); Kim, Hee Jin [Department of Diagnostic Radiology Bundang CHA General Hospital, Pochon CHA University (Korea, Republic of); Cho, Jin Ho; Cha, Sun Hee [Department of Obstetrics and Gynecology, Bundang CHA General Hospital, Pochon CHA University (Korea, Republic of)

    2010-02-15

    Objective: The aim of the present study is to determine long-term clinical efficacy of uterine fibroid embolization (UFE) for symptomatic fibroids in conjunction with MR evaluation. Materials and methods: Sixteen patients with a follow-up period of 4 years or longer were analyzed retrospectively. Ages ranged from 27 to 45 (mean 39.5) years. Mean follow-up periods were 5.8 years (range: 4.1-6.9 years). The symptom changes, in terms of menorrhagia and dysmenorrhea and bulk-related symptoms, were assessed. The primary embolic agent was polyvinyl alcohol particle (250-710 {mu}m). All patients underwent preprocedural and long-term follow up MR imaging. Uterine volumes were calculated using MRI. Results: Symptom improvements were reported for menorrhagia (8/9, 88.9%), dysmenorrhea (5/5, 100%), and bulk-related symptoms (7/9, 77.8%) at long-term follow up. Two patients (12.5%) had symptom recurrences at long-term follow-up. Tumor regrowth from incomplete infarction was a cause of recurrence in one patient and newly developed leiomyomas in the other one. One patient underwent hysterectomy because endometriosis developed 4 years after UFE. Of the 14 necrotic myomas on short-term follow up MR after UFE, eight (57.1%) demonstrated maintaining necrosis with further shrinkage and six (42.9%) were no longer visualized on long-term follow up MR images. Overall, the mean volume reduction rates of the predominant fibroid and uterus were 80.5%, 36.7% at long-term follow up, respectively. Conclusion: UFE is an effective treatment for symptomatic fibroids with an acceptable long-term success rate. Long-term MR imaging after UFE revealed persistent necrotic fibroid, non-visualization of fibroids and tumor regrowth when incompletely infarcted.

  17. Low-grade endometrial stromal sarcoma developing in a postmenopausal woman under toremifene treatment for breast cancer.

    Science.gov (United States)

    Kashiyama, Tomoko; Oda, Katsutoshi; Kawana, Kei; Arimoto, Takahide; Kanetaka, Yukiko; Takazawa, Yutaka; Maeda, Daichi; Nakagawa, Shunsuke; Yano, Tetsu; Kozuma, Shiro

    2013-01-01

    Low-grade endometrial stromal sarcoma (ESS) is a rare neoplasm that is generally estrogen-receptor- and progesterone-receptor-positive and develops in premenopausal women. Although tamoxifen treatment is associated with an increased risk of ESS, the effect of other selective estrogen receptor modulators, including toremifene, on the risk of ESS is not clear. A 61-year-old postmenopausal woman was treated with toremifene as an adjuvant therapy for breast cancer. A cystic mass developed during the treatment, with gradual growth in the uterine myometrium. The patient was treated with hysterectomy and bilateral salpingo-oophorectomy, and the tumor was diagnosed as low-grade ESS (stage IA) with estrogen-receptor and progesterone-receptor. The patient discontinued toremifene and has been progression-free for 21 months. Our data suggest that toremifene might be associated with the development of ESS in certain patients through its estrogen-like effects in the uterus. PMID:22690656

  18. Miomatosis uterina e infertilidad: indicaciones de tratamiento convencional Conventional treatment for uterine myomatosis - induced infertility

    Directory of Open Access Journals (Sweden)

    Jaime Saavedra

    2003-06-01

    Full Text Available Los fibromas son relativamente comunes en las pacientes en edad reproductiva y son exclusivamente responsables de infertilidad y abortos en una pequeña (5% pero significante proporción de pacientes. Aproximadamente el 50% de las mujeres con infertilidad y miomas uterinos se embarazan después de miomectomía. Una proporción relativamente alta de mujeres con historia de abortos recurrentes se embaraza después miomectomía. Lo más importante, hay una disminución significativa en la tasa de abortos en el primer y segundo trimestre. La evidencia sugiere que la mayoría de mujeres que desean embarazarse son capaces de hacerlo en el primer año, con una caída de estas tasas en forma aguda después de este tiempo. Esto se puede atribuir a la recurrencia de los fibromas. Por tanto, la cirugía se debería realizar cuando la mujer esté lista para iniciar una familia. El sitio, número y tamaño de los miomas así como la experiencia del cirujano junto con la preferencia de la paciente puede influenciar la opción del manejo. Son indicaciones para realizar cirugía en una mujer que esté considerando la posibilidad de embarazo por los métodos naturales o por reproducción asistida la presencia de un mioma submucoso o un mioma intramural que distorsione la cavidad uterina, fibromas mayores de 5 centímetros y múltiples fibromas. Para fibromas intramurales menores de 5 centímetros y múltiples fibromas. Para fibromas intramurales menores de 5 centímetros y fibromas subserosos la historia reproductiva debe ser una consideración importante en la determinación en lo tocante a la necesidad de una intervención quirúrgica.Fibroids are a fairly frequent occurrence in the reproductive age group and exclusively responsible for both infertility and pregnancy wastage in a small (5% but significant proportion of patients. Approximately 50% of women with infertility and uterine myomas conceive after myomectomy. A slightly higher proportion of women with history of recurrent pregnancy loss conceive following myomectomy. More importantly, there is highly significant reduction in early and mid trimester miscarriage rates. Evidence suggests that most women wish to conceive are able to do so in the first year, with pregnancy rates dropping sharply after this time. This may be attributed to recurrence of fibroids. If possible, therefore, the surgery should be timed to take place when the woman is ready to start a family. The site, number and size of the myomas as well as the expertise of the surgeon along with patient preference may all influence the management option. A submucous fibroid or an intramural fibroid distorting the uterine cavity, fibroids > 5 cm and multiple fibroids are all indications for surgery in woman considering a pregnancy. For relatively small (< 5 cm intramural or subserosal fibroids, reproductive history is an important consideration in counseling the patient regarding the need for surgical intervention.

  19. SALL4 is a new target in endometrial cancer.

    Science.gov (United States)

    Li, A; Jiao, Y; Yong, K J; Wang, F; Gao, C; Yan, B; Srivastava, S; Lim, G S D; Tang, P; Yang, H; Tenen, D G; Chai, L

    2015-01-01

    Aggressive cancers and embryonic stem (ES) cells share a common gene expression signature. Identifying the key factors/pathway(s) within this ES signature responsible for the aggressiveness of cancers can lead to a potential cure. In this study, we find that SALL4, a gene involved in the maintenance of ES cell self-renewal, is aberrantly expressed in 47.7% of primary human endometrial cancer samples. It is not expressed in normal or hyperplastic endometrial. More importantly, SALL4 expression is positively correlated with worse patient survival and aggressive features such as metastasis in endometrial carcinoma. Further functional studies have shown that loss of SALL4 inhibits endometrial cancer cell growth in vitro and tumorigenicity in vivo, as a result of inhibition of cell proliferation and increased apoptosis. In addition, downregulation of SALL4 significantly impedes the migration and invasion properties of endometrial cancer cells in vitro and their metastatic potential in vivo. Furthermore, manipulation of SALL4 expression can affect drug sensitivity of endometrial cancer cells to carboplatin. Moreover, we show that SALL4 specifically binds to the c-Myc promoter region in endometrial cancer cells. While downregulation of SALL4 leads to a decreased expression of c-Myc at both protein and mRNA levels, ectopic SALL4 overexpression causes increased c-Myc protein and mRNA expression, indicating that c-Myc is one of the SALL4 downstream targets in endometrial tumorigenesis. In summary, we are the first to demonstrate that SALL4 has functional role(s) in metastasis and drug resistance in aggressive endometrial cancer. As a consequence of its functional roles in cancer cell and absence in normal tissue, SALL4 is a potential novel therapeutic target for the high-risk endometrial cancer patient population. PMID:24336327

  20. Endometrial inflammatory markers of the early immune response in mares susceptible or resistant to persistent breeding-induced endometritis.

    Science.gov (United States)

    Woodward, E M; Christoffersen, M; Campos, J; Betancourt, A; Horohov, D; Scoggin, K E; Squires, E L; Troedsson, M H T

    2013-03-01

    Transient endometritis after breeding is necessary for clearance of bacteria and spermatozoa; however, in a subpopulation of mares, the inflammation fails to resolve in a timely fashion. The objective of this study was to describe the uterine inflammatory response in mares susceptible or resistant to persistent breeding-induced endometritis (PBIE) during the first 24 h after induction of uterine inflammation.Twelve mares were classified as susceptible (nZ6) or resistant (nZ6) to PBIE. Mares were inseminated over five estrous cycles and endometrial biopsies were collected at one time point per cycle before (0) and 2, 6, 12, and 24 h after insemination. qPCR analysis for IL1B, IL6, IL8, IFNG, TNF (TNFA), IL10, and IL1RN was performed, and endometrial inflammatory cells were counted for each sample. Relative quantification values reported fold changes in mRNA expression from 0 h values. A general pattern of expression post insemination was observed in both groups of mares. Cytokine mRNA increased at 2 h, peaked between 2 and 12 h, and then decreased.Differences were detected between groups of mares 6 h after challenge; resistant mares had higher mRNA expression of IL6, IL1RN,and IL10 than susceptible mares. Susceptible mares had an increased number of polymorphonuclear neutrophils in the endometrium 2 and 12 h after breeding when compared with resistant mares. These findings describe an inherent difference in the initial immune response to insemination and may help explain the transient nature of inflammation in resistant mares, whereas susceptible mares develop a persistent inflammation. PMID:23580950

  1. Identification of a novel, recurrent MBTD1-CXorf67 fusion in low-grade endometrial stromal sarcoma.

    Science.gov (United States)

    Dewaele, Barbara; Przybyl, Joanna; Quattrone, Anna; Finalet Ferreiro, Julio; Vanspauwen, Vanessa; Geerdens, Ellen; Gianfelici, Valentina; Kalender, Zeynep; Wozniak, Agnieszka; Moerman, Philippe; Sciot, Raf; Croce, Sabrina; Amant, Frederic; Vandenberghe, Peter; Cools, Jan; Debiec-Rychter, Maria

    2014-03-01

    Endometrial stromal sarcomas (ESSs) are a genetically heterogeneous group of rare uterine neoplasms that are commonly driven by recurrent gene rearrangements. In conventional low-grade ESS, JAZF1-SUZ12, PHF1-JAZF1, EPC1-PHF1 and MEAF6-PHF1, and recently described ZC3H7-BCOR chimeric fusions have been reported in > 50% of cases. Conversely, oncogenic t(10;17)(q22;p13) translocation yields YWHAE-FAM22A/B chimeric proteins that are associated with histologically high-grade and clinically more aggressive ESS. Integrating whole-transcriptome paired-end RNA sequencing with fluorescence in situ hybridization (FISH) and banding cytogenetics, we identified MBTD1 (malignant brain tumor domain-containing 1) and CXorf67 (chromosome X open reading frame 67) as the genes involved in the novel reciprocal t(X;17)(p11.2;q21.33) translocation in two independent low-grade ESS of classical histology. The presence of the MBTD1-CXorf67 fusion transcript was validated in both cases using reverse-transcription polymerase chain reaction followed by Sanger sequencing. A specific FISH assay was developed to detect the novel t(X;17) translocation in formalin-fixed paraffin-embedded material, and resulted in identification of an additional low-grade ESS case positive for the MBTD1-CXorf67 fusion among 25 uterine stromal tumors [14 ESS and 11 undifferentiated endometrial sarcomas (UESs)] that were negative for JAZF1 and YWHAE rearrangements. Gene expression profiles of seven ESS (including three with YWHAE and two with JAZF1 rearrangements) and four UES without specific chromosomal aberrations indicated clustering of tumors with MBTD1-CXorf67 fusion together with low-grade JAZF1-associated ESS. The chimeric MBTD1-CXorf67 fusion identifies yet another cytogenetically distinct subgroup of low-grade ESS and offers the opportunity to shed light on the functions of two poorly characterized genes. PMID:23959973

  2. Risk factor analysis of recurrence in low-grade endometrial adenocarcinoma.

    Science.gov (United States)

    Roma, Andres A; Rybicki, Lisa A; Barbuto, Denise; Euscher, Elizabeth; Djordjevic, Bojana; Frauenhoffer, Elizabeth; Kim, Insun; Hong, Sung Ran; Montiel, Delia; Ali-Fehmi, Rouba; Malpica, Anais; Silva, Elvio G

    2015-10-01

    Prognosis of endometrial adenocarcinoma is favorable; however, the risk of recurrence ranges from 7% to 13%. Recurrence has been related to age, tumor type, International Federation of Gynecology and Obstetrics grade, depth of invasion, and lymphovascular invasion (LVI); however, morphologic features that would predict the site of recurrence have not been established. In this multi-institutional study, we reviewed 589 patients with International Federation of Gynecology and Obstetrics grades 1 or 2 endometrial adenocarcinoma, endometrioid type. Cox proportional hazard analysis was used to identify univariate and multivariate risk factors for recurrence and survival. Univariate analysis revealed features of tumors that recurred only in the vagina: low nuclear grade; superficial myoinvasion; minimal to no LVI; and minimal myoinvasion with microcystic, elongated, and fragmented (MELF) pattern; low nuclear grade and superficial myoinvasion persisted on multivariate analysis. Features of tumors that recurred at other sites included large size, deep myoinvasion, tumor necrosis, 1 or more LVI foci, LVI foci distant/deeper than invasive tumor front, MELF myoinvasion pattern, lower uterine segment and cervical stromal involvement, pelvic and/or paraaortic lymph node metastases at presentation, and higher grade of tumor in the metastatic foci, whereas increased percentage of solid component and lower percentage of mucinous features were marginally associated. Tumors with recurrences only in vagina had different features than tumors that recurred at other sites. The presence of tumor necrosis, MELF foci at the invasive tumor front, and the percentage of solid component and mucinous features could be helpful in grading endometrioid adenocarcinomas, if a 2-tier rather than a 3-tier grading system is accepted in the future. PMID:26264257

  3. Dynamics of postpartum endometrial cytology and bacteriology and their relationship to fertility in dairy cows.

    Science.gov (United States)

    Gilbert, Robert O; Santos, Natalia R

    2016-05-01

    Endometrial samples were obtained from 56 consecutively calving dairy cows examined for endometrial cytology and for aerobic and anaerobic bacterial growth. Changes over time, correlations between different cell types and between cell and bacterial populations and with fertility measures were calculated. The proportion of neutrophils in cytologic preparations decreased with time postpartum. Other cell types did not change significantly with time. The proportion of neutrophils early (Day 0 and 7) postpartum was negatively correlated with neutrophil proportion at 5 or 7 weeks postpartum and positively correlated with fertility. Cows with high proportion of neutrophils at 7 days postpartum (>40%) were significantly more likely to become pregnant than those with lower proportions of neutrophils. Escherichia coli were the bacteria most frequently isolated at 0 or 7 days postpartum but were uncommon after that. Trueperella pyogenes were most prevalent at 3 weeks postpartum and were more likely to infect cows that had previously been infected with E coli. The presence of T pyogenes at 3 weeks postpartum increased the risk of concomitant or later infection with gram-negative anaerobes. The presence of T pyogenes at 3 weeks postpartum significantly reduced the risk of pregnancy at 150 days in milk. The presence of alpha-hemolytic Streptoccus spp. at 7 days postpartum was associated with improved reproductive performance. The proportion of neutrophils at 5 and 7 weeks postpartum was related to concomitant bacterial infection. These findings suggest that rapid mobilization of neutrophils to the postpartum uterus is a beneficial response for uterine health in dairy cows. PMID:26944540

  4. The Promyelocytic Leukemia Zinc Finger Transcription Factor Is Critical for Human Endometrial Stromal Cell Decidualization.

    Science.gov (United States)

    Kommagani, Ramakrishna; Szwarc, Maria M; Vasquez, Yasmin M; Peavey, Mary C; Mazur, Erik C; Gibbons, William E; Lanz, Rainer B; DeMayo, Francesco J; Lydon, John P

    2016-04-01

    Progesterone, via the progesterone receptor (PGR), is essential for endometrial stromal cell decidualization, a cellular transformation event in which stromal fibroblasts differentiate into decidual cells. Uterine decidualization supports embryo implantation and placentation as well as subsequent events, which together ensure a successful pregnancy. Accordingly, impaired decidualization results not only in implantation failure or early fetal miscarriage, but also may lead to potential adverse outcomes in all three pregnancy trimesters. Transcriptional reprogramming on a genome-wide scale underlies progesterone dependent decidualization of the human endometrial stromal cell (hESC). However, identification of the functionally essential signals encoded by these global transcriptional changes remains incomplete. Importantly, this knowledge-gap undercuts future efforts to improve diagnosis and treatment of implantation failure based on a dysfunctional endometrium. By integrating genome-wide datasets derived from decidualization of hESCs in culture, we reveal that the promyelocytic leukemia zinc finger (PLZF) transcription factor is rapidly induced by progesterone and that this induction is indispensable for progesterone-dependent decidualization. Chromatin immunoprecipitation followed by next generation sequencing (ChIP-Seq) identified at least ten progesterone response elements within the PLZF gene, indicating that PLZF may act as a direct target of PGR signaling. The spatiotemporal expression profile for PLZF in both the human and mouse endometrium offers further support for stromal PLZF as a mediator of the progesterone decidual signal. To identify functional targets of PLZF, integration of PLZF ChIP-Seq and RNA Pol II RNA-Seq datasets revealed that the early growth response 1 (EGR1) transcription factor is a PLZF target for which its level of expression must be reduced to enable progesterone dependent hESC decidualization. Apart from furnishing essential insights into the molecular mechanisms by which progesterone drives hESC decidualization, our findings provide a new conceptual framework that could lead to new avenues for diagnosis and/or treatment of adverse reproductive outcomes associated with a dysfunctional uterus. PMID:27035670

  5. Management of disfunctional uterine bleeding

    Directory of Open Access Journals (Sweden)

    Bumin

    2011-03-01

    Full Text Available Dysfunctional uterine bleeding (DUB is defined as abnormal uterine bleeding in the absence of demonstrable structural or organic pathology. Bleeding occurs frequently or irregularly, lasts longer, or is heavier. DUB is the most common cause of abnormal vaginal bleeding during a woman's reproductive years and occurs most commonly at the beginning of the reproductive years in adolescent girls. The frequency is 20% in adolescent girls. DUB is diagnosed when all other possible causes of vaginal bleeding have been excluded such as bleeding disorders, pregnancy, medications, iatrogenic causes, genital tract pathology, malignancy, and systemic disease by appropriate investigations. Approximately 90% of DUB cases result from hypothalamic anovulation in adolescents during early puberty. The goal of therapy should be to arrest bleeding, replace lost iron to avoid anemia, and prevent future bleeding. Conjugated estrogen (Premarin 25 mg IV can be given every 4-6 hours until the bleeding stops for very heavy bleeding. After bleeding stops, low doses of the oral contraceptive may then be prescribed for at least 3 months to prevent the bleeding from recurring. Combination oral contraceptive pills with 35 mcg of ethinyl estradiol may be used or progesterone alone can be used to stabilize an immature endometrium until the bleeding stops for up to 7 days in patients with moderate bleeding. Gonadotropin-releasing hormone agonists may be helpful for short-term use when oral contraceptive pills are contradicated. (Turk Arch Ped 2011; 46 Suppl: 103-6

  6. The role o thallium-201 whole body scan with pelvic SPECT in patients with uterine cervical treated by radiation therapy. A preliminary report

    International Nuclear Information System (INIS)

    Evaluation of tumor extent before treatment and its response to therapy is important. The aim of this report is to assess the usefulness with thallium-201 (Tl-201) imaging study including whole body scan and pelvic single photon emission computed tomography (SPECT) in patients with uterine cervical cancers treated by radiation therapy. Before irradiation, eleven patients received detailed physical examination and Tl-201 imaging studies. A 4-score grading system was set for evaluation. The interval between Tl-201 imaging follow-up and completion of radiotherapy is one to four months, and its findings were compared with those from CT scan and clinical evidence. Before radiation, left supraclavicular and paraaortic lymphadenopathy was identified in one patient from whole body scan. Accumulation of Tl-201 uptake is observed from pelvic SPECT in all patients. It seems that patients with more tumor bulk had more intense uptake, except for one case with history of suspected pelvic inflammatory disease (PID). After radiotherapy, complete or partial regression is observed. For 6 patients with complete regression (score=0), no evidence of recurrence is confirmed by follow-up examinations. For three patients with little residual uptake (score=1), one is suspected with residual density and she is under close follow-up, the other two patients seem due to uterine myoma or short latency. These three patients received another Tl-201 scan 6 months after irradiation completion and the score became zero. One patient with residual intense uptake (score=2) suffered from relapse in the pelvis and abdomen. This preliminary report indicates that Tl-201 whole body scan and pelvic SPECT has potential in the assessment of response to radiotherapy in patients with uterine cervical cancers. However, further studies including more cases and longer follow-up are needed. (author)

  7. Hypoxia Promotes Invasion of Endometrial Stromal Cells via Hypoxia-Inducible Factor 1α Upregulation-Mediated β-Catenin Activation in Endometriosis.

    Science.gov (United States)

    Xiong, Wenqian; Zhang, Ling; Xiong, Yao; Liu, Hengwei; Liu, Yi

    2016-04-01

    Endometriosis is a common benign gynecological disease defined as the presence of endometrial tissue outside the uterine cavity. The aim of this study was to identify the molecular mechanism underlying hypoxia-induced increases in invasive ability of human endometrial stromal cells (HESCs). Herein, we show that the expression levels of hypoxia-inducible factor lα (HIF-1α) and β-catenin were greater in ectopic endometriotic tissue compared with eutopic tissue from controls. Exposure of eutopic endometrial stromal cells under hypoxic conditions or treated with desferrioxamine (DFO, chemical hypoxia) resulted in a time-dependent increase in β-catenin expression and its dephosphorylation. Hypoxia/HIF-1α also activated the β-catenin/T-cell factor (TCF) signaling pathway and the expression of target genes, vascular endothelial growth factor and matrix metalloproteinase 9, and knockdown of HIF-1α or β-catenin abrogated hypoxia-induced increases in HESC invasiveness. These results suggest that HIF-1α interacting with β-catenin/TCF signaling pathway, which is activated by hypoxia, may provide new insights into the etiology of endometriosis. PMID:26482209

  8. Feasibility investigation of allogeneic endometrial regenerative cells

    Directory of Open Access Journals (Sweden)

    Reid Michael

    2009-02-01

    Full Text Available Abstract Endometrial Regenerative Cells (ERC are a population of mesenchymal-like stem cells having pluripotent differentiation activity and ability to induce neoangiogenesis. In vitro and animal studies suggest ERC are immune privileged and in certain situations actively suppress ongoing immune responses. In this paper we describe the production of clinical grade ERC and initial safety experiences in 4 patients with multiple sclerosis treated intravenously and intrathecally. The case with the longest follow up, of more than one year, revealed no immunological reactions or treatment associated adverse effects. These preliminary data suggest feasibility of clinical ERC administration and support further studies with this novel stem cell type.

  9. Positron emission tomography findings in atypical polypoid adenomyoma

    Directory of Open Access Journals (Sweden)

    Tatsuya Fukami

    2016-03-01

    Full Text Available Atypical polypoid adenomyoma (APAM is a rare polypoid tumor of the uterus composed of atypical endometrial glands surrounded by smooth muscle. A 29-year-old nulligravida, was clinically diagnosed with endocervical myoma and underwent trans-uterine cervical resection with hysteroscope. The histopathological diagnosis of specimens was APAM. Eight months later, she diagnosed recurrent uterine tumor. The positron emission tomography (PET-CT imaging showed an increased fluorodeoxyglucose uptake. She has performed hysterectomy and was diagnosed APAM. Therapy for APAM depends on multiple factors such as age at presentation and desire for childbearing among others. This is the first report of PET-CT findings in APAM.

  10. Mig-6 regulates endometrial genes involved in cell cycle and progesterone signaling

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Jung-Yoon; Kim, Tae Hoon; Lee, Jae Hee [Department of Obstetrics, Gynecology & Reproductive Biology, Michigan State University, Grand Rapids, MI (United States); Dunwoodie, Sally L. [Developmental and Stem Cell Biology Division, Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales 2010 (Australia); St. Vincent' s Clinical School and the School of Biotechnology and Biomolecular Sciences, University of New South Wales, Kensington, New South Wales 2033 (Australia); Ku, Bon Jeong, E-mail: bonjeong@cnu.ac.kr [Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon (Korea, Republic of); Jeong, Jae-Wook, E-mail: JaeWook.Jeong@hc.msu.edu [Department of Obstetrics, Gynecology & Reproductive Biology, Michigan State University, Grand Rapids, MI (United States); Department of Women' s Health, Spectrum Health System, Grand Rapids, MI (United States)

    2015-07-10

    Mitogen inducible gene 6 (Mig-6) is an important mediator of progesterone (P4) signaling to inhibit estrogen (E2) signaling in the uterus. Ablation of Mig-6 in the murine uterus leads to the development of endometrial hyperplasia and E2-induced endometrial cancer. To identify the molecular pathways regulated by Mig-6, we performed microarray analysis on the uterus of ovariectomized Mig-6{sup f/f} and PGR{sup cre/+}Mig-6{sup f/f} (Mig-6{sup d/d}) mice treated with vehicle or P4 for 6 h. The results revealed that 772 transcripts were significantly regulated in the Mig-6{sup d/d} uterus treated with vehicle as compared with Mig-6{sup f/f} mice. The pathway analysis showed that Mig-6 suppressed the expression of gene-related cell cycle regulation in the absence of ovarian steroid hormone. The epithelium of Mig-6{sup d/d} mice showed a significant increase in the number of proliferative cells compared to Mig-6{sup f/f} mice. This microarray analysis also revealed that 324 genes are regulated by P4 as well as Mig-6. Cited2, the developmentally important transcription factor, was identified as being regulated by the P4-Mig-6 axis. To determine the role of Cited2 in the uterus, we used the mice with Cited2 that were conditionally ablated in progesterone receptor-positive cells (PGR{sup cre/+}Cited2{sup f/f}; Cited2{sup d/d}). Ablation of Cited2 in the uterus resulted in a significant reduction in the ability of the uterus to undergo a hormonally induced decidual reaction. Identification and analysis of these responsive genes will help define the role of P4 as well as Mig-6 in regulating uterine biology. - Highlights: • We identify Mig-6- and P4-regulated uterine genes by microarray analysis. • Mig-6 suppresses cell cycle progression and epithelial cell proliferation in uterus. • We identify the Mig-6 dependent induced genes by P4. • Cited2 plays an important role for decidualization as a P4 and Mig-6 target gene.

  11. Mig-6 regulates endometrial genes involved in cell cycle and progesterone signaling

    International Nuclear Information System (INIS)

    Mitogen inducible gene 6 (Mig-6) is an important mediator of progesterone (P4) signaling to inhibit estrogen (E2) signaling in the uterus. Ablation of Mig-6 in the murine uterus leads to the development of endometrial hyperplasia and E2-induced endometrial cancer. To identify the molecular pathways regulated by Mig-6, we performed microarray analysis on the uterus of ovariectomized Mig-6f/f and PGRcre/+Mig-6f/f (Mig-6d/d) mice treated with vehicle or P4 for 6 h. The results revealed that 772 transcripts were significantly regulated in the Mig-6d/d uterus treated with vehicle as compared with Mig-6f/f mice. The pathway analysis showed that Mig-6 suppressed the expression of gene-related cell cycle regulation in the absence of ovarian steroid hormone. The epithelium of Mig-6d/d mice showed a significant increase in the number of proliferative cells compared to Mig-6f/f mice. This microarray analysis also revealed that 324 genes are regulated by P4 as well as Mig-6. Cited2, the developmentally important transcription factor, was identified as being regulated by the P4-Mig-6 axis. To determine the role of Cited2 in the uterus, we used the mice with Cited2 that were conditionally ablated in progesterone receptor-positive cells (PGRcre/+Cited2f/f; Cited2d/d). Ablation of Cited2 in the uterus resulted in a significant reduction in the ability of the uterus to undergo a hormonally induced decidual reaction. Identification and analysis of these responsive genes will help define the role of P4 as well as Mig-6 in regulating uterine biology. - Highlights: • We identify Mig-6- and P4-regulated uterine genes by microarray analysis. • Mig-6 suppresses cell cycle progression and epithelial cell proliferation in uterus. • We identify the Mig-6 dependent induced genes by P4. • Cited2 plays an important role for decidualization as a P4 and Mig-6 target gene

  12. Multivariate assessment of cervical invasion of endometrial carcinoma. Comparison of transvaginal ultrasonography, hysteroscopy, and magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Miyagi, Yasunari; Yamada, Shinako; Miyagi, Yuji [Okayama Univ. (Japan). School of Medicine] [and others

    1997-07-01

    From 1991 to 1995, 71 patients with endometrial cancer at Okayama University Medical School underwent transvaginal ultrasonography with a 6.5-MHz transducer, MRI at 1.5 T, and hysteroscopy using a rigid hysteroscope. The findings of these examinations were compared against pathologic results. The sensitivity/specificity/accuracy were 0.73/0.89/0.86 for transvaginal ultrasonography, 0.73/0.88/0.85 for MRI, and 0.73/0.80/0.79 for hysteroscopy. The coefficient values for transvaginal ultrasonography/MRI/hysteroscopy were 0.69/0.62/-0.21 and 1.99/1.89/0.79 in quantification theory second family analysis and logistic regression, respectively. Misdiagnosed cases had the following factors: large tumor volume; tumor near the internal os; tumor descending from the uterine cavity; polypoid tumor in the endocervix; artifacts due to the use of a cervix dilator made from stems of the seaweed Laminaria japonica; endocervical glandular involvement only; and atypical signals on MRI. For the preoperative assessment of cervical invasion, transvaginal ultrasonography and MRI were the most reliable. Hysteroscopy was least reliable, because of a large number of false-positive results. The use of these examinations in combination, especially transvaginal ultrasonography and MRI, would be of great value in surgical planning for endometrial cancer, considering the factors responsible for misdiagnosis. (K.H.)

  13. Multivariate assessment of cervical invasion of endometrial carcinoma. Comparison of transvaginal ultrasonography, hysteroscopy, and magnetic resonance imaging

    International Nuclear Information System (INIS)

    From 1991 to 1995, 71 patients with endometrial cancer at Okayama University Medical School underwent transvaginal ultrasonography with a 6.5-MHz transducer, MRI at 1.5 T, and hysteroscopy using a rigid hysteroscope. The findings of these examinations were compared against pathologic results. The sensitivity/specificity/accuracy were 0.73/0.89/0.86 for transvaginal ultrasonography, 0.73/0.88/0.85 for MRI, and 0.73/0.80/0.79 for hysteroscopy. The coefficient values for transvaginal ultrasonography/MRI/hysteroscopy were 0.69/0.62/-0.21 and 1.99/1.89/0.79 in quantification theory second family analysis and logistic regression, respectively. Misdiagnosed cases had the following factors: large tumor volume; tumor near the internal os; tumor descending from the uterine cavity; polypoid tumor in the endocervix; artifacts due to the use of a cervix dilator made from stems of the seaweed Laminaria japonica; endocervical glandular involvement only; and atypical signals on MRI. For the preoperative assessment of cervical invasion, transvaginal ultrasonography and MRI were the most reliable. Hysteroscopy was least reliable, because of a large number of false-positive results. The use of these examinations in combination, especially transvaginal ultrasonography and MRI, would be of great value in surgical planning for endometrial cancer, considering the factors responsible for misdiagnosis. (K.H.)

  14. Pathogenic Escherichia coli and lipopolysaccharide enhance the expression of IL-8, CXCL5, and CXCL10 in canine endometrial stromal cells.

    Science.gov (United States)

    Karlsson, Iulia; Hagman, Ragnvi; Guo, Yongzhi; Humblot, Patrice; Wang, Liya; Wernersson, Sara

    2015-07-01

    Chemokines play a central role in cellular communication in response to bacterial infection. However, the knowledge of the chemokine responses to bacterial infections in dogs remains limited. Uterine bacterial infection (pyometra) is one of the most common bacterial diseases in dogs and causes sepsis in most of the cases. We have shown previously that dogs with pyometra have higher messenger RNA (mRNA) levels of chemokines in uterus. To assess whether the stromal part of the endometrium expresses chemokines in response to bacterial infection, we cultured endometrial stromal cells isolated from healthy dogs and exposed them to either live pathogenic Escherichia coli, isolated from the uterus of a dog with pyometra, or lipopolysaccharide. Changes in the mRNA expression of ELR(+) CXC chemokines, IL-8, CXCL5, CXCL7, and ELR(-) CXC chemokine, CXCL10, were measured after 24 hours using quantitative real-time polymerase chain reaction. Levels of IL-8, CXCL5, and CXCL10 were upregulated in endometrial stromal cells exposed to E coli and lipopolysaccharide, whereas the level of CXCL7 was decreased or unaffected. In addition, levels of IL-8 and CXCL5, but not CXCL7 or CXCL10, were significantly higher in dogs with pyometra than those in healthy dogs. Our findings show that pathogenic uterine-derived E coli induces a CXC chemokine response both in cultured endometrial stromal cells within 24 hours and in pyometra-affected uteri from dogs. Stromal cells could therefore play an important role in early neutrophil and T cell recruitment to the site of inflammation during gram-negative bacterial infection of the uterus. Further studies are needed to clarify the role of chemokines in host response to bacterial infection in dogs and the possibility of using chemokines as diagnostic parameters for bacterial infection in this species. PMID:25765298

  15. Regulated expression of matrix metalloproteinases, inflammatory mediators, and endometrial matrix remodeling by 17beta-estradiol in the immature rat uterus

    Directory of Open Access Journals (Sweden)

    Caruso Joseph A

    2009-11-01

    Full Text Available Abstract Background Administration of a single physiological dose of 17beta-estradiol (E2:40 microg/kg to the ovariectomized immature rat rapidly induces uterine growth and remodeling. The response is characterized by changes in endometrial stromal architecture during an inflammatory-like response that likely involves activated matrix-metalloproteinases (MMPs. While estrogen is known as an inducer of endometrial growth, its role in specific expression of MMP family members in vivo is poorly characterized. E2-induced changes in MMP-2, -3, -7, and -9 mRNA and protein expression were analyzed to survey regulation along an extended time course 0-72 hours post-treatment. Because E2 effects inflammatory-like changes that may alter MMP expression, we assessed changes in tissue levels of TNF-alpha and MCP-1, and we utilized dexamethasone (600 microg/kg to better understand the role of inflammation on matrix remodeling. Methods Ovariectomized 21 day-old female Sprague-Dawley rats were administered E2 and uterine tissues were extracted and prepared for transmission electron microscopy (TEM, mRNA extraction and real-time RT-PCR, protein extraction and Western blot, or gelatin zymography. In inhibitor studies, pretreatment compounds were administered prior to E2 and tissues were harvested at 4 hours post-hormone challenge. Results Using a novel TEM method to quantitatively assess changes in stromal collagen density, we show that E2-induced matrix remodeling is rapid in onset ( Conclusion The data demonstrate that E2-regulated endometrial remodeling is rapid in onset (

  16. Clinical significance of three-dimensional sonohysterography

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Eun Hye; Lee, Mi Hwa; Lee, Chan; Kim, Jong Wook; Shin, Myung Choel [Pochon Cha University College of Medicine, Pochon (Korea, Republic of)

    1999-12-15

    To evaluate the usefulness of three dimensional sonohysterography (3D SHG) in the evaluation of uterine endometrial and submucosal lesions in comparison with conventional two-dimensional sonohysterography (2D SHG). Our series consisted of 26 patients (mean aged 41 years) who complained of uterine bleeding, menorrhagia, or dysmenorrhea. 2D SHG was performed, and then 3D SHG was done after the volume mode was switched on. Simultaneous display of three perpendicular two-dimensional planes and surface rendering of findings on particular section were obtained. We analyzed whether the endometrium was thickened or not, and the location, size, shape, echogenicity, posterior shadowing, and echogenic rim of the focal lesion. The results were compared with the pathologic findings or MRI. There were submucosal myomas (n=12), intramural myomas (n=2), endometrial polyps (n=7), placental polyp (n=1), and normal endometrial cavities (n=4) on SHG. Nineteen cases were confirmed by pathologic findings or MRI. The results were correlated in 89% (17/19) of the cases. We misdiagnosed 2 cases: focal endometrial hyperplasia and choriocarcinoma were misdiagnosed as endometrial polyp and placental polyp, respectively. Imaging diagnoses were same in the techniques. Comparing with 2D SHG, 3D SHG provided a subjective display of pathologic findings and an additional information about spatial relationship between focal lesion and surroundings.

  17. Epidermal growth factor: Porcine uterine luminal epithelial cell migratory signal during the peri-implantation period of pregnancy.

    Science.gov (United States)

    Jeong, Wooyoung; Jung, Seoungo; Bazer, Fuller W; Song, Gwonhwa; Kim, Jinyoung

    2016-01-15

    The majority of early conceptus mortality in pregnancy occurs during the peri-implantation period, suggesting that this period is important for conceptus viability and the establishment of pregnancy. Successful establishment of pregnancy in all mammalian species depends on the orchestrated molecular events that transpire at the conceptus-uterine interface during the peri-implantation period of pregnancy. This maternal-conceptus interaction is especially crucial in pigs because they have a non-invasive epitheliochorial placentation during a protracted peri-implantation period. During the pre-implantation period of pregnancy, conceptus survival and the establishment of pregnancy depend on the developing conceptus receiving an adequate supply of histotroph which contains a wide range of nutrients and growth factors. Evidence links epidermal growth factor (EGF) to embryogenesis or implantation in various mammalian species. EGF exhibits potential growth-promoting activities on the conceptus and endometrium; however, in the case of pigs, little is known its functions, especially their regulatory mechanisms at the maternal-conceptus interface. EGF receptor (EGFR) mRNA and protein are abundant in endometrial luminal (LE) and glandular (GE) epithelia and conceptus trophectoderm on Days 13-14 of pregnancy, suggesting that EGF provides an autocrine signal to uterine LE and GE just prior to implantation. Therefore, the objectives of this study were to determine: 1) the potential intracellular signaling pathways responsible for the activities of EGF in porcine uterine LE (pLE) cells; and 2) the changes in cellular activities induced by EGF. EGF treatment of pLE cells increased the abundance of phosphorylated (p)-ERK1/2, p-P70RSK and p-RPS6 compared to that for control cells. Furthermore, EGF-stimulated phosphorylation of ERK1/2 MAPK was inhibited in pLE cells transfected with an EGFR siRNA compared with control siRNA-transfected pLE cells. Moreover, EGF stimulated migration of pLE cells, but this stimulatory effect was blocked by U0126, a pharmacological inhibitor or ERK1/2 MAPK. Collectively, these results provide new insights into mechanisms whereby EGF regulates development of the peri-implantation uterine LE at the fetal-maternal interface. These results indicate that endometrial- and/or conceptus derived EGF effects migration of uterine LE and that those stimulatory effects are regulated via the ERK1/2 MAPK pathway during early pregnancy in pigs. PMID:26620571

  18. Uterine transplantation: a promising surrogate to surrogacy?

    Science.gov (United States)

    Grynberg, Michael; Ayoubi, Jean-Marc; Bulletti, Carlo; Frydman, Rene; Fanchin, Renato

    2011-03-01

    Infertility due to the inability of the uterus to carry a pregnancy ranks among the most unresolved issues in reproductive medicine. It affects millions of women worldwide who have congenital or acquired uterine affections, often requiring hysterectomy, and potentially represents a considerable fraction of the general infertile population. Patients suffering from severe uterine infertility are currently compelled to go through gestational surrogacy or adoption; both approaches, unfortunately, deprive them of the maternal experience of pregnancy and birth. Uterine transplantation represents an outstanding, yet complex, perspective to alleviating definitive uterine infertility. In the past decades, a number of scientific experiments conducted both in animals and women, focusing on uterine transplantation, have led to promising results. Collectively, these findings undoubtedly constitute a sound basis to clinically apply uterine transplantation in the near future. This paper is, however, an overview not only of the extent and limitations of accumulated scientific knowledge on uterine transplantation, but also its ethical implications, in an effort to define the actual place of such an approach among the therapeutic arsenal for alleviating infertility. PMID:21401629

  19. Ancient Transposable Elements Transformed the Uterine Regulatory Landscape and Transcriptome during the Evolution of Mammalian Pregnancy

    Directory of Open Access Journals (Sweden)

    Vincent J. Lynch

    2015-02-01

    Full Text Available A major challenge in biology is determining how evolutionarily novel characters originate; however, mechanistic explanations for the origin of new characters are almost completely unknown. The evolution of pregnancy is an excellent system in which to study the origin of novelties because mammals preserve stages in the transition from egg laying to live birth. To determine the molecular bases of this transition, we characterized the pregnant/gravid uterine transcriptome from tetrapods to trace the evolutionary history of uterine gene expression. We show that thousands of genes evolved endometrial expression during the origins of mammalian pregnancy, including genes that mediate maternal-fetal communication and immunotolerance. Furthermore, thousands of cis-regulatory elements that mediate decidualization and cell-type identity in decidualized stromal cells are derived from ancient mammalian transposable elements (TEs. Our results indicate that one of the defining mammalian novelties evolved from DNA sequences derived from ancient mammalian TEs co-opted into hormone-responsive regulatory elements distributed throughout the genome.

  20. Influence of the uterine environment on the development of in vitro-produced equine embryos.

    Science.gov (United States)

    Smits, Katrien; Govaere, Jan; Peelman, Luc J; Goossens, Karen; de Graaf, Dirk C; Vercauteren, Dries; Vandaele, Leen; Hoogewijs, Maarten; Wydooghe, Eline; Stout, Tom; Van Soom, Ann

    2012-02-01

    The necessity for early interaction between the embryo and the oviductal and/or uterine environment in the horse is reflected by several striking differences between equine embryos that develop in vivo and those produced in vitro. Better understanding of the salient interactions may help to improve the efficiency of in vitro equine embryo production. In an initial experiment, cleavage-stage in vitro-produced (IVP) equine embryos were transferred into the uterus of recipient mares that had ovulated recently to determine whether premature placement in this in vivo environment would improve subsequent development. In a second experiment, an important element of the uterine environment was mimicked by adding uterocalin, a major component of the endometrial secretions during early pregnancy, to the culture medium. Intrauterine transfer of cleavage-stage IVP equine embryos yielded neither ultrasonographically detectable pregnancies nor day 7 blastocysts, indicating that the uterus is not a suitable environment for pre-compact morula stage horse embryos. By contrast, exposure to uterocalin during IVP improved capsule formation, although it did not measurably affect the development or expression of a panel of genes known to differ between in vivo and in vitro embryos. Further studies are required to evaluate whether uterocalin serves purely as a carrier protein or more directly promotes improved capsule development. PMID:22089531

  1. Risk factors of distant metastasis in patients with squamous cell carcinoma of the uterine cervix treated with postoperative irradiation

    International Nuclear Information System (INIS)

    This paper reports the results of a study of risk factors for recurrence in non-irradiated sites in patients with squamous cell carcinoma of the uterine cervix who received postoperative irradiation. It also discusses clinical experience with such patients, particularly those with a poor prognosis, based on a review of the literature. The study was conducted at the National Shikoku Cancer Center in 62 patients with squamous cell carcinoma of the uterine cervix (mean age=50.5, range=30-66) who received 10 MeV postoperative irradiation with a Linac between 1981 and 1990. An analysis was performed in terms of sites and times of recurrence, risk factors for distant metastasis, and groups at high risk for distant metastasis. Based on the results of the study as well as the review of the literature, it was concluded that squamous cell carcinoma of the uterine cervix is sensitive to radiation therapy and that the clinical outcome of local treatment is satisfactory. However, systemic chemotherapy should be considered for patients who are suspected of having minute distant metastasis at the time of surgical operation, i.e., those with moderate to severe vascular space invasion, multiple lymph node metastasis, parametrium infiltration, and/or endometrial infiltration. (K.H.)

  2. Diffuse uterine leiomyomatosis in a child

    Energy Technology Data Exchange (ETDEWEB)

    Pai, Deepa; Coletti, Monette C.; Ladino-Torres, Maria; Caoili, Elaine [University of Michigan Health System, Department of Radiology, Section of Pediatric Radiology, Ann Arbor, MI (United States); Elkins, Matthew [University of Michigan Health System, Department of Pathology, Ann Arbor, MI (United States)

    2012-01-15

    Leiomyomas are the most common benign uterine tumor; however, this entity is relatively uncommon in the pediatric population. Although leiomyomas most commonly present as solitary uterine masses, unusual patterns of growth have been described including diffuse leiomyomatosis. In this condition, the myometrium of the uterus is symmetrically expanded by innumerable confluent leiomyomas; this pattern of growth is quite uncommon and has never been reported in a pediatric patient. This case report illustrates the imaging appearance of diffuse uterine leiomyomatosis in an otherwise healthy 16-year-old girl. (orig.)

  3. Diffuse uterine leiomyomatosis in a child

    International Nuclear Information System (INIS)

    Leiomyomas are the most common benign uterine tumor; however, this entity is relatively uncommon in the pediatric population. Although leiomyomas most commonly present as solitary uterine masses, unusual patterns of growth have been described including diffuse leiomyomatosis. In this condition, the myometrium of the uterus is symmetrically expanded by innumerable confluent leiomyomas; this pattern of growth is quite uncommon and has never been reported in a pediatric patient. This case report illustrates the imaging appearance of diffuse uterine leiomyomatosis in an otherwise healthy 16-year-old girl. (orig.)

  4. Endometrial cancer: Diagnostic methods in postmenopausal vaginal bleeding

    Directory of Open Access Journals (Sweden)

    Mandi? Aljoša

    2003-01-01

    Full Text Available Postmenopausal vaginal bleeding (PMB is the leading symptom of endometrial cancer. More than 70% of patients with endometrial cancer are postmenopausal. Despite PMB as a leading symptom in diagnosis of endometrial cancer, PMB could be caused by some benign processes in endometrium such as hyperplasia and focal endometrial disease, such as a polyp. The golden standard for histological evaluation of the endometrium is curettage. Transvaginal ultrasound (TVS and measurement of endometrium thickness is also one of the favored methods in the last decade. Sonographic imaging of the endometrium can be extremely helpful, because endometrial cancer is nearly always associated with thickening and heterogeneity of the endometrium except in case of atrophy-associated adenocarcinoma of the endometrium, which is not associated with thickening. Hysteroscopy found place as a favored method in diagnosis of focal endometrial lesions. Saline infusion sonohysterography (SIS is a relatively new imaging procedure. The SIS will show whether the endometrium is diffusely thickened, in which case curettage would be the next step, or focally thickened, in which case hysteroscopy with biopsy would be the next step. Combination of some diagnostic procedures, such as TVS, SIS, hysteroscopy, endometrial biopsy and curettage, should decrease false positive and false negative results which may affect the correct diagnosis and treatment.

  5. Uterine artery embolisation and magnetic resonance-guided focused ultrasound treatment of uterine fibroids

    International Nuclear Information System (INIS)

    Uterine fibroids are the most common benign female tumours during reproductive age. The traditional treatment for this condition is typically hysterectomy. However, there are new technologies on the rise, such as Uterine Artery Embolisation and Magnetic Resonance-guided Focused Ultrasound which are directed towards a minimally invasive or even noninvasive treatment of uterine fibroids. These modern procedures allow for a fast recovery and preservation of fertility. In this work, we presented these alternative procedures and highlighted their advantages and limitations

  6. Risk factor analysis of coexisting endometrial carcinoma in patients with endometrial hyperplasia: a retrospective observational study of Taiwanese Gynecologic Oncology Group

    OpenAIRE

    Chen, Yu-Li; Wang, Kung-Liahng; Chen, Min-Yu; Yu, Mu-Hsien; Wu, Chen-Hsuan; Ke, Yu-Min; Chen, Yi-Jen; Chang, Yin-Yi; Hsu, Keng-Fu; Yen, Ming-Shyen

    2013-01-01

    Objective To evaluate the clinical outcome and parameters related to coexisting endometrial carcinoma in women with tissue-diagnosed endometrial hyperplasia. Methods Between January 1991 and December 2009, three hundred and eighty-six patients with the presumptive diagnosis of endometrial hyperplasia were retrieved. Among these, one hundred and twenty-five patients were identified as having coexisting endometrial carcinoma in hysterectomy specimens. The three hundred and eighty-six patients w...

  7. Value of radiation therapy in uterine sarcoma

    International Nuclear Information System (INIS)

    Fifty-eight cases of leiomyosarcoma of the uterus and 47 endometrial sarcomas of the uterus are reviewed based on the pertinent information related to recurrence patterns. The following conclusions are made: (1) Cases of endometrial sarcoma should receive preoperative pelvic irradiation, or postoperative pelvic irradiation if a diagnosis is not made until the postoperative period. This plan will probably be of most benefit, if at all, in stage I disease. (2) A case for pelvic irradiation as an adjuvant to surgery in leiomyosarcoma cannot be made from a review of this material, either from a viewpoint at recurrence patterns or radio-responsiveness. (U.S.)

  8. Endometrial stem/progenitor cells: the first 10 years

    Science.gov (United States)

    Gargett, Caroline E.; Schwab, Kjiana E.; Deane, James A.

    2016-01-01

    BACKGROUND The existence of stem/progenitor cells in the endometrium was postulated many years ago, but the first functional evidence was only published in 2004. The identification of rare epithelial and stromal populations of clonogenic cells in human endometrium has opened an active area of research on endometrial stem/progenitor cells in the subsequent 10 years. METHODS The published literature was searched using the PubMed database with the search terms ‘endometrial stem cells and menstrual blood stem cells' until December 2014. RESULTS Endometrial epithelial stem/progenitor cells have been identified as clonogenic cells in human and as label-retaining or CD44+ cells in mouse endometrium, but their characterization has been modest. In contrast, endometrial mesenchymal stem/stromal cells (MSCs) have been well characterized and show similar properties to bone marrow MSCs. Specific markers for their enrichment have been identified, CD146+PDGFRβ+ (platelet-derived growth factor receptor beta) and SUSD2+ (sushi domain containing-2), which detected their perivascular location and likely pericyte identity in endometrial basalis and functionalis vessels. Transcriptomics and secretomics of SUSD2+ cells confirm their perivascular phenotype. Stromal fibroblasts cultured from endometrial tissue or menstrual blood also have some MSC characteristics and demonstrate broad multilineage differentiation potential for mesodermal, endodermal and ectodermal lineages, indicating their plasticity. Side population (SP) cells are a mixed population, although predominantly vascular cells, which exhibit adult stem cell properties, including tissue reconstitution. There is some evidence that bone marrow cells contribute a small population of endometrial epithelial and stromal cells. The discovery of specific markers for endometrial stem/progenitor cells has enabled the examination of their role in endometrial proliferative disorders, including endometriosis, adenomyosis and Asherman's syndrome. Endometrial MSCs (eMSCs) and menstrual blood stromal fibroblasts are an attractive source of MSCs for regenerative medicine because of their relative ease of acquisition with minimal morbidity. Their homologous and non-homologous use as autologous and allogeneic cells for therapeutic purposes is currently being assessed in preclinical animal models of pelvic organ prolapse and phase I/II clinical trials for cardiac failure. eMSCs and stromal fibroblasts also exhibit non-stem cell-associated immunomodulatory and anti-inflammatory properties, further emphasizing their desirable properties for cell-based therapies. CONCLUSIONS Much has been learnt about endometrial stem/progenitor cells in the 10 years since their discovery, although several unresolved issues remain. These include rationalizing the terminology and diagnostic characteristics used for distinguishing perivascular stem/progenitor cells from stromal fibroblasts, which also have considerable differentiation potential. The hierarchical relationship between clonogenic epithelial progenitor cells, endometrial and decidual SP cells, CD146+PDGFR-β+ and SUSD2+ cells and menstrual blood stromal fibroblasts still needs to be resolved. Developing more genetic animal models for investigating the role of endometrial stem/progenitor cells in endometrial disorders is required, as well as elucidating which bone marrow cells contribute to endometrial tissue. Deep sequencing and epigenetic profiling of enriched populations of endometrial stem/progenitor cells and their differentiated progeny at the population and single-cell level will shed new light on the regulation and function of endometrial stem/progenitor cells. PMID:26552890

  9. Treatment and clinical behavior of endometrial endometrioid adenocarcinoma

    International Nuclear Information System (INIS)

    Cases of endometrial carcinoma treated in a university hospital between 1986 and 1998 were analyzed. More specifically, cases of endometrial carcinoma treated at Kumamoto University Hospital during the past 13 years were analyzed in terms of additional treatment given as adjuvant therapy after surgery. Among the total of 175 cases of endometrial carcinoma, surgery was the primary treatment modality in 173 (98.9%) and the other 2 (1.1%) were treated by chemotherapy and/or radiotherapy without surgery. Of the 173 surgical cases, 158 (91.4%) were cases of endometrioid adenocarcinoma, and after excluding the cases of double cancer, the remaining 147 cases were included in the analysis. At Kumamoto University hospital, radical hysterectomy and pelvic lymphadenectomy have been performed in cases in which cervical invasion is indicated by hysteroscopy and/or MRI, invasion of the muscle coat of the uterus appears on MRI images, and in which carcinoma with specific histology (e.g., serous adenocarcinoma) or anaplastic endometrioid adenocarcinoma is seen. Semi-radical hysterectomy and pelvic lymphadenectomy have been considered to be indicated in all other cases. Adjuvant chemotherapy and radiotherapy after surgery has been indicated for cases in which invasion of the muscle coat of the uterus is to a depth of more than half its thickness, stromal invasion of the cervix is seen, or invasion of the serosa or metastasis to the uterine adnexae or lymph nodes is seen. Patients were externally irradiated with a dose of 50 Gy to the whole pelvis as adjuvant radiotherapy. The follow-up period ranged from 4 to 148 months. Of the 147 cases, 105 (71.4%) were treated by hysterectomy alone and the other 42 received adjuvant therapy (chemotherapy in 27 cases, radiotherapy in 15 cases). All stage Ia patients (16 cases) survived, and none were given additional therapy. Only 4.8% of the stage Ib cases (62) and 7.1% of the stage 2a cases (14) received adjuvant therapy, and no recurrences were seen. Recurrences were seen in 3 of the stage 1c cases (17) (2 treated by hysterectomy alone and 1 that received adjuvant chemotherapy), and all 3 patients died. All patients who received adjuvant radiotherapy survived, but there were no statistically significant differences in outcome among the three groups (i.e., hysterectomy alone, hysterectomy+chemotherapy, and hysterectomy+radiotherapy). One of 14 patients with stage 2b, disease treated by hysterectomy+chemotherapy died. No significant difference in outcome was seen among the three groups. Two of the 11 patients with stage 3a disease died (1 treated by hysterectomy+chemotherapy and 1 by hysterectomy+radiotherapy). No significant differences in outcome were found among the three groups. All 11 patients with stage 3c disease, who had lymph node metastasis, were given adjuvant therapy and 7 of them experienced a relapse and died. No significant differences in outcome were seen among the three groups. Both of the patients with stage 4a disease survived. Recurrence was observed in 9 (33.3%) of the 27 cases treated by hysterectomy+chemotherapy and 2 (13.3%) of the 15 cases treated by hysterectomy+radiotherapy. Because of the small number of subjects, no statistically significant differences in outcome were found among the three treatment groups in this analysis. No adjuvant therapy is considered necessary in stage Ia and Ib if systematic lymphadenectomy is performed, whereas radiotherapy is considered effective in stage 1c. Similarly, no additional therapy is necessary in stage II if invasion of the muscular coat of the uterus is to a depth of less than half its thickness or in stage 3a, if invasion of the muscular coat of uterus is to a depth of less than half its thickness and only the results of peritoneae cytology lymph node are positive. However, because when there is infiltration of the serosa and/or adnexal metastasis recurrence is very frequent in stage 3a and 3c despite radiotherapy and/or chemotherapy, and additional chemotherapy is required for such patients. Based on the results of t his analysis,

  10. Treatment and clinical behavior of endometrial endometrioid adenocarcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Katabuchi, Hidetaka; Suenaga, Yoshito; Okamura, Hitoshi [Kumamoto Univ. (Japan). School of Medicine

    2001-08-01

    Cases of endometrial carcinoma treated in a university hospital between 1986 and 1998 were analyzed. More specifically, cases of endometrial carcinoma treated at Kumamoto University Hospital during the past 13 years were analyzed in terms of additional treatment given as adjuvant therapy after surgery. Among the total of 175 cases of endometrial carcinoma, surgery was the primary treatment modality in 173 (98.9%) and the other 2 (1.1%) were treated by chemotherapy and/or radiotherapy without surgery. Of the 173 surgical cases, 158 (91.4%) were cases of endometrioid adenocarcinoma, and after excluding the cases of double cancer, the remaining 147 cases were included in the analysis. At Kumamoto University hospital, radical hysterectomy and pelvic lymphadenectomy have been performed in cases in which cervical invasion is indicated by hysteroscopy and/or MRI, invasion of the muscle coat of the uterus appears on MRI images, and in which carcinoma with specific histology (e.g., serous adenocarcinoma) or anaplastic endometrioid adenocarcinoma is seen. Semi-radical hysterectomy and pelvic lymphadenectomy have been considered to be indicated in all other cases. Adjuvant chemotherapy and radiotherapy after surgery has been indicated for cases in which invasion of the muscle coat of the uterus is to a depth of more than half its thickness, stromal invasion of the cervix is seen, or invasion of the serosa or metastasis to the uterine adnexae or lymph nodes is seen. Patients were externally irradiated with a dose of 50 Gy to the whole pelvis as adjuvant radiotherapy. The follow-up period ranged from 4 to 148 months. Of the 147 cases, 105 (71.4%) were treated by hysterectomy alone and the other 42 received adjuvant therapy (chemotherapy in 27 cases, radiotherapy in 15 cases). All stage Ia patients (16 cases) survived, and none were given additional therapy. Only 4.8% of the stage Ib cases (62) and 7.1% of the stage IIa cases (14) received adjuvant therapy, and no recurrences were seen. Recurrences were seen in 3 of the stage Ic cases (17) (2 treated by hysterectomy alone and 1 that received adjuvant chemotherapy), and all 3 patients died. All patients who received adjuvant radiotherapy survived, but there were no statistically significant differences in outcome among the three groups (i.e., hysterectomy alone, hysterectomy+chemotherapy, and hysterectomy+radiotherapy). One of 14 patients with stage IIb, disease treated by hysterectomy+chemotherapy died. No significant difference in outcome was seen among the three groups. Two of the 11 patients with stage IIIa disease died (1 treated by hysterectomy+chemotherapy and 1 by hysterectomy+radiotherapy). No significant differences in outcome were found among the three groups. All 11 patients with stage IIIc disease, who had lymph node metastasis, were given adjuvant therapy and 7 of them experienced a relapse and died. No significant differences in outcome were seen among the three groups. Both of the patients with stage IVa disease survived. Recurrence was observed in 9 (33.3%) of the 27 cases treated by hysterectomy+chemotherapy and 2 (13.3%) of the 15 cases treated by hysterectomy+radiotherapy. Because of the small number of subjects, no statistically significant differences in outcome were found among the three treatment groups in this analysis. No adjuvant therapy is considered necessary in stage Ia and Ib if systematic lymphadenectomy is performed, whereas radiotherapy is considered effective in stage Ic. Similarly, no additional therapy is necessary in stage II if invasion of the muscular coat of the uterus is to a depth of less than half its thickness or in stage IIIa, if invasion of the muscular coat of uterus is to a depth of less than half its thickness and only the results of peritoneae cytology lymph node are positive. However, because when there is infiltration of the serosa and/or adnexal metastasis recurrence is very frequent in stage IIIa and IIIc despite radiotherapy and/or chemotherapy, and additional chemotherapy is required for such patients. Based on the results of t h

  11. The effect of peri-implantation administration of uterine relaxing agents in assisted reproduction treatment cycles: a systematic review and meta-analysis.

    Science.gov (United States)

    Khairy, Mohammed; Dhillon, Rima K; Chu, Justin; Rajkhowa, Madhurima; Coomarasamy, Arri

    2016-04-01

    Sub-endometrial junctional zone peristalsis is increased by ovarian stimulation and traumatic embryo transfer, and is linked with decreased implantation and pregnancy rates in assisted reproduction treatments. Various agents have been used to inhibit uterine hyper-peristalsis at the time of embryo transfer with conflicting results. This systematic review aimed to identify if uterine relaxants administered in the peri-implantation period during assisted reproduction treatments could improve pregnancy outcomes through literature search with no language restrictions. The review reports on 3546 patients in 17 randomized controlled trials published between 1993 and 2014. Women undergoing assisted reproduction techniques who either received a uterine relaxant agent in the peri-implantation period versus placebo or no treatment were included. Primary outcome was live birth rate. The meta-analyses did not show statistically significant benefit of any uterine relaxing agents on live birth rate. Other meta-analyses did not show a significant effect on the clinical pregnancy, spontaneous abortion, ectopic pregnancy and multiple pregnancy rate. Most of the included studies were of low quality and lacked significant power to detect minimally important effect. Evidence is insufficient to recommend using these agents in routine practice. Further methodologically robust randomized controlled trials with more refined selection criteria might reveal a beneficial effect. PMID:26936145

  12. Intestinal Infarctus following Dilatation and Uterine Curettage

    OpenAIRE

    Ngowe, N.M.; Atangana, R.; Eyenga, V.C.; Sosso, M.A.

    2008-01-01

    We present a case of intestinal infarctus through the vagina. This was a consequence of induced abortion done clandestinely. The main objective was to point out the surgical complications of uterine dilatation and curettage by means of this rare case.

  13. Bioinformatic detection of E47, E2F1 and SREBP1 transcription factors as potential regulators of genes associated to acquisition of endometrial receptivity

    Directory of Open Access Journals (Sweden)

    Croxatto Horacio B

    2011-01-01

    Full Text Available Abstract Background The endometrium is a dynamic tissue whose changes are driven by the ovarian steroidal hormones. Its main function is to provide an adequate substrate for embryo implantation. Using microarray technology, several reports have provided the gene expression patterns of human endometrial tissue during the window of implantation. However it is required that biological connections be made across these genomic datasets to take full advantage of them. The objective of this work was to perform a research synthesis of available gene expression profiles related to acquisition of endometrial receptivity for embryo implantation, in order to gain insights into its molecular basis and regulation. Methods Gene expression datasets were intersected to determine a consensus endometrial receptivity transcript list (CERTL. For this cluster of genes we determined their functional annotations using available web-based databases. In addition, promoter sequences were analyzed to identify putative transcription factor binding sites using bioinformatics tools and determined over-represented features. Results We found 40 up- and 21 down-regulated transcripts in the CERTL. Those more consistently increased were C4BPA, SPP1, APOD, CD55, CFD, CLDN4, DKK1, ID4, IL15 and MAP3K5 whereas the more consistently decreased were OLFM1, CCNB1, CRABP2, EDN3, FGFR1, MSX1 and MSX2. Functional annotation of CERTL showed it was enriched with transcripts related to the immune response, complement activation and cell cycle regulation. Promoter sequence analysis of genes revealed that DNA binding sites for E47, E2F1 and SREBP1 transcription factors were the most consistently over-represented and in both up- and down-regulated genes during the window of implantation. Conclusions Our research synthesis allowed organizing and mining high throughput data to explore endometrial receptivity and focus future research efforts on specific genes and pathways. The discovery of possible new transcription factors orchestrating the CERTL opens new alternatives for understanding gene expression regulation in uterine function.

  14. Placenta accreta in a separate uterine horn.

    Science.gov (United States)

    Baughn, Mariah R; Vaux, Keith; Masliah, Eliezer

    2010-01-01

    We report the case of a 30-year-old woman who presented with intrauterine fetal demise of a 17-2/7-week male fetus. The patient failed misoprostol induction and was taken for surgical evaluation. At the time of surgery an ectopic pregnancy in a noncommunicating rudimentary uterine horn was found. Histologic examination of the excised remnant uterine horn showed there was a placenta accreta. PMID:19642813

  15. To study the correlation between endometrial thickness on transvaginal sonography and endometrial histopathology in women with postmenopausal bleeding

    Directory of Open Access Journals (Sweden)

    Leena Chaudhari

    2016-05-01

    Conclusions: Postmenopausal bleeding, should always be taken seriously, no matter how minimal or nonpersistent it is, because though majority of causes underlying postmenopausal bleeding are benign, endometrial carcinoma may be seen in around 10% cases. So, patients with PMB must undergo thorough evaluation by endometrial sampling which cannot be replaced by transvaginal sonography which though has more sensitivity to detect endometrial thickening, at the same time, has low specificity for detection of malignancy. [Int J Reprod Contracept Obstet Gynecol 2016; 5(5.000: 1309-1315

  16. Progesterone receptor levels independently predict survival in endometrial adenocarcinoma

    DEFF Research Database (Denmark)

    Nyholm, H C; Christensen, Ib Jarle; Nielsen, Anette Lynge

    1995-01-01

    Estrogen receptor (ER) and progesterone receptor (PR) contents were determined by biochemical (dextran charcoal-coated (DCC) assay) and immunohistochemical (ICA) methods in biopsies from 145 primary endometrial adenocarcinomas and those with eligible receptor measurements were analyzed with respect...

  17. 6 Common Cancers - Gynecologic Cancers Cervical, Endometrial, and Ovarian

    Science.gov (United States)

    ... control pills for a long time, or have HIV infection. Endometrial cancer: Although the exact cause of ... consistency of the uterus or its surrounding, supporting structures may be ... virus (HPV) targeted by the vaccine. (Ovarian) Combined Treatment: ...

  18. Low-Grade Endometrial Stromal Sarcoma with Intravenous and Intracardiac Extension: A Multidisciplinary Approach

    Science.gov (United States)

    Inafuku, Hitoshi; Nakamoto, Tomoko; Taira, Yusuke; Taira, Rie; Tsubakimoto, Maho; Totsuka, Yuichi; Kuniyoshi, Yukio; Tamaki, Tomoko; Aoyama, Hajime

    2016-01-01

    Background. A rare case of low-grade endometrial stromal sarcoma (LG-ESS) extending to inferior vena cava (IVC) and cardiac chambers. Case Report. A 40-year-old woman had IVC tumor, which was incidentally detected by abdominal ultrasonography during a routine medical checkup. CT scan revealed a tumor in IVC, right iliac and ovarian veins, which was derived from the uterus and extended into the right atrium and ventricle. The operation was performed, the heart and IVC were exposed, and cardiopulmonary bypass was initiated. A right atriotomy was performed, and the intracardiac mass was removed. Then the tumor in IVC and the right internal iliac vein were removed after longitudinal venotomies in the suprarenal and infrarenal vena cava, the right common iliac vein. Next the pelvis was explored. Tumors were found originating from the posterior wall of the uterus and continuing into both the right uterine and ovarian vein. The patient underwent total hysterectomy with bilateral salpingooophorectomy. Complete tumor resection was achieved. Histopathological analysis confirmed a diagnosis of LG-ESS. She showed no evidence of disease for 2 years and 3 months. Conclusions. Our case highlights the importance of a multidisciplinary approach in treating this rare cardiovascular pathological condition through preoperative assessment to final operation.

  19. Studies on MRI diagnostic accuracy of invasion to body muscular layer and cervix of endometrial cancer

    International Nuclear Information System (INIS)

    This study was conducted to know usefulness of preoperative MRI to detect invasions of endometrial cancer to uterine body muscular layer and cervix. Subjects were 132 patients (median age of 57 y, pre- and post-menopause, 11.2 and 78.8%, respectively) with the cancer at stage I (66 cases) and >II in authors' facility, who had undergone the preoperative MRI with 1.5T Siemens machine by imaging with T1 and T2 weighted, Gd-enhanced T1 weighted, dynamic study and STIR. Imaging findings were compared with histopathological ones to assess the accuracy of imaging diagnosis. Positive predictive accuracy for muscular invasion was found to be as high as 95.5% and negative one, as low as 29.5%: especially, in pre-menopause group, tendency of underestimation for the invasion was thought notable. In contrast, negative accuracy was found low for cervical invasion and positive one, high: overestimation was possibly occurring. Thus, MRI diagnosis of those invasions should be seriously judged with careful consideration of menopause state. (R.T.)

  20. Pathophysiology and management of endometrial hyperplasia and carcinoma.

    OpenAIRE

    Fu, Y. S.; Gambone, J. C.; Berek, J S

    1990-01-01

    Endometrial cancer is currently the commonest pelvic malignancy affecting American women, most of whom share the same pathophysiologic basis, that is, unopposed estrogenic stimulation. The initial result of hyperestrogenism is the development of endometrial hyperplasia, which is reversible in most cases by appropriate hormonal therapy. Persistent stimulation eventually leads to atypical hyperplasia with nuclear atypia and invasive carcinoma. Because there is no cost-effective screening method...

  1. RNF43 is frequently mutated in colorectal and endometrial cancers.

    Science.gov (United States)

    Giannakis, Marios; Hodis, Eran; Jasmine Mu, Xinmeng; Yamauchi, Mai; Rosenbluh, Joseph; Cibulskis, Kristian; Saksena, Gordon; Lawrence, Michael S; Qian, Zhi Rong; Nishihara, Reiko; Van Allen, Eliezer M; Hahn, William C; Gabriel, Stacey B; Lander, Eric S; Getz, Gad; Ogino, Shuji; Fuchs, Charles S; Garraway, Levi A

    2014-12-01

    We report somatic mutations of RNF43 in over 18% of colorectal adenocarcinomas and endometrial carcinomas. RNF43 encodes an E3 ubiquitin ligase that negatively regulates Wnt signaling. Truncating mutations of RNF43 are more prevalent in microsatellite-unstable tumors and show mutual exclusivity with inactivating APC mutations in colorectal adenocarcinomas. These results indicate that RNF43 is one of the most commonly mutated genes in colorectal and endometrial cancers. PMID:25344691

  2. RNF43 is frequently mutated in colorectal and endometrial cancers

    Science.gov (United States)

    Giannakis, Marios; Hodis, Eran; Mu, Xinmeng Jasmine; Yamauchi, Mai; Rosenbluh, Joseph; Cibulskis, Kristian; Saksena, Gordon; Lawrence, Michael S.; Qian, ZhiRong; Nishihara, Reiko; Van Allen, Eliezer M.; Hahn, William C.; Gabriel, Stacey B.; Lander, Eric S.; Getz, Gad; Ogino, Shuji; Fuchs, Charles S.; Garraway, Levi A.

    2014-01-01

    We report somatic mutations of RNF43 in over 18% of colorectal adenocarcinomas and endometrial carcinomas. RNF43 encodes an E3 ubiquitin ligase that negatively regulates Wnt signaling. Truncating mutations of RNF43 are more prevalent in microsatellite-unstable tumors and show mutual exclusivity with inactivating APC mutations in colorectal adenocarcinomas. These results indicate that RNF43 is one of the most commonly mutated genes in colorectal and endometrial cancers. PMID:25344691

  3. RNF43 is frequently mutated in colorectal and endometrial cancers

    OpenAIRE

    Giannakis, Marios; Hodis, Eran; Mu, Xinmeng Jasmine; Yamauchi, Mai; Rosenbluh, Joseph; Cibulskis, Kristian; Saksena, Gordon; Michael S. Lawrence; Qian, Zhirong; Nishihara, Reiko; Van Allen, Eliezer M.; Hahn, William C; Gabriel, Stacey B.; Lander, Eric S; Getz, Gad

    2014-01-01

    We report somatic mutations of RNF43 in over 18% of colorectal adenocarcinomas and endometrial carcinomas. RNF43 encodes an E3 ubiquitin ligase that negatively regulates Wnt signaling. Truncating mutations of RNF43 are more prevalent in microsatellite-unstable tumors and show mutual exclusivity with inactivating APC mutations in colorectal adenocarcinomas. These results indicate that RNF43 is one of the most commonly mutated genes in colorectal and endometrial cancers.

  4. Inverse Relationship between Progesterone Receptor and Myc in Endometrial Cancer

    Science.gov (United States)

    Dai, Donghai; Meng, Xiangbing; Thiel, Kristina W.; Leslie, Kimberly K.; Yang, Shujie

    2016-01-01

    Endometrial cancer, the most common gynecologic malignancy, is a hormonally-regulated disease. Response to progestin therapy positively correlates with hormone receptor expression, in particular progesterone receptor (PR). However, many advanced tumors lose PR expression. We recently reported that the efficacy of progestin therapy can be significantly enhanced by combining progestin with epigenetic modulators, which we term “molecularly enhanced progestin therapy.” What remained unclear was the mechanism of action and if estrogen receptor ? (ER?), the principle inducer of PR, is necessary to restore functional expression of PR via molecularly enhanced progestin therapy. Therefore, we modeled advanced endometrial tumors that have lost both ER? and PR expression by generating ER?-null endometrial cancer cell lines. CRISPR-Cas9 technology was used to delete ER? at the genomic level. Our data demonstrate that treatment with a histone deacetylase inhibitor (HDACi) was sufficient to restore functional PR expression, even in cells devoid of ER?. Our studies also revealed that HDACi treatment results in marked downregulation of the oncogene Myc. We established that PR is a negative transcriptional regulator of Myc in endometrial cancer in the presence or absence of ER?, which is in contrast to studies in breast cancer cells. First, estrogen stimulation augmented PR expression and decreased Myc in endometrial cancer cell lines. Second, progesterone increased PR activity yet blunted Myc mRNA and protein expression. Finally, overexpression of PR by adenoviral transduction in ER?-null endometrial cancer cells significantly decreased expression of Myc and Myc-regulated genes. Analysis of the Cancer Genome Atlas (TCGA) database of endometrial tumors identified an inverse correlation between PR and Myc mRNA levels, with a corresponding inverse correlation between PR and Myc downstream transcriptional targets SRD5A1, CDK2 and CCNB1. Together, these data reveal a previously unanticipated inverse relationship between the tumor suppressor PR and the oncogene Myc in endometrial cancer. PMID:26859414

  5. Outpatient versus inpatient uterine polyp treatment for abnormal uterine bleeding: randomised controlled non-inferiority study

    OpenAIRE

    Cooper, Natalie A.M.; Clark, T. Justin; Middleton, Lee; Diwakar, Lavanya; Smith, Paul; Denny, Elaine; Roberts, Tracy; Stobert, Lynda; Jowett, Susan; Daniels, Jane

    2015-01-01

    Objective To compare the effectiveness and acceptability of outpatient polypectomy with inpatient polypectomy. Design Pragmatic multicentre randomised controlled non-inferiority study. Setting Outpatient hysteroscopy clinics in 31 UK National Health Service hospitals. Participants 507 women who attended as outpatients for diagnostic hysteroscopy because of abnormal uterine bleeding and were found to have uterine polyps. Interventions Participants were randomly assigned to either outpatient ut...

  6. Reciprocal communication between endometrial stromal cells and macrophages.

    Science.gov (United States)

    Eyster, Kathleen M; Hansen, Keith A; Winterton, Emily; Klinkova, Olga; Drappeau, Donis; Mark-Kappeler, Connie J

    2010-09-01

    This study tested the hypothesis that reciprocal communication occurs between macrophages and cultured human endometrial stromal cells and that this communication may contribute to the pathology of endometriosis. An endometrial stromal cell line (telomerase-immortalized human endometrial stromal cell [T-HESC]) was treated with macrophage-conditioned medium (CM) +/- estradiol + progesterone. Macrophages were treated without or with T-HESC CM. DNA microarray identified 716 differentially expressed genes in T-HESCs in response to factors secreted by macrophages. Upregulated genes in T-HESC included interleukin 8 (IL-8)/chemokine (C-X-C motif) ligand 8 (CXCL8), matrix metalloproteinase 3 (MMP3), phospholamban, cysteine-rich angiogenic inducer 61 (CYR61), connective tissue growth factor (CTGF), tenascin C, and nicotinamide N-methyltransferase (NNMT), whereas integrin alpha-6 was downregulated. In contrast, 15 named genes were differentially expressed in macrophages in response to factors secreted by endometrial stromal cells. The data document reciprocal communication between macrophages and endometrial stromal cells and suggest that interaction with macrophages stimulates the expression of genes in endometrial stromal cells that may support the establishment of endometriosis. PMID:20601541

  7. Endometrial thickness after menopause: effect of hormone replacement.

    Science.gov (United States)

    Lin, M C; Gosink, B B; Wolf, S I; Feldesman, M R; Stuenkel, C A; Braly, P S; Pretorius, D H

    1991-08-01

    Ultrasound (US) images of the pelvis were evaluated in 112 asymptomatic postmenopausal women to investigate the normal range of endometrial thickness (double-layer measurement) and the effect of hormone replacement on these measurements. Twenty-one patients (19%) had endometrial thickness greater than 0.8 cm. One patient, with an endometrial thickness of 2.5 cm, had endometrial carcinoma. Consideration of the known actions of estrogen and progestogen on the endometrium led the authors to believe that the clinical significance of an endometrium measuring more than 0.8 cm depends on the patient's hormonal status. Among asymptomatic postmenopausal women with an endometrial thickness between 0.8 and 1.5 cm, those receiving unopposed estrogen or continuous estrogen and progestogen need to undergo dilatation and curettage (D&C) or biopsy and those receiving no hormones or receiving sequential estrogen and progestogen should be encouraged to undergo D&C or biopsy. If a patient in one of the latter two groups is unwilling to undergo an invasive procedure, then US examination at 3-month intervals is acceptable. Any patient with endometrial thickness of at least 1.5 cm should undergo histologic diagnosis, regardless of symptoms or hormone status. PMID:1829843

  8. Uterine Expression of NDRG4 Is Induced by Estrogen and Up-Regulated during Embryo Implantation Process in Mice

    Science.gov (United States)

    Zhang, Xuan; Wang, Jian-Mei; He, Ya-Ping; Shi, Yan; Sun, Zhao-Gui; Shi, Hui-Juan; Wang, Jian

    2016-01-01

    Embryo implantation is an essential step for the establishment of pregnancy and dynamically regulated by estrogen and progesterone. NDRG4 (N-myc down-regulated gene 4) is a tumor suppressor that participates in cell survival, tumor invasion and angiogenesis. The objective of this study was to preliminarily explore the role of NDRG4 in embryo implantation. By immunohistochemistry (IHC) and quantitive RT-PCR (qRT-PCR), we found that uterine expression of NDRG4 was increased along with puberal development, and its expression in adult females reached the peak at the estrus stage during the estrus cycle. Furthermore, uterine NDRG4 expression was significantly induced by the treatment of estradiol (E2) both in pre-puberty females and ovariectomized adult females. Uterine expression pattern of NDRG4 during the peri-implantation period in mice was determined by IHC, qRT-PCR and Western blot. It was observed that NDRG4 expression was up-regulated during the implantation process, and its expression level at the implantation sites was significantly higher than that at the inter-implantation sites. Meanwhile, an increased expression in NDRG4 was associated with artificial decidualization as well as the activation of delayed implantation. By qRT-PCR and Western blot, we found that the in vitro decidualization of endometrial stromal cells (ESCs) was accompanied by up-regulation of NDRG4 expression, whereas knockdown of its expression in these cells by siRNA inhibited the decidualization process. In addition, Western blot analysis showed that NDRG4 protein expression was decreased in human villus tissues of recurrent miscarriage (RM) patients compared to normal pregnant women. Collectively, these data suggested that uterine NDRG4 expression could be induced by estrogen, and NDRG4 might play an important role during early pregnancy. PMID:27175791

  9. Uterine Artery Embolization to Treat Uterine Adenomyosis with or without Uterine Leiomyomata: Results of Symptom Control and Health-Related Quality of Life 40 Months after Treatment

    International Nuclear Information System (INIS)

    Purpose: To evaluate the clinical outcome for uterine adenomyosis with or without uterine leiomyomata 40 months after uterine artery embolization (UAE). Methods: Forty women aged 39–56 years (median 46 years) with symptomatic uterine adenomyosis and magnetic resonance imaging findings of uterine adenomyosis with or without combined uterine leiomyomata underwent UAE. Self-perceived changes in clinical symptoms were assessed, and residual symptom severity and health-related quality of life (HRQOL) after UAE were evaluated. Clinical failure was defined as no symptomatic improvement or second invasive therapy after UAE. Results were stratified by the extent of uterine adenomyosis at baseline magnetic resonance imaging. Results: Patients were followed for a median of 40 months (range 5–102 months). UAE led to symptomatic control after UAE in 29 (72.5%) of 40 patients while 11 women underwent hysterectomy (n = 10) or dilatation and curettage (n = 1) for therapy failure. No significant difference between women with pure uterine adenoymosis and women with uterine adenomyosis combined with uterine leiomyomata was observed. Best results were shown for UAE in uterine adenomyosis with uterine leiomyomata predominance as opposed to predominant uterine adenomyosis with minor fibroid disease (clinical failure 0% vs. 31.5%, P = 0.058). Throughout the study group, HRQOL score values increased and symptom severity scores decreased after UAE. Least improvement was noted for women with pure adenomyosis. Conclusions: UAE is clinically effective in the long term in most women with uterine adenomyosis. Symptomatic control and HRQOL were highest in patients with combined disease of uterine adenomyosis but leiomyomata predominance.

  10. Clinical application of uterine artery embolization in treating uterine scar pregnancy

    International Nuclear Information System (INIS)

    Objective: To evaluate uterine artery embolization in treating uterine scar pregnancy. Methods: During the period from November 2007 to February 2010, 11 patients with uterine scar pregnancy were encountered in authors' hospital. All the patients had a history of lower uterine segment cesarean section. Four patients had to receive an emergency uterine artery embolization due to acute massive vaginal bleeding. The other 7 patients received intravenous chemotherapy with MTX (0.4 mg/kg/day, every 5 days as a treatment course). Emergency uterine artery embolization had to be carried out in three patients as they developed acute massive vaginal bleeding (blood loss ≥ 100 ml/hour) during the course of chemotherapy, while subsequent uterine artery embolization was performed in the remaining 4 patients after they had completed two courses of treatment when their blood HCG showed no significant decrease. The clinical results were analyzed. Results: Remarkable decrease in serum HCG was seen in all 11 patients after interventional management. The vaginal bleeding in 7 patients was significantly reduced within half an hour after uterine artery embolization. The uterus together with intact fertility was successfully preserved in all 11 patients. Conclusion: For the treatment of uterine scar pregnancy complicated by massive vaginal bleeding (blood loss ≥ 500 ml/24 h) and/or abnormal elevation of serum HCG (blood β-HCG ≥ 20000 IU/L), ectopic pregnancy with the mass diameter ≥ 5 cm, uterine artery embolization treatment is very safe and effective. This technique can well preserve female patient's uterus and fertility ability. It is of value to employ this treatment in clinical practice. (authors)

  11. All-trans retinoic acid protects against arsenic-induced uterine toxicity in female Sprague-Dawley rats

    Energy Technology Data Exchange (ETDEWEB)

    Chatterjee, A.; Chatterji, U., E-mail: urmichatterji@gmail.com

    2011-12-15

    Background and purpose: Arsenic exposure frequently leads to reproductive failures by disrupting the rat uterine histology, hormonal integrity and estrogen signaling components of the rat uterus, possibly by generating reactive oxygen species. All-trans retinoic acid (ATRA) was assessed as a prospective therapeutic agent for reversing reproductive disorders. Experimental approach: Rats exposed to arsenic for 28 days were allowed to either recover naturally or were treated simultaneously with ATRA for 28 days or treatment continued up to 56 days. Hematoxylin-eosin double staining was used to evaluate changes in the uterine histology. Serum gonadotropins and estradiol were assayed by ELISA. Expression of the estrogen receptor (ER{alpha}), an estrogen responsive gene vascular endothelial growth factor (VEGF), and cell cycle regulatory proteins, cyclin D1 and CDK4, was assessed by RT-PCR, immunohistochemistry and western blot analysis. Key results: ATRA ameliorated sodium arsenite-induced decrease in circulating estradiol and gonadotropin levels in a dose- and time-dependent manner, along with recovery of luminal epithelial cells and endometrial glands. Concomitant up regulation of ER{alpha}, VEGF, cyclin D1, CDK4 and Ki-67 was also observed to be more prominent for ATRA-treated rats as compared to the rats that were allowed to recover naturally for 56 days. Conclusions and implications: Collectively, the results reveal that ATRA reverses arsenic-induced disruption of the circulating levels of gonadotropins and estradiol, and degeneration of luminal epithelial cells and endometrial glands of the rat uterus, indicating resumption of their functional status. Since structural and functional maintenance of the pubertal uterus is under the influence of estradiol, ATRA consequently up regulated the estrogen receptor and resumed cellular proliferation, possibly by an antioxidant therapeutic approach against arsenic toxicity. Highlights: Black-Right-Pointing-Pointer Arsenic disrupts the uterine histology and estrogen signaling components in rats. Black-Right-Pointing-Pointer Decrease in estradiol and gonadotropin levels, ER{alpha}, VEGF and cell cycle proteins. Black-Right-Pointing-Pointer Arsenic disrupts the above components by inhibiting antioxidant defense mechanism. Black-Right-Pointing-Pointer ATRA treatment led to recovery of uterine histology and ER{alpha} signaling components. Black-Right-Pointing-Pointer Vitamin A in diet is a promising cure for arsenic-induced reproductive failures.

  12. Adenocarcinoma of the Uterine Cervix

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Eun Ji; Shin, Hyun Soo; Lee, Hyung Sik; Kim, Gwi Eon; Loh, Juhn Kyu; Suh, Chang Ok [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1991-12-15

    Survival data, prognostic factors, and patterns of failure were retrospectively analyzed for a total of 76 patients with adenocarcinoma of the uterine cervix treated between January 1981 and December 1987, which represents 4.1% of all primary cervical carcinomas treated, at Department of Radiation Oncology, Yensei Cancer Center, Yonsei University College of Medicine. The mean age of the patients was 49years(range, 27-79years) and the peak incidence was in the group 50 to 59years of age. More half of the patients were postmenopausal (46/76=60.5%). Most patients(76%)had abnormal vaginal bleeding either alone or in combination with other symptoms. The proportion of stage Iib was 43.4%. There were 4 major histologic subtypes: pure adenocarcinoma(48/76=63.2%), adenosquamous carcinoma(20/76=26.3%), papillary (5/76=6.6%) and clear cell carcinoma(3/76=3.9%). Of the many clinicopathologic variables evaluated for prognosis, the most significant prognostic factors were stage of disease and the size of tumor. The overall 5-year survival rate was 68%, and the 5-year survival rates for stage Ib, II and III were 90%, 66% and 54%, respectively. Control of pelvic tumors was achieved in 938%, 90.2% and 50.0% of cases of stage Ib, II and III disease, respectively. In present study, treatment modalities (radiation therapy alone/combined operative and radiation therapy) did not affect the local control of tumor and the survival.

  13. Uterine adenosarcomas are mesenchymal neoplasms.

    Science.gov (United States)

    Piscuoglio, Salvatore; Burke, Kathleen A; Ng, Charlotte Ky; Papanastasiou, Anastasios D; Geyer, Felipe C; Macedo, Gabriel S; Martelotto, Luciano G; de Bruijn, Ino; De Filippo, Maria R; Schultheis, Anne M; Ioris, Rafael A; Levine, Douglas A; Soslow, Robert A; Rubin, Brian P; Reis-Filho, Jorge S; Weigelt, Britta

    2016-02-01

    Uterine adenosarcomas (UAs) are biphasic lesions composed of a malignant mesenchymal (ie stromal) component and an epithelial component. UAs are generally low-grade and have a favourable prognosis, but may display sarcomatous overgrowth (SO), which is associated with a worse outcome. We hypothesized that, akin to breast fibroepithelial lesions, UAs are mesenchymal neoplasms in which clonal somatic genetic alterations are restricted to the mesenchymal component. To characterize the somatic genetic alterations in UAs and to test this hypothesis, we subjected 20 UAs to a combination of whole-exome (n = 6), targeted capture (n = 13) massively parallel sequencing (MPS) and/or RNA sequencing (n = 6). Only three genes, FGFR2, KMT2C and DICER1, were recurrently mutated, all in 2/19 cases; however, 26% (5/19) and 21% (4/19) of UAs harboured MDM2/CDK4/HMGA2 and TERT gene amplification, respectively, and two cases harboured fusion genes involving NCOA family members. Using a combination of laser-capture microdissection and in situ techniques, we demonstrated that the somatic genetic alterations detected by MPS were restricted to the mesenchymal component. Furthermore, mitochondrial DNA sequencing of microdissected samples revealed that epithelial and mesenchymal components of UAs were clonally unrelated. In conclusion, here we provide evidence that UAs are genetically heterogeneous lesions and mesenchymal neoplasms. Copyright © 2015 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. PMID:26592504

  14. Uterine biology in pigs and sheep

    Directory of Open Access Journals (Sweden)

    Bazer Fuller W

    2012-07-01

    Full Text Available Abstract There is a dialogue between the developing conceptus (embryo-fetus and associated placental membranes and maternal uterus which must be established during the peri-implantation period for pregnancy recognition signaling, implantation, regulation of gene expression by uterine epithelial and stromal cells, placentation and exchange of nutrients and gases. The uterus provide a microenvironment in which molecules secreted by uterine epithelia or transported into the uterine lumen represent histotroph required for growth and development of the conceptus and receptivity of the uterus to implantation. Pregnancy recognition signaling mechanisms sustain the functional lifespan of the corpora lutea (CL which produce progesterone, the hormone of pregnancy essential for uterine functions that support implantation and placentation required for a successful outcome of pregnancy. It is within the peri-implantation period that most embryonic deaths occur due to deficiencies attributed to uterine functions or failure of the conceptus to develop appropriately, signal pregnancy recognition and/or undergo implantation and placentation. With proper placentation, the fetal fluids and fetal membranes each have unique functions to ensure hematotrophic and histotrophic nutrition in support of growth and development of the fetus. The endocrine status of the pregnant female and her nutritional status are critical for successful establishment and maintenance of pregnancy. This review addresses the complexity of key mechanisms that are characteristic of successful reproduction in sheep and pigs and gaps in knowledge that must be the subject of research in order to enhance fertility and reproductive health of livestock species.

  15. Uterine biology in pigs and sheep.

    Science.gov (United States)

    Bazer, Fuller W; Song, Gwonhwa; Kim, Jinyoung; Dunlap, Kathrin A; Satterfield, Michael Carey; Johnson, Gregory A; Burghardt, Robert C; Wu, Guoyao

    2012-01-01

    There is a dialogue between the developing conceptus (embryo-fetus and associated placental membranes) and maternal uterus which must be established during the peri-implantation period for pregnancy recognition signaling, implantation, regulation of gene expression by uterine epithelial and stromal cells, placentation and exchange of nutrients and gases. The uterus provide a microenvironment in which molecules secreted by uterine epithelia or transported into the uterine lumen represent histotroph required for growth and development of the conceptus and receptivity of the uterus to implantation. Pregnancy recognition signaling mechanisms sustain the functional lifespan of the corpora lutea (CL) which produce progesterone, the hormone of pregnancy essential for uterine functions that support implantation and placentation required for a successful outcome of pregnancy. It is within the peri-implantation period that most embryonic deaths occur due to deficiencies attributed to uterine functions or failure of the conceptus to develop appropriately, signal pregnancy recognition and/or undergo implantation and placentation. With proper placentation, the fetal fluids and fetal membranes each have unique functions to ensure hematotrophic and histotrophic nutrition in support of growth and development of the fetus. The endocrine status of the pregnant female and her nutritional status are critical for successful establishment and maintenance of pregnancy. This review addresses the complexity of key mechanisms that are characteristic of successful reproduction in sheep and pigs and gaps in knowledge that must be the subject of research in order to enhance fertility and reproductive health of livestock species. PMID:22958877

  16. Uterine artery embolization for adenomyosis without fibroids

    Energy Technology Data Exchange (ETDEWEB)

    Kim, M.D. E-mail: mdkim@cha.ac.kr; Won, J.W.; Lee, D.Y.; Ahn, C.-S

    2004-06-01

    AIM: To evaluate the potential usefulness of transcatheter uterine artery embolization as a treatment for symptomatic adenomyosis in patients without uterine fibroids. MATERIALS AND METHODS: Uterine artery embolization using polyvinyl alcohol particles sized 250-710 mm was performed in 43 patients (mean; 40.3 years, range; 31-52 years) with dysmenorrhoea, menorrhagia, or bulk-related symptoms (pelvic heaviness, urinary frequency) due to adenomyosis without fibroids. All patients underwent pre-procedural and 3.5 months (range 1-8 months) follow-up magnetic resonance imaging (MRI) with contrast enhancement. Clinical symptoms were also assessed at the time of MRI before and after embolization. RESULTS: Significant improvement of dysmenorrhoea (95.2%) and menorrhagia (95.0%) was reported in most patients. Contrast-enhanced MRI revealed non-enhancing areas suggesting coagulation necrosis of adenomyosis in 31 patients (72.1%), decreased size without necrosis in 11 patients (25.6%), and no change in one patient (2.3%). The mean volume reduction of the uteri after uterine artery embolization was 32.5% (from 321.7{+-}142.9 to 216.7{+-}130.1 cm{sup 3}). CONCLUSION: Transcatheter uterine artery embolization is an effective therapy for the treatment of symptomatic pure adenomyosis, and may be a valuable alternative to hysterectomy.

  17. Uterine artery embolization for adenomyosis without fibroids

    International Nuclear Information System (INIS)

    AIM: To evaluate the potential usefulness of transcatheter uterine artery embolization as a treatment for symptomatic adenomyosis in patients without uterine fibroids. MATERIALS AND METHODS: Uterine artery embolization using polyvinyl alcohol particles sized 250-710 mm was performed in 43 patients (mean; 40.3 years, range; 31-52 years) with dysmenorrhoea, menorrhagia, or bulk-related symptoms (pelvic heaviness, urinary frequency) due to adenomyosis without fibroids. All patients underwent pre-procedural and 3.5 months (range 1-8 months) follow-up magnetic resonance imaging (MRI) with contrast enhancement. Clinical symptoms were also assessed at the time of MRI before and after embolization. RESULTS: Significant improvement of dysmenorrhoea (95.2%) and menorrhagia (95.0%) was reported in most patients. Contrast-enhanced MRI revealed non-enhancing areas suggesting coagulation necrosis of adenomyosis in 31 patients (72.1%), decreased size without necrosis in 11 patients (25.6%), and no change in one patient (2.3%). The mean volume reduction of the uteri after uterine artery embolization was 32.5% (from 321.7±142.9 to 216.7±130.1 cm3). CONCLUSION: Transcatheter uterine artery embolization is an effective therapy for the treatment of symptomatic pure adenomyosis, and may be a valuable alternative to hysterectomy

  18. Long-term impact of preeclampsia on maternal endometrial cancer risk

    DEFF Research Database (Denmark)

    Hallum, Sara; Pinborg, Anja; Kamper-Jørgensen, Mads

    2016-01-01

    BACKGROUND: Endometrial cancer is mainly dependent on oestrogen exposure. Preeclampsia has shown to reduce oestrogen levels hence preeclampsia may affect later endometrial cancer risk. METHODS: We conducted a case-control study of 523 Danish women with endometrial cancer and 52 299controls during...... 1978-2010. The association between preeclampsia and later endometrial cancer was evaluated overall and according to preeclampsia onset and type of endometrial cancer in conditional logistic regression models. RESULTS: We observed no overall association between preeclampsia and endometrial cancer risk...... (OR=1.11 (95% CI 0.68-1.81)). This was true for all endometrial cancer subtypes. In an analysis of preeclampsia onset, however, we report a markedly increased risk of endometrial cancer following early-onset preeclampsia (OR=2.64 (95% CI 1.29-5.38)). CONCLUSIONS: Although we report no obvious...

  19. Placenta accrete treated with uterine arterial embolization (case report)

    International Nuclear Information System (INIS)

    Objective: To investigate the possibility of interventional treatment of placenta accrete. Methods: One patient with placenta accrete was treated with uterine arterial infusion of cef and MTX followed by embolization. Results: Her placenta discharged through vagina at the 27 th day after uterine arterial embolization. No remnant was found in the uterine by Doppler imaging. The patient uneventfully recovered. Conclusions: Interventional therapy with uterine arterial embolization is a new and reliable method for treatment for placenta accrete

  20. Steroidal regulation of uterine resistance to bacterial infection in livestock

    OpenAIRE

    Lewis Gregory S

    2003-01-01

    Abstract Postpartum uterine infections reduce reproductive efficiency and have significant animal welfare and economic consequences. Postpartum uterine infections are classified as nonspecific, but Arcanobacterium pyogenes and Escherichia coli are usually associated with them in cattle and sheep. Pyometra is the most common type of uterine infection in dairy cattle, and it is detected almost exclusively in cows with active corpora lutea. Luteal progesterone typically down-regulates uterine im...

  1. Uterine vascular lesions: a rare cause of abnormal uterine bleeding, reporting of two cases

    Directory of Open Access Journals (Sweden)

    Sunita Arora

    2014-06-01

    Full Text Available Uterine vascular lesions in the form of arteriovenous malformation or pseudo aneurysm are rare but potential life-threatening source of bleeding. A high index of suspicion and accurate diagnosis of the condition in a timely manner are essential because instrumentation that is often used for other causes of uterine bleeding can lead to massive hemorrhage. We describe two cases of uterine vascular malformation, one presenting as postabortal hemorrhage and other as postpartum hemorrhage. Case one presented as postabortal hemorrhage after induced abortion following dilatation and curettage. Case two presented as delayed postpartum hemorrhage after six weeks following cesarean section. In both cases diagnosis of uterine arteriovenous malformation was made on Doppler ultrasonography which was subsequently confirmed on pelvic angiography. The embolization of affected uterine arteries was performed successfully in both cases. Uterine vascular lesion should be suspected in patient with abnormal vaginal bleeding, especially who has recent medical history of induced abortion or dilatation and curettage or cesarean section and so on. Although angiography remains the gold standard for making diagnosis, Doppler ultrasonography is also a good noninvasive technique for the same. Uterine artery embolization offers a safe and effective treatment. [Int J Reprod Contracept Obstet Gynecol 2014; 3(3.000: 749-753

  2. Uterine arterial methotrexate infusion and embolization in the treatment of uterine adenomyosis

    International Nuclear Information System (INIS)

    Objective: To study the efficacy of treating different types of uterine adenomyosis with transcatheter local infusion of methotrexate (MTX) combined with uterine arterial embolization under guidance of digital subtraction angiography (DSA). Methods: 33 cases were primarily screened out according to clinical symptoms and color Doppler and then further diagnosis as diffuse or local adenomyosis were undertaken with super selective uterine arterial angiography. The patients were then treated with uterine arterial local infusion (50 mg MTX)and embolization with PVA microsphere (diameter 450-650 μm), individually. Finally, the comparison between the preoperative and postoperative menstruation volumes, the degrees of dysmenorrheal, uterine sizes and the levels of sexual hormones of diffuse and local adenomyosis was carried out. Results: The uterine arterial local infusion of MTX combined with embolization showed no chemotherapeutic side effects. In all cases, there were decrease of menstruation amount, alleviated dysmenorrhea, reduction of uterine size, and the efficacy was more evident in diffuse adenomyosis (P<0.05). Conclusions: Micro-invasive interventional technique combined with drug therapy is promising for diffuse and local adenomyosis especially for the former. (authors)

  3. Selective uterine artery embolization: its application in treating symptomatic uterine leiomyomas

    International Nuclear Information System (INIS)

    Objective: To discuss the feasibility and safety of uterine artery embolization(UAE) for the treatment of symptomatic uterine leiomyomas. Methods: During the period of Jan. 2005-June 2009, UAE was performed in 85 patients with uterine leiomyomas in the authors' hospital. The main symptoms included hypermenorrhea, delayed menstruation and pelvic pressure symptoms. The bilateral uterine arteries were embolized with polyvinyl alcohol particles (diameter 500-710 μm) and Gelfoam. The technical success rate and the clinical results were observed. The patients were followed up for 6-36 months. Results: The technical success rate of bilateral uterine artery embolization was 100%. No serious complications occurred. During the follow-up period, menses returned to regular cycle in all patients and the hemoglobin concentration rose up to normal level in patients with anemia. The sizes of uterine leiomyomas were decreased by 57.5% after 6 months of the procedure. Conclusion: UAE is an effective and less-invasive treatment for symptomatic uterine leiomyomas with reliable results and fewer complications. This technique can greatly avoid unnecessary uterectomy and, thus, preserve the fertility of the female patients.(authors)

  4. Relação entre a espessura endometrial e os níveis do beta-HCG com a resposta ao tratamento da gravidez ectópica com metotrexato / Relationship between endometrial thickness and beta-HCG levels in the response to treatment of ectopic pregnancy with methotrexate

    Scientific Electronic Library Online (English)

    Roberto da Costa, Soares; Júlio, Elito Júnior; Luiz, Camano.

    2004-07-01

    Full Text Available OBJETIVO: avaliar a relação entre os níveis séricos do hormônio gonadotrópico coriônico (beta-hCG) e a medida da espessura endometrial, em pacientes submetidas ao tratamento de gravidez ectópica com metotrexate. MÉTODOS: estudo clínico prospectivo, no qual foram avaliados os títulos do beta-hCG e a [...] maior medida da espessura endometrial no eixo longitudinal uterino por meio da ultra-sonografia transvaginal, em 38 pacientes com gravidez ectópica íntegra, com diâmetro 10,0 mm), independente da resposta terapêutica. Para análise estatística foi utilizado o teste t de Student. RESULTADOS: as médias dos valores iniciais do beta-hCG das 28 mulheres que apresentaram resposta terapêutica medicamentosa foi de 1936,2 mUI/ml, significativamente menor do que a média das 10 mulheres sem resposta, 6831,3 mUI/ml (10,0 mm, cuja média foi de 6925,9 mUI/ml. CONCLUSÕES: a medida da espessura endometrial avaliada pela ultra-sonografia sofre influência dos níveis séricos do beta-hCG, se mostrando valiosa como fator orientador adicional na indicação do tratamento medicamentoso com metotrexate na gravidez ectópica íntegra. Abstract in english OBJECTIVE: to evaluate the correlation between the beta-human chorionic gonadotropin (beta-hCG) serum levels and the measurement of the endometrial thickness, in patients under treatment of ectopic pregnancy with methotrexate. METHODS: a prospective study in which the levels of beta-hCG as well as t [...] he largest measurement of the endometrial thickness on the uterine longitudinal axis through transvaginal ultrasound were evaluated at 24-48 h intervals in thirty-eight patients with hemodynamic stability, ectopic pregnancy, diameter 10.0 mm) independently of the response to treatment employing the Student t-test. RESULTS: the mean values of beta-hCG and endometrial thickness in patients with successful treatment (28 cases) were 1936.2 mIU/ml and 6.4 mm, respectively, significanlty lower than the mean values for insuccessful cases: 6831.3 mIU/ml and 11.7 mm, respectively (p10.0 mm, whose mean values were 6925.9 mIU/ml (

  5. The clinical application of uterine arterial embolization with dextran microspheres in treating uterine leiomyomas

    International Nuclear Information System (INIS)

    Objective: To prospectively investigate the clinical application of bilateral uterine arterial embolization with dextran microspheres in treating uterine leiomyomas. Methods: A total of 60 patients with uterine leiomyomas, encountered in the authors' hospital during the period from Jan. 2003 to Dec. 2010, were enrolled in this study. The patients were randomly divided into study group and control group with 30 cases in each group. Patients in the study group received bilateral uterine artery embolization by using dextran microspheres (Sephadex, g-50, 100-300 μm) as embolic agents, while patients in control group received bilateral uterine artery embolization by using KMG (500-700 μm) as embolic agents. Before and after the treatment, all patients were kept under observation for the menstrual flow, the size of the uterine and the leiomyoma and the changes in sex hormone level. The hospitalization costs were recorded. The results were compared between the two groups. Results: The technical success rate of catheterization and embolization procedure was 100% in both groups. After the therapy, the volumes of both the uterine and the leiomyoma were significantly decreased, but no significant difference in the size reduction existed between the two groups (both P.0.05). The clinical symptoms were markedly improved in all patients. The sex hormone level showed no obvious changes. No serious complications occurred. The hospitalization cost of the study group was significantly lower than that of the control group (P<0.05). Conclusion: For the treatment of uterine leiomyomas, uterine artery embolization with dextran microspheres is very effective and safe. Moreover, the hospitalization cost is lower. Therefore, it is of value to use this technique in clinical practice. (authors)

  6. Giant Uterine Leiomyoma. A Case Report

    Directory of Open Access Journals (Sweden)

    Luis Noel Marrero Quiala

    2014-09-01

    Full Text Available Giant uterine fibromyoma is a benign condition which has a very low incidence. Its management poses a challenge for the surgical team due to the volume of the surgical specimen and the variations in the distribution of the intra-abdominal organs caused by the uterine growth. The case of a 29-year-old patient misdiagnosed with giant hepatomegaly at admission is presented. Her symptoms included hard abdomen and feeling of heaviness. Successful completion of the interview, physical examination and imaging studies led to the correct diagnosis of giant uterine fibromyoma. Surgical treatment was applied. A total abdominal hysterectomy was performed with satisfactory results. This case is presented to the medical community for teaching purposes and due to its rarity.

  7. Giant Uterine Fibromyoma. A Case Report

    Directory of Open Access Journals (Sweden)

    Tahiluma Santana Pedraza

    2013-12-01

    Full Text Available The uterus is the common site for multiple benign and malignant conditions. Giant uterine fibromyoma is a benign tumor of low incidence. Its management poses a challenge for the surgical team because of the volume of the surgical specimen and the variations in the distribution of intra-abdominal organs caused by uterine growth. A case of a 43-year-old patient with a history of bronchial asthma and hypertension who presented with enlargement of the abdomen and vaginal bleeding is reported. The patient was attended by the General Surgery Department of the María Genoveva Guerrero Ramos Comprehensive Diagnostic Center in the Libertador Municipality, Capital District, Venezuela. Total abdominal hysterectomy and complementary appendectomy were performed. The histopathological study showed a giant uterine fibromyoma. Postoperative progress was satisfactory. It was decided to present the case due to its rarity.

  8. Comparative study of saline infusion sonography and hysteroscopy for evaluation of uterine cavity in abnormal uterine bleeding