Science.gov

Sample records for huge uterine myoma

  1. A proteomic analysis of human uterine myoma.

    PubMed

    Rizzello, A; Franck, J; Pellegrino, M; De Nuccio, F; Simeone, P; Fiore, G; Di Tommaso, S; Malvasi, A; Tinelli, A; Fournier, I; Salzet, M; Maffia, M; Vergara, D

    2016-03-22

    Uterine leiomyoma is a benign smooth muscle tumor characterized by a high incidence in women of reproductive age. The aetiology of this tumor is still unknown but established risk factors include high levels of female hormones, family history, African ancestry, early age of menarche and obesity. Here, to identify proteomic features associated with this tumor type, we performed a liquid cromatography-mass spectrometry (LC-MS/MS) analysis of uterine myomas. The identified proteins were subjected to a gene ontology analysis to generate biological functions, molecular processes, and protein networks that were relevant to the uploaded dataset. Pathway-based analysis was an effective approach to investigate the molecular mechanisms underlying the disease and to create biological hypotheses about regulation of our proteins including the identification of upstream regulators and main protein nodes. Moreover, proteomic and in silico data were combined with immunohistochemistry and western blotting to identify a group of proteins representative of some selected pathways, with a dysregulated expression in in myoma, pseudocapsule, and normal myometrium samples. Based on these results, we confirmed the over-expression of extracellular matrix components, and estrogen and progesterone receptors in uterine myomas, and proposed biological networks, canonical pathways and functions that may be relevant to the pathophysiology of this tumor.

  2. Epidemiology of Uterine Myomas: A Review

    PubMed Central

    Sparic, Radmila; Mirkovic, Ljiljana; Malvasi, Antonio; Tinelli, Andrea

    2016-01-01

    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. PMID:26985330

  3. Effect of the levonorgestrel-releasing intrauterine system on uterine myomas in a renal transplant patient.

    PubMed

    Fong, Y F; Singh, K

    1999-07-01

    The levonorgestrel-releasing intrauterine system (LNG-IUS) has been used in the treatment of both idiopathic menorrhagia and adenomyosis. An electronic search of the on-line medical literature revealed no reports of its use for menorrhagia secondary to uterine myomas. Presented here is the successful treatment of uterine myomas with menorrhagia in a woman with a renal transplant. There was a significant reduction in menorrhagia, dysmenorrhea, and uterine and myoma size with the use of the LNG-IUS. We believe that this system provides an alternative to conventional hysterectomy and gonadotrophin-releasing hormonal analog medical treatment for uterine myomas, with a possibly inhibitory effect on myoma growth.

  4. [Efficacy of general magnetotherapy in conservative therapy of uterine myoma in women of reproductive age].

    PubMed

    Kulishova, T V; Tabashnikova, N A; Akker, L V

    2005-01-01

    Sixty women of the reproductive age with uterine myoma were divided into two groups. Thirty patients of the study group received combined therapy plus general magnetotherapy (GMT). Patients of the control group received only combined treatment. Ultrasound investigation registered a reduction in the size of myoma nodes by 16.7% in the study group, while in the controls myoma size did not change (p < 0.05). 1-year follow-up data for the study group demonstrated no cases of the myoma growth while 16.6% of the controls showed growth of myoma nodes, in 6.6% of them supravaginal myoma amputation was made for rapidly growing myoma.

  5. Treatment of Uterine Myomas by Radiofrequency Thermal Ablation

    PubMed Central

    Chen, Ming; Yang, Shujun; Li, Juan; Zhu, Tongyu; Zhao, Xiaoli

    2015-01-01

    Patients’ selection criteria, effectiveness, and safety of radiofrequency thermal ablation (RFTA) therapy for uterine myomas (UM) were assessed using a 10-year retrospective cohort study. From July 2001 to July 2011, a total of 1216 patients treated for UM were divided into 2 groups. Group A consisted of 476 premenopause patients, average age 36.5 ± 8.5 years, average number of myomas 1.7 ± 0.9, and average diameter of myomas 4.5 ± 1.5 cm, and group B consisted of 740 menopause patients, average age 48.5 ± 3.5 years, average number of myomas 2.6 ± 1.3, and average diameter of myomas 5.0 ± 2.5 cm. Average follow-up period was 36.5 ± 11.5 months. At 1, 3, 6, 12, and 24 months after RFTA, average diameters of myomas in group A were 3.8, 3.0, 2.7, 2.4, and 2.2 cm, respectively, and 47.7% (227 of 476) of patients had tumor trace at 12 months after RFTA. In group B, the results were 4.7, 3.7, 3.3, 2.3, and 2.3 cm, respectively, and 58.8% (435 of 740) of patients had tumor trace at 12 months after RFTA. Three months after treatment, myoma volumes were significantly reduced in both the groups (P < .01), and group B had higher rate of tumor trace at 12 months after RFTA than group A (P < .05). Clinical symptoms and health-related quality-of-life outcome (HRQL) were significantly improved after RFTA in both groups and the postoperative recurrence rate of UM was significantly higher in group A at 10.7% (51 of 476) than group B at 2.4% (18 of 740; P < .05). Radiofrequency thermal ablation is an excellent minimally invasive treatment for UM smaller than 5.0 cm in diameter. PMID:25355802

  6. Preoperative 3-dimensional Magnetic Resonance Imaging of Uterine Myoma and Endometrium Before Myomectomy.

    PubMed

    Kim, Young Jae; Kim, Kwang Gi; Lee, Sa Ra; Lee, Seung Hyun; Kang, Byung Chul

    2017-02-01

    Uterine myomas are the most common gynecologic benign tumor affecting women of childbearing age, and myomectomy is the main surgical option to preserve the uterus and fertility. During myomectomy for women with multiple myomas, it is advisable to identify and remove as many as possible to decrease the risk of future myomectomies. With deficient preoperative imaging, gynecologists are challenged to identify the location and size of myomas and the endometrium, which, in turn, can lead to uterine rupture during future pregnancies. Current conventional 2-dimensional imaging has limitations in identifying precise locations of multiple myomas and the endometrium. In our experience, we preferred to use 3-dimensional imaging to delineate the myomas, endometrium, or blood vessels, which we were able to successfully reconstruct by using the following imaging method. To achieve 3-dimensional imaging, we matched T2 turbo spin echo images to detect uterine myomas and endometria with T1 high-resolution isotropic volume excitation-post images used to detect blood vessels by using an algorithm based on the 3-dimensional region growing method. Then, we produced images of the uterine myomas, endometria, and blood vessels using a 3-dimensional surface rendering method and successfully reconstructed selective 3-dimensional imaging for uterine myomas, endometria, and adjacent blood vessels. A Web-based survey was sent to 66 gynecologists concerning imaging techniques used before myomectomy. Twenty-eight of 36 responding gynecologists answered that the 3-dimensional image produced in the current study is preferred to conventional 2-dimensional magnetic resonance imaging in identifying precise locations of uterine myomas and endometria. The proposed 3-dimensional magnetic resonance imaging method successfully reconstructed uterine myomas, endometria, and adjacent vessels. We propose that this will be a helpful adjunct to uterine myomectomy as a preoperative imaging technique in future

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

    PubMed Central

    Boclin, Karine de Lima Sírio; Torres, Fernanda Pelegrini; Faerstein, Eduardo

    2015-01-01

    ABSTRACT 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. PMID:26558353

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

    SciTech Connect

    Kawamura, Sachiko |; Kodama, Kazunori; Fujiwara, Saeko

    1997-06-01

    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.

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

    NASA Astrophysics Data System (ADS)

    Funaki, Kaoru; Fukunishi, Hidenobu

    2011-09-01

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

  10. Treatment of uterine myomas by radiofrequency thermal ablation: a 10-year retrospective cohort study.

    PubMed

    Yin, Geping; Chen, Ming; Yang, Shujun; Li, Juan; Zhu, Tongyu; Zhao, Xiaoli

    2015-05-01

    Patients' selection criteria, effectiveness, and safety of radiofrequency thermal ablation (RFTA) therapy for uterine myomas (UM) were assessed using a 10-year retrospective cohort study. From July 2001 to July 2011, a total of 1216 patients treated for UM were divided into 2 groups. Group A consisted of 476 premenopause patients, average age 36.5 ± 8.5 years, average number of myomas 1.7 ± 0.9, and average diameter of myomas 4.5 ± 1.5 cm, and group B consisted of 740 menopause patients, average age 48.5 ± 3.5 years, average number of myomas 2.6 ± 1.3, and average diameter of myomas 5.0 ± 2.5 cm. Average follow-up period was 36.5 ± 11.5 months. At 1, 3, 6, 12, and 24 months after RFTA, average diameters of myomas in group A were 3.8, 3.0, 2.7, 2.4, and 2.2 cm, respectively, and 47.7% (227 of 476) of patients had tumor trace at 12 months after RFTA. In group B, the results were 4.7, 3.7, 3.3, 2.3, and 2.3 cm, respectively, and 58.8% (435 of 740) of patients had tumor trace at 12 months after RFTA. Three months after treatment, myoma volumes were significantly reduced in both the groups (P < .01), and group B had higher rate of tumor trace at 12 months after RFTA than group A (P < .05). Clinical symptoms and health-related quality-of-life outcome (HRQL) were significantly improved after RFTA in both groups and the postoperative recurrence rate of UM was significantly higher in group A at 10.7% (51 of 476) than group B at 2.4% (18 of 740; P < .05). Radiofrequency thermal ablation is an excellent minimally invasive treatment for UM smaller than 5.0 cm in diameter.

  11. Huge uterine fibroid in a postmenopausal woman associated with polycythaemia: a case report.

    PubMed

    Abdul Ghaffar, Nor Aliza; Ismail, M Pazudin; Nik Mahmood, N M Zaki; Daud, Khurshiah; Abu Dzarr, G A

    2008-06-20

    Uterine fibroid or leiomyoma is the commonest benign uterine tumour. Its occurrence in the postmenopausal age group is rare and if enlargement of the fibroid noted during this time, the diagnosis of leiomyosarcoma is provisional until proven otherwise. A case of a postmenopausal woman with a huge uterine fibroid associated with polycythaemia is presented whereby the mass was noted to increase in size within 2 years. The patient was otherwise well except for the growing uterine mass. She had venesection done to treat her polycythaemia and later underwent surgery for total abdominal hysterectomy and bilateral salpingoophoorectomy. The histopathology report confirmed leiomyoma of uterus with no evidence of sarcomatous changes. It was suggested that large uterine myoma may cause secondary polycythaemia by three postulated mechanisms, i.e. presence of hypoxia suggesting shunting within the tumour, second, the uterine fibroid was compressing the ureters resulting in inappropriate excessive production of erythropoietin by the kidneys, and third, the tumour itself may have been producing the erythropoietin.

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

    NASA Astrophysics Data System (ADS)

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

    2007-02-01

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

  13. Huge uterine-cervical diverticulum mimicking as a cyst.

    PubMed

    Chufal, S; Thapliyal, Naveen; Gupta, Manoj; Pangtey, Nirmal

    2012-01-01

    Here we report an incidental huge uterine-cervical diverticulum from a total abdominal hysterectomy specimen in a perimenopausal woman who presented with acute abdominal pain. The diverticulum was mimicking with various cysts present in the lateral side of the female genital tract. Histopathological examination confirmed this to be a cervical diverticulum with communication to uterine cavity through two different openings. They can attain huge size if left ignored for long duration and present a diagnostic challenge to clinicians, radiologists, as well as pathologists because of its extreme rarity. Therefore, diverticula should also be included as a differential diagnosis. Its histopathological confirmation also highlights that diverticula can present as an acute abdomen, requiring early diagnosis with appropriate timely intervention. Immunohistochemistry CD 10 has also been used to differentiate it from a mesonephric cyst.

  14. A Prospective Multicenter Registry of Patients Undergoing Hysteroscopic Morcellation of Uterine Polyps and Myomas

    PubMed Central

    Chen, Serena H.

    2016-01-01

    Abstract Background: Hysteroscopic morcellation removes uterine pathology under direct visualization with continuous real-time tissue fragment removal. Objective: The aim of this study was to explore the feasibility of hysteroscopic morcellation across a diverse set of facilities, including both surgical and office-based settings. Design: This was a prospective, single-arm, multicenter registry development (Canadian Task Force classification II-3). Materials and Methods: Thirty-four U.S. obstetrics and gynecology facilities enrolled subjects into the registry. Inclusion criteria were women ages 18–65 with indications for hysteroscopic myomectomy and/or polypectomy who were treated with the MyoSure® Hysteroscopic Tissue Removal System (Hologic Inc., Marlborough, MA). Intrauterine lesion type/size and removal parameters, adverse events (AEs), and physician satisfaction ratings were recorded. Results: A total of 559 pathologies (187 fibroids; 372 polyps) were removed from 278 registered subjects (mean age: 43.9 ± 9.0 years), with 250 procedures (89.9%) performed in an ambulatory surgery center or hospital outpatient setting and 28 (10.1%) in a gynecologic office setting. Most patients (n = 206, 74.1%) were treated for abnormal uterine bleeding, and 42 (15.1%) were treated for infertility. Mean fibroid diameter was 2.2 ± 1.2 cm. Mean polyp diameter was 1.3 ± 1.0 cm. Overall mean percentage of pathology removed was 95.4% (polyps 99.3%, fibroids 86.8%). Five AEs included four incidents of blunt cervical trauma and a single postoperative case of pedal edema; all were considered mild and resolved spontaneously. Postprocedure surveys indicated that 95% of reporting physicians were “satisfied” or “highly satisfied” with device performance. Conclusions: Hysteroscopic morcellation of intrauterine pathology was accomplished safely with a high degree of physician satisfaction in 278 patients treated in diverse healthcare settings that are

  15. Cervical Myomas

    MedlinePlus

    ... Interest (Quiz) Breast Cancer (Video) Overview of the Female Reproductive System (News) Study: Plenty of IV Fluids May Make Childbirth Safer, Easier (News) Zejula Approved for Certain Female Cancers Additional Content Medical News Cervical Myomas By S. ...

  16. Pulmonary embolus arising from sloughed off myoma in late puerperium.

    PubMed

    Ergenoğlu, Ahmet Mete; Yeniel, Ahmet Özgür; Ulukuş, Murat; Aşkar, Niyazi

    2010-01-01

    Pulmonary embolus is a rare and serious complication of myoma uteri in the puerperium that resulted in late postpartum hysterectomy A 38-year-old, multiparous woman with a large myoma located on the left lateral wall of the uterus underwent emergency cesarean section due to fetal distres at 28 weeks. During the operation, a 15 cm sized intramural myoma was left without any intervention. On the 40(th) day postpartum the patient returned to the clinic with sepsis and pulmonary embolus because of obstruction of lochia drainage by the sloughed off myoma. The patient underwent hysterectomy and medical therapy for pulmonary embolus. We presented an unusual complication of uterine leiomyoma in the late postpartum period after cesarean section. Whatever the mode of sloughing off of the myoma, the results of the obstruction of lochia drainage may be devastating as in our case. To avoid these complications, clinicians must be aware of these symptoms and prompt intervention is essential.

  17. Office Hysteroscopic Laser Enucleation of Submucous Myomas without Mass Extraction: A Case Series Study

    PubMed Central

    Haimovich, Sergio; López-Yarto, Maite; Urresta Ávila, Julio; Saavedra Tascón, Alejandro; Hernández, José L.; Carreras Collado, Ramón

    2015-01-01

    Background and Objectives. A new two-step hysteroscopic myomectomy carried out in the office setting and without anesthesia was feasible for the excision of submucous myomas. The objective of this study was to assess whether removal of submucous myomas from the uterine cavity after hysteroscopic laser enucleation is necessary. Methods. Between June 2009 and April 2013, all outpatients with symptomatic myomatosis (bleeding, pelvic pain, and infertility) assessed ultrasonographically were eligible to participate in a prospective study. All patients underwent office hysteroscopic enucleation of submucous myomas. Enucleated myomas were left in the uterine cavity. Neither anesthesia nor antibiotic prophylaxis was used. Results. Sixty-one women (mean age: 47.3 years) were included. Regardless of hysteroscopic localization and grading, all myomas were enucleated. The mean (standard deviation, SD) diameter of the myoma as measured by the ultrasound scan was 22.6 (8.5) mm. In 29 cases (47.5%), the diameter of the resected myoma was >20 mm and in 10 cases (16.4%) >30 mm. After a mean follow-up of 68.2 (16.5) days, none of the patients showed a residual myoma inside the uterine cavity. Conclusions. The present results indicate that leaving laser-enucleated submucous myoma in the uterine cavity is a feasible and safe therapeutic option. PMID:26090457

  18. Laser-induced interstitial thermotherapy (LITT) for treatment of uterine leiomyomas: 750 myomas were treated by LITT and the results over a five-year period are analyzed

    NASA Astrophysics Data System (ADS)

    Chapman, Roxana

    1997-05-01

    Approximately 750 leiomyomas of 250 symptomatic patients were treated by LITT over a five-year period. Only 12% were lost to follow-up. Most were treated by a combination of the KTP/YAG laser, rarely by one or the other alone, and a few with the diode laser. The fiber optic was inserted 2 cm apart and, depending on the size of the tumor, 480 - 20,000 Joules were required. Most were treated laparoscopically but very large myomas were treated percutaneously under ultrasound control. Symptoms were nearly always relieved and the six failures were found to be due to unrecognized adenomyosis and other associated pathology. Half the patients complaining of infertility became pregnant and, in those whose only pathology had been leiomyomas it approached 90%. Vaginal delivery was not found to be contraindicated. Finally, oestrogen receptors and epidermal growth factor were found to be destroyed. It is concluded that LITT enables leiomyomas of all sizes and locations to be treated by a minimally invasive method with preservation of the uterus.

  19. Laparoscopic Management of Large Myomas

    PubMed Central

    Sinha, Rakesh; Sundaram, Meenakshi

    2009-01-01

    The objective of this article is to review the different techniques that have been adopted for removal of large myomas laparoscopically. We have also quoted literature about the impact of myomas on Pregnancy and obstetrical outcome and the effect of laparoscopic myomectomy on the same. Technical modifications to remove large myomas have been described along with methods to reduce intraoperative bleeding. This comprehensive review describes all possibilities of laparoscopic myomectomy irrespective of size, site and number. PMID:22442517

  20. Ulipristal Acetate in Myomectomy Optimization in an Infertile Patient with Giant Myomas

    PubMed Central

    Borrás, María Dolores; Rubio, Miriam; Abril, Nuria

    2016-01-01

    The use of ulipristal acetate (UPA) has been recently introduced in the treatment of uterine leiomyomas. This drug has proven useful to control menometrorrhagia and to reduce myoma size. In the case presented here, we show the benefits of UPA treatment in facilitating surgical removal of giant myomas in an infertile patient. In addition to myoma reduction and a better control of preoperative bleeding, the treatment with UPA reduced the duration and complexity of the surgery, as well as the area of uterine wall involved and the resulting scar. No side effects were observed and the patient became pregnant 6 months after the surgery and had a normal pregnancy and delivery. This case report shows the beneficial effects of UPA in the preoperative treatment of myomas which affect uterus function. PMID:27594886

  1. Parasitic Myoma After Morcellation

    PubMed Central

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

    2009-01-01

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

  2. Fertility and Pregnancy Outcome after Myoma Enucleation by Minilaparotomy under Microsurgical Conditions in Pronounced Uterus Myomatosus.

    PubMed

    Floss, K; Garcia-Rocha, G-J; Kundu, S; von Kaisenberg, C S; Hillemanns, P; Schippert, C

    2015-01-01

    Introduction: Besides the typical complaints and symptoms, myomas can cause sterility, infertility and complications during pregnancy. Laparoscopic interventions reach their limits with regard to organ preservation and the simultaneous desire to have children in the removal of multiple and larger intramural myoma nodes. The aim of this study is to examine fertility status and pregnancy outcome after myoma removal by minilaparotomy (skin incision maximal 8 cm) in women with pronounced uterus myomatosus. Materials and Methods: This retrospective study makes use of the data from 160 patients with an average age of 34.6 years. Factors analysed include number, size and localisation of the myomas, complaints due to the myoma, pre- and postoperative gravidity, mode of delivery, and complications of birth. Results: Indications for organ-sparing myoma enucleation were the desire to have children (72.5 %), bleeding disorders (60 %) and pressure discomfort (36.5 %). On average 4.95 (SD ± 0.41), maximally 46 myomas were removed. The largest myoma had a diameter of 6.64 cm (SD ± 2.74). 82.5 % of the patients had transmural myomas, in 17.5 % the uterine cavity was inadvertently opened. On average the operating time was 163 minutes (SD ± 45.47), the blood loss 1.59 g/dL (SD ± 0.955). 60.3 % of the patients with the desire to have children became pregnant postoperatively. 75.3 % of the pregnancies were on average carried through to the 38th week (28.4 % vaginal deliveries, 71.6 % Caesarean sections). In the postoperative period there was one case of uterine rupture in the vicinity of a previous scar. Discussion: By means of the microsurgical "mini-laparotomy" even extensive myomatous uterine changes can, in the majority of cases, be operated in an organ-sparing manner with retention of the ability to conceive and to carry a pregnancy through to maturity of the infant. The risk for a postoperative uterine rupture in a subsequent pregnancy and

  3. Endoscopic management of uterine fibroids: an update.

    PubMed

    Soto, E; Flyckt, R; Falcone, T

    2012-12-01

    Recent technological advances in endoscopy have allowed gynecological surgeons to expand the operative approaches that can be utilized in the conservative management of uterine myomas. Commonly used approaches in gynecological practice now include laparoscopic myomectomy, laparoscopic-assisted myomectomy through a mini-laparotomy incision and robotic-assisted laparoscopic myomectomy. Adequate preoperative evaluation with careful selection of the best operative approach for each particular patient constitutes the basis of safe and effective surgery for the operative management of uterine myomas.

  4. Cystic Endometriosis in a Huge Degenerated Subserous Leiomyoma Mimicking Bilateral Multicystic Endometriomas in an Infertile Woman with Diminished Ovarian Reserve: A Rare Endometriotic Implantation

    PubMed Central

    Colak, Sabri; Reis, Abdulkadir

    2016-01-01

    Uterine leiomyomas are the most common pelvic tumor in women. Leiomyoma can show atypical locations and degenerations and may not be easily differentiated from adnexal masses. Uterine leiomyoma can undergo cystic degeneration and is said to be found in 4% of all types of degenerations. The commonest type of degeneration is hyaline seen in 60% of patients. Usually uterine leiomyoma does not present as clinical and radiological diagnostic challenge. However, when leiomyoma undergoes massive cystic degeneration they may become clinical and radiological diagnostic dilemmas. The MRI showed a huge cystic mass protruding up to the pelvis not differentiated from bilateral endometriomas and accompanying subserous myomas. Surgery revealed that the mass is not bilateral endometriomas but a huge pedunculated leiomyoma with cystic degeneration and cystic endometriosis. Endometriosis is a troubling gynecologic condition occurring in 10% to 15% of women of reproductive age and is associated with fertility problems. As a peritoneal disease, the locations of endometriotic lesions are predominantly the ovaries (96.4%), followed by the soft tissue (2.8%), gastrointestinal tract (0.3%), and urinary tract (0.2%) and other rare locations. The presented case is multiple sized cystic endometriosis (endometriomas) located in a huge pedunculated subserous leiomyoma in an infertile woman having a history of laparoscopic bilateral endometrioma surgery. Conclusion. To our knowledge, this is the first reported case for endometriotic cysts (endometriomas) located in a huge cystic degenerated leiomyoma. PubMed search revealed no report concerning endometriotic implantation in the leiomyomas. PMID:27057369

  5. Multiple Layer Closure of Myoma Bed in Laparoscopic Myomectomy

    PubMed Central

    Jain, Nutan

    2011-01-01

    Objective: To assess the feasibility and outcome of laparoscopic myomectomy and multiple layer closure of the myoma bed, for management of myomas, at a tertiary care hospital. Materials and Methods: From September 2005 to September 2010, 417 patients, with large and moderate size myomas, were managed by laparoscopic myomectomy. Indications were subfertility, menorrhagia, and abdominal mass. Preoperative evaluation included history, clinical examination, and sonographic mapping. The myomas were enucleated and retrieved laparoscopically. Myoma beds were sutured in multiple layers by endoscopic intracorporeal suturing. Results: Three hundred and fifteen patients presented with subfertility, 45 with menorrhagia, and 57 with abdominal mass. The average maximum diameter of a myoma was 9 cm. The mean duration of surgery was 120 minutes. The mean postoperative stay was 24 hours. No intraoperative complication occurred and the hospital course was uncomplicated. In one case, a minilap incision was performed for retrieval of the myoma with suturing of the bed. Two patients had minor delayed wound healing of the morcellator port site. The patients did not report any complaints during the follow-up, except one patient who developed omental hernia at the morcellator port site. There was no rupture of the scar and very low adhesion scores in the subsequent cesarean sections or second-look scopies. Conclusion: With proper multilayer closure of the myoma bed, laparoscopic myomectomy was feasible for moderate and even large myomas and had excellent outcomes. PMID:22442535

  6. Multiple Layer Closure of Myoma Bed in Laparoscopic Myomectomy

    PubMed Central

    Jain, Nutan; Sahni, Priyanka

    2011-01-01

    Objective: To assess the feasibility and outcome of laparoscopic Myomectomy and multiple layer closure of myoma bed for management of myomas at a tertiary care hospital. Materials and Methods: Four hundred and seventeen patients from September 2005 to September 2010 with large and moderate size myomas were managed by laparoscopic Myomectomy. Indications were subfertility, menorrhagia and abdominal mass. Pre-operative evaluation included history, clinical examination and sonographic mapping. Myomas were enucleated and retrieved laparoscopically. Myoma beds were sutured in multiple layers by endoscopic intracorporeal suturing. Results: Three hundred and fifteen patients presented with subfertility, 45 with menorrhagia and 57 with abdominal mass. The average maximum diameter of myoma was 9 cm. The mean duration of surgery was 120 min. The mean post-operative stay was 24 h. No intra-operative complication occurred and hospital course was uncomplicated. In one case, minilap incision was given for retrieval of myoma and suturing of the bed. Two patients had minor delayed wound healing of the morcellator port site. The patients did not report any complaints during follow-up except one patient who developed omental hernia at morcellator port site. There was no rupture of scar and very low adhesion scores in subsequent caesarian sections or second look scopies. Conclusion: With proper multilayer closure of the myoma bed, laparoscopic Myomectomy is feasible for moderate and even large myomas and has excellent outcomes. PMID:26085750

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

    PubMed Central

    Amanti, L; Sadeghi-Bazargani, H; Abdollahi, H; Ehdaeivand, F

    2011-01-01

    Background and aim: Despite the high prevalence of uterine leiomyoma, according to recent review studies there is uncertainty and a paucity of information regarding its predisposing or protective factors. The aim of this study was to assess the possible association between menstrual cycle pattern and occurrence of surgically treated myomas and also to check if depo-medroxyprogesterone acetate (DMPA) injection earlier in reproductive life can affect the later occurrence of myomas needing surgical treatment. Methods: In a case–control study in Ardabil, 85 women with definite diagnosis of surgically treated uterine leiomyoma and 154 community controls were enrolled. Possible predictors of myoma including menstrual cycle and menstrual bleeding patterns were assessed. Data were analyzed using SPSS software (SPSS, IBM, Somers, NY). Odds ratios were used as the main statistic in assessing the strength of observed associations. Results: Mean age of the participants was 41.8 ± 8.5 years. Length of menstrual cycle was associated with myoma and a higher likelihood of myoma was observed among those having shorter menstrual cycles (P < 0.05). Number of menstrual bleeding days was also associated with surgically treated myoma and longer bleeding periods increased the likelihood of myoma (P < 0.05). Only one of the eight women who had a history of depo-medroxyprogesterone acetate injections had developed surgically treated uterine leiomyoma and the others belonged to the control group without a history of surgical treatment for uterine leiomyoma. Conclusion: Menstrual cycle pattern is associated with developing leiomyomas requiring surgical treatment. DMPA, other than its role in myoma treatment, is also assumed to have a role in preventing myomas, but due to the small sample size in this study, larger scale prospective trials are needed in the future. PMID:21845062

  8. Infertility and uterine fibroids.

    PubMed

    Zepiridis, Leonidas I; Grimbizis, Grigoris F; Tarlatzis, Basil C

    2016-07-01

    Uterine fibroids are the most common tumors in women and their prevalence is higher in patients with infertility. At present, they are classified according to their anatomical location, as no classification system includes additional parameters such as their size or number. There is a general agreement that submucosal fibroids negatively affect fertility, when compared to women without fibroids. Intramural fibroids above a certain size (>4 cm), even without cavity distortion, may also negatively influence fertility. However, the presence of subserosal myomas has little or no effect on fertility. Many possible theories have been proposed to explain how fibroids impair fertility: mechanisms involving alteration of local anatomical location, others involving functional changes of the myometrium and endometrium, and finally endocrine and paracrine molecular mechanisms. Nevertheless, any of the above mentioned mechanisms can cause reduced reproductive potential, thereby leading to impaired gamete transport, reduced ability for embryo implantation, and creation of a hostile environment. The published experience defines the best practice strategy, as not many large, well-designed, and properly powered studies are available. Myomectomy appears to have an effect in fertility improvement in certain cases. Excision of submucosal myomas seems to restore fertility with pregnancy rates after surgery similar to normal controls. Removal of intramural myomas affecting pregnancy outcome seems to be associated with higher pregnancy rates when compared to non-operated controls, although evidence is still nοt sufficient. Treatment of subserosal myomas of reasonable size is not necessary for fertility reasons. The results of endoscopic and open myomectomy are similar; thus, endoscopic treatment is the recommended approach due to its advantages in patient's postoperative course.

  9. Low-power interstitial photocoagulation of uterine leiomyomas by KTP/YAG laser: a review of 50 consecutive cases

    NASA Astrophysics Data System (ADS)

    Chapman, Roxana

    1994-12-01

    Interstitial laser photocoagulation (ILP), which is a new method of low power laser destruction of tumors, has been used to treat laparoscopically 50 consecutive patients with symptomatic uterine leiomyomas which were difficult or impossible to remove via laparoscopy. The KTP/YAG laser, with wavelengths of 532 and 1064 nm respectively, was employed. Holes 2 cm apart were drilled with a 600 micrometers quartz laser fiber employing the KTP component at 8 W and subsequent coagulation of the surrounding myoma tissue was accomplished during the withdrawal of the fiber over the course of 10 - 30 s but using the YAG component at 8 W until the whole myoma had been treated. Thirty seven became symptom free and have remained so. Six were lost to follow up. Of 10 complaining of subfertility 4, in whom uterine myomas were the only etiological factor, have become pregnant. Seven patients required further treatment: Two were retreated because their myomas were excessively large and did not completely disappear with the initial ILP, 2 received further ILP because of the development of new myomas and 3 were subjected to laparoscopically assisted vaginal hysterectomy at patients' request (2 because of the development of new myomas and 1 because of the development of further endometriosis). Finally, in 7 cases, residual tumor or scar tissue was biopsied and examined for the presence of oestrogen and progesterone receptors. None was discovered and in 2 subsequent pregnancy did not cause further growth of residual myoma tissue.

  10. Surgical removal of multiple mesenteric fibroids (Kg 4,500) by abdominal spread of previous laparoscopic uterine myomectomy

    PubMed Central

    LEANZA, V.; GULINO, F.A.; LEANZA, G.; ZARBO, G.

    2015-01-01

    Introduction Huge and multiple mesenteric fibroids (4,500 Kg weight) are very unusual. In many cases they are mistaken for subserosal fibroids of the womb due to the proximity with uterine walls. When they have a rapid growth, the risk of becoming malignant (sarcoma) has not to be underestimated. Surgery is challenging to remove abdominal nodes. Case report A case of a 40-year old woman, admitted to the hospital with abdominal masses occupying the entire cavity was reported. Both computerized tomography (CT) and ultrasounds (US) were not diriment for belonging of tumours. Clinical history of patient reports a laparoscopic removal of uterine fibroids, using the morcellator. Laparoscopy was performed four years before. Open surgery by means of a large transversal suprapubic laparotomy according to Pfannestiel was carried out. Multiple and huge mesenteric, peritoneal and intestinal tumours spread in the whole abdominal cavity were found, removed and examined by frozen section histology; in addition a series of small conglomerated myomas in the site of previous laparoscopic transumbilical route was taken away as well (the largest fibroid weighed Kg 3.500 and the all tumors removed 4,500 Kg); the result was benign (fibroids) and genital apparatus was preserved. Operation was challenging. Postoperative course was uneventful; after five days patient was discharged. Conclusions This case is very interesting for many factors: A) many extra-uterine fibroids spread throughout abdominal cavity; B) considerable weight of the masses C) intraoperative and postoperative danger. Finally, due to involvement of previous laparoscopic transumbilical incision together with other findings, the hypothesis of post laparoscopic dissemination has to be considered. A case of so large extragenital abdominal fibroids following laparoscopic uterine myomectomy has never been published so far. PMID:25827668

  11. Uterine primitive neuroectodermal tumor.

    PubMed

    Aminimoghaddam, Soheila; Seifirad, Soroush; Abbasi Dezfouli, Golbahar; Abbasi, Neda; Zare Mehrjardi, Ali; Razavi, Seyed Mohsen; Mahmoudzadeh, Fatemeh

    2015-04-01

    Primitive neuroectodermal tumors are fairly rare in uterus. A case of uterine body primitive neuroectodermal tumor in a 32-year-old Iranian woman is presented. The patient was admitted with abdominal pain and fever and underwent emergency exploratory surgery with total abdominal hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymph node dissection. Posterior wall of the uterus was necrotic and ruptured and a huge tumor disrupted the uterine body. The tumor was strongly positive for CD99, NSE, and chromogranin; No reaction was seen for CD10, CD45 and myogenin. To the best of our knowledge, this is the first report of an uterine body primitive neuroectodermal tumor and the second report of uterine primitive neuroectodermal tumor from Iran.

  12. Uterine Fibroids: Pathogenesis and Interactions with Endometrium and Endomyometrial Junction

    PubMed Central

    Stortoni, Piergiorgio; Montik, Nina; Giannubilo, Stefano R.; Litta, Pietro; Islam, Md. Soriful; Tranquilli, Andrea L.; Reis, Fernando M.

    2013-01-01

    Uterine leiomyomas (fibroids or myomas) are benign tumors of uterus and clinically apparent in a large part of reproductive aged women. Clinically, they present with a variety of symptoms: excessive menstrual bleeding, dysmenorrhoea and intermenstrual bleeding, chronic pelvic pain, and pressure symptoms such as a sensation of bloatedness, increased urinary frequency, and bowel disturbance. In addition, they may compromise reproductive functions, possibly contributing to subfertility, early pregnancy loss, and later pregnancy complications. Despite the prevalence of this condition, myoma research is underfunded compared to other nonmalignant diseases. To date, several pathogenetic factors such as genetics, microRNA, steroids, growth factors, cytokines, chemokines, and extracellular matrix components have been implicated in the development and growth of leiomyoma. This paper summarizes the available literature regarding the ultimate relative knowledge on pathogenesis of uterine fibroids and their interactions with endometrium and subendometrial myometrium. PMID:24163697

  13. Rectouterine fistula after laparoscopic ultrasound-guided radiofrequency ablation of a uterine fibroid

    PubMed Central

    Jeong, Hyo Joo; Kwon, Byung-Su; Choi, Young Joon

    2014-01-01

    In the conservative management of uterine fibroids is radiofrequency ablation (RFA) considered to be one of the safe, effective and minimal invasive approaches in selected women who desire to retain their uterus. Few studies were conducted on its adverse outcomes and most of the reported complications were minor events such as pain, discharge, adhesion which didn't require any intervention. However, although safe and effective, the RFA of a uterine myoma can be the cause for severe complications such as penetration and burn injuries of pelvic organs. In general, a rectouterine fistula is one of the rarest complications but can lead to serious adverse outcomes. Herein, to our knowledge, we report the first case involving a rectouterine fistula after laparoscopic ultrasound-guided RFA of a uterine myoma with pelvic endometriosis. In addition, we provide a brief review of the relevant literature. PMID:25469349

  14. Rectouterine fistula after laparoscopic ultrasound-guided radiofrequency ablation of a uterine fibroid.

    PubMed

    Jeong, Hyo Joo; Kwon, Byung-Su; Choi, Young Joon; Huh, Chu Yeop

    2014-11-01

    In the conservative management of uterine fibroids is radiofrequency ablation (RFA) considered to be one of the safe, effective and minimal invasive approaches in selected women who desire to retain their uterus. Few studies were conducted on its adverse outcomes and most of the reported complications were minor events such as pain, discharge, adhesion which didn't require any intervention. However, although safe and effective, the RFA of a uterine myoma can be the cause for severe complications such as penetration and burn injuries of pelvic organs. In general, a rectouterine fistula is one of the rarest complications but can lead to serious adverse outcomes. Herein, to our knowledge, we report the first case involving a rectouterine fistula after laparoscopic ultrasound-guided RFA of a uterine myoma with pelvic endometriosis. In addition, we provide a brief review of the relevant literature.

  15. Elevated blood active ghrelin and normal total ghrelin and obestatin concentrations in uterine leiomyoma.

    PubMed

    Markowska, A; Ziolkowska, A; Nowinka, K; Malendowicz, L K

    2009-01-01

    Ghrelin and obestatin originate from the same peptide precursor, preproghrelin. Both peptides are secreted in the blood. We investigated serum active and total ghrelin and obestatin concentrations in women with uterine myomatosis. Serum concentrations of active ghrelin in uterine leiomyoma were significantly higher compared to women in the control group (86 +/- 3 vs 56 +/- 9 pg/ml, respectively; p < 0.02). On the other hand, serum concentrations of total ghrelin and obestatin in uterine leiomyoma did not differ from those in the control group. In the control group the ratio of active to total ghrelin concentrations amounted to 0.62, while in women with uterine myoma it was 0.95, pointing to a prevalence of the active form of ghrelin in women with uterine myoma. Also the ratio of active ghrelin concentration to obestatin concentration was higher in the latter group while the ratio of total circulating ghrelin to obestatin concentrations was similar in the two groups. The data may suggest a role of active ghrelin in the development of a myoma. Moreover, the results indicate that increased blood ratios of active to total ghrelin and to obestatin concentrations are not specific for cachexia.

  16. Uterine Cancer

    MedlinePlus

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

  17. Morcellator's Port-site Metastasis of a Uterine Smooth Muscle Tumor of Uncertain Malignant Potential After Minimally Invasive Myomectomy.

    PubMed

    Bogani, Giorgio; Ditto, Antonino; Martinelli, Fabio; Signorelli, Mauro; Chiappa, Valentina; Lorusso, Domenica; Sabatucci, Ilaria; Carcangiu, Maria L; Fiore, Marco; Gronchi, Alessandro; Raspagliesi, Francesco

    2016-01-01

    Since the safety warning from the US Food and Drug Administration on the use of power morcellators, minimally invasive procedures involving the removal of uterine myomas and large uteri are under scrutiny. Growing evidence suggests that morcellation of undiagnosed uterine malignancies is associated with worse survival outcomes of patients affected by uterine sarcoma. However, to date, only limited data regarding morcellation of low-grade uterine neoplasms are available. In the present article, we reported a case of a (morcellator) port-site implantation of a smooth muscle tumor that occurred 6 years after laparoscopic morcellation of a uterine smooth muscle tumor of uncertain potential. This case highlights the effects of intra-abdominal morcellation, even in low-grade uterine neoplasms. Caution should be used when determining techniques for tissue extraction; the potential adverse consequences of morcellation should be more fully explored.

  18. Uterine Fibroids

    MedlinePlus

    ... in the uterine wall they grow: Submucosal (pronounced sub-myoo-KOH-sul ) fibroids grow just underneath the ... between the muscles of the uterus. Subserosal (pronounced sub-sur-OH-sul ) fibroids grow on the outside ...

  19. Uterine fibroids

    MedlinePlus

    ... discharge Hysterectomy - vaginal - discharge Uterine artery embolization - discharge Review Date 9/26/2015 Updated by: Daniel N. ... gynecology in private practice, West Palm Beach, FL. Review Provided by VeriMed Healthcare Network. Internal review and ...

  20. Uterine prolapse

    MedlinePlus

    Pelvic relaxation - uterine prolapse; Pelvic floor hernia; Prolapsed uterus ... Muscles, ligaments, and other structures hold the uterus in the ... into the vaginal canal. This is called prolapse. This condition ...

  1. Leiomyosarcoma: a rare malignant transformation of a uterine leiomyoma.

    PubMed

    Di Luigi, G; D'Alfonso, A; Patacchiola, F; Di Stefano, L; Palermo, P; Carta, G

    2015-01-01

    The malignant transformation of a uterine leiomyoma is still debated and, if it occurs, it is very rare. The case of a patient affected by one small leiomyoma is described. Diagnosis was made postoperatively on histopathological examination. The case reported here is meant to underline the need to keep all uterine myomas in check since the transition into leiomyosarcomas (LMSs) may occur with an evolution over a time period which has not been established so far. Specific receptors for luteinizing hormone/human chorionic gonadotropin (LH/hCG) have also been identified in the myometrium of several animal species, including humans. Conventional LMSs express estrogen receptors (ER), progesterone receptors (PR), and androgen receptors (AR) in 30-40% of cases. In comparison with other more common uterine malignancies, uterine LMSs bear some resemblance to type 2 endometrial carcinomas and high-grade serous carcinomas of ovary/fallopian tube origin, based on their genetic instability, frequent p53 abnormalities, aggressive behavior, and resistance to chemotherapy. It could be useful to understand with further researches if hormonal stimulation could be a contributing factor of uterine leiomyoma transformation into LMS. Until today the oncogenic mechanisms underlying the development of uterine LMSs remain elusive.

  2. Uterine Fibroids Fact Sheet

    MedlinePlus

    ... Topics Uterine fibroids fact sheet (PDF, 950 KB) FDA warning on power morcellators in treatment for uterine ... Topics Uterine fibroids fact sheet (PDF, 950 KB) FDA warning on power morcellators in treatment for uterine ...

  3. Should Prophylactic Anticoagulation Be Considered with Large Uterine Leiomyoma? A Case Series and Literature Review

    PubMed Central

    Paredes Saenz, Carmen; Raju, Rubin; Cuthpert, Sierra; Kanzy, Abed; Abhari, Sina; Hebert III, John; Rocha, Frederico G.

    2016-01-01

    Introduction. Uterine leiomyomas, also called uterine fibroids or myomas, are the most common pelvic tumors in women. They are very rarely the cause of acute complications. However, when complications occur they cause significant morbidity and mortality. Thromboembolic disease has been described as a rare complication of uterine leiomyomas. DVT is a serious illness, sometimes causing death due to acute PE. Cases. We report a case series of 3 patients with thromboembolic disease associated with uterine leiomyoma at Hurley Medical Center, Flint, Michigan, during 2015 and conduct a literature review on the topic. A literature search was conducted using Medline, PubMed, and PMC databases from 1966 to 2015. Conclusion. The uterine leiomyoma is a very rare cause of PE and only few cases have been reported. DVT secondary to uterine leiomyoma should be considered in a female presenting with abdominal mass and pelvic pressure, if there is no clear common cause for her symptoms. Thromboembolic disease secondary to large uterine leiomyoma should be treated with acute stabilization and then hysterectomy. Prophylactic anticoagulation would be beneficial for lowering the risk of VTE in patients with large uterine leiomyoma. PMID:27885348

  4. [Uterine inversion].

    PubMed

    Dirken, J J; Vlaanderen, W

    1994-01-01

    Inversion of the uterus is a rare complication of childbirth. A primigravida aged 21 and a multigravida aged 32, hospitalized as emergency cases because of inversion of the uterus with major blood loss, were treated with infusion of liquids (to combat shock), repositioning of the uterus under anaesthesia and prevention of reinversion by uterine tonics. Inversion of the uterus should be part of the differential diagnosis in every case of fluxus post partum.

  5. Laparoscopic Myomectomy with Uterine Artery Ligation: Review Article and Comparative Analysis

    PubMed Central

    Sinha, Rakesh; Sundaram, Meenakshi; Mahajan, Chaitali; Raje, Shweta; Kadam, Pratima; Rao, Gayatri

    2011-01-01

    Uterine leiomyomas are one of the most common benign smooth muscle tumors in women, with a prevalence of 20 to 40% in women over the age of 35 years. Although many women are asymptomatic, problems such as bleeding, pelvic pain, and infertility may necessitate treatment. Laparoscopic myomectomy is one of the treatment options for myomas. The major concern of myomectomy either by open method or by laparoscopy is the bleeding encountered during the procedure. Most studies have aimed at ways of reducing blood loss during myomectomy. There are various ways in which bleeding during laparoscopic myomectomy can be reduced, the most reliable of which is ligation of the uterine vessels bilaterally. In this review we propose to discuss the benefits and possible disadvantages of ligating the uterine arteries bilaterally before performing laparoscopic myomectomy. PMID:22442527

  6. Morcellation of undiagnosed uterine sarcoma: A critical review.

    PubMed

    Bogani, Giorgio; Chiappa, Valentina; Ditto, Antonino; Martinelli, Fabio; Donfrancesco, Cristina; Indini, Alice; Lorusso, Domenica; Raspagliesi, Francesco

    2016-02-01

    In the recent decades, laparoscopy has replaced open abdominal procedures in the setting of gynecologic surgery. Extraction of large specimens (e.g., large uteri or myomas) following operative laparoscopy is technically challenging. Technological attempts allow the removal of large and solid pelvic masses via small abdominal incisions (using instruments called morcellators), thus reducing unnecessary laparotomies and improving short-term patients' outcomes. However, morcellation of undiagnosed uterine malignancies may lead to worse survival outcomes. Therefore, the Food and Drug Administration (FDA) warns about the use of power morcellators, thus causing ongoing concerns on the applicability of minimally invasive approaches for myomectomy and the removal of large uteri. In the present review, we sought to assess pro and cons regarding minimally invasive morcellation. This review will discuss the effects of morcellation of undiagnosed uterine malignancies, focusing on possible techniques for preoperative detection of uterine sarcoma and for avoiding intra-abdominal dissemination of potentially malignant tissues. Further efforts are necessary in order to identify tools to make a more accurate and reliable preoperative diagnosis of uterine masses. However, on the light of the current evidence, intra-abdominal morcellation should be banned from clinical practice.

  7. Surgical Management of Neurovascular Bundle in Uterine Fibroid Pseudocapsule

    PubMed Central

    Malvasi, Antonio; Hurst, Brad S.; Tsin, Daniel A.; Davila, Fausto; Dominguez, Guillermo; Dell'edera, Domenico; Cavallotti, Carlo; Negro, Roberto; Gustapane, Sarah; Teigland, Chris M.; Mettler, Liselotte

    2012-01-01

    The uterine fibroid pseudocapsule is a fibro-neurovascular structure surrounding a leiomyoma, separating it from normal peripheral myometrium. The fibroid pseudocapsule is composed of a neurovascular network rich in neurofibers similar to the neurovascular bundle surrounding a prostate. The nerve-sparing radical prostatectomy has several intriguing parallels to myomectomy. It may serve either as a useful model in modern fibroid surgical removal, or it may accelerate our understanding of the role of the fibrovascular bundle and neurotransmitters in the healing and restoration of reproductive potential after intracapsular myomectomy. Surgical innovations, such as laparoscopic or robotic myomectomy applied to the intracapsular technique with magnification of the fibroid pseudocapsule surrounding a leiomyoma, originated from the radical prostatectomy method that highlighted a careful dissection of the neurovascular bundle to preserve sexual functioning after prostatectomy. Gentle uterine leiomyoma detachment from the pseudocapsule neurovascular bundle has allowed a reduction in uterine bleeding and uterine musculature trauma with sparing of the pseudocapsule neuropeptide fibers. This technique has had a favorable impact on functionality in reproduction and has improved fertility outcomes. Further research should determine the role of the myoma pseudocapsule neurovascular bundle in the formation, growth, and pathophysiological consequences of fibroids, including pain, infertility, and reproductive outcomes. PMID:22906340

  8. Surgical Methods for the Treatment of Uterine Fibroids – Risk of Uterine Sarcoma and Problems of Morcellation: Position Paper of the DGGG

    PubMed Central

    Beckmann, M. W.; Juhasz-Böss, I.; Denschlag, D.; Gaß, P.; Dimpfl, T.; Harter, P.; Mallmann, P.; Renner, S. P.; Rimbach, S.; Runnebaum, I.; Untch, M.; Brucker, S. Y.; Wallwiener, D.

    2015-01-01

    The appropriate surgical technique to treat patients with uterine fibroids is still a matter of debate as is the potential risk of incorrect treatment if histological examination detects a uterine sarcoma instead of uterine fibroids. The published epidemiology for uterine sarcoma is set against the incidence of accidental findings during surgery for uterine fibroids. International comments on this topic are discussed and are incorporated into the assessment by the German Society for Gynecology and Obstetrics (DGGG). The ICD-O-3 version of 2003 was used for the anatomical and topographical coding of uterine sarcomas, and the “Operations- und Prozedurenschlüssel” (OPS) 2014, the German standard for process codes and interventions, was used to determine surgical extirpation methods. Categorical qualifiers were defined to analyze the data provided by the Robert Koch Institute (RKI), the German Federal Bureau of Statistics (DESTATIS; Hospital and Causes of Death Statistics), the population-based Cancer Register of Bavaria. A systematic search was done of the MEDLINE database and the Cochrane collaboration, covering the period from 1966 until November 2014. The incidence of uterine sarcoma and uterine fibroids in uterine surgery was compared to the literature and with the different registries. The incidence of uterine sarcoma in 2010, standardized for age, was 1.53 for Bavaria, or 1.30 for every 100 000 women, respectively, averaged for the years 2002–2011, and 1.30 for every 100 000 women in Germany. The mean incidence collated from various surveys was 2.02 for every 100 000 women (0.35–7.02; standard deviation 2.01). The numbers of inpatient surgical procedures such as myoma enucleation, morcellation, hysterectomy or cervical stump removal to treat the indication “uterine myoma” have steadily declined in Germany across all age groups (an absolute decrease of 17 % in 2012 compared to 2007). There has been a shift in the preferred method of surgical

  9. Huge interparietal posterior fontanel meningohydroencephalocele

    PubMed Central

    Dos Santos, Manuel Filipe Dias; de Santa Barbara, Rita de Cassia

    2015-01-01

    Congenital encephalocele is a neural tube defect characterized by a sac-like protrusion of the brain, meninges, and other intracranial structures through the skull, which is caused by an embryonic development abnormality. The most common location is at the occipital bone, and its incidence varies according to different world regions. We report a case of an 1-month and 7-day-old male child with a huge interparietal-posterior fontanel meningohydroencephalocele, a rare occurrence. Physical examination and volumetric computed tomography were diagnostic. The encephalocele was surgically resected. Intradural and extradural approaches were performed; the bone defect was not primarily closed. Two days after surgery, the patient developed hydrocephaly requiring ventriculoperitoneal shunting. The surgical treatment of the meningohydroencephalocele of the interparietal-posterior fontanel may be accompanied by technical challenges and followed by complications due to the presence of large blood vessels under the overlying skin. In these cases, huge sacs herniate through large bone defects including meninges, brain, and blood vessels. The latter present communication with the superior sagittal sinus and ventricular system. A favorable surgical outcome generally follows an accurate strategy taking into account individual features of the lesion. PMID:26484324

  10. Uterine artery embolization - discharge

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000161.htm Uterine artery embolization - discharge To use the sharing features on this page, please enable JavaScript. You had uterine artery embolization (UAE). UAE is a procedure to treat ...

  11. Uterine Fibroid Embolization (UFE)

    MedlinePlus

    ... embolization. This occurs when fibroids located inside the uterine cavity detach after embolization. Women with this problem may require a procedure called D & C (dilatation and curettage) to ... who undergo uterine fibroid embolization, normal menstrual cycles resume after the ...

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

    SciTech Connect

    Mara, Michal; Kubinova, Kristyna; Maskova, Jana; Horak, Petr; Belsan, Tomas; Kuzel, David

    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).

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

    PubMed

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

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  15. Huge abdominal cyst occurred after kidney transplantation.

    PubMed

    Hwang, H P; Yu, H C; Park, H S; Song, J S; Kang, K P; Kim, W; Park, S K; Lee, S

    2014-01-01

    This case demonstrates continuous ambulatory peritoneal dialysis-related endometrial tissue migration and occurrence of huge cystic endometriosis by the recovery of menstrual period after kidney transplantation.

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

    SciTech Connect

    Kim, Man Deuk Kim, Nahk Keun; Kim, Hee Jin; Lee, Mee Hwa

    2005-06-15

    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 {mu}m.Results:Among 94 patients who underwent UFE with PVA, 74 were on contraceptives, 6 had been single until the point of interview, and 8 were lost to follow-up. Of the remaining 6 patients who desired future pregnancy, 5 (83%) succeeded in becoming pregnant (1 patient became pregnant twice). Of a total of 8 pregnancies, 6 were planned pregnancies and 2 occurred after contraception failed. Five deliveries were vaginal, and 2 were by elective cesarean. Artificial abortion was performed in 1 case of unplanned pregnancy. There was 1 case of premature rupture of membrane (PROM) followed by preterm labor and delivery of an infant who was small-for-gestational-age. 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.

  17. Intelligent Classification in Huge Heterogeneous Data Sets

    DTIC Science & Technology

    2015-06-01

    signals and through data dimension reduction, and to develop and tailor algorithms for the extraction of intelligence from several huge heterogeneous...dimension reduction and feature extraction . These techniques are employed when no training set is available, and therefore also no target output...algorithms for application to huge, heterogeneous data sets enabling the extraction of intelligence from information. The approach uses two-scale supervised

  18. Uterine fibroids: current perspectives

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2013-11-01

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

  20. Uterine artery embolization

    MedlinePlus

    ... 111:22-33. Munro MG. Uterine leiomyomas, current concepts: pathogenesis, impact on reproductive health, and medical, procedural, and surgical management. Obstet Gynecol Clin N Am . 2011;38:703- ...

  1. Uterine Cancer Statistics

    MedlinePlus

    ... Research AMIGAS Fighting Cervical Cancer Worldwide Stay Informed Statistics for Other Kinds of Cancer Breast Cervical Colorectal ( ... Skin Vaginal and Vulvar Cancer Home Uterine Cancer Statistics Language: English Español (Spanish) Recommend on Facebook Tweet ...

  2. Puerperal uterine inversion managed by the uterine balloon tamponade.

    PubMed

    Thiam, Mariétou; Niang, Mouhamadou Mansour; Gueye, Lamine; Sarr, Fatou Rachel; Dieme, Marie Edouard Faye; Cisse, Mamadou Lamine

    2015-01-01

    The uterine inversion is a rare and severe puerperal complication. Uncontrolled cord traction and uterine expression are the common causes described. We report a case of uterine inversion stage III caused by poor management of the third stage of labor. It was about a 20 years old primigravida referred in our unit for postpartum hemorrhage due to uterine atony. After manual reduction of the uterus, the use of intra uterine balloon tamponade helped to stop the hemorrhage. The uterine inversion is a rare complication that may cause maternal death. The diagnosis is clinical and its management must be immediate to avoid maternal complications.

  3. Connecting slow earthquakes to huge earthquakes.

    PubMed

    Obara, Kazushige; Kato, Aitaro

    2016-07-15

    Slow earthquakes are characterized by a wide spectrum of fault slip behaviors and seismic radiation patterns that differ from those of traditional earthquakes. However, slow earthquakes and huge megathrust earthquakes can have common slip mechanisms and are located in neighboring regions of the seismogenic zone. The frequent occurrence of slow earthquakes may help to reveal the physics underlying megathrust events as useful analogs. Slow earthquakes may function as stress meters because of their high sensitivity to stress changes in the seismogenic zone. Episodic stress transfer to megathrust source faults leads to an increased probability of triggering huge earthquakes if the adjacent locked region is critically loaded. Careful and precise monitoring of slow earthquakes may provide new information on the likelihood of impending huge earthquakes.

  4. Non-puerperal Uterine Inversion Presented with Hypovolemic Shock.

    PubMed

    Song, Yong Jung; Yang, Juseok; Yun, Hyun Sil; Lee, Sun Kyung; Kim, Hwi Gon; Lee, Dong Hyung; Choi, Ook Hwan; Na, Yong Jin

    2016-12-01

    We report a non-puerperal uterine inversion with nulliparous women caused by huge pedunculated submucosal fibroid. Massive bleeding from protruding mass through vagina brought the heart to stop in 42-year-old nulliparous woman. She became cardiopulmonary resuscitation survivor in emergency room and then underwent laparotomy which ended in successful myomectomy rather than hysterectomy considering her demand for future fertility. Meticulous and adequate fluid therapy and transfusion was also administered to recover from hypovolemic status. Pathologic report confirmed benign submucosal fibroid with degeneration, necrosis and abscess formation. Thus, clinician should be aware of uterine inversion when encountered with huge protruding vaginal mass and consider uterus-preserving management as surgical option when the future fertility is concerned.

  5. Non-puerperal Uterine Inversion Presented with Hypovolemic Shock

    PubMed Central

    Song, Yong Jung; Yang, Juseok; Yun, Hyun Sil; Lee, Sun Kyung; Kim, Hwi Gon; Lee, Dong Hyung; Choi, Ook Hwan

    2016-01-01

    We report a non-puerperal uterine inversion with nulliparous women caused by huge pedunculated submucosal fibroid. Massive bleeding from protruding mass through vagina brought the heart to stop in 42-year-old nulliparous woman. She became cardiopulmonary resuscitation survivor in emergency room and then underwent laparotomy which ended in successful myomectomy rather than hysterectomy considering her demand for future fertility. Meticulous and adequate fluid therapy and transfusion was also administered to recover from hypovolemic status. Pathologic report confirmed benign submucosal fibroid with degeneration, necrosis and abscess formation. Thus, clinician should be aware of uterine inversion when encountered with huge protruding vaginal mass and consider uterus-preserving management as surgical option when the future fertility is concerned. PMID:28119900

  6. Uterine Vascular Lesions

    PubMed Central

    Vijayakumar, Abhishek; Srinivas, Amruthashree; Chandrashekar, Babitha Moogali; Vijayakumar, Avinash

    2013-01-01

    Vascular lesions of the uterus are rare; most reported in the literature are arteriovenous malformations (AVMs). Uterine AVMs can be congenital or acquired. In recent years, there has been an increasing number of reports of acquired vascular lesions of the uterus following pregnancy, abortion, cesarean delivery, and curettage. It can be seen from these reports that there is confusion concerning the terminology of uterine vascular lesions. There is also a lack of diagnostic criteria and management guidelines, which has led to an increased number of unnecessary invasive procedures (eg, angiography, uterine artery embolization, hysterectomy for abnormal vaginal bleeding). This article familiarizes readers with various vascular lesions of the uterus and their management. PMID:24340126

  7. A huge presacral Tarlov cyst. Case report.

    PubMed

    Ishii, Kazuhiko; Yuzurihara, Masahito; Asamoto, Shunji; Doi, Hiroshi; Kubota, Motoo

    2007-08-01

    Perineural cysts have become a common incidental finding during lumbosacral magnetic resonance (MR) imaging. Only some of the symptomatic cysts warrant treatment. The authors describe the successful operative treatment of a patient with, to the best of their knowledge, the largest perineural cyst reported to date. A 29-year-old woman had been suffering from long-standing constipation and low-back pain. During an obstetric investigation for infertility, the clinician discovered a huge presacral cystic mass. Computed tomography myelography showed the lesion to be a huge Tarlov cyst arising from the left S-3 nerve root and compressing the ipsilateral S-2 nerve. The cyst was successfully treated by ligation of the cyst neck together with sectioning of the S-3 nerve root. Postoperative improvement in her symptoms and MR imaging findings were noted. Identification of the nerve root involved by the cyst wall, operative indication, operative procedure, and treatment of multiple cysts are important preoperative considerations.

  8. Gemcitabine Hydrochloride and Docetaxel With or Without Bevacizumab in Treating Patients With Advanced or Recurrent Uterine Leiomyosarcoma

    ClinicalTrials.gov

    2015-11-11

    Recurrent Uterine Corpus Sarcoma; Stage IIIA Uterine Sarcoma; Stage IIIB Uterine Sarcoma; Stage IIIC Uterine Sarcoma; Stage IVA Uterine Sarcoma; Stage IVB Uterine Sarcoma; Uterine Corpus Leiomyosarcoma

  9. Abnormal Uterine Bleeding FAQ

    MedlinePlus

    ... PROBLEMS Abnormal Uterine Bleeding • What is a normal menstrual cycle? • When is bleeding abnormal? • At what ages is ... treat abnormal bleeding? •Glossary What is a normal menstrual cycle? The normal length of the menstrual cycle is ...

  10. Use of dietary phytochemicals to target inflammation, fibrosis, proliferation, and angiogenesis in uterine tissues: Promising options for prevention and treatment of uterine fibroids?

    PubMed Central

    Islam, Md Soriful; Akhtar, Most Mauluda; Ciavattini, Andrea; Giannubilo, Stefano Raffaele; Protic, Olga; Janjusevic, Milijana; Procopio, Antonio Domenico; Segars, James H.; Castellucci, Mario; Ciarmela, Pasquapina

    2014-01-01

    Uterine leiomyomas (fibroids, myomas) are the most common benign tumors of female reproductive tract. They are highly prevalent, with 70–80% of women burdened by the end of their reproductive years. Fibroids are a leading cause of pelvic pain, abnormal vaginal bleeding, pressure on the bladder, miscarriage, and infertility. They are the leading indication for hysterectomy, and costs exceed 6 billion dollars annually in the United States. Unfortunately, no long-term medical treatments are available. Dysregulation of inflammatory processes are thought to be involved in the initiation of leiomyoma and extracellular matrix deposition, cell proliferation, and angiogenesis are the key cellular events implicated in leiomyoma growth. In modern pharmaceutical industries, dietary phytochemicals are used as source of new potential drugs for many kinds of tumors. Dietary phytochemicals may exert therapeutic effects by interfering with key cellular events of the tumorigenesis process. At present, a negligible number of phytochemicals have been tested as therapeutic agents against fibroids. In this context, our aim was to introduce some of the potential dietary phytochemicals that have shown anti-inflammatory, antiproliferative, antifibrotic, and antiangiogenic activities in different biological systems. This review could be useful to stimulate the evaluation of these phytochemicals as possible therapies for uterine fibroids. PMID:24976593

  11. Effects of herbal medicine on human uterine tumor-bearing nude mice

    PubMed Central

    Ohh, Mi Hyang; Kim, Seong Jin; Han, Jong Kwon; Pak, Sok Cheon; Chee, Kew-mahn

    2016-01-01

    Aim: Uterine leiomyomas are the most common benign uterine neoplasms associated with significant morbidity. Herbal formulas capable of restoring yin-yang balance by dispersing blood stasis may be useful for managing fibroid symptoms. Materials and Methods: In this study, the antitumor properties of three herbs viz., Trogopterus xanthipes Milen-Edwards, Paeonia lactiflora Pallas, and Ulmus davidiana Planch were evaluated in nude mice injected intravenously with human malignant myomas. Tumor fragments were xenografted subcutaneously through a flank incision in female mice. The mice entered the study for 8 weeks when their tumors reached the threshold volume (260 mm3). The mice were randomly allocated to receive subcutaneous injections of normal saline (Group 1; negative control), P. lactiflora Pallas (Group 2), U. davidiana Planch (Group 3), T. xanthipes Milen-Edwards (Group 4), and intravenous injections of paclitaxel (Group 5; positive control). The weight and tumor volume were measured, followed by histopathology. Results: A few cases of abdominal distention and death were observed in the negative control group. Furthermore, a considerable enlargement of the liver and spleen was observed in the negative control group at autopsy with a gradual increase in body weight during the experiment. The mean tumor volume which increased in negative control mice reduced in mice treated with herbal remedies or paclitaxel from day 14 onwards (P < 0.05). The degree of necrosis and apoptosis induction from herbal treatments was similar to that of paclitaxel. Conclusion: Collectively, three herbs viz., T. xanthipes Milen-Edwards, P. lactiflora Pallas, and U. davidiana Planch were able to induce necrosis and apoptosis of uterine leiomyoma cells, proving antitumor properties against uterine fibroids. PMID:27757274

  12. Uterine fibroid vascularization and clinical relevance to uterine fibroid embolization.

    PubMed

    Pelage, Jean-Pierre; Cazejust, Julien; Pluot, Etienne; Le Dref, Olivier; Laurent, Alexandre; Spies, James B; Chagnon, Sophie; Lacombe, Pascal

    2005-10-01

    Embolization has become a first-line treatment for symptomatic uterine fibroid tumors. Selective catheterization and embolization of both uterine arteries, which are the predominant source of blood flow to fibroid tumors in most cases, is the cornerstone of treatment. Although embolization for treatment of uterine fibroid tumors is widely accepted, great familiarity with the normal and variant pelvic arterial anatomy is needed to ensure the safety and success of the procedure. The uterine artery classically arises as a first or second branch of the anterior division of the internal iliac artery and is usually dilated in the presence of a uterine fibroid tumor. Angiography is used for comprehensive pretreatment assessment of the pelvic arterial anatomy; for noninvasive evaluation, Doppler ultrasonography, contrast material-enhanced magnetic resonance (MR) imaging, and MR angiography also may be used. After the uterine artery is identified, selective catheterization should be performed distal to its cervicovaginal branch. For targeted embolization of the perifibroid arterial plexus, injection of particles with diameters larger than 500 mum is generally recommended. Excessive embolization may injure normal myometrium, ovaries, or fallopian tubes and lead to uterine necrosis or infection or to ovarian failure. Incomplete treatment or additional blood supply to the tumor (eg, via an ovarian artery) may result in clinical failure. The common postembolization angiographic end point is occlusion of the uterine arterial branches to the fibroid tumor while antegrade flow is maintained in the main uterine artery.

  13. [Life after uterine cancer].

    PubMed

    Koskas, Martin; Rodier, Jean-Michel; Bretel, Jean-Jacques; Bonneau, Claire; Luton, Dominique; Touboul, Cyril; Rouzier, Roman

    2014-06-01

    This overview focuses on the follow up after uterine cervix and corpus cancers. At early stage, both are associated with good prognosis. Screening for recurrence is mainly based on clinical examination. Screening for a second cancer after endometrial cancer is already planned according to the French recommendations for systematic breast and colon cancer screening. Screening for a second cancer after cervical cancer requires a close examination of organs close to the cervix receiving high doses of radiations and HPV exposed (anus, vulva, vagina and perineum). Late chemotherapy related toxicity after both cancers is rarely encountered and mainly comprise neurological peripheral effects. Late surgical and/or radiation related side effects are more frequent. However, no more than 10% of patients are affected and in such cases, digestive, urinary and lymphatic systems are impaired. Prevalence of sexual dysfunction in patients with uterine cancers is particularly high but the radiotherapy related anatomical modifications (vaginal stenosis for example) might not be the sole reason. Fertility preservation is possible for uterine cancers but requires a rigorous selection of candidates and should be coordinated by specialized team.

  14. Tubo-uterine implantation.

    PubMed

    Green-armytage, V G

    1957-02-01

    After characterizing 2 types of patients presenting with tubal infertility (1 that is "as a rule overweight (the uterus is fixed (and there is easily palpable tubo-uterine pathology," and 1 that is "slim, young, intelligent and often beautiful", 12 1-sentence suggestions are made to increase the success of tubo-uterine implantations in the second type of presenting patient (because the first group has, in the author's mind, disappointing prognosis). Figures are the bulk of the document, with 3 figures demonstrating the type of operation, 3 showing the scheme of the operation, 1 figure showing a posterior view of the implanted tube in utero with a polyethylene prosthesis in situ down to the cervix, and 1 figure showing the instruments used in the operation. A few points of experience the author shares are: 1) operate immediately after a menstrual period; 2) give antibiotics prophylactically and after the procedure; 3) use a Bonney Myomectomy Clamp to elevate the uterus; 4) never use a knife or bistoury at the cornua; 5) use polyethylene rods, when available; and 6) caesarean section is the indicated delivery route after tubo-uterine implantation. Out of 38 patients with the requisite history and findings who have been operated on by this author, 14 have gone to full-term, i.e., 36.1%; 2 have aborted, giving a pregnancy rate of 42.2%, and there was 1 ectopic pregnancy.

  15. Uterine transplantation: a systematic review

    PubMed Central

    Ejzenberg, Dani; Mendes, Luana Regina Baratelli Carelli; de Paiva Haddad, Luciana Bertocco; Baracat, Edmund Chada; D’Albuquerque, Luiz Augusto Carneiro; Andraus, Wellington

    2016-01-01

    Up to 15% of the reproductive population is infertile, and 3 to 5% of these cases are caused by uterine dysfunction. This abnormality generally leads women to consider surrogacy or adoption. Uterine transplantation, although still experimental, may be an option in these cases. This systematic review will outline the recommendations, surgical aspects, immunosuppressive drugs and reproductive aspects related to experimental uterine transplantation in women. PMID:27982170

  16. Huge Tongue Lipoma: A Case Report

    PubMed Central

    Damghani, Mohammad Ali; Safari, Mohammad

    2015-01-01

    Introduction: Lipomas are among the most common tumors of the human body. However, they are uncommon in the oral cavity and are observed as slow growing, painless, and asymptomatic yellowish submucosal masses. Surgical excision is the treatment of choice and recurrence is not expected.  Case Report: The case of a 30-year-old woman with a huge lipoma on the tip of her tongue since 3 years, is presented. She had difficulty with speech and mastication because the tongue tumor was filling the oral cavity. Clinical examination revealed a yellowish lesion, measuring 8 cm in maximum diameter, protruding from the lingual surface. The tumor was surgically excised with restoration of normal tongue function and histopathological examination of the tumor confirmed that it was a lipoma. Conclusion: Tongue lipoma is rarely seen and can be a cause of macroglossia. Surgical excision for lipoma is indicated for symptomatic relief and exclusion of associated malignancy. PMID:25938089

  17. Nanocellulose, a tiny fiber with huge applications.

    PubMed

    Abitbol, Tiffany; Rivkin, Amit; Cao, Yifeng; Nevo, Yuval; Abraham, Eldho; Ben-Shalom, Tal; Lapidot, Shaul; Shoseyov, Oded

    2016-06-01

    Nanocellulose is of increasing interest for a range of applications relevant to the fields of material science and biomedical engineering due to its renewable nature, anisotropic shape, excellent mechanical properties, good biocompatibility, tailorable surface chemistry, and interesting optical properties. We discuss the main areas of nanocellulose research: photonics, films and foams, surface modifications, nanocomposites, and medical devices. These tiny nanocellulose fibers have huge potential in many applications, from flexible optoelectronics to scaffolds for tissue regeneration. We hope to impart the readers with some of the excitement that currently surrounds nanocellulose research, which arises from the green nature of the particles, their fascinating physical and chemical properties, and the diversity of applications that can be impacted by this material.

  18. Huge congenital haemangioma of the tongue.

    PubMed

    Kucuk, Ulku; Pala, Emel Ebru; Bayol, Umit; Cakir, Ebru; Cukurova, Ibrahim; Gumussoy, Murat

    2014-12-01

    Haemangiomas, the most common type of benign vascular tumours, are rare in the oral cavity. Some of these lesions are congenital and show symptoms in late childhood or early adult life. A 32-years-old woman presented with a huge lesion on her tongue which caused dysphagia and dysphasia. She had first noticed the lesion when she was 6. Her obstructive symptoms started when she was 28 and, despite various medical treatments, the size of the lesion gradually increased. Magnetic resonance imaging revealed a 7 x 5 x 3 cm mass on the right side of the tongue. Because of severe functional and cosmetic problems, the lesion was excised with partial haemiglossectomy. Histopathological examination was consistent with intramuscular haemangioma. Haemangiomas are benign tumours with a benign course and are rarely seen on the tongue. They have clinical importance when localised in the oral cavity. Different treatment modalities exist, but in cases of large tumours, surgery may be the mainstay treatment.

  19. Rare case of giant cystic adenomyoma mimicking a uterine malformation, diagnosed and treated by hysteroscopy.

    PubMed

    Pontrelli, Giovanni; Bounous, Valentina Elisabetta; Scarperi, Stefano; Minelli, Luca; Di Spiezio Sardo, Attilio; Florio, Pasquale

    2015-08-01

    We describe a case of giant cystic uterine adenomyoma that was diagnosed and treated by hysteroscopy. In a 27-year-old woman with menometrorrhagia, severe dysmenorrhea, and chronic pelvic pain, pelvic ultrasonography revealed an enlarged uterine cavity filled with homogeneous low echogenic fluid content. A large cornual hematometra of 8.0 cm in diameter in a bicornuate uterus was suspected, and this hypothesis was also supported by magnetic resonance imaging findings. On the contrary, hysteroscopy revealed a bilocular huge cystic lesion of the posterior uterine wall that was removed by means of monopolar loop resection. The operative finding and the histopathologic examination confirmed the diagnosis of cystic adenomyoma of the uterus. Hysteroscopy may represent a valid tool for diagnosis and minimally invasive treatment of cystic adenomyoma, including those of large volume. Its use is helpful in differential diagnosis between cystic adenomyoma and uterine malformations as a possible cause of pelvic pain.

  20. Uterine tumor resembling ovarian sex cord tumor. Case report and review of literature.

    PubMed

    Stefanovic, A; Jeremic, K; Kadija, S; Mitrovic, M; Filimonovic, D; Jankovic-Raznatovic, S; Tavcar, J

    2013-01-01

    A uterine tumor resembling an ovarian sex cord tumor (UTROSCT) shows a poly phenotypic immunophenotype with coexpression of epithelial, myoid, and sex cord markers, as well as hormone receptors. The authors present a case of a 59-year-old multiparous woman admitted to the Institute of Gynecology and Obstetrics Clinical Centre of Serbia in January 2010 due to prolonged vaginal bleeding and abdominal discomfort. The vaginal ultrasound showed an enlarged uterus size of 100 x 74 x 81 mm, with extended cavity with an unhomogenic content and myomas sized 54 x 69 mm located in fundus with secondary changes. She underwent abdominal hysterectomy with adnexectomy. Microscopic examination revealed submucosal uterine tumor with variabile histological organization that had anastomotic trabeculae with solid cellular grupations. Rare mitotic figures (2/10 HPF) were found. Additional imunohistochemistry showed immunophenotype: the sex cord areas were positive for vimentin(++), aSMA(++), AE1/AE3(+), PR(+), and ER(+). The poly phenotypic immunophenotype can be useful in differential diagnosis from other neoplasms but also suggests an origin of UTROSCT from uncommitted stem cell enabling for multidirectional differentiation.

  1. HUBBLE SPIES HUGE CLUSTERS OF STARS FORMED

    NASA Technical Reports Server (NTRS)

    2002-01-01

    BY ANCIENT ENCOUNTER This stunningly beautiful image [right] taken with the NASA Hubble Space Telescope shows the heart of the prototypical starburst galaxy M82. The ongoing violent star formation due to an ancient encounter with its large galactic neighbor, M81, gives this galaxy its disturbed appearance. The smaller picture at upper left shows the entire galaxy. The image was taken in December 1994 by the Kitt Peak National Observatory's 0.9-meter telescope. Hubble's view is represented by the white outline in the center. In the Hubble image, taken by the Wide Field and Planetary Camera 2, the huge lanes of dust that crisscross M82's disk are another telltale sign of the flurry of star formation. Below the center and to the right, a strong galactic wind is spewing knotty filaments of hydrogen and nitrogen gas. More than 100 super star clusters -- very bright, compact groupings of about 100,000 stars -- are seen in this detailed Hubble picture as white dots sprinkled throughout M82's central region. The dark region just above the center of the picture is a huge dust cloud. A collaboration of European and American scientists used these clusters to date the ancient interaction between M82 and M81. About 600 million years ago, a region called 'M82 B' (the bright area just below and to the left of the central dust cloud) exploded with new stars. Scientists have discovered that this ancient starburst was triggered by the violent encounter with M81. M82 is a bright (eighth magnitude), nearby (12 million light-years from Earth) galaxy in the constellation Ursa Major (the Great Bear). The Hubble picture was taken Sept. 15, 1997. The natural-color composite was constructed from three Wide Field and Planetary Camera 2 exposures, which were combined in chromatic order: 4,250 seconds through a blue filter (428 nm); 2,800 seconds through a green filter (520 nm); and 2,200 seconds through a red (820 nm) filter. Credits for Hubble image: NASA, ESA, R. de Grijs (Institute of

  2. Post-uterine artery embolization pain and clinical outcomes for symptomatic myomas using gelfoam pledgets alone versus embospheres plus gelfoam pledgets: a comparative pilot study.

    PubMed

    Vilos, Angelos G; Vilos, George A; Hollett-Caines, Jackie; Garvin, Greg; Kozak, Roman; Abu-Rafea, Basim

    2014-11-01

    Contexte : Évaluer l’efficacité et la douleur post-interventionnelle associées à l’embolisation de l’artère utérine (EAU) au seul moyen du produit Gelfoam, par comparaison avec l’utilisation combinée des produits Embosphere et Gelfoam, chez des femmes présentant des fibromes utérins symptomatiques. Méthode : Nous avons mené une étude pilote non randomisée prospective. Une EAU par voie transfémorale guidée par fluoroscopie a été menée seulement au moyen de tampons Gelfoam ou au moyen des produits Embosphere (500-700 mg) et Gelfoam, sous sédation consciente et anesthésie locale, le tout ayant été suivi par la mise en œuvre d’une analgésie contrôlée par la patiente (ACP) pendant la nuit suivant l’intervention (au moyen d’une pompe à morphine). La douleur post-interventionnelle a été évaluée en fonction de la quantité moyenne de morphine auto-administrée au moyen de la pompe d’ACP (ml) entre 0 et 19 heures au sein de chaque groupe. Les volumes moyens de l’utérus et du fibrome dominant ont été calculés par échographie au départ, à trois mois, à six mois et à 12 mois. Résultats : Au total, 17 femmes ont participé à l’étude. Une occlusion bilatérale de l’artère utérine a été menée chez huit femmes en n’utilisant que le produit Gelfoam et la même intervention a été menée au moyen des produits Embosphere et Gelfoam chez neuf autres femmes. Une des femmes du groupe « Embosphere et Gelfoam » en est venue à présenter un hématome au point de ponction ayant nécessité une autre intervention, une semaine plus tard. La quantité moyenne (σ) de morphine auto-administrée au moyen de la pompe d’ACP à 0, à 1 et à 2 heures a été de 3,4 mg (3,1), de 2,9 mg (2,2) et de 2,4 mg (3,3), au sein du groupe « Gelfoam seulement », et de 6,1 mg (3,0), de 9,6 mg (7,1) et de 5,3 mg (4,4), au sein du groupe « Embosphere et Gelfoam », respectivement. Après trois heures, la quantité de morphine utilisée était équivalente au sein des deux groupes. La dose totale moyenne (σ) de morphine utilisée a été de 29,5 mg (18,6) au sein du groupe « Gelfoam seulement » et de 41,1 mg (19,3) au sein du groupe « Embosphere et Gelfoam » (P = 0,228). À 12 mois, la diminution du volume utérin total médian et du volume médian du fibrome dominant était équivalente au sein des deux groupes. Conclusion : La tenue d’une embolisation de l’artère utérine en n’utilisant que le produit Gelfoam ou au moyen des produits Gelfoam et Embosphere a donné lieu à des issues cliniques équivalentes. Bien que la douleur post-interventionnelle immédiate puisse être moins intense lorsque l’on n’a recours qu’au produit Gelfoam, nous n’avons pas été en mesure de le démontrer de façon objective en utilisant la quantité de morphine auto-administrée à titre de mesure de la douleur.

  3. The management of uterine leiomyomas.

    PubMed

    Vilos, George A; Allaire, Catherine; Laberge, Philippe-Yves; Leyland, Nicholas; Vilos, Angelos G; Murji, Ally; Chen, Innie

    2015-02-01

    Objectifs : La présente directive clinique a pour objectif d’aider les cliniciens à mieux comprendre la pathophysiologie, la prévalence et l’importance clinique des myomes, et de leur faire part des meilleures données probantes disponibles quant aux modalités de traitement. Options : Dans le cadre de la rédaction de la présente directive clinique, nous avons tenu compte des aspects suivants de la pratique clinique : évaluation, traitements médicaux, traitements conservateurs par myolyse, occlusion sélective de l’artère utérine et solutions de rechange chirurgicales (dont la myomectomie et l’hystérectomie). Le rapport risques-avantages doit faire l’objet d’une analyse personnalisée dans le cadre des discussions menées entre la patiente et son fournisseur de soins. Issues : La mise en œuvre de la présente directive clinique devrait optimiser le processus décisionnel pour les patientes et les fournisseurs de soins en ce qui a trait à la tenue d’autres explorations ou à la façon d’assurer la prise en charge des léiomyomes utérins, en ayant tenu compte du processus pathogénique (et des options disponibles en matière de traitement) et en ayant passé en revue les risques et les avantages anticipés. Résultats : La littérature publiée a été récupérée par l’intermédiaire de recherches menées dans PubMed, CINAHL et Cochrane Systematic Reviews en février 2013 au moyen d’un vocabulaire contrôlé (p. ex. « uterine fibroids », « myoma », « leiomyoma », « myomectomy », « myolysis », « heavy menstrual bleeding » et « menorrhagia ») et de mots clés (p. ex. « myoma », « leiomyoma », « fibroid », « myomectomy », « uterine artery embolization », « hysterectomy », « heavy menstrual bleeding », « menorrhagia ») appropriés. Des recherches ont également été menées dans les listes de références des articles identifiés en vue d’en tirer d

  4. Radiation Therapy, Paclitaxel, and Carboplatin in Treating Patients With Uterine Cancer

    ClinicalTrials.gov

    2015-01-16

    Stage IA Uterine Sarcoma; Stage IB Uterine Sarcoma; Stage IC Uterine Sarcoma; Stage IIA Uterine Sarcoma; Stage IIB Uterine Sarcoma; Stage IIIA Uterine Sarcoma; Stage IIIB Uterine Sarcoma; Stage IIIC Uterine Sarcoma; Stage IVA Uterine Sarcoma; Stage IVB Uterine Sarcoma; Uterine Carcinosarcoma

  5. Uterine Contraction Modeling and Simulation

    NASA Technical Reports Server (NTRS)

    Liu, Miao; Belfore, Lee A.; Shen, Yuzhong; Scerbo, Mark W.

    2010-01-01

    Building a training system for medical personnel to properly interpret fetal heart rate tracing requires developing accurate models that can relate various signal patterns to certain pathologies. In addition to modeling the fetal heart rate signal itself, the change of uterine pressure that bears strong relation to fetal heart rate and provides indications of maternal and fetal status should also be considered. In this work, we have developed a group of parametric models to simulate uterine contractions during labor and delivery. Through analysis of real patient records, we propose to model uterine contraction signals by three major components: regular contractions, impulsive noise caused by fetal movements, and low amplitude noise invoked by maternal breathing and measuring apparatus. The regular contractions are modeled by an asymmetric generalized Gaussian function and least squares estimation is used to compute the parameter values of the asymmetric generalized Gaussian function based on uterine contractions of real patients. Regular contractions are detected based on thresholding and derivative analysis of uterine contractions. Impulsive noise caused by fetal movements and low amplitude noise by maternal breathing and measuring apparatus are modeled by rational polynomial functions and Perlin noise, respectively. Experiment results show the synthesized uterine contractions can mimic the real uterine contractions realistically, demonstrating the effectiveness of the proposed algorithm.

  6. Cholangiocarcinoma Presenting as Uterine Metastasis

    PubMed Central

    Dendas, W.; Cappelle, L.; Verguts, J.; Orye, G.

    2014-01-01

    Metastases to the female genital tract are rare, with metastatic disease restricted to the uterus being even less frequent. The primary tumor is most often intragenital rather than extragenital. The diagnosis is usually made after occurrence of gynecological symptoms. We describe the case of a 26-year-old female, in whom a curettage for menorrhagia revealed a uterine malignancy, at first thought to be a carcinosarcoma. Biochemistry only showed iron deficiency anemia. Imaging showed discrepant results with liver lesions, suspect of neoplastic or inflammatory disease. She underwent an abdominal hysterectomy and, peroperatively, a frozen section of a mass in the liver hilus demonstrated a cholangiocarcinoma. The diagnosis of a uterine metastasized cholangiocarcinoma was made. We emphasize the fact that uterine metastases have to be excluded in every woman with abnormal uterine bleeding and a personal history of malignancy. However, our case also indicates that gynecological metastatic disease may be the first presentation of an extragenital primary neoplasm. PMID:25610676

  7. Surgical treatment of uterine sarcoma.

    PubMed

    Nam, Joo-Hyun

    2011-12-01

    Uterine sarcomas are rare, heterogeneous malignant tumours of several histologic types originating from mesenchymal tissues of the uterus. The most common histologic types are carcinosarcoma, leiomyosarcoma, and endometrial stromal sarcoma, accounting for 90% of uterine sarcomas. To date, no effective treatment has been found to achieve a high rate of cure or prolong survival. Although complete surgical excision of the tumour is the only curative treatment modality, the rarity of these tumours and their diversity of histologic types have precluded the development of standard surgical strategies. Surgery may also be optimal for recurrent uterine sarcomas, but indications for secondary surgical treatment have not been established. Here, we describe recent changes in, and updates of, the surgical treatment of the three most common types of malignant uterine sarcomas.

  8. Postpartum uterine health in cattle.

    PubMed

    Sheldon, I M; Dobson, H

    2004-07-01

    Uterine health is often compromised in cattle because postpartum contamination of the uterine lumen by bacteria is ubiquitous, and pathogenic bacteria frequently persist causing clinical disease. The subfertility associated with uterine infection involves perturbation of the hypothalamus, pituitary and ovary, in addition to the direct effects on the uterus, and appears to persist even after clinical resolution of the disease. Absorption of bacterial components from the uterus can prevent the follicular phase LH surge and ovulation. In addition, the first postpartum dominant follicle has a slower growth rate and secretes less estradiol at the end of the growth phase. There are also localised ovarian effects of high uterine bacterial growth density, because fewer first dominant follicles are selected in the ovary ipsilateral than contralateral to the previously gravid uterine horn. Thus, it is important to diagnose and treat uterine disease promptly and effectively. Examination of the contents of the vagina for the presence of pus is the most useful method for diagnosis of endometritis. The character and odor of the vaginal mucus can be scored and this endometritis score is correlated with the growth density of pathogenic bacteria in the uterus, and is prognostic for the likely success of treatment. The challenge for the future is to design prevention and control programs to reduce the incidence of disease, and understand how the immune and endocrine systems are integrated.

  9. The etiopathogenesis of uterine fibromatosis

    PubMed Central

    Manta, L; Suciu, N; Toader, O; Purcărea, RM; Constantin, A; Popa, F

    2016-01-01

    Uterine fibroids or uterine leiomyomas are the most common benign tumors of the uterus among women of fertile age, while the etiology is still incompletely elucidated. The occurrence and development of the fibromatosis may be related to certain risk factors and genic mechanisms, although the exact causes are not yet fully known. The development of uterine fibroids is correlated not only with the metabolism and with the level of female sexual hormones, estrogen, and progesterone, but also with the number of these hormone receptors expressed on the surface of the myometrium. Proliferative effects of estrogen and progesterone may be exercised through proinflammatory factors (TNF alpha), growth factors (IGF1, IGF2, TGFbeta3 and betaFGF) or inhibitors of apoptosis (p53 suppression). A number of predisposing factors such as ethnicity – black skin, early menarche, nulliparity, caffeine and alcohol, chronic inflammation, obesity, were also identified. Approximately 40% of the uterine fibroids are caused by the same cytogenetic alterations found in the other tumor types such as kidney, lung, or leiomyosarcoma. As part of a system dysfunction, uterine fibromatosis was connected to other disorders such as AHT (arterial hypertension), endometrium adenocarcinoma, adenomyosis, endometriosis, diabetes mellitus, breast tumors, seemingly with a common causality. The action and effect of some hormonal imbalances over the various organs depend on the histological and local expression particularities of the various receptors, being the cause for many disorders, among which the uterine fibromatosis, coexisting or accompanying the later. This article examines and summarizes the latest data refreshed literature etiopathogenesis offering indicators of uterine fibroids. PMID:27974911

  10. Anesthetic management of a parturient with placenta previa totalis undergoing preventive uterine artery embolization before placental expulsion during cesarean delivery: a case report.

    PubMed

    Lee, Jae Woo; Song, In Ae; Ryu, Junghee; Park, Hee-Pyoung; Jeon, Young-Tae; Hwang, Jung-Won

    2014-10-01

    Placenta previa totalis can cause life-threatening massive postpartum hemorrhage, and careful anesthetic management is essential. Preventive uterine artery embolization (UAE) before placental expulsion was introduced to reduce postpartum bleeding in cases of placenta previa totalis. We describe the case of a 40-year-old woman (gravida 0, para 0) with placenta previa totalis and uterine myomas who underwent intraoperative UAE, which was preoperatively planned at the strong recommendation of the anesthesiologist, immediately after delivery of a fetus and before removal of the placenta during cesarean delivery under spinal-epidural anesthesia. After confirming embolization of both uterine arteries, removal of the placenta resulted in moderate bleeding. The estimated blood loss was 2.5 L, and 5 units of red blood cells were transfused. The parturient was discharged uneventfully on postoperative day 4. This case shows that the bleeding risk is reduced by intraoperative UAE in a patient with placenta previa totalis, and anesthesiologists have an important role in a multidisciplinary team approach.

  11. Anesthetic management of a parturient with placenta previa totalis undergoing preventive uterine artery embolization before placental expulsion during cesarean delivery: a case report

    PubMed Central

    Lee, Jae Woo; Song, In Ae; Ryu, Junghee; Jeon, Young-Tae; Hwang, Jung-won

    2014-01-01

    Placenta previa totalis can cause life-threatening massive postpartum hemorrhage, and careful anesthetic management is essential. Preventive uterine artery embolization (UAE) before placental expulsion was introduced to reduce postpartum bleeding in cases of placenta previa totalis. We describe the case of a 40-year-old woman (gravida 0, para 0) with placenta previa totalis and uterine myomas who underwent intraoperative UAE, which was preoperatively planned at the strong recommendation of the anesthesiologist, immediately after delivery of a fetus and before removal of the placenta during cesarean delivery under spinal-epidural anesthesia. After confirming embolization of both uterine arteries, removal of the placenta resulted in moderate bleeding. The estimated blood loss was 2.5 L, and 5 units of red blood cells were transfused. The parturient was discharged uneventfully on postoperative day 4. This case shows that the bleeding risk is reduced by intraoperative UAE in a patient with placenta previa totalis, and anesthesiologists have an important role in a multidisciplinary team approach. PMID:25368788

  12. Ventriculoperitoneal shunt infection following uterine instrumentation for dysfunctional uterine bleeding.

    PubMed

    Shaw, Andrew B; Marlin, Evan S; Ikeda, Daniel S; Ammirati, Mario

    2014-08-01

    Shunt infections are most common within the first 6 months following implantation. A shunt infection 19 years after implantation secondary to uterine ablation has not been reported to our knowledge. Office hysteroscopic procedures have become commonplace in gynecologic practice. Infectious complication rates are low, but peritonitis has been described. We present a patient with a ventriculoperitoneal shunt infection following a uterine ablation for dysfunctional uterine bleeding. Three days following the ablation she developed abdominal pain. CT scan of the abdomen 5 months after the procedure revealed a pseudocyst. She then underwent removal of her shunt with intra-operative cultures revealing Streptococcus agalactiae. Definitive treatment consisted of shunt explantation and antibiotic treatment with complete resolution of her pain and pseudocyst. Consideration for prophylactic antibiotics should be made when a patient with a ventriculoperitoneal shunt undergoes any transvaginal procedure.

  13. [Inhibition of premature uterine contractions].

    PubMed

    Troszyński, M; Leibschang, J; Chazan, B; Adamowicz, R; Brankowska, J

    1979-01-01

    Various drugs used to stop premature uterine contractions are discussed in the paper. Particular attention is paid to beta-mimetic drugs. The results of ming Partusisten, one of beta-mimetic drugs, is presented on the material of 104 patients with threatening immature and premature labour. Partusisten was administered in the form of intravenous drip infusion or tablets. During treatment monitoring of the uterine contractility and of foetal heart rate took place. Inhibition of the uterine contraction activity was successful in 100 per cent of cases. In 60,9 per cent in the group of threatening immature labour and in 38,1 per cent in the group threatening premature labour, the delay of delivery was more then 28 days. The delay of delivery by 48 hours was 87 per cent and 84 per cent in both groups respectively. Tachycardia was one of the first side effects observed in 15,2 per cent of cases. There is also presented an example of pregnancy when delivery was delayed by 21 days in spite of premature outflow of amniotic fluid (at a high rupture of membrane). The authors are of the opinion that Partusisten is very effective and gives little side effects, preventing premature uterine contractions. Dosage should be individualized according to the case and labour advancement, and should be based on topographic evaluation of uterine contraction. Negative influence of the drug on foetuses was not observed.

  14. Uterine prolapse in a primigravid woman

    PubMed Central

    Kim, Jeong Ok; Jang, Shin A; Yun, Nae Ri; Lee, Sang-Hun; Hwang, Sung Ook

    2016-01-01

    Uterine prolapse during pregnancy is an uncommon condition. It can cause preterm labor, spontaneous abortion, fetal demise, maternal urinary complication, maternal sepsis and death. We report the case of uterine prolapse in a 32-year-old healthy primigravid woman. She had no risk factors associated with uterine prolapse. She was conservatively treated, resulting in a successful vaginal delivery. This report is a very rare case of uterine prolapse in a young healthy primigravid woman, resulting in a successful vaginal delivery. PMID:27200317

  15. Herbal preparations for uterine fibroids

    PubMed Central

    Liu, Jian Ping; Yang, Hong; Xia, Yun; Cardini, Francesco

    2011-01-01

    Background Uterine fibroids are the most common non-malignant growths in women of childbearing age. They are associated with heavy menstrual bleeding and subfertility. Herbal preparations are commonly used as alternatives to surgical procedures. Objectives To assess the benefits and risks of herbal preparations for uterine fibroids. Search strategy Authors searched following electronic databases: the Trials Registers of the Cochrane Menstrual Disorders and Subfertility Group and the Cochrane Complementary Medicine Field, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2008, Issue 3), MEDLINE, EMBASE, the Chinese Biomedical Database, the Traditional Chinese Medical Literature Analysis and Retrieval System (TCMLARS), AMED, and LILACS. The searches ended on 31st December 2008. Selection criteria Randomised controlled trials comparing herbal preparations with no intervention, placebo, medical treatment or surgical procedures in women with uterine fibroids. We also included trials of herbal preparations with or without conventional therapy. Data collection and analysis Two review authors collected data independently. We assessed trial risk of bias according to our methodological criteria. We presented dichotomous data as risk ratios (RR) and continuous outcomes as mean difference (MD), both with 95% confidence intervals (CI). Main results We included two randomised trials (involved 150 women) with clear description of randomisation methods. The methodological risk of bias of the trials varied. There were variations in the tested herbal preparations, and the treatment duration was six months. The outcomes available were not the primary outcomes selected for this review, such as symptom relief or the need for surgical treatment; trials mainly reported outcomes in terms of shrinkage of the fibroids. Compared with mifepristone, Huoxue Sanjie decoction showed no significant difference in the disappearance of uterine fibroids, number of

  16. Gemcitabine Hydrochloride, Docetaxel, and Radiation Therapy in Treating Patients With Uterine Sarcoma That Has Been Removed By Surgery

    ClinicalTrials.gov

    2015-01-16

    Stage IA Uterine Sarcoma; Stage IB Uterine Sarcoma; Stage IC Uterine Sarcoma; Stage IIA Uterine Sarcoma; Stage IIB Uterine Sarcoma; Stage IIIA Uterine Sarcoma; Stage IIIB Uterine Sarcoma; Stage IIIC Uterine Sarcoma; Stage IVA Uterine Sarcoma; Stage IVB Uterine Sarcoma; Uterine Corpus Leiomyosarcoma

  17. Safety after extended repeated use of ulipristal acetate for uterine fibroids

    PubMed Central

    Donnez, Jacques; Bouchard, Philippe; Barlow, David H.; Vázquez, Francisco; Skouby, Sven O.; Palacios, Santiago; Tomaszewski, Janusz; Lemieszczuk, Boguslaw; William, Alistair R. W.

    2017-01-01

    Objective To assess long term safety of extended repeated 3-month courses of ulipristal acetate (UPA) 10 mg/day, for up to 8 courses, with focus on endometrial and laboratory safety parameters. Methods This long-term, multi-center, open-label cohort, follow up study consisted of up to 8 consecutive 3-month courses of daily UPA 10 mg, each separated by a drug free period of 2 spontaneous menstrual bleeds. Sixty-four pre-menopausal women, with moderate to severe symptomatic uterine myoma(s) and heavy bleeding were enrolled and were studied for approximately 4 years. The main outcome measures were endometrial histology, laboratory parameters and general safety. Results All data was reported in a descriptive manner with no formal statistical comparisons. In the 64 women, non-physiological changes (mostly cyst formation, epithelial and vascular changes) in endometrial histology at screening and after treatment courses 4 and 8 were observed in 18.0%, 21.4% and 16.3% of biopsies, respectively. After treatment cessation, such changes were observed in 9.1% of biopsies. All endometrial biopsies were benign after course 8. The median endometrial thickness was 7.0 mm, 10–18 days after the start of menses following treatment courses 5–8, compared to 9.0 mm at screening (before UPA treatment). No changes in the number and type of laboratory results outside the normal ranges were observed with the increasing treatment courses. In total, adverse events were reported in 10 (16%), 12 (19%), 8 (14%) and 5 (9%) subjects, during treatment courses 5, 6, 7 and 8, respectively of which the most frequent adverse events were headache and hot flush. Conclusion The results of this study further support the safety profile of extended repeated 3 months treatment of symptomatic fibroids with ulipristal acetate 10 mg/day. Repeated UPA treatment courses did not result in any changes of concern in endometrial histology, endometrial thickness, or laboratory safety measures. PMID:28267814

  18. A case of a huge gastroepiploic arterial aneurysm

    PubMed Central

    Ikeda, Hirokuni; Takeo, Masahiko; Mikami, Ryuuichi; Yamamoto, Mistuo

    2015-01-01

    An 85-year-old man complaining of vague abdominal discomfort was admitted to our hospital. A pulsatile 8 × 7-cm mass in the right upper abdomen was noticed on clinical examination. Computed tomography of the abdomen showed a huge arterial aneurysm in the right gastroepiploic artery, and the left gastroepiploic artery was meandering and expanding. An image diagnosis of gastroepiploic arterial aneurysm (GEAA) was made. Because of the huge size of the aneurysm and the predicted high risk of perforation, surgical intervention was planned. The aneurysm was identified in the greater curve and was found to adhere firmly to the transverse colon. Partial resection of the stomach, aneurysmectomy and partial resection of the transverse colon were performed. Clinically, splanchnic arterial aneurysms are rare. Among them, GEAA is especially rare. We report a rare case of a huge GEAA that was treated successfully by surgery. PMID:26246477

  19. Anaesthetic management in a case of huge plunging ranula

    PubMed Central

    Sheet, Jagabandhu; Mandal, Anamitra; Sengupta, Swapnadeep; Jana, Debaleena; Mukherji, Sudakshina; Swaika, Sarbari

    2014-01-01

    Plunging ranula is a rare form of mucous retention cyst arising from submandibular and sublingual salivary glands, which may occasionally become huge occupying the whole of the floor of the mouth and extending into the neck, thus, restricting the neck movement as well as disfiguring the normal airway anatomy. Without fiberoptic assistance, blind or retrograde nasal intubation remains valuable choices in this type of situation. Here, we present a case of successful management of airway by blind nasal intubation in a patient posted for excision of a huge plunging ranula. PMID:25886120

  20. Huge Gastric Teratoma in an 8-Year Old Boy

    PubMed Central

    Ratan, Simmi K; Man, Parveen k

    2016-01-01

    Gastric teratoma is very rare tumor and usually presents in early infancy. An 8-year-old boy presented with a huge mass in abdomen extending from epigastrium to the pelvis. Ultrasound and CT scan of abdomen revealed a huge mass with solid and cystic components and internal calcifications. The preoperative diagnosis was a teratoma but not specifically gastric one. At operation, it was found to be gastric teratoma. The mass was excised completely with part of the stomach wall. The histopathology confirmed it to be mature gastric teratoma. The rarity of the teratoma with delayed presentation prompted us to report the case. PMID:27900279

  1. Systemic sclerosis with hemoptysis and a huge lung cavity

    PubMed Central

    Cheepsattayakorn, Attapon; Cheepsattayakorn, Ruangrong

    2011-01-01

    Systemic sclerosis or scleroderma is associated with distal vasculitis, Raynaud's phenomenon, and inflammation of internal organs and the skin. We present on a 58-year-old Thai woman with systemic sclerosis who came to the 10th Zonal Tuberculosis and Chest Disease Center, Chiang Mai, Thailand in 2009 and presented with hemoptysis and a solitary huge-lung cavity as the predominant clinical manifestations which spontaneously resoluted 2 months later. This case demonstrates a solitary huge-lung cavity with hemoptysis and looked like from non-tuberculous Mycobacterial infections or malignancy with spontaneous resolution of hemoptysis and the lung cavity, which does not need invasive investigations. PMID:24765399

  2. Pharmacological treatment of uterine fibroids.

    PubMed

    Moroni, Rm; Vieira, Cs; Ferriani, Ra; Candido-Dos-Reis, Fj; Brito, Lgo

    2014-09-01

    Uterine fibroids (UF) are common, benign gynecologic tumors, affecting one in three to four women, with estimates of up to 80%, depending on the population studied. Their etiology is not well established, but it is under the influence of several risk factors, such as early menarche, nulliparity and family history. More than 50% of affected women are asymptomatic, but the lesions may be related to bothersome symptoms, such as abnormal uterine bleeding, pelvic pain and bloating or urinary symptoms. The treatment of UF is classically surgical; however, various medical options are available, providing symptom control while minimizing risks and complications. A large number of clinical trials have evaluated commonly used medical treatments and potentially effective new ones. Through a comprehensive literature search using PubMed, EMBASE, CENTRAL, Scopus and Google Scholar databases, through which we included 41 studies out of 7658 results, we thoroughly explored the different pharmacological options available for management of UF, their indications, advantages and disadvantages.

  3. Uterine adenocarcinoma with feline leukemia virus infection.

    PubMed

    Cho, Sung-Jin; Lee, Hyun-A; Hong, Sunhwa; Kim, Okjin

    2011-12-01

    Feline endometrial adenocarcinomas are uncommon malignant neoplasms that have been poorly characterized to date. In this study, we describe a uterine adenocarcinoma in a Persian cat with feline leukemia virus infection. At the time of presentation, the cat, a female Persian chinchilla, was 2 years old. The cat underwent surgical ovariohystectomy. A cross-section of the uterine wall revealed a thickened uterine horn. The cat tested positive for feline leukemia virus as detected by polymerase chain reaction. Histopathological examination revealed uterine adenocarcinoma that had metastasized to the omentum, resulting in thickening and the formation of inflammatory lesions. Based on the histopathological findings, this case was diagnosed as a uterine adenocarcinoma with abdominal metastasis. To the best of our knowledge, this is the first report of a uterine adenocarcinoma with feline leukemia virus infection.

  4. GCIG Consensus Review: Uterine and Ovarian Leiomyosarcomas

    PubMed Central

    Hensley, Martee L.; Barrette, Brigitte A.; Baumann, Klaus; Gaffney, David; Hamilton, Anne L.; Kim, Jae-Weon; Maenpaa, Johanna U.; Pautier, Patricia; Siddiqui, Nadeem Ahmad; Westermann, Anneke M.; Ray-Coquard, Isabelle

    2016-01-01

    Objective The GCIG aimed to provide an overview of uterine and ovarian leiomyosarcoma management. Methods Published articles and author experience were used to draft management overview. The draft manuscript was circulated to international members of the GCIG for review and comment, and appropriate revisions were made. Results The approach to management of uterine and ovarian leiomyosarcoma management is reviewed. Conclusions Uterine and ovarian leiomyosarcomas are rare, aggressive cancers that require specialized expertise for optimal management. PMID:25341583

  5. What's New in Uterine Sarcoma Research and Treatment?

    MedlinePlus

    ... and Treatment? Uterine Sarcoma About Uterine Sarcoma What's New in Uterine Sarcoma Research and Treatment? Molecular pathology ... the chromosomes leads to the formation of a new gene, called JAZF1/JJAZ. This gene may help ...

  6. What Are the Key Statistics about Uterine Sarcoma?

    MedlinePlus

    ... Sarcoma About Uterine Sarcoma What Are the Key Statistics About Uterine Sarcoma? The American Cancer Society's estimates ... uterine corpus. Visit the American Cancer Society’s Cancer Statistics Center for more key statistics. Written by References ...

  7. Maternal Uterine Vascular Remodeling During Pregnancy

    PubMed Central

    Osol, George; Mandala, Maurizio

    2009-01-01

    Sufficient uteroplacental blood flow is essential for normal pregnancy outcome and is accomplished by the coordinated growth and remodeling of the entire uterine circulation, as well as the creation of a new fetal vascular organ: the placenta. The process of remodeling involves a number of cellular processes, including hyperplasia and hypertrophy, rearrangement of existing elements, and changes in extracellular matrix. In this review, we provide information on uterine blood flow increases during pregnancy, the influence of placentation type on the distribution of uterine vascular resistance, consideration of the patterns, nature, and extent of maternal uterine vascular remodeling during pregnancy, and what is known about the underlying cellular mechanisms. PMID:19196652

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

    PubMed

    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.

  9. Medroxyprogesterone in Treating Patients With Endometrioid Adenocarcinoma of the Uterine Corpus

    ClinicalTrials.gov

    2016-03-17

    Endometrial Adenocarcinoma; Endometrial Adenosquamous Carcinoma; Endometrial Endometrioid Adenocarcinoma, Variant With Squamous Differentiation; Recurrent Uterine Corpus Carcinoma; Stage I Uterine Corpus Cancer; Stage II Uterine Corpus Cancer; Stage III Uterine Corpus Cancer; Stage IV Uterine Corpus Cancer

  10. Uterine arteriovenous malformation with positive serum beta-human chorionic gonadotropin: Embolization of both uterine arteries and extra-uterine feeding arteries

    PubMed Central

    Kim, Su Mi; Ahn, Hee Young; Choi, Min Jeong; Kang, Yun Dan; Park, Jin Wan; Park, Choong Hak

    2016-01-01

    The incidence of uterine arteriovenous malformation (AVM) is rare. However, it is clinically significant in that it can cause life-threatening vaginal bleeding. We report a case of a large uterine AVM with positive serum beta-human chorionic gonadotropin. A presumptive diagnosis was made; a uterine AVM accompanied by, early pregnancy or retained product of conception. Because this uterine AVM was extensive, transcatheter arterial embolization of both uterine arteries and extra-uterine feeding arteries was performed. Three months after undergoing transcatheter arterial embolization, complete resolution of the uterine AVM was confirmed without major complication. PMID:27896262

  11. A Huge Cystic Retroperitoneal Lymphangioma Presenting with Back Pain

    PubMed Central

    Kubachev, Kubach; Abdullaev, Elbrus; Babyshin, Valentin; Neronov, Dmitriy; Abdullaev, Abakar

    2016-01-01

    Retroperitoneal lymphangioma is a rare location and type of benign abdominal tumors. The clinical presentation of this rare disease is nonspecific, ranging from abdominal distention to sepsis. Here we present a 73-year-old female patient with 3-month history of back pain. USG and CT revealed a huge cystic mass which was surgically excised and appeared to be lymphangioma on histopathology. PMID:27843456

  12. The effect of puerperal uterine disease on uterine involution in cows assessed by Doppler sonography of the uterine arteries.

    PubMed

    Heppelmann, M; Weinert, M; Brömmling, A; Piechotta, M; Hoedemaker, M; Bollwein, H

    2013-12-01

    The objective of this study was to investigate the effects of puerperal uterine disease on uterine blood flow using trans-rectal Doppler sonography. Lactating Holstein Friesian cows (n=44) were divided into two groups based on whether they were healthy (UD-; n=23) or had uterine disease (UD+; n=21) defined as retained fetal membranes and/or metritis. General clinical examination, vaginoscopy, trans-rectal palpation, and trans-rectal B-Mode sonography were conducted on Days 8, 11, 18, 25 and then every 10 days until Day 65 after calving. Doppler sonography of the uterine arteries was conducted on Day 8, during diestrus after the second ovulation (Days 40-60 after calving) and during diestrus before breeding (Days 63-75 after calving). Cows with uterine disease had greater (P<0.05) uterine size as assessed trans-rectally compared with cows of the UD group. Sonographic measurements on Day 11 after parturition revealed a greater (P<0.05) horn diameter in cows of the UD+ than in the UD- group. Both uterine size and uterine horn diameter decreased more earlier following parturition (P<0.05) in cows of the UD- group. Blood flow volume (BFV) was greater and pulsatility index was less on Day 8 after calving in cows of UD+ than UD- group (P<0.05). In cows of the UD-, but not in those of the UD+ group, there was a further reduction in BFV subsequent to Day 45 after calving (P<0.05). The results of this study show that uterine blood flow measures by trans-rectal Doppler sonography are affected by puerperal uterine disease.

  13. Paclitaxel and Intraperitoneal Carboplatin Followed by Radiation Therapy in Treating Patients With Stage IIIC-IV Uterine Cancer

    ClinicalTrials.gov

    2015-02-10

    Endometrial Serous Adenocarcinoma; 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

  14. [Increased spontaneous uterine motility with serotonin].

    PubMed

    Lechner, W; Sölder, E; Sölder, B; Kölle, D; Huter, O

    1992-01-01

    The influence of serotonine, a vasoactive neurotransmitter, on the spontaneous motility of uterine strips was investigated. A highly significant (p less than 0.001) increase of uterine activity was observed when serotonine 10(-6) M was added to the perfusing medium.

  15. Preoperative Uterine Artery Embolization (PUAE) Before Uterine Fibroid Myomectomy

    SciTech Connect

    Dumousset, E.; Chabrot, P.; Rabischong, B.; Mazet, N.; Nasser, S.; Darcha, C.; Garcier, J.M.; Mage, G.; Boyer, L.

    2008-05-15

    Purpose. To evaluate the potential of uterine artery embolization to minimize blood loss and facilitate easier removal of fibroids during subsequent myomectomy. Methods. This retrospective study included 22 patients (median age 37 years), of whom at least 15 wished to preserve their fertility. They presented with at least one fibroid (mean diameter 85.6 mm) and had undergone preoperative uterine artery embolization (PUAE) with resorbable gelatin sponge. Results. No complication or technical failure of embolization was identified. Myomectomies were performed during laparoscopy (12 cases) and laparotomy (9 cases). One hysterectomy was performed. The following were noted: easier dissection of fibroids (mean 5.6 per patient, range 1-30); mean intervention time 113 min (range 25-210 min); almost bloodless surgery, with a mean peroperative blood loss of 90 ml (range 0-806 ml); mean hemoglobin pretherapeutically 12.3 g/dl (range 5.9-15.2 g/dl) and post-therapeutically 10.3 g/dl (range 5.6-13.3 g/dl), with no blood transfusion needed. Patients were discharged on day 4 on average and the mean sick leave was 1 month. Conclusion. Preoperative embolization is associated with minimal intraoperative blood loss. It does not increase the complication rate or impair operative dissection, and improves the chances of performing conservative surgery.

  16. Uterine metrology devices for IUD selection.

    PubMed

    1981-11-01

    Accurate measurements of the length of the uterine cavity would make it feasible to select an IUD that is compatible with a given cavity size. Considerable evidence exists to indicate that selecting an IUD on the basis of accurate longitudinal measurements of the uterine cavity improves IUD performance. There are study findings to suggest that as more data are available, specific IUDs can be prescribed for defined ranges of uterine cavity length. Metrology (uterine measuring) devices improve the ability of the clinican to measure accurately longitudinal and, in some instances, lateral dimensions of the uterine cavity. Longitudinal measurements depend on identifying the location of the internal os in order to determine the total length of the cervical canal. Lateral metrology devices also provide a measurement of uterine cavity width. Pain and discomfort associated with the use of the prototype lateral measurement instruments developed thus far is a major deterrent to their wide-scale use. 2 metrology devices -- the Crochet Hook Sound and the Hasson Wing Sound -- are designed to obtain longitudinal measurements of total uterine cavity length and of the length of the cervical canel. 2 new instruments -- the Cavimeter and the Hasson Wing Sound 2 -- designed to obtain both lateral and longitudinal measurements are now available for evaluation. The Hasson Wing Sound appears to be the only uterine metrology device available for service programs that could affect continuation rates of IUD users. It can measure the length of the uterine cavity directly, thus permitting improved IUD selection of individual women or the ability to exclude women who should not be IUD users because of small uterine size. An illustration of the prescriptive approach is included in a table.

  17. Uterine caliper and depth gauge

    DOEpatents

    King, Loyd L.; Wheeler, Robert G.; Fish, Thomas M.

    1977-01-01

    A uterine caliper and sound consisting of an elongated body having outwardly biased resilient caliper wings and a spring-loaded slidable cervical stop. A slide on the body is operatively connected to the wings by a monofilament and operates with respect to a first scale on the body as a width indicator. A rod extending longitudinally on the body is connected to the cervical stop and cooperates with a second scale on the body as a depth indicator. The instrument can be positioned to measure the distance from the outer cervical ostium to the fundus, as read on said second scale. The wings may be allowed to open by moving the slide, and when the wings engage the utero-tubal junctions, the width may be read on said first scale. By adjustment of the caliper wings the instrument may be retracted until the resistance of the inner ostium of the cervix is felt, enabling the length of the cervical canal to be read directly by the position of the longitudinal indicator rod with respect to said second scale. The instrument may be employed to measure the width of the uterine cavity at any position between the inner ostium of the cervix and the fundus.

  18. A huge benign prostatic hyperplasia presenting with renal failure

    PubMed Central

    Basatac, Cem; Cicek, Mehmet Cagatay

    2015-01-01

    Although transurethral resection of the prostate is still standard of care in many patients suffering from benign prostatic hyperplasia, traditional open prostatectomy (OP) seems as a widely applied method in larger glands. In spite of the fact that holmium laser enucleation can be performed in large glands, upper limits of prostate size in this method are not clearly identified in the current literature. In this case, we aim to report feasibility and efficacy of OP in huge prostate size measured as 680 ml by transrectal ultrasound and review the current literature. PMID:26034239

  19. The market of huge monolithic mirror substrates for optical astronomy

    NASA Astrophysics Data System (ADS)

    Döhring, Thorsten

    2013-09-01

    Professional astronomical telescopes are complex optical systems at the limit of technical feasibility. Often monolithic primary mirrors and sometimes even secondary mirrors with huge dimensions are used. Prominent examples are the two reflectors of the Large Binocular Telescope and the giant mirrors of VLT, GEMINI, and SUBARU. The performance of such precision optical components significantly depends on the physical parameters and the quality of their substrate materials. Within this paper selection criteria for mirror substrates will be discussed, thereby considering the important technical parameters as well as commercial points and aspects of project management. Qualities and limitations of classical mirror substrate materials like Zerodur, ULE, Sitall, borosilicate glass and Cervit will be evaluated and compared to new substrate materials like silicon carbide and beryllium. The different suppliers and their production processes are presented. In addition large mirrors of existing observatories and of telescopes under construction will be listed, thereby concentrating on mirrors above three meter in diameter. An outlook on material trends and on future astronomical telescopes closes this overview on the market of huge monolithic mirror substrates for optical astronomy.

  20. Endovascular Treatment of Huge Dissecting Aneurysms Involving the Basilar Artery

    PubMed Central

    Yang, X.; Mu, S.; Lv, M.; Li, L.; Wu, Z.

    2007-01-01

    Summary Dissecting aneurysms involving the basilar artery (BA) are lesions with significant morbidity and mortality. Their management is controversial and often difficult. There is no generally approved strategy. Two cases of huge dissections involving the BA presented with subarachnoid hemorrhage in one case and mass effect in both cases. The dissection of case 1 involved the upper two thirds of the BA distal to the anterior inferior cerebellar arteries (AICA). Another dissection of case 2 involved the bilateral vertebral arteries (VA) distal to bilateral PICA and extended to upper third of the BA. After making a basket with coils inside the pseudoaneursym, proximal dissection was totally occluded in case 1. Dissection on the bilateral VA distal to the bilateral PICA and proximal BA was occluded in case 2 with a small residual dissection on the left VA. Case 1 had an excellent recovery with a durable image and clinical result. But recanalization and regrowth occurred in case 2, which might have originated from the residual dissection on the left VA, induced acute mass effect and sudden coma six weeks after the initial treatment. The residual and regrown dissection had to be occluded in a second intervention. The patient died two days later. BA occlusion is safe and efficient for dissections involving the BA as in our case and the literature. Proximal occlusion might be enough for huge and long lesions like ours. It seems that completely dense packing of proximal dissection is the key point to prevent recanalization. PMID:20566106

  1. Huge biloma after endoscopic retrograde cholangiopancreatography and endoscopic biliary sphincterotomy

    PubMed Central

    Alkhateeb, Harith M.; Aljanabi, Thaer J.; Al-azzawi, Khairallh H.; Alkarboly, Taha A.

    2015-01-01

    Background Biliary leak can occur as a complication of biliary surgery, endoscopic retrograde cholangiopancreatography manipulations and endoscopic biliary sphincterotomy. Consequently, bile may collect in the abdominal cavity, a condition called biloma. Rarely, it may reach a massive size. Case presentation A 72-year-old man presented with gastric upset with gradual abdominal distension reaching a large size due to intra-abdominal bile collection (biloma) after endoscopic retrograde cholangiopancreatography plus endoscopic biliary sphincterotomy and stenting for post laparoscopic cholecystectomy common bile duct stricture. This huge biloma was treated by percutaneous insertion of a tube drain for a few days, evacuating the collection successfully without recurrence. Discussion This patient might sustain injury to the common bile duct either by the guide wire or stent, or the injury occurred at the angle between the common bile duct and duodenum during sphincterotomy of the ampulla. Although any of these rents may lead to a bile leak, causing a huge biloma, they could be successfully treated by percutaneous drainage. Conclusions (1) Following endoscopic retrograde cholangiopancreatography, a patient’s complaints should not be ignored. (2) A massive biloma can occur due to such procedures. (3) Conservative treatment with minimal invasive technique can prove to be effective. PMID:26402876

  2. Errors in Seismic Hazard Assessment are Creating Huge Human Losses

    NASA Astrophysics Data System (ADS)

    Bela, J.

    2015-12-01

    The current practice of representing earthquake hazards to the public based upon their perceived likelihood or probability of occurrence is proven now by the global record of actual earthquakes to be not only erroneous and unreliable, but also too deadly! Earthquake occurrence is sporadic and therefore assumptions of earthquake frequency and return-period are both not only misleading, but also categorically false. More than 700,000 people have now lost their lives (2000-2011), wherein 11 of the World's Deadliest Earthquakes have occurred in locations where probability-based seismic hazard assessments had predicted only low seismic low hazard. Unless seismic hazard assessment and the setting of minimum earthquake design safety standards for buildings and bridges are based on a more realistic deterministic recognition of "what can happen" rather than on what mathematical models suggest is "most likely to happen" such future huge human losses can only be expected to continue! The actual earthquake events that did occur were at or near the maximum potential-size event that either already had occurred in the past; or were geologically known to be possible. Haiti's M7 earthquake, 2010 (with > 222,000 fatalities) meant the dead could not even be buried with dignity. Japan's catastrophic Tohoku earthquake, 2011; a M9 Megathrust earthquake, unleashed a tsunami that not only obliterated coastal communities along the northern Japanese coast, but also claimed > 20,000 lives. This tsunami flooded nuclear reactors at Fukushima, causing 4 explosions and 3 reactors to melt down. But while this history of huge human losses due to erroneous and misleading seismic hazard estimates, despite its wrenching pain, cannot be unlived; if faced with courage and a more realistic deterministic estimate of "what is possible", it need not be lived again. An objective testing of the results of global probability based seismic hazard maps against real occurrences has never been done by the

  3. Uterine motility in patients with bicornuate uterus.

    PubMed

    Oliva, G C; Fratoni, A; Genova, M; Romanini, C

    1992-01-01

    This study analyzes uterine motility in 12 women with a bicornuate uterus using the results of the recordings of endo-uterine pressure, obtained with two balloon-closed catheters. Seven patients had symmetric uterine cavities, while the rest (5 patient) had very dissimilar ones. The registration of the uterine motility was carried out during various phases of the cycle and after the administration of two drugs (oxitocin and methylergobasine), with the following results: the bicornuate uterus has a spontaneous activity similar to that of a normal uterus. A similar contractile response was observed in the uteri with two anatomically symmetric horns, whereas a dissimilar response was typical of the uteri with marked anatomic differences between the two horns.

  4. Fetal heart and uterine contraction monitor (image)

    MedlinePlus

    The fetal heart monitor and uterine contraction monitor provide a continuous record of the baby's heart rate and the mother's contraction rate as labor progresses. This device can provide early warning of fetal distress.

  5. Focused Ultrasound Surgery for Uterine Fibroids

    MedlinePlus

    Focused ultrasound surgery for uterine fibroids Overview By Mayo Clinic Staff Focused ultrasound surgery (FUS) is a noninvasive treatment option for ... whether you're a good candidate for focused ultrasound surgery, your doctor may perform a pelvic magnetic ...

  6. Distributed and parallel approach for handle and perform huge datasets

    NASA Astrophysics Data System (ADS)

    Konopko, Joanna

    2015-12-01

    Big Data refers to the dynamic, large and disparate volumes of data comes from many different sources (tools, machines, sensors, mobile devices) uncorrelated with each others. It requires new, innovative and scalable technology to collect, host and analytically process the vast amount of data. Proper architecture of the system that perform huge data sets is needed. In this paper, the comparison of distributed and parallel system architecture is presented on the example of MapReduce (MR) Hadoop platform and parallel database platform (DBMS). This paper also analyzes the problem of performing and handling valuable information from petabytes of data. The both paradigms: MapReduce and parallel DBMS are described and compared. The hybrid architecture approach is also proposed and could be used to solve the analyzed problem of storing and processing Big Data.

  7. A huge pelvic calculus causing acute renal failure.

    PubMed

    Lai, Allen Yu-Hung; Kuo, Yuh-Chen

    2008-02-01

    We present a 69-year-old man with repeated urinary tract infection and lower abdominal pain. Kidney-ureter-bladder (KUB) scout film showed a huge, 320-g triangular pelvic calculus that was surgically removed with excellent results. Bladder stone is a common disease, but it is rare for such a calculus to be so large as to cause bilateral hydronephrosis. Surgical intervention by cystolithotomy or endoscopic cystolithotripsy can achieve satisfactory results. Bladder outlet obstruction should be treated simultaneously. Close follow-up, however, is mandatory because the recurrence of urolithiasis is high in those patients with voiding problems and recurrent urinary infection. To the best of our knowledge, this is the largest bladder stone in a human male. This case report also illustrates the importance of radiologic evaluation of patients with repeated urinary infections.

  8. Huge positive magnetoresistance in antiferromagnetic double perovskite metals.

    PubMed

    Singh, Viveka Nand; Majumdar, Pinaki

    2014-07-23

    Metals with large positive magnetoresistance are rare. We demonstrate that antiferromagnetic metallic states, as have been predicted for the double perovskites, are excellent candidates for huge positive magnetoresistance. An applied field suppresses long range antiferromagnetic order leading to a state with short range antiferromagnetic correlations and strong electronic scattering. The field induced resistance ratio can be more than tenfold, at moderate field, in a structurally ordered system, and continues to be almost twofold even in systems with ∼ 25% antisite disorder. Although our explicit demonstration is in the context of a two- dimensional spin-fermion model of the double perovskites, the mechanism we uncover is far more general, complementary to the colossal negative magnetoresistance process, and would operate in other local moment metals that show a field driven suppression of non-ferromagnetic order.

  9. Electromotive force and huge magnetoresistance in magnetic tunnel junctions.

    PubMed

    Pham, Nam Hai; Ohya, Shinobu; Tanaka, Masaaki; Barnes, Stewart E; Maekawa, Sadamichi

    2009-03-26

    The electromotive force (e.m.f.) predicted by Faraday's law reflects the forces acting on the charge, -e, of an electron moving through a device or circuit, and is proportional to the time derivative of the magnetic field. This conventional e.m.f. is usually absent for stationary circuits and static magnetic fields. There are also forces that act on the spin of an electron; it has been recently predicted that, for circuits that are in part composed of ferromagnetic materials, there arises an e.m.f. of spin origin even for a static magnetic field. This e.m.f. can be attributed to a time-varying magnetization of the host material, such as the motion of magnetic domains in a static magnetic field, and reflects the conversion of magnetic to electrical energy. Here we show that such an e.m.f. can indeed be induced by a static magnetic field in magnetic tunnel junctions containing zinc-blende-structured MnAs quantum nanomagnets. The observed e.m.f. operates on a timescale of approximately 10(2)-10(3) seconds and results from the conversion of the magnetic energy of the superparamagnetic MnAs nanomagnets into electrical energy when these magnets undergo magnetic quantum tunnelling. As a consequence, a huge magnetoresistance of up to 100,000 per cent is observed for certain bias voltages. Our results strongly support the contention that, in magnetic nanostructures, Faraday's law of induction must be generalized to account for forces of purely spin origin. The huge magnetoresistance and e.m.f. may find potential applications in high sensitivity magnetic sensors, as well as in new active devices such as 'spin batteries'.

  10. Potential Therapeutic Targets in Uterine Sarcomas

    PubMed Central

    Cuppens, Tine; Tuyaerts, Sandra; Amant, Frédéric

    2015-01-01

    Uterine sarcomas are rare tumors accounting for 3,4% of all uterine cancers. Even after radical hysterectomy, most patients relapse or present with distant metastases. The very limited clinical benefit of adjuvant cytotoxic treatments is reflected by high mortality rates, emphasizing the need for new treatment strategies. This review summarizes rising potential targets in four distinct subtypes of uterine sarcomas: leiomyosarcoma, low-grade and high-grade endometrial stromal sarcoma, and undifferentiated uterine sarcoma. Based on clinical reports, promising approaches for uterine leiomyosarcoma patients include inhibition of VEGF and mTOR signaling, preferably in combination with other targeted or cytotoxic compounds. Currently, the only targeted therapy approved in leiomyosarcoma patients is pazopanib, a multitargeted inhibitor blocking VEGFR, PDGFR, FGFR, and c-KIT. Additionally, preclinical evidence suggests effect of the inhibition of histone deacetylases, tyrosine kinase receptors, and the mitotic checkpoint protein aurora kinase A. In low-grade endometrial stromal sarcomas, antihormonal therapies including aromatase inhibitors and progestins have proven activity. Other potential targets are PDGFR, VEGFR, and histone deacetylases. In high-grade ESS that carry the YWHAE/FAM22A/B fusion gene, the generated 14-3-3 oncoprotein is a putative target, next to c-KIT and the Wnt pathway. The observation of heterogeneity within uterine sarcoma subtypes warrants a personalized treatment approach. PMID:26576131

  11. Hysteroscopic Transcervical Resection of Uterine Septum

    PubMed Central

    Shi, Xiaoyan; Hua, Xiangdong; Gu, Xiaoyan; Yang, Dazhen

    2013-01-01

    Objective: To explore the method of diagnosis for uterine septum and the clinical effect of hysteroscopic transcervical resection of the septum. Methods: One-hundred ninety cases of patients with uterine septum who were diagnosed and treated at our hospital during 2007–2011 were selected, and their general information, perioperative status, postoperative recovery treatment, and postoperative pregnancy rates were statistically analyzed. Results: All 190 patients were cured with one surgery, with an average hysteroscopic operating time of 22.60 ± 10.67 minutes and intraoperative blood loss of 15.74 ± 9.64 mL. There were no complications such as uterine perforation, water intoxication, infection, or heavy bleeding. Among the 115 patients that we followed up, 86 became pregnant and delivered infants, 81 of which were born at term and 5 that were born premature. Conclusion: The combination of hysteroscopy and laparoscopy is still the most reliable method for the diagnosis of uterine septum. With a shorter operative time, less blood loss, a significantly increased postoperative pregnancy rate and live birth rate, and a significantly lower spontaneous abortion rate, transcervical resection of the septum was the preferred method for the treatment of uterine septum, and surgical instruments and skills were critical to the prognosis of uterine septum. PMID:24398191

  12. Spontaneous Posterior Uterine Rupture in Twin-Twin Transfusion Syndrome

    PubMed Central

    Smid, Marcela C.; Waltner-Toews, Rebecca; Goodnight, William

    2015-01-01

    Background The maternal and fetal risks of uterine distension in rapidly progressive twin-twin transfusion syndrome (TTTS) in the setting of prior uterine scar are poorly characterized. Case We present the case of a 42-year-old woman, G4P1201, at 21 weeks gestation with stage-1 TTTS who developed a spontaneous posterior uterine rupture necessitating emergent laparotomy and delivery of previable fetuses, possibly due to prior uterine scar from a displaced intrauterine device. Conclusion TTTS may be a risk factor for uterine rupture, including uterine rupture in atypical anatomic locations. Prior unrecognized uterine scars, including perforations, may magnify the risk for atypical uterine rupture in the setting of excessive uterine distension. PMID:26929874

  13. Uterine distension differentially affects remodelling and distensibility of the uterine vasculature in non-pregnant rats.

    PubMed

    Osol, George; Barron, Carolyn; Mandalà, Maurizio

    2012-01-01

    During pregnancy the mammalian uterine circulation undergoes significant expansive remodelling necessary for normal pregnancy outcome. The underlying mechanisms are poorly defined. The goal of this study was to test the hypothesis that myometrial stretch actively stimulates uterine vascular remodelling by developing a new surgical approach to induce unilateral uterine distension in non-pregnant rats. Three weeks after surgery, which consisted of an infusion of medical-grade silicone into the uterine lumen, main and mesometrial uterine artery and vein length, diameter and distensibility were recorded. Radial artery diameter, distensibility and vascular smooth muscle mitotic rate (Ki67 staining) were also measured. Unilateral uterine distension resulted in significant increases in the length of main uterine artery and vein and mesometrial segments but had no effect on vessel diameter or distensibility. In contrast, there were significant increases in the diameter of the radial arteries associated with the distended uterus. These changes were accompanied by reduced arterial distensibility and increased vascular muscle hyperplasia. In summary, this is the first report to show that myometrial stretch is a sufficient stimulus to induce significant remodelling of uterine vessels in non-pregnant rats. Moreover, the results indicate differential regulation of these growth processes as a function of vessel size and type.

  14. STAT3 accelerates uterine epithelial regeneration in a mouse model of decellularized uterine matrix transplantation

    PubMed Central

    Hiraoka, Takehiro; Saito-Fujita, Tomoko; Matsuo, Mitsunori; Egashira, Mahiro; Matsumoto, Leona; Haraguchi, Hirofumi; Dey, Sudhansu K.; Furukawa, Katsuko S.; Fujii, Tomoyuki; Osuga, Yutaka

    2016-01-01

    Although a close connection between uterine regeneration and successful pregnancy in both humans and mice has been consistently observed, its molecular basis remains unclear. We here established a mouse model of decellularized uterine matrix (DUM) transplantation. Resected mouse uteri were processed with SDS to make DUMs without any intact cells. DUMs were transplanted into the mouse uteri with artificially induced defects, and all the uterine layers were recovered at the DUM transplantation sites within a month. In the regenerated uteri, normal hormone responsiveness in early pregnancy was observed, suggesting the regeneration of functional uteri. Uterine epithelial cells rapidly migrated and formed a normal uterine epithelial layer within a week, indicating a robust epithelial-regenerating capacity. Stromal and myometrial regeneration occurred following epithelial regeneration. In ovariectomized mice, uterine regeneration of the DUM transplantation was similarly observed, suggesting that ovarian hormones are not essential for this regeneration process. Importantly, the regenerating epithelium around the DUM demonstrated heightened STAT3 phosphorylation and cell proliferation, which was suppressed in uteri of Stat3 conditional knockout mice. These data suggest a key role of STAT3 in the initial step of the uterine regeneration process. The DUM transplantation model is a powerful tool for uterine regeneration research. PMID:27358915

  15. Uterine infarction in a patient with uterine adenomyosis following biochemical pregnancy

    PubMed Central

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

    2014-01-01

    Adenomyosis is a common gynecological disorder characterized by the presence of endometrial glands and stroma deep within the myometrium associated with myometrial hypertrophy and hyperplasia. Focal uterine infarction after IVF-ET in a patient with adenomyosis following biochemical pregnancy has not been previously reported, although it occurs after uterine artery embolization in order to control symptoms caused by fibroids or adenomyosis. We report a case of a nulliparous woman who had uterine adenomyosis presenting with fever, pelvic pain and biochemical abortion after undergoing an IVF-ET procedure and the detection of a slightly elevated serum hCG. Focal uterine infarction was suspected after a pelvic magnetic resonance imaging demonstrated preserved myometrium between the endometrial cavity and inner margin of the necrotic myometrium. This case demonstrates that focal uterine infarction should be considered in the differential diagnosis of acute abdominal pain, vaginal bleeding and infectious signs in women experiencing biochemical abortion after an IVF-ET procedure. PMID:25599041

  16. 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

    SciTech Connect

    Froeling, V. Scheurig-Muenkler, C. Hamm, B. Kroencke, T. J.

    2012-06-15

    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.

  17. Nanomedicine for Uterine Leiomyoma Therapy

    PubMed Central

    Ali, Hazem; Kilic, Gokhan; Vincent, Kathleen; Motamedi, Massoud; Rytting, Erik

    2013-01-01

    Aims The purpose of this work was to engineer polymeric nanoparticles to encapsulate and deliver 2-methoxyestradiol, a potential antitumor drug for treatment of uterine leiomyoma (fibroids), the most common hormone-dependent pathology affecting women of reproductive age. Materials & Methods Encapsulation efficiency and drug release from the nanoparticles were monitored by HPLC. Cell morphology and in vitro cytotoxicity experiments were carried out in a human leiomyoma cell line (huLM). Results The nanoparticles displayed high encapsulation efficiency (>86%), which was verified by differential scanning calorimetry and X-ray diffraction. Excellent long-term stability of the nanoparticles and gradual drug release without burst were also observed. Cellular uptake of fluorescent nanoparticles was confirmed by confocal imaging. The drug-loaded poly(lactic acid) and poly(lactic-co-glycolic acid) nanoparticles induced cytotoxicity in huLM cells to a significantly greater extent than the free drug at 0.35 μM. Conclusion This novel approach represents a potential fertility-preserving alternative to hysterectomy. PMID:23343157

  18. Personalized Care in Uterine Cancer

    PubMed Central

    Iglesias, David A.; Bodurka, Diane C.

    2016-01-01

    Endometrial cancer typically presents at an early stage when surgery alone, with or without radiotherapy, is often curative. However, in women who present with advanced disease or who develop disease recurrence, long-term prognosis is poor. While surgical cytoreduction remains the mainstay of initial therapy, over the last several decades, the roles of cytotoxic chemotherapy, radiotherapy, and hormonal therapy have been evaluated in both the adjuvant and recurrent setting in an attempt to improve long-term survival while also minimizing associated toxicities. Unfortunately, response rates remain poor and survival is limited in these settings. More recently, with the introduction of personalized cancer treatment, several biologic agents have been developed that target specific pathways critical to tumor initiation and growth. Molecular studies have found that many endometrial cancers are driven by some of these tumorigenic pathways, which has led to early clinical studies evaluating the role of these targeted agents in patients with advanced or recurrent endometrial cancer. This review describes existing treatment options for patients with early and advanced endometrioid endometrial cancer, as well as for patients with uterine serous cancers. Furthermore, this review examines the growing body of literature involving targeted biologic agents as treatment for patients with advanced or recurrent endometrial cancer. PMID:23271352

  19. Uterine adenosarcomas are mesenchymal neoplasms

    PubMed Central

    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

    2016-01-01

    Uterine adenosarcomas (UA) are biphasic lesions composed of a malignant mesenchymal (i.e. 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 where 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. PMID:26592504

  20. Intra-uterine contraceptive devices.

    PubMed

    Elias, J

    1985-05-01

    Among the advantages of IUDs are the device's high continuation rate, the lack of systemic side effects, and the absence of a need for continual motivation to practice contraception. The effectiveness of plastic IUDs is directly proportional to their surface area, but the degree of excessive bleeding experienced is inversely related to device size. Thus, devices represent a compromise between large size for effectiveness and small size for acceptability. The optimum time to fit an IUD is during the 1st hald of the menstrual cycle. Absolute contraindications to IUD use include the presence of active pelvic inflammatory disease, undiagnosed irregular bleeding, a history of ectopic pregnancy or tubal surgery, and a distorted uteine cavity. Failure rates associated with IUD use range from 2-3% in the 1st year and then decrease. Since the main mechanism of action appears to be production of a sterile inflammatory reaction in the uterine cavity, the IUD prevents intrauterine pregnancy more effectively than ectopic pregnancy. Nonetheless, there is little evidence to suggest that IUD use actually increases the incidence of ectopic pregnancy. Resumption of fertility after IUD removal is not delayed. There is not need to change inert plastic IUDs in women who remain symptom free. The copper devices should be changed every 3-4 years. A search is under way for antifertility agents that can be incorporated into the device to reduce side effects. In general, the IUD is most suitable for older, parous women.

  1. Uterine angioleiomyoma – a rare variant of uterine leiomyoma: review of literature and case reports

    PubMed Central

    2016-01-01

    Introduction Uterine angioleiomyoma (AL) is an extremely rare variant of uterine leiomyoma. It is composed of smooth muscle cells and thick-walled blood vessels. Angioleiomyoma usually occurs in middle-aged women, 40-60 years old. Aim of the study was to review of literature research reports on uterine AL. Discussion of nine case reports of uterine AL in the patients operated on in our ward. Material and methods The paper presents analysis of accessible research reports on uterine AL, and medical records of the patients operated on in our ward. Results Mean age of the patients with uterine AL was 47.11 ±5.21, body mass index (BMI) 25.88 ±3.95. All women had given birth (1-5 natural deliveries, 2.44 mean). Uterine AL occurred in 0.34% to 0.40% cases of leiomyomas. Angioleiomyoma were located intramurally and subserosally in six and three patients (respectively, 66.7% and 33.3%). Laparotomy was undertaken in seven cases (77.8%), transvaginal access in two cases (22.2%), and myomectomy in one case (11.1%). Blood transfusion was required in four cases (44.4%). Conclusions In the group of uterine leiomyomas, uterine ALs occurred in 0.34-0.40% of cases. Angioleiomyoma cases posed a greater risk of complications threatening the patient’s health and life. Preoperative differentiation of AL with ovarian tumour was more difficult due to frequent degenerative lesions in the course of uterine AL. PMID:27980528

  2. Effects of estradiol on uterine perfusion in anesthetized cyclic mares affected with uterine vascular elastosis.

    PubMed

    Esteller-Vico, A; Liu, I K M; Vaughan, B; Steffey, E P; Brosnan, R J

    2016-01-01

    Uterine vascular elastosis in mares is characterized by degeneration of uterine vasculature through thickening of the elastin layers. Factors commonly associated with this degeneration include age, parity, and chronic uterine endometritis. Affected mares have also been shown to exhibit decreases in uterine blood flow and perfusion of the uterus. Due to the increased thickness of the elastin layers, we hypothesize that vasodilatation of the uterine vasculature is also impaired. To test the functionality of these vessels, we evaluated the vasodilatory effects of estradiol on the uterine vascular bed in mares with normal vasculature and mares with severe elastosis. Both groups were tested in estrus and diestrus. Fluorescent microspheres were used to determine basal blood perfusion, followed by the intravenous administration of 1.0 μg/kg of 17β-estradiol. After 90 min, perfusion was measured once again to determine the vascular response to estradiol. Control mares in estrus displayed a significant increase in total uterine blood flow after the administration of estradiol when compared to baseline levels. No other group had a significant increase in total blood flow and perfusion after estradiol administration. The administration of estradiol in control mares induced regional increases in perfusion in the uterine horns and uterine body during estrus and only in the uterine horns during diestrus. Mares affected by elastosis exhibited no regional differences in perfusion levels post-estradiol administration. The difference in the vasodilatory response induced by estradiol between reproductively healthy mares and mares affected with elastosis indicates that the functionality of the affected vessels is compromised.

  3. Indexing huge genome sequences for solving various problems.

    PubMed

    Sadakane, K; Shibuya, T

    2001-01-01

    Because of the increase in the size of genome sequence databases, the importance of indexing the sequences for fast queries grows. Suffix trees and suffix arrays are used for simple queries. However these are not suitable for complicated queries from huge amount of sequences because the indices are stored in disk which has slow access speed. We propose storing the indices in memory in a compressed form. We use the compressed suffix array. It compactly stores the suffix array at the cost of theoretically a small slowdown in access speed. We experimentally show that the overhead of using the compressed suffix array is reasonable in practice. We also propose an approximate string matching algorithm which is suitable for the compressed suffix array. Furthermore, we have constructed the compressed suffix array of the whole human genome. Because its size is about 2G bytes, a workstation can handle the search index for the whole data in main memory, which will accelerate the speed of solving various problems in genome informatics.

  4. Huge group-velocity dispersion in a photonic crystal

    NASA Astrophysics Data System (ADS)

    Ouyang, Zhengbiao; Cai, Yanyan; Meng, Qingsheng; Lu, Yali; Sun, Yiling; Zhang, Dengguo; Ruan, Shuangchen; Li, Jingzhen

    2005-11-01

    We investigated the group-velocity dispersion of a one dimensional uniform photonic crystal by the optical transmission method. For application in optical communications, the wavelength should be near one of the two edges of a photonic bandgap. Four kinds of dispersion-compensation may be obtained with a photonic crystal. Huge negative and positive group-velocity-dispersion (GVD) about a zero-dispersion-point as large as 5.1 Tera- ps/nm/km by a photonic crystal of 100 periods can be realized. Such a value is about 50 Giga times the GVD of conventional dispersion-compensation fibers. The GVD reaches a maximum when the optical length ratio of the high refractive index material to the low refractive index material is 1.2 for given operating parameters. When we keep the optical length of each layer being constant, the GVD is found to increase rapidly with the refractive index ration of the high refractive index material to the low one and even more rapidly with the number of periods of a photonic crystal. Under quite common operating parameters, a thin piece of photonic crystal of 100 periods may play the role of an ordinary dispersion-compensation fiber with a length over 158 kilo-meters.

  5. A huge bladder calculus causing acute renal failure.

    PubMed

    Komeya, Mitsuru; Sahoda, Tamami; Sugiura, Shinpei; Sawada, Takuto; Kitami, Kazuo

    2013-02-01

    A 81-year-old male was referred to our emergency outpatient unit due to acute renal failure. The level of serum creatinine was 276 μmol/l. A CT scan showed bilateral hydronephroureter, large bladder stone (7 cm × 6 cm × 6 cm) and bladder wall thickness. He was diagnosed as post renal failure due to bilateral hydronephroureter. Large bladder stone is thought to be the cause of bilateral hydronephroureter and renal failure. To improve renal failure, we performed open cystolithotomy and urethral catheterization. Three days after the surgery, the level of serum creatinine decreased to 224 μmol/l. He was discharged from our hospital with uneventful course. Bladder calculus is thought to be a rare cause of renal failure. We summarize the characteristics of bladder calculus causing renal failure. We should keep that long-term pyuria and urinary symptom, and repeated urinary tract infection can cause huge bladder calculus and renal failure in mind.

  6. Black hole firewalls require huge energy of measurement

    NASA Astrophysics Data System (ADS)

    Hotta, Masahiro; Matsumoto, Jiro; Funo, Ken

    2014-06-01

    The unitary moving mirror model is one of the best quantum systems for checking the reasoning of the original firewall paradox of Almheiri et al. [J. High Energy Phys. 02 (2013) 062] in quantum black holes. Though the late-time part of radiations emitted from the mirror is fully entangled with the early part, no firewall exists with a deadly, huge average energy flux in this model. This is because the high-energy entanglement structure of the discretized systems in almost maximally entangled states is modified so as to yield the correct description of low-energy effective field theory. Furthermore, the strong subadditivity paradox of firewalls is resolved using nonlocality of general one-particle states and zero-point fluctuation entanglement. Due to the Reeh-Schlieder theorem in quantum field theory, another firewall paradox is inevitably raised with quantum remote measurements in the model. We resolve this paradox from the viewpoint of the energy cost of measurements. No firewall appears, as long as the energy for the measurement is much smaller than the ultraviolet cutoff scale.

  7. Uterine glands impact uterine receptivity, luminal fluid homeostasis and blastocyst implantation

    PubMed Central

    Kelleher, Andrew M.; Burns, Gregory W.; Behura, Susanta; Wu, Guoyao; Spencer, Thomas E.

    2016-01-01

    Uterine glands are essential for pregnancy in mice and likely humans, because they secrete or transport bioactive substances that regulate uterine receptivity for blastocyst implantation. In mice, the uterus becomes receptive to blastocyst implantation on day 4, but is refractory by day 5. Here, blastocysts could be recovered from progesterone-induced uterine gland (PUGKO) but not wildtype (WT) mice on day 5 post-mating. Anti-adhesive Muc1 protein and microvilli were present on the luminal epithelium of PUGKO but not WT uteri. A number of known uterine receptivity genes and gland-specific genes were altered in the PUGKO uterus. Next, the uterus and uterine luminal fluid (ULF) were obtained from WT and PUGKO mice on day 3, 4 and 5. Transcriptome analysis revealed that 580 genes were decreased in the PUGKO uterus, however ULF secrotome analysis revealed that many proteins and several amino acids were increased in the PUGKO ULF. Of note, many proteins encoded by many gland-specific genes were not identified in the ULF of WT mice. These results support the ideas that uterine glands secrete factors that regulate ULF homeostasis and interact with other cell types in the uterus to influence uterine receptivity and blastocyst implantation for the establishment of pregnancy. PMID:27905495

  8. Paracrine effects of uterine leucocytes on gene expression of human uterine stromal fibroblasts.

    PubMed

    Germeyer, Ariane; Sharkey, Andrew Mark; Prasadajudio, Mirari; Sherwin, Robert; Moffett, Ashley; Bieback, Karen; Clausmeyer, Susanne; Masters, Leanne; Popovici, Roxana Maria; Hess, Alexandra Petra; Strowitzki, Thomas; von Wolff, Michael

    2009-01-01

    The endometrium contains a distinct population of immune cells that undergo cyclic changes during the menstrual cycle and implantation. The majority of these leucocytes are uterine NK (uNK) cells, however how these cells interact with uterine stromal fibroblasts remains unclear. We therefore investigated the paracrine effect of medium conditioned by uterine decidual leucocytes (which are enriched for uNK cells) on the gene expression profile of endometrial stromal fibroblasts in vitro using a cDNA microarray. Our results, verified by real-time PCR, ELISA and FACS analysis, reveal that soluble factors from uterine leucocytes substantially alter endometrial stromal fibroblast gene expression. The largest group of up-regulated genes found was chemokines and cytokines. These include IL-8, CCL8 and CXCL1, which have also been shown to be stimulated by contact of stromal fibroblasts with trophoblast, suggesting that uNK cells work synergistically to support trophoblast migration during implantation. The decidual leucocytes also up-regulated IL-15 and IL-15Ralpha in stromal fibroblasts which could produce a niche for uNK cells allowing proliferation within and recruitment into the uterus, as seen in bone marrow. Overall this study demonstrates, for the first time, the paracrine communication between uterine leucocytes and uterine stromal fibroblasts, and adds to the understanding of how the uterine immune system contributes to the changes seen within the cycling endometrium.

  9. MRI Verification of a Case of Huge Infantile Rhabdomyoma

    PubMed Central

    Ramadani, Naser; Kreshnike, Kreshnike Dedushi; Muçaj, Sefedin; Kabashi, Serbeze; Hoxhaj, Astrit; Jerliu, Naim; Bejiçi, Ramush

    2016-01-01

    Introduction: Cardiac rhabdomyoma is type of benign myocardial tumor that is the most common fetal cardiac tumor. Cardiac rhabdomyomas are usually detected before birth or during the first year of life. They account for over 60% of all primary cardiac tumors. Case report: A 6 month old child with coughing and obstruction in breathing, was hospitalized in the Pediatric Clinic in UCCK, Pristine. The difficulty of breathing was heard and the pathological noise of the heart was noticed from the pediatrician. In the echo of the heart at the posterior and apico-lateral part of the left ventricle a tumoral mass was presented with the dimensions of 56 × 54 mm that forwarded the contractions of the left ventricle, the mass involved also the left ventricle wall and was not vascularized. The right ventricle was deformed and with the shifting of the SIV on the right the contractility was preserved. Aorta, the left arch and AP were normal with laminar circulation. The pericard was presented free. Radiography of thoracic organs was made; it resulted on cardiomegaly and significant bronchovascular drawing. It was completed with an MRI and it resulted on: Cardiomegaly due to large tumoral mass lesion (60×34 mm) involving lateral wall of left ventricle. It was isointense to the muscle on T1W images, markedly hyperintense on T2W images. There were a few septa or bant like hypointensities within lesion. On postcontrast study it showed avid enhancement. The left ventricle volume was decreased. Mild pericardial effusion was also noted. Surgical intervention was performed and it resulted on the histopathological aspect as a huge infantile rhadbomyoma. Conclusion: In most cases no treatment is required and these lesions regress spontaneously. Patients with left ventricular outflow tract obstruction or refractory arrhythmias respond well to surgical excision. Rhabdomyomas are frequently diagnosed by means of fetal echocardiography during the prenatal period. PMID:27147810

  10. Use of Cyclosporine in Uterine Transplantation

    PubMed Central

    Saso, Srdjan; Logan, Karl; Abdallah, Yazan; Louis, Louay S.; Ghaem-Maghami, Sadaf; Smith, J. Richard; Del Priore, Giuseppe

    2012-01-01

    Uterine transplantation has been proposed as a possible solution to absolute uterine factor infertility untreatable by any other option. Since the first human attempt in 2000, various teams have tried to clarify which immunosuppressant would be most suitable for protecting the allogeneic uterine graft while posing a minimal risk to the fetus. Cyclosporine A (CsA) is an immunosuppressant widely used by transplant recipients. It is currently being tested as a potential immunosuppressant to be used during UTn. Its effect on the mother and fetus and its influence upon the graft during pregnancy have been of major concern. We review the role of CsA in UTn and its effect on pregnant transplant recipients and their offspring. PMID:22132302

  11. Uterine geometry and IUD-induced pain.

    PubMed

    Toppozada, M; Ismail, A A; Bakry, M A

    1986-06-01

    Sixty women using IUDs were included in two equal groups in the present study. Group I consisted of women presenting with pelvic pain for which they requested removal of the IUD, while the comparison group (group II) requested removal of the IUD for non-medical reasons. After extraction of the IUD, the Wing Sound II device was used to measure uterine cavity length and fundal transverse diameter. The uterine cavity measurements in both groups were not significantly different. When the ratios of IUD dimensions to uterine cavity measurements were compared, it was also found that there were no significant differences between groups. Factors other than discrepancies in size probably contribute to the pathogenesis of IUD-induced pain.

  12. [Ultrasonic diagnosis of congenital uterine abnormalities].

    PubMed

    Funk, A; Fendel, H

    1988-01-01

    1-2% of women has abnormal uterine development due to nonunification of the Müllerian ducts in the embryonal period. At the RWTH Aachen, in the department of gynaecology and obstetrics, between January and June 1987, we had searched systematically for maldevelopment of the uterus in 2299 echosonografies. In 13 cases we found maldevelopment of internal genital; 5 of these cases were diagnosed by an echosonografic routine-examination. The echografic criteria of the different grades of uterine malformations have been determined, systematized and discussed in relation to the symptoms. The most frequent malformations as uterus subseptus, uterus septus, uterus bicornis and uterus duplex are subject of a detailed discussion. This work demonstrates that echosonografic is a very efficient instrument to diagnose uterine malformations and gives us a very exact anatomic interpretation of malformations.

  13. Uterine cirsoid aneurysm: MRI and MRA

    SciTech Connect

    Joja, Ikuo; Asakawa, Mari; Motoyama, Kazumi

    1996-03-01

    Uterine cirsoid aneurysm is uncommon. It is important to make a diagnosis of this disease preoperatively, because repeated curettages may induce life-threatening massive genital bleeding. We present a case of a 51-year-old woman with uterine cirsoid aneurysm in whom MRI and MRA were very useful for the preoperative diagnosis. The radiologic appearances on ultrasonography, CT, conventional SE MRI, MRA, dynamic MRI, and pelvic angiography are presented. Conventional SE T1-weighted and T2-weighted images demonstrated multiple flow voids in the uterus and bilateral adnexal regions. MRA demonstrated a cluster of distinct, tortuous, and coiled vascular channels in the pelvis. MRA could obtain images almost equal to angiography and was considered to be an excellent noninvasive imaging technique for the diagnosis of uterine cirsoid aneurysm. 28 refs., 7 figs

  14. Uterine artery embolisation and magnetic resonance-guided focused ultrasound treatment of uterine fibroids

    PubMed Central

    Sieroń, Dominik; Wiggermann, Philipp; Skupiński, Jarosław; Kukawska-Sysio, Karolina; Lisek, Urszula; Koczy, Aleksandra

    2011-01-01

    Summary 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. PMID:22802829

  15. Assessment and optimization of uterine activity during labor.

    PubMed

    Simpson, Kathleen R; Miller, Lisa

    2011-03-01

    Accurate assessment of uterine activity during labor is essential to promote optimal patient outcomes. This review provides clinicians with information to develop an evidence-based, standardized approach to the evaluation and management of uterine activity during labor including identification and treatment of excessive uterine activity. Common terminology is defined in an effort to enhance clear and direct communication and accurate assessment. The latest evidence regarding normal labor is presented along with physiology related to uterine activity and fetal oxygenation. Suggestions for managing excessive uterine activity are offered as well as a synopsis of risk reduction strategies for clinical practice.

  16. MRI Assessment of Uterine Artery Patency and Fibroid Infarction Rates 6 Months after Uterine Artery Embolization with Nonspherical Polyvinyl Alcohol

    SciTech Connect

    Das, Raj Gonsalves, Michael; Vlahos, Ioannis; Manyonda, Issac; Belli, Anna-Maria

    2013-10-15

    Purpose: We have observed significant rates of uterine artery patency after uterine artery embolization (UAE) with nonspherical polyvinyl alcohol (nsPVA) on 6 month follow-up MR scanning. The study aim was to quantitatively assess uterine artery patency after UAE with nsPVA and to assess the effect of continued uterine artery patency on outcomes. Methods: A single centre, retrospective study of 50 patients undergoing bilateral UAE for uterine leiomyomata was undertaken. Pelvic MRI was performed before and 6 months after UAE. All embolizations were performed with nsPVA. Outcome measures included uterine artery patency, uterine and dominant fibroid volume, dominant fibroid percentage infarction, presence of ovarian arterial collaterals, and symptom scores assessed by the Uterine Fibroid Symptom and Quality of Life questionnaire (UFS-QOL). Results: Magnetic resonance angiographic evidence of uterine artery recanalization was demonstrated in 90 % of the patients (64 % bilateral, 26 % unilateral) at 6 months. Eighty percent of all dominant fibroids demonstrated >90 % infarction. The mean percentage reduction in dominant fibroid volume was 35 %. No significant difference was identified between nonpatent, unilateral, and bilateral recanalization of the uterine arteries with regard to percentage dominant fibroid infarction or dominant fibroid volume reduction. The presence of bilaterally or unilaterally patent uterine arteries was not associated with inferior clinical outcomes (symptom score or UFS-QOL scores) at 6 months. Conclusion: The high rates of uterine artery patency challenge the current paradigm that nsPVA is a permanent embolic agent and that permanent uterine artery occlusion is necessary to optimally treat uterine fibroids. Despite high rates of uterine artery recanalization in this cohort, satisfactory fibroid infarction rates and UFS-QOL scores were achieved.

  17. Uterine rupture. A seat belt hazard.

    PubMed

    van Enk, A; van Zwam, W

    1994-05-01

    A case is described of a uterine rupture resulting from a car accident occurring in a woman who was wearing a seat belt as generally recommended. The rupture was initially not recognised and only became apparent after attempts to induce labor which led to expulsion of the fetus into the abdominal cavity.

  18. Uterine cavity assessment prior to IVF.

    PubMed

    Pundir, Jyotsna; El Toukhy, Tarek

    2010-11-01

    Approximately 15% of couples are affected with subfertility, of which up to 20% remain unexplained. Uterine cavity abnormalities can be a contributing cause of subfertility and recurrent implantation failure. Uterine cavity assessment has been suggested as a routine investigation in the evaluation of subfertile women. Traditionally, hysterosalpingography has been the most commonly used technique in the evaluation of infertility. Transvaginal ultrasound scan allows visualization of the endometrial lining and cavity, and has been used as a screening test for the assessment of uterine cavity. Abnormal uterine findings on a baseline scan can be further evaluated with saline hysterosonography, which is highly sensitive and specific in identifying intrauterine abnormalities. Hysteroscopy is considered as the definitive diagnostic tool to evaluate any abnormality suspected on hysterosalpingography, transvaginal ultrasound scan or saline hysterosonography during routine investigation of infertile patients. Minimally invasive hysteroscopes have minimized the pain experienced by patients during the procedure and made it feasible to use hysteroscopy as a routine outpatient examination. Following recurrent IVF failure there is some evidence of benefit from hysteroscopy in increasing the chance of pregnancy in the subsequent IVF cycle, both in those with abnormal and normal hysteroscopic findings. Various possible mechanisms have been proposed for this beneficial effect, but more randomized controlled trials are needed before its routine use in the general subfertile population can be recommended.

  19. Uterine fibroid tumors: diagnosis and treatment.

    PubMed

    Evans, Patricia; Brunsell, Susan

    2007-05-15

    The incidence of uterine fibroid tumors increases as women grow older, and they may occur in more than 30 percent of women 40 to 60 years of age. Risk factors include nulliparity, obesity, family history, black race, and hypertension. Many tumors are asymptomatic and may be diagnosed incidentally. Although a causal relationship has not been established, fibroid tumors are associated with menorrhagia, pelvic pain, pelvic or urinary obstructive symptoms, infertility, and pregnancy loss. Transvaginal ultrasonography, magnetic resonance imaging, sonohysterography, and hysteroscopy are available to evaluate the size and position of tumors. Ultrasonography should be used initially because it is the least invasive and most cost-effective investigation. Treatment options include hysterectomy, myomectomy, uterine artery embolization, myolysis, and medical therapy. Treatment must be individualized based on such considerations as the presence and severity of symptoms, the patient's desire for definitive treatment, the desire to preserve childbearing capacity, the importance of uterine preservation, infertility related to uterine cavity distortions, and previous pregnancy complications related to fibroid tumors.

  20. Towards improving uterine electrical activity modeling and electrohysterography: ultrasonic quantification of uterine movements during labor.

    PubMed

    de Lau, Hinke; Rabotti, Chiara; Haazen, Nicole; Oei, S Guid; Mischi, Massimo

    2013-11-01

    The electrohysterogram is a potential new tool for diagnosing preterm labor. Parameters from the electrohysterogram may be influenced by uterine movement. An observational study was performed quantifying uterine movement during labor as a step towards improving electrohysterogram analysis for predicting preterm labor. The uterine wall was continuously tracked by ultrasound imaging during first stage of labor while an accelerometer recorded external abdominal accelerations in six women. A cyclic cranial-caudal movement of the uterine wall, caused by maternal respiration, was observed. This is reported and quantified for the first time. Average frequency, amplitude, and peak speed were 0.27 ± 0.07 Hz, 0.68 ± 0.84 cm, and 1.04 ± 1.20 cm/s, respectively. The accelerometer signal correlated with uterine movement and therefore can possibly provide a reference for removing movement-induced artifacts. There is a need to model and measure the effect of uterine movement on the electrohysterogram parameters and make measurements more robust to movement artifacts.

  1. Steroid Hormones and Uterine Vascular Adaptation to Pregnancy

    PubMed Central

    Chang, Katherine; Zhang, Lubo

    2008-01-01

    Pregnancy is a physiological state that involves a significant decrease in uterine vascular tone and an increase in uterine blood flow, which is mediated in part by steroid hormones, including estrogen, progesterone, and cortisol. Previous studies have demonstrated the involvement of these hormones in the regulation of uterine artery contractility through signaling pathways specific to the endothelium and the vascular smooth muscle. Alterations in endothelial nitric oxide synthase expression and activity, nitric oxide production, and expression of enzymes involved in PGI2 production contribute to the uterine artery endothelium-specific responses. Steroid hormones also have an effect on calcium-activated potassium channel activity, PKC signaling pathway and myogenic tone, and alterations in pharmacomechanical coupling in the uterine artery smooth muscle. This review addresses current understanding of the molecular mechanisms by which steroid hormones including estrogen, progesterone, and cortisol modulate uterine artery contractility to alter uterine blood flow during pregnancy with an emphasis on the pregnant ewe model. PMID:18497342

  2. Efficient visualization of unsteady and huge scalar and vector fields

    NASA Astrophysics Data System (ADS)

    Vetter, Michael; Olbrich, Stephan

    2016-04-01

    The simulation of climate data tends to produce very large data sets, which hardly can be processed in classical post-processing visualization applications. Within the most traditional post-processing scenarios the visualization pipeline consisting of the processes data generation, visualization mapping and rendering is distributed into two parts over the network or separated via file transfer: the data generation on a supercomputer on the one hand and the other tasks on a special visualization system on the other hand. That way either temporary data sets with huge volume have to be transferred over the network, which leads to bandwidth bottlenecks and volume limitations. As an alternative all simulation and visualization processes are integrated in a monolithic application, where just 2D pixel data is stored, which reduces the user's possibilities for 3D interaction with visualization to frame skipping. Within the Climate Visualization Lab - as part of the Cluster of Excellence "Integrated Climate System Analysis and Prediction" (CliSAP at the University of Hamburg, in cooperation with the German Climate Computing Center (DKRZ) - we plan to integrate a different approach, which has been proven to be successful in former meteorology applications, e.g. PALM (Parallel Large Eddy Simulation Model). Our software framework DSVR is based on the separation of the process chain between the mapping and the rendering processes. We have developed a parallelized visualization library based on MPI and evaluated on various supercomputers. DSVR can be used to integrate the visualization into a parallel simulation model to support in-situ processing, resulting in a sequence of time-based geometric 3D objects which can be interactively rendered in a separate 3D viewer application. To meet the actual requirements (a) to visualize existing data sets, (b) to support more than rectilinear grids, and (c) to integrate in-situ processing in the ICON model, all based on our DSVR framework

  3. Huge "Superbubble" of Gas Blowing Out of Milky Way

    NASA Astrophysics Data System (ADS)

    2006-01-01

    Astronomers using the National Science Foundation's Robert C. Byrd Green Bank Telescope (GBT) have discovered a huge "superbubble" of hydrogen gas rising nearly 10,000 light-years above the plane of our Milky Way Galaxy. They believe the gas may be driven by supernova explosions and the intense stellar winds from an unseen cluster of young stars in one of our Galaxy's spiral arms. The Green Bank Telescope The Robert C. Byrd Green Bank Telescope CREDIT: NRAO/AUI/NSF (Click on image for GBT gallery) "This giant gas bubble contains about a million times more mass than the Sun and the energy powering its outflow is equal to about 100 supernova explosions," said Yurii Pidopryhora, of the National Radio Astronomy Observatory (NRAO) and Ohio University. Pidopryhora, along with Jay Lockman of NRAO, and Joseph Shields of Ohio University, presented their results to the American Astronomical Society's meeting in Washington, DC. The superbubble is nearly 23,000 light-years from Earth. The astronomers discovered it by combining numerous smaller images made with the GBT into one large image. In addition, they added images of ionized hydrogen in the region that were made by a University of Wisconsin optical telescope on Kitt Peak in Arizona. "We see that all the hydrogen gas in this region of the Galaxy is disturbed, with many smaller outflows closer to the plane of the Galaxy and then a giant plume of gas that forms a sort of cap on the whole thing," Pidopryhora said. The ionized hydrogen, with atoms violently stripped of their electrons, seems to fill the interior of the superbubble while the neutral hydrogen forms its walls and cap. Our Milky Way Galaxy, about 100,000 light-years across, somewhat resembles a giant dinner plate, with most of its stars and gas residing in a flat disk. "Gas driven outward from the plane of the Galaxy's disk has been seen many times before, but this superbubble is particularly large," Lockman said. "The eruption that drove this much mass so far

  4. Decreased interleukin-2 production by rat uterine artery, aorta and uterine tissues during pregnancy.

    PubMed

    Huleihel, M; Leiberman, J R; Yohay, D; Glezerman, M

    1996-06-01

    Changes in size and function during pregnancy are unique to the uterine artery. The aim of this study was to determine the interleukin (IL)-6 activity of the uterine artery wall tissue in pregnant rats. A total of 18 Charles River white rats (nine virgin and nine in midpregnancy) were used for the study. Bilateral uterine arteries were obtained, together with reference tissues from aorta and uterus. IL-6 production was measured as optical density (OD)/mg protein, in control culture media, and in the presence of stimulants including IL-1, tumour necrosis factor alpha and lipopolysaccharide. Polyclonal rabbit anti-human IL-6 antibodies were used to assess IL-6 activity. In control culture medium, uterine artery tissue samples from virgin rats produced significantly higher concentrations of IL-6 than samples obtained from pregnancy animals (1.8 +/- 0.3 versus 0.9 +/- 0.25 OD/mg protein respectively (mean +/- SE, P = 0.001). Stimulation by lipopolysaccharide increased IL-6 activity of the uterine artery wall. In comparison with the uterine artery, the aorta produced higher activities of IL-6, and its production in virgin animal samples was higher than during pregnancy. Stimulants increased IL-6 production by both aorta and uterus tissues. Neutralization of IL-6 activity was obtained in a range of 77-93% in all samples. The lower level of IL-6 activity during pregnancy in the uterine artery and in reference tissues including aorta and uterus, may be related to acceptance of pregnancy by maternal tissues.

  5. Uterine rupture in pregnancies following myomectomy: A multicenter case series

    PubMed Central

    Kim, Hee-Sun; Oh, Soo-Young; Choi, Suk-Joo; Park, Hyun-Soo; Cho, Geum-Joon; Chung, Jin-Hoon; Seo, Yong-Soo; Jung, Sun-Young; Kim, Jung-Eun; Chae, Su-Hyun

    2016-01-01

    Objective The purpose of this case series was to retrospectively examine records of cases with uterine rupture in pregnancies following myomectomy and to describe the clinical features and pregnancy outcomes. Methods This study was conducted as a multicenter case series. The patient databases at 7 tertiary hospitals were queried. Records of patients with a diagnosis of uterine rupture in the pregnancy following myomectomy between January 2012 and December 2014 were retrospectively collected. The uterine rupture cases enrolled in this study were defined as follows: through-and-through uterine rupture or tear of the uterine muscle and serosa, occurrence from 24+0 to 41+6 weeks’ gestation, singleton pregnancy, and previous laparoscopic myomectomy (LSM) or laparotomic myomectomy (LTM) status. Results Fourteen pregnant women experienced uterine rupture during their pregnancy after LSM or LTM. Preterm delivery of less than 34 weeks’ gestation occurred in 5 cases, while intrauterine fetal death occurred in 3, and 3 cases had fetal distress. Of the 14 uterine rupture cases, none occurred during labor. All mothers survived and had no sequelae, unlike the perinatal outcomes, although they were receiving blood transfusion or treatment for uterine artery embolization because of uterine atony or massive hemorrhage. Conclusion In women of childbearing age who are scheduled to undergo LTM or LSM, the potential risk of uterine rupture on subsequent pregnancy should be explained before surgery. Pregnancy in women after myomectomy should be carefully observed, and they should be adequately counseled during this period. PMID:27896247

  6. Uterine microRNA signature and consequence of their dysregulation in uterine disorders

    PubMed Central

    Chegini, Nasser

    2011-01-01

    MicroRNA (miRNA) has emerged as key post-transcriptional regulator and through this mechanism control many normal developmental and physiological processes. Conversely, aberrant expression of some miRNAs has been correlated with various disorders, more specifically, development and progression of malignancy. Endometrium is a dynamic tissue which undergoes extensive cyclic changes in preparation for embryo implantation during reproductive years, as well as changes that occur following menopause, and establishment of benign and malignant uterine disorders. These processes are highly regulated by ovarian steroids and locally expressed genes in response to steroid hormone receptor-mediated signaling and include genes related to inflammatory reaction, apoptosis, cell-cycle progression, angiogenesis and tissue remodeling. Here we present an overview of our current understanding of uterine miRNA biogenesis and highlights their potential regulatory functions in cellular processes relevant to normal uterine physiological and pathological disorders such as endometriosis, dysfunctional uterine bleeding and endometrial cancer. Understanding the expression, regulation and functional aspects of miRNAs in uterine environment under normal and various disorders may lead to their potential utilization as diagnostic as well as therapeutic tool. PMID:22328907

  7. Integrated Molecular Characterization of Uterine Carcinosarcoma.

    PubMed

    Cherniack, Andrew D; Shen, Hui; Walter, Vonn; Stewart, Chip; Murray, Bradley A; Bowlby, Reanne; Hu, Xin; Ling, Shiyun; Soslow, Robert A; Broaddus, Russell R; Zuna, Rosemary E; Robertson, Gordon; Laird, Peter W; Kucherlapati, Raju; Mills, Gordon B; Weinstein, John N; Zhang, Jiashan; Akbani, Rehan; Levine, Douglas A

    2017-03-13

    We performed genomic, epigenomic, transcriptomic, and proteomic characterizations of uterine carcinosarcomas (UCSs). Cohort samples had extensive copy-number alterations and highly recurrent somatic mutations. Frequent mutations were found in TP53, PTEN, PIK3CA, PPP2R1A, FBXW7, and KRAS, similar to endometrioid and serous uterine carcinomas. Transcriptome sequencing identified a strong epithelial-to-mesenchymal transition (EMT) gene signature in a subset of cases that was attributable to epigenetic alterations at microRNA promoters. The range of EMT scores in UCS was the largest among all tumor types studied via The Cancer Genome Atlas. UCSs shared proteomic features with gynecologic carcinomas and sarcomas with intermediate EMT features. Multiple somatic mutations and copy-number alterations in genes that are therapeutic targets were identified.

  8. Ultrasonographic characterization of the uterine artery in the nonestrus bitch.

    PubMed

    Alvarez-Clau, A; Liste, F

    2005-12-01

    The canine species is often used as an experimental animal model in medicine. Doppler ultrasound of uterine arteries has important clinical implications in obstetrics and gynecology in women and animal species. To our knowledge, the ultrasonographic features of uterine arteries in the bitch have not been reported. Thus, an ultrasonographic technique to locate the uterine arteries in the bitch is described in this study. A total of 11 nonspayed nonestrus bitches underwent abdominal ultrasound examination. Pulsed-wave, color and power Doppler settings were used to detect the location and characterize the flow of the uterine arteries. Mean values for systolic peak velocity, diastolic peak velocity, diastolic reversal flow and resistive index were calculated. Uterine arteries had a high pulsatility flow in all cases. Future work is needed to fully assess the clinical importance of the uterine artery flow in the bitch, as well as to study possible waveform changes at different estrus phases and throughout gestation.

  9. Dealing with uterine fibroids in reproductive medicine.

    PubMed

    Gambadauro, P

    2012-04-01

    Women who wish to conceive are nowadays more likely to present with uterine fibroids, mainly because of the delay in childbearing in our society. The relationship between uterine fibroids and human reproduction is still controversial and counselling patients might sometimes be challenging. This paper is to assist those involved in the management of patients of reproductive age presenting with uterine fibroids. The interference of fibroids on fertility largely depends on their location. Submucous fibroids interfere with fertility and should be removed in infertile patients, regardless of the size or the presence of symptoms. Intramural fibroids distorting the cavity reduce the chances of conception, while investigations on intramural fibroids not distorting the cavity have so far given controversial results. No evidence supports the systematic removal of subserosal fibroids in asymptomatic, infertile patients. Myomectomy is still the 'gold standard' in fibroid treatment for fertility-wishing patients. In experienced hands, hysteroscopic myomectomy is minimally invasive, safe, and effective. Abdominal and laparoscopic myomectomy might be challenging, but potential risks could be reduced by new strategies and techniques.

  10. Uterine Fibroid (Leiomyoma) with Acute Urinary Retention: A Case Series.

    PubMed

    Singh, Sweta; Jena, Saubhagya Kumar; Naik, Monalisha; Ray, Lipsa; Behera, Satyanarayan

    2016-04-01

    Uterine leiomyomas are an extremely rare cause of acute urinary retention in women. The delay in diagnosing uterine leiomyomas presenting with acute urinary retention further complicates the management. The rarity of the condition makes it difficult to plan either prospective or retrospective trials. Hence, most of the evidence comes from case reports or series. We report a case series of acute urinary retention in women with uterine leiomyomas and discuss the pathophysiology, diagnosis and management options.

  11. Uterine Fibroid (Leiomyoma) with Acute Urinary Retention: A Case Series

    PubMed Central

    Jena, Saubhagya Kumar; Naik, Monalisha; Ray, Lipsa; Behera, Satyanarayan

    2016-01-01

    Uterine leiomyomas are an extremely rare cause of acute urinary retention in women. The delay in diagnosing uterine leiomyomas presenting with acute urinary retention further complicates the management. The rarity of the condition makes it difficult to plan either prospective or retrospective trials. Hence, most of the evidence comes from case reports or series. We report a case series of acute urinary retention in women with uterine leiomyomas and discuss the pathophysiology, diagnosis and management options. PMID:27190903

  12. Uterine cancer in the writings of ancient Greek physicians.

    PubMed

    Tsoucalas, Gregory; Karamanou, Marianna; Sgantzos, Markos; Deligeoroglou, Efthimios; Androutsos, George

    2015-01-01

    In this article, we present the views on uterine cancer of the ancient Greek physicians. We emphasize on uterine's cancer aetiology according to the dominant in antiquity humoural theory, on its surgical treatment suggested by Soranus of Ephesus, and in the vivid description provided by Aretaeus of Cappadocia. During that period, uterine cancer was considered as an incurable and painful malignancy and its approach was mainly palliative.

  13. Iatrogenic Uterine Diverticulum in Pregnancy After Robotic-assisted Myomectomy.

    PubMed

    DeStephano, Christopher C; Jernigan, Amelia M; Szymanski, Linda M

    2015-01-01

    Uterine diverticula are rare outpouchings of the uterus associated with abnormal uterine bleeding, pelvic pain, dysmenorrhea, and adverse obstetric events. At the time of cesarean delivery at 36 5/7 weeks' gestation during the patient's first pregnancy and 36 6/7 weeks during the second pregnancy, a fundal iatrogenic uterine diverticulum at the site of a prior robotic-assisted myomectomy was noted. The outpouching communicated with the endometrial cavity and was extremely attenuated, palpably 2 to 3 mm thick. Further research is needed to determine the incidence of iatrogenic uterine diverticulum after robotic myomectomy and whether these malformations increase the risk of adverse obstetric outcomes.

  14. Radiographic and ultrasonographic findings of uterine neoplasms in nine dogs.

    PubMed

    Patsikas, Michail; Papazoglou, Lysimachos G; Jakovljevic, Samuel; Papaioannou, Nikolaos G; Papadopoulou, Paraskevi L; Soultani, Christina B; Chryssogonidis, Ioannis A; Kouskouras, Konstantinos A; Tziris, Nikolaos E; Charitanti, Afroditi A

    2014-01-01

    The records of nine female intact dogs with histologically confirmed uterine tumors were reviewed retrospectively, and the related radiographic and ultrasonographic signs of the lesions detected were recorded. Radiography revealed a soft-tissue opacity between the urinary bladder and colon in six of seven dogs with uterine body and/or cervical tumors, and a soft-tissue opacity in the midventral abdomen in two dogs with uterine horn tumors. Ultrasonography revealed masses in all dogs with uterine body/cervical tumors and could delineate the origin of the mass in one of two dogs with uterine horn tumors. The mass was characterized ultrasonographically as solid in three dogs (all leiomyomas), solid with cystic component in four dogs (two adenocarcinomas, one leiomyoma, and one fibroleiomyoma), and cystic in two (both leiomyomas). Hyperechoic foci in the mass were observed in three dogs. Ultrasonography was a useful method for demonstrating uterine body and/or cervical tumors. However, it was not possible to ascertain sonographically that a mass originated in a uterine horn unless there was associated evidence of uterine horn to which the mass could be traced. The ultrasonographic appearance of uterine tumors was variable, and the type of neoplasm could only be determined by taking biopsies of the mass.

  15. Uterine disorders and pregnancy complications: insights from mouse models

    PubMed Central

    Lim, Hyunjung Jade; Wang, Haibin

    2010-01-01

    Much of our knowledge of human uterine physiology and pathology has been extrapolated from the study of diverse animal models, as there is no ideal system for studying human uterine biology in vitro. Although it remains debatable whether mouse models are the most suitable system for investigating human uterine function(s), gene-manipulated mice are considered by many the most useful tool for mechanistic analysis, and numerous studies have identified many similarities in female reproduction between the two species. This Review brings together information from studies using animal models, in particular mouse models, that shed light on normal and pathologic aspects of uterine biology and pregnancy complications. PMID:20364098

  16. The Role of Vitamin D in Uterine Fibroid Biology

    PubMed Central

    Brakta, Soumia; Diamond, Justin S.; Al-Hendy, Ayman; Diamond, Michael P.; Halder, Sunil K.

    2015-01-01

    Objective To provide a detailed summary of current scientific knowledge on uterine fibroids (leiomyomas) in vitro and in in vivo animal models, as well as to postulate the potential role of vitamin D3 as an effective, inexpensive, safe long-term treatment option for uterine fibroids. Design PubMed search articles were used to identify the most relevant studies on uterine fibroids as well as effects of vitamin D3 on uterine fibroid cells and fibroid tumor growth in in vivo animal models. Setting University research laboratory - affiliated infertility clinic. Patient(s) Not applicable. Intervention(s) None Main Outcome Measure(s) Not applicable. Results Despite numerous publications available on uterine fibroids, information about the role that vitamin D3 plays in the regulation of uterine fibroids are limited. Most of the recent vitamin D3-related studies on uterine fibroids were published from our group. Recent studies have demonstrated that vitamin D deficiency plays a significant role in the development of uterine fibroids. Our recent studies have demonstrated that vitamin D3 reduces leiomyoma cell proliferation in vitro, and leiomyoma tumor growth in in vivo animal models. These results postulate the potential role of vitamin D3 for an effective, safe non-surgical medical treatment option for uterine fibroids. Conclusions This article reviews human and animal studies and uncover new possibilities for understanding the vitamin D-based therapeutic option for an effective, safe long-term treatment of uterine fibroids. Based on these results, a clinical trial with vitamin D3 or a hypocalcemic analog, paricalcitol may be warranted for non-surgical medical treatment of uterine fibroids. PMID:26079694

  17. 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

    ClinicalTrials.gov

    2016-10-26

    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

  18. New Clues to Huge Jump in U.S. Mosquito Population

    MedlinePlus

    ... Clues to Huge Jump in U.S. Mosquito Population Urbanization, DDT pesticide ban played roles, but climate change ... past 50 years in certain U.S. states: Increased urbanization and shrinking levels of the pesticide DDT in ...

  19. Uterine uptake of iodine-123 metaiodobenzylguanidine during the menstrual phase of uterine cycle

    SciTech Connect

    Bomanji, J.; Britton, K.E.

    1987-08-01

    Radioiodinated I-123 metaiodobenzylguanidine (MIBG) has been used for diagnostic purposes for detection of apudomas. In this paper normal physiological uptake of I-123 MIBG by the uterus during the menstrual phase of the uterine cycle is reported. It is likely that I-123 MIBG can be used to evaluate some of the problems in this context.

  20. A huge ovarian mucinous cystadenoma causing virilization, preterm labor, and persistent supine hypotensive syndrome during pregnancy

    PubMed Central

    Acar, Canan; Temizkan, Osman; Ozagari, Aysim; Gozukara, Ilay; Akyol, Atif

    2016-01-01

    Mucinous cystadenoma (MC) of the ovary is an unilateral, multilocular cystic benign epithelial tumor. Supposed to be hormone responsive, MC reaches huge sizes during pregnancy. Aortocaval compression is common during pregnancy, especially when the pregnant woman is in the supine position. However, the compression recovers with a change in position. The authors report the first case of a huge mucinous cystadenoma of the ovary complicating pregnancy and causing virilization, premature labor, and persistent supine hypotensive syndrome. PMID:27547742

  1. Vitamin D and Risk of Uterine Fibroids

    PubMed Central

    Baird, Donna Day; Hill, Michael C; Schectman, Joel M; Hollis, Bruce W.

    2015-01-01

    Background Uterine leiomyomata, benign tumors of uterine smooth muscle that are characterized by overproduction of extracellular matrix (fibroids), are the leading indication for hysterectomy in the United States. The active metabolite of Vitamin D has been shown to inhibit cell proliferation and extracellular matrix production in fibroid tissue culture and to reduce fibroid volume in the Eker rat. No previous epidemiologic study has examined whether vitamin D is related to fibroid status in women. Methods The National Institute of Environmental Health Sciences Uterine Fibroid Study enrolled randomly selected 35–49 year-old members of an urban health plan during 1996–1999. Fibroid status was determined by ultrasound screening of premenopausal women (620 blacks, 416 whites). Vitamin D status was assessed in stored plasma by radioimmunoassay of 25-hydroxyvitamin D (25(OH)D) and questionnaire data on sun exposure. Associations were evaluated with logistic regression, controlling for potential confounders. Results Only 10% of blacks and 50% of whites had sufficient 25(OH)D levels [>20 ng/ml]. Women with sufficient vitamin D had an estimated 32% reduced odds of fibroids compared with those with vitamin D insufficiency (adjusted odds ration, aOR=0.68, 95% confidence interval, CI=0.48, 0.96). The association was similar for blacks and whites. Self-reported sun exposure ≥1 hr/day (weather permitting) was also associated with reduced odds of fibroids (aOR=0.6, 95% CI=0.4, 0.9) with no evidence of heterogeneity by ethnicity. Conclusions The consistency of findings for questionnaire and biomarker data, the similar patterns seen in blacks and whites, and the biological plausibility provide evidence that sufficient vitamin D is associated with a reduced risk of fibroids. PMID:23493030

  2. Reproductive Management for Optimal Uterine Preparedness for Pregnancy

    Technology Transfer Automated Retrieval System (TEKTRAN)

    It is clear that decreased serum concentrations of preovulatory estradiol create uterine deficiencies that prevent the maintenance of pregnancy and losses are related to reduced ability of the developing embryo to implant. The uterine deficiencies in response to reduced post-ovulatory progesterone ...

  3. Diagnosis and Nonsurgical Management of Uterine Arteriovenous Malformation

    SciTech Connect

    Rangarajan, R. D.; Moloney, J. C.; Anderson, H. J.

    2007-11-15

    Uterine arteriovenous malformation (AVM) is an uncommon problem and traditional treatment by hysterectomy excludes the possibility of future pregnancy. Developments in interventional techniques make transcatheter embolization of the feeding vessel(s) a therapeutic alternative, potentially preserving the patient's fertility. We present a case of successful endovascular treatment of uterine AVM.

  4. Uterine leucocyte infiltration after artificial insemination in bitches.

    PubMed

    Ribeiro, Ana Paula Coelho; Vicente, Wilter Ricardo Russiano; Apparício, Maricy; Gadelha, Carla Renata Figueiredo; Alves, Aracélle Elisane; Covizzi, Gabriela Jayme

    2006-10-01

    In the present study, polymorphonuclear neutrophils (PMN) were enumerated to evaluate acute uterine inflammation after artificial insemination in the bitch. It was concluded that the canine seminal plasma possessed an immunomodulating action. However, the most commonly used extender for freezing canine semen (Tris glucose with egg yolk and glycerol) was a potential inducer of uterine inflammation.

  5. Assessment of uterine shape and size using Kurz's Cavimeter.

    PubMed

    de Castro, A

    1988-06-01

    The Kurz's Cavimeter was used to determine uterine shape and dimensions in 509 women prior to IUD insertion. The women were separated into six groups, depending on parity. A slight increase was noted in total uterine length due to endometrial cavity length and transverse fundal diameter in relationship to parity. However, the differences did not reach statistical significance.

  6. Trophoblast-uterine interactions at implantation

    PubMed Central

    Aplin, John D; Kimber, Susan J

    2004-01-01

    Implantation of the embryo in the uterus is a critical and complex event and its failure is widely considered an impediment to improved success in assisted reproduction. Depending on whether placentation is invasive or superficial (epitheliochorial), the embryo may interact transiently or undergo a prolonged adhesive interaction with the uterine epithelium. Numerous candidate interactions have been identified, and there is good progress on identifying gene networks required for early placentation. However no molecular mechanisms for the epithelial phase are yet firmly established in any species. It is noteworthy that gene ablation in mice has so far failed to identify obligatory initial molecular events. PMID:15236654

  7. Uterine Epithelioid Angiosarcoma on F-18 FDG PET/CT.

    PubMed

    Hwang, Jae Pil; Lim, Sang Moo

    2013-06-01

    Uterine epithelioid angiosarcoma can have conventional imaging characteristics similar to those of other uterine tumors, such as leiomyoma, leiomyosarcomas or hemangioendothelioma. Uterine epithelioid angiosarcoma exhibiting increased fluorine-18 fluorodeoxyglucose (F-18 FDG) activity can be misdiagnosed. A 61-year-old woman who was diagnosed with uterine epithelioid angiosarcoma underwent F-18 FDG positron emission tomography/computed tomography (PET/CT) as a part of the pretreatment work up for surgery. F-18 FDG PET/CT showed an intense F-18 FDG uptake in the uterus in addition to increased F-18 FDG uptake at the paraaortic and aortocaval lymph nodes. To our knowledge, this is the first case report of intense F-18 FDG uptake in uterine epithelioid angiosarcoma in Korea.

  8. Radiation-induced uterine changes: MR imaging

    SciTech Connect

    Arrive, L.; Chang, Y.C.; Hricak, H.; Brescia, R.J.; Auffermann, W.; Quivey, J.M.

    1989-01-01

    To assess the capability of magnetic resonance (MR) imaging to demonstrate postirradiation changes in the uterus, MR studies of 23 patients who had undergone radiation therapy were retrospectively examined and compared with those of 30 patients who had not undergone radiation therapy. MR findings were correlated with posthysterectomy histologic findings. In premenopausal women, radiation therapy induced (a) a decrease in uterine size demonstrable as early as 3 months after therapy ended; (b) a decrease in signal intensity of the myometrium on T2-predominant MR images, reflecting a significant decrease in T2 relaxation time, demonstrable as early as 1 month after therapy; (c) a decrease in thickness and signal intensity of the endometrium demonstrable on T2-predominant images 6 months after therapy; and (d) loss of uterine zonal anatomy as early as 3 months after therapy. In postmenopausal women, irradiation did not significantly alter the MR imaging appearance of the uterus. These postirradiation MR changes in both the premenopausal and postmenopausal uteri appeared similar to the changes ordinarily seen on MR images of the nonirradiated postmenopausal uterus.

  9. A non-surgical uterine lavage technique in large cats intended for treatment of uterine infection-induced infertility.

    PubMed

    Hildebrandt, T B; Göritz, F; Boardman, W; Strike, T; Strauss, G; Jewgenow, K

    2006-10-01

    This paper presents the successful use of a non-surgical, transcervical uterine lavage technique for the treatment of uterine infection-induced infertility in three female large cats. We developed a non-surgical uterine lavage technique, which allowed repeated flushing of the uterine lumen and installation of therapeutic antibiotics. The entire procedure was performed under general anaesthesia (duration of anesthesia ranged from 40 to 70 min). It was successfully applied in a Sumatran tiger (Panthera tigris sumatrae), a Corbett tiger (Panthera tigris corbetti) and an Amur leopard (Panthera pardus orientalis). The tigers were treated only once, whereas the leopard received four uterine treatments, due to re-infection after mating. Decisions to conduct uterine treatments were based on detection of uterine fluid during previous transrectal ultrasound examinations. The catheter was guided into the vagina, with the aid of an endoscope, passing the urethra, and then into the uterus, with the aid of transrectal ultrasonography. Both uterine horns were separately flushed with approximately 300 mL of cell medium M199, followed by an antibiotic infusion. Upon ultrasonographic re-examination, the topical uterine treatments resulted in an apparent decline in the inflammatory and/or degenerative processes. The Corbett tiger had the most severe uterine alterations, in addition to an aseptic pyometra. As a result, she was treated 1 month prior to ovariohysterectomy (in order to reduce the surgical risk). The Sumatran tiger was artificially inseminated twice after hormone-induced estrus, and the Amur leopard expressed a spontaneous estrus and re-initiated mating behaviour.

  10. Newtonian self-gravitating system in a relativistic huge void universe model

    NASA Astrophysics Data System (ADS)

    Nishikawa, Ryusuke; Nakao, Ken-ichi; Yoo, Chul-Moon

    2016-12-01

    We consider a test of the Copernican Principle through observations of the large-scale structures, and for this purpose we study the self-gravitating system in a relativistic huge void universe model which does not invoke the Copernican Principle. If we focus on the the weakly self-gravitating and slowly evolving system whose spatial extent is much smaller than the scale of the cosmological horizon in the homogeneous and isotropic background universe model, the cosmological Newtonian approximation is available. Also in the huge void universe model, the same kind of approximation as the cosmological Newtonian approximation is available for the analysis of the perturbations contained in a region whose spatial size is much smaller than the scale of the huge void: the effects of the huge void are taken into account in a perturbative manner by using the Fermi-normal coordinates. By using this approximation, we derive the equations of motion for the weakly self-gravitating perturbations whose elements have relative velocities much smaller than the speed of light, and show the derived equations can be significantly different from those in the homogeneous and isotropic universe model, due to the anisotropic volume expansion in the huge void. We linearize the derived equations of motion and solve them. The solutions show that the behaviors of linear density perturbations are very different from those in the homogeneous and isotropic universe model.

  11. The effect of cinnamon extract on isolated rat uterine strips.

    PubMed

    Alotaibi, Mohammed

    2016-03-01

    Cinnamon is a spice used by some populations as a traditional remedy to control blood pressure and thus hypertension. Cinnamon extract decreases contractility in some smooth muscles, but its effect on uterine smooth muscle is unknown. The aim of this study was to determine the physiological and pharmacological effects of cinnamon extract (CE) on the contractions of isolated rat uterine strips and to investigate its possible mechanism of action. Isolated longitudinal uterine strips were dissected from non-pregnant rats, mounted vertically in an organ bath chamber, and exposed to different concentrations of CE (10-20mg/mL). The effect of CE was investigated in the presence of each of the following solutions: 60mM KCl, 5nM oxytocin, and 1μM Bay K8644. CE significantly decreased the force of uterine contraction in a concentration-dependent manner and significantly attenuated the uterine contractions elicited by KCl and oxytocin. In addition, CE significantly decreased the contractile force elicited when L-type Ca(2+) channels were activated by Bay K8644. CE's major mechanism may be inhibition of L-type Ca(2+) channels, which limits calcium influx. These data demonstrate that CE can be a potent tocolytic that can decrease uterine activity regardless of how the force was produced, even when the uterus was stimulated by agonists. As a result, cinnamon may be used to alleviate menstrual pain associated with dysmenorrhoea or prevent unwanted uterine activity in early pregnancy.

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

    PubMed

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

    2012-10-15

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

  13. Bilateral segmental aplasia with unilateral uterine horn torsion in a Pomeranian bitch.

    PubMed

    Nakamura, Kensuke; Yamasaki, Masahiro; Osaki, Tomohiro; Ohta, Hiroshi; Sasaki, Noboru; Aoshima, Keisuke; Kimura, Takashi; Takiguchi, Mitsuyoshi

    2012-01-01

    Bilateral segmental aplasia of the uterine horns with unilateral pyometra and uterine horn torsion were diagnosed in a Pomeranian bitch that presented with chronic abdominal distension and an acute onset of anorexia and lethargy. Because radiographic and ultrasonographic findings revealed the presence of markedly enlarged bilateral uterine horns filled with fluid in the caudal abdomen, a tentative diagnosis of either pyometra or hydrometra with uterine horn torsion was made. Exploratory laparotomy showed bilateral, segmentally distended uterine horns with unilateral uterine horn torsion. Ovariohysterectomy was performed, and bilateral segmental aplasia of the uterine horns with the development of unilateral uterine horn torsion was diagnosed histopathologically. To the authors' knowledge, this is the first report of uterine horn torsion in conjunction with segmental aplasia of the uterine horn in a bitch.

  14. A large uterine leiomyoma leading to non-puerperal uterine inversion: A case report

    PubMed Central

    Teimoori, Batool; Esmailzadeh, Arezoo

    2017-01-01

    Background: Although leiomyomas are the most common gynecologic disorders, non-puerperal uterine inversion due to leiomyoma is considered as a rare clinical problem. This condition can occur as a complication of a large sub-mucous leiomyoma that leads to dilate cervix and protrude into vagina. The patient may have several symptoms such as heavy vaginal bleeding, pelvic pain and intermittent acute urinary retention. Case: We presented a 32-year-old nulliparous woman with 17 years of unexplained infertility and diagnosis of a large vaginal prolapsed non-pedunculated leiomyoma. Conclusion: Haultain’s procedure was used to reposition uterine inversion and remove leiomyoma through a posterior incision, using laparotomy. PMID:28280801

  15. Intraoperative fluorescent cholangiography using indocyanine green for laparoscopic fenestration of nonparasitic huge liver cysts.

    PubMed

    Kitajima, Toshihiro; Fujimoto, Yasuhiro; Hatano, Etsuro; Mitsunori, Yusuke; Tomiyama, Koji; Taura, Kojiro; Mizumoto, Masaki; Uemoto, Shinji

    2015-02-01

    Bile duct injury is one of the known serious complications of laparoscopic fenestration for nonparasitic liver cysts. Herein, we report the case of a huge liver cyst for which we performed laparoscopic fenestration using intraoperative fluorescent cholangiography with indocyanine green. A 71-year-old woman with abdominal distention was referred to our hospital. CT demonstrated a 17 × 11.5-cm simple cyst replacing the right lobe of the liver, so laparoscopic fenestration was performed. Although the biliary duct could not be detected because of compression by the huge cyst, fluorescent cholangiography with indocyanine green through endoscopic naso-biliary drainage tube clearly delineated the intrahepatic bile duct in the remaining cystic wall. The patient had no complications at 3 months after surgery. Fluorescent cholangiography using indocyanine green is a safe and effective procedure to avoid bile duct injury during laparoscopic fenestration, especially in patients with a huge liver cyst.

  16. Intrauterine tamponade balloon use in the treatment of uterine inversion.

    PubMed

    Haeri, Sina; Rais, Sheliza; Monks, Brian

    2015-01-06

    Uterine inversion is a rare but life-threatening obstetrical emergency that occurs when the fundus of the uterus prolapses through the cervix, hence turning the uterus inside out. In this case report, we present our experience using an intrauterine tamponade balloon for management of uterine inversion, and a review of the literature. The utility of an intrauterine tamponade balloon in cases of uterine inversion, especially when maternal medical conditions preclude the use of uterotonics, or reinversion is observed should be kept in mind.

  17. Possible role of DaVinci Robot in uterine transplantation.

    PubMed

    Iavazzo, Christos; Gkegkes, Ioannis D

    2015-01-01

    Minimally invasive surgery, specifically robotic surgery, became a common technique used by gynecological surgeons over the last decade. The realization of the first human uterine transplantation commenced new perspectives in the treatment of uterine agenesia or infertility in women with history of hysterectomy at a young age. Robot-assisted technique may enhance the safety of the procedure by facilitating the microvascular anastomosis, vaginal anastomosis, and ligaments' fixation. This study proposes the formation of a multicenter collaboration group to organize a protocol with the aim to clarify the possible role of robotic surgery in uterine transplantation.

  18. Uterine Arteriovenous Malformation with Sudden Heavy Vaginal Hemmorhage

    PubMed Central

    Selby, Sarah T.; Haughey, Marianne

    2013-01-01

    Dysfunctional uterine bleeding (DUB) is a common presentation in the emergency department and has a wide differential. Most presentations of DUB are in hemodynamically stable patients and can be evaluated as an outpatient. Uterine arteriovenous malformation (AVM) is one presentation that can result in a life-threatening medical emergency with unexpected sudden and massive vaginal bleeding. We describe a case of a 24-year-old female with sudden heavy vaginal bleeding requiring a blood transfusion, ultrasound evidence of uterine AVM, and a treatment method of expectant management using an intrauterine device in an attempt to preserve fertility. PMID:24106528

  19. Is manual palpation of the uterine scar following vaginal birth after cesarean section (VBAC) helpful?

    PubMed

    Dinglas, C; Rafael, T J; Vintzileos, A

    2015-05-01

    Risk of uterine rupture with trial of labor after cesarean (TOLAC) is less than one percent. Discovery of uterine rupture often occurs during labor. In our case, the uterine scar is discovered to be ruptured during the postpartum period. The exact cause and time of uterine rupture is difficult to ascertain in this case, yet manual palpation of the uterine scar did not aid in the eventual diagnosis.

  20. Endometrial cancer with congenital uterine anomalies: three case reports and a literature review.

    PubMed

    Gao, Jinping; Zhang, Jintian; Tian, Wenyan; Teng, Fei; Zhang, Huiying; Zhang, Xuhong; Wang, Yingmei; Xue, Fengxia

    2017-01-24

    Background Uterine malformation is a rare deformity in woman, and only a few cases concerning endometrial cancer arising in patients with congenital uterine anomalies have been reported. Herein, we present three cases of endometrial cancer with different congenital uterine anomalies, and review studies involving congenital uterine anomalies associated with endometrial cancer in the past 25 years, in order to identify similarities and differences in clinicopathologic characteristics and prognosis between endometrial cancer associated with uterine anomalies, and normal uterus.

  1. Huge dissected ascending aorta associated with pseudo aneurysm and aortic coarctation feridoun.

    PubMed

    Sabzi, Feridoun; Khosravi, Donya

    2015-07-01

    We report a unique case of chronic dissection of the ascending aorta complicated with huge and thrombotic pseudoaneurysm in a patient with coarctation of descending aorta. Preoperative investigations such as transesophageal echocardiography (TEE) confirmed the diagnosis of dissection. Intraoperative findings included a12 cm eccentric bulge of the right lateral side of dilated the ascending aorta filled with the clot and a circular shaped intimal tear communicating with an extended hematoma and dissection of the media layer. The rarity of the report is an association of the chronic dissection with huge pseudoaneurysm and coarctation. The patient underwent staged repair of an aneurysm and coarctation and had an uneventful postoperative recovery period.

  2. [Children's OSAHS caused by the huge fibrolipoma in pharynx nasalis: a case report].

    PubMed

    Xia, Siwen; Li, Xiaomiao; Ma, Qiongfan

    2015-08-01

    We reported a case of children's OSAHS caused by the huge fibrolipoma in pharynx nasalis. The patient was a 10-years-old child who went to the hospital with the chief complaint of "Snoring and mouth breathing during sleep for 10 years". Imaging tests found one huge tumor in pharynx nasalis before the operation. The tumor was resected totally. The postoperative pathological diagnosis was fibrolipoma. No recurrence was noted during the follow-up visit one year postoperatively. The clinical features, diagnosis, treatment, pathology and prognosis were reviewed herein.

  3. Autofluorescent particles of human uterine muscle cells.

    PubMed Central

    Gosden, R. G.; Hawkins, H. K.; Gosden, C. A.

    1978-01-01

    Smooth muscle tissue collected from the uterine fundus of 24 patients undergoing hysterectomy was examined for chromolipoid pigments by histochemical and electron microscopic techniques. Certain cytoplasmic particles were found, mainly in smooth muscle cells, which exhibited characteristic autofluorescence, sudanophilia, and acid phosphatase activity but did not correspond to any typical pigment described previously. These particles were present in all subjects and they tended to increase in number with age. Chemical tests on tissue lipid extracts failed to prove that vitamin A was responsible for the fluorescence. The ultrastructural appearance of the particles somewhat variable, but most particles were rounded and of low electron density, with a lucent central space and dense bodies, probably lysosomes, at the periphery. The whole complex was enclosed by a single trilaminar membrane. Images Figure 5 Figure 1 Figure 2 Figure 6 Figure 7 Figure 3 Figure 8 Figure 4 PMID:645817

  4. Adrenal Metastasis from Uterine Papillary Serous Carcinoma

    PubMed Central

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

    2016-01-01

    Patient: Female, 60 Final Diagnosis: UPSC with adrenal metastasis Symptoms: Post menopausal bleeding Medication: — Clinical Procedure: Adrenalectomy Specialty: Oncology Objective: Rare disease 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

  5. Antenatal 3-D sonographic features of uterine synechia.

    PubMed

    Sato, Miki; Kanenishi, Kenji; Ito, Megumi; Tanaka, Hirokazu; Takemoto, Mikihiko; Hata, Toshiyuki

    2013-01-01

    We present a case of uterine synechia diagnosed by conventional 2-D color Doppler, 3-D sonography, and magnetic resonance imaging at 26 weeks' gestation. 3-D sonography clearly revealed umbilical cord prolapse through an oblique transverse uterine synechia. Loops of the umbilical cord were below and the fetus was superior to the uterine synechia. The edge of the umbilical cord loops was attached to the amniotic membrane, and a small echo-free space was noted beneath the attachment. 2-D color Doppler showed arterial blood flow consistent with the maternal heart rate. Magnetic resonance imaging confirmed the oblique horizontal membrane dividing the uterus with umbilical cord prolapse, its attachment to the amniotic membrane, and a small echo-free space in the low, liquor-filled amniotic cavity. We demonstrate how 3-D sonography provided a novel visual depiction of uterine synechia, which greatly helped in prenatal diagnosis and counseling.

  6. Apparatus for treating carcinoma of the uterine cervix

    SciTech Connect

    Kumar, P.P.

    1984-03-06

    Disclosed is an apparatus for treating carcinoma of the uterine cervix by judiciously applying radioactive material immediately adjacent the uterine cervix for an extended period of time empirically determined by the radiologist. The novel apparatus comprises three radioactively chargeable components including a central tubular tandem vaginally insertable longitudinally into the uterine cervix and two non-lineal tubular ovoidal assemblies longitudinally locatable at the cervix and positioned laterally between the respective vaginal walls and the uterine cervix. The ovoidal assemblies are conveniently removably and pivotably connected to the central tandem component externally of the vaginal along the sagittal plane through a novel adapter member whereby the radioactively chargeable ovoidal assemblies tend to remain within a laterally extending plane located substantially midway the transversely separated vasicovaginal and rectovaginal septa, even though the patient periodically shifts her reclining posture during the extended treatment by said vaginally protruding apparatus.

  7. Huge right atrial myxoma causing fixed tricuspid stenosis with constitutional symptoms.

    PubMed

    Kuralay, Erkan; Cingöz, Faruk; Günay, Celalettin; Demirkiliç, Ufuk; Tatar, Harun

    2003-01-01

    Nonspecific constitutional symptoms are reported mostly in patients with left-atrial myxomas, which occur five times as often as its right-atrial counterpart. We present huge right-atrial myxoma, which obstructs tricuspid orifice with nonspecific constitutional symptoms without any pulmonary embolism attack.

  8. Constructing Optimal Coarse-Grained Sites of Huge Biomolecules by Fluctuation Maximization.

    PubMed

    Li, Min; Zhang, John Zenghui; Xia, Fei

    2016-04-12

    Coarse-grained (CG) models are valuable tools for the study of functions of large biomolecules on large length and time scales. The definition of CG representations for huge biomolecules is always a formidable challenge. In this work, we propose a new method called fluctuation maximization coarse-graining (FM-CG) to construct the CG sites of biomolecules. The defined residual in FM-CG converges to a maximal value as the number of CG sites increases, allowing an optimal CG model to be rigorously defined on the basis of the maximum. More importantly, we developed a robust algorithm called stepwise local iterative optimization (SLIO) to accelerate the process of coarse-graining large biomolecules. By means of the efficient SLIO algorithm, the computational cost of coarse-graining large biomolecules is reduced to within the time scale of seconds, which is far lower than that of conventional simulated annealing. The coarse-graining of two huge systems, chaperonin GroEL and lengsin, indicates that our new methods can coarse-grain huge biomolecular systems with up to 10,000 residues within the time scale of minutes. The further parametrization of CG sites derived from FM-CG allows us to construct the corresponding CG models for studies of the functions of huge biomolecular systems.

  9. Uterine cancer in the writings of Byzantine physicians.

    PubMed

    Karamanou, Marianna; Tsoucalas, Gregory; Laios, Konstantinos; Deligeoroglou, Efthimios; Agapitos, Emmanouil; Androutsos, George

    2015-01-01

    Byzantine physicians recognized uterine cancer as a distinct disease and tried to suggest a therapeutic approach. The work of Oribasius, Aetius of Amida, Paul of Aegina, Cleopatra Metrodora and Theophanes Nonnus reflects the Hippocratic-Galenic scientific ideas as well as their own concept on this malignancy. According to their writings uterine cancer was considered an incurable disease and its treatment was based mainly on palliative herbal drugs.

  10. Novel Image-Guided Management of a Uterine Arteriovenous Malformation

    SciTech Connect

    Przybojewski, Stefan J. Sadler, David J.

    2011-02-15

    The investigators present a novel image-guided embolization, not previously described, of a uterine arteriovenous malformation (AVM) resistant to endovascular management. The uterus was exposed surgically, and Histoacryl (Braun, Fulda, Germany) was injected directly into the nidus using ultrasound guidance and fluoroscopy. The patient had a successful full-term pregnancy after this procedure. This technique may be a useful alternative management strategy in patients with uterine AVM who fail traditional endovascular embolization and who still desire fertility.

  11. Classical caesarean section through the posterior uterine wall.

    PubMed

    Bolaji, I I; Rafla, N M; Mylotte, M J

    1992-02-01

    We report a case of myomectomy and classical caesarean section through the posterior uterine wall necessitated by 180 degrees dextro-rotation of a gravid uterus with large fibroids. The non-specific clinical course and rarity of pathological torsion of the gravid uterus makes the preoperative diagnosis difficult. Ultrasound recognition antenatally of a fibroid changing its position should help with the prediction preoperatively of uterine rotation.

  12. Endoscopic OCT for imaging of uterine body and cervix pathologies

    NASA Astrophysics Data System (ADS)

    Shakhova, Natalia M.; Kuznetzova, Irina N.; Gladkova, Natalia D.; Snopova, Ludmila; Gelikonov, Valentin M.; Gelikonov, Grigory V.; Feldchtein, Felix I.; Kuranov, Roman V.; Sergeev, Alexander M.

    1998-04-01

    First results of endoscopic applications of optical coherence tomography (OCT) in gynecology are presented. We have studied mucosa of uterus, uterine cervix and vagina in vivo. Images of healthy endometrium in different stages of menstrual cycle have been recorded. For uterine cervix not only OCT data of normal state but some kids of pathology have been analyzed. Capability of OCT to identify alterations of mucosa makes this method promising for early diagnosis of tumors and precise guiding of excisional biopsy.

  13. Uterine ALK3 is essential during the window of implantation

    PubMed Central

    Monsivais, Diana; Clementi, Caterina; Peng, Jia; Titus, Mary M.; Barrish, James P.; Creighton, Chad J.; Lydon, John P.; DeMayo, Francesco J.; Matzuk, Martin M.

    2016-01-01

    The window of implantation is defined by the inhibition of uterine epithelial proliferation, structural epithelial cell remodeling, and attenuated estrogen (E2) response. These changes occur via paracrine signaling between the uterine epithelium and stroma. Because implantation defects are a major cause of infertility in women, identifying these signaling pathways will improve infertility interventions. Bone morphogenetic proteins (BMPs) are TGF-β family members that regulate the postimplantation and midgestation stages of pregnancy. In this study, we discovered that signaling via activin-like kinase 3 (ALK3/BMPR1A), a BMP type 1 receptor, is necessary for blastocyst attachment. Conditional knockout (cKO) of ALK3 in the uterus was obtained by producing Alk3flox/flox-Pgr-cre–positive females. Alk3 cKO mice are sterile and have defects in the luminal uterine epithelium, including increased microvilli density and maintenance of apical cell polarity. Moreover, Alk3 cKO mice exhibit an elevated uterine E2 response and unopposed epithelial cell proliferation during the window of implantation. We determined that dual transcriptional regulation of Kruppel-like factor 15 (Klf15), by both the transforming growth factor β (TGF-β) transcription factor SMAD family member 4 (SMAD4) and progesterone receptor (PR), is necessary to inhibit uterine epithelial cell proliferation, a key step for embryo implantation. Our findings present a convergence of BMP and steroid hormone signaling pathways in the regulation of uterine receptivity. PMID:26721398

  14. Reproductive Outcome Following Hysteroscopic Treatment of Uterine Septum

    PubMed Central

    Esmaeilzadeh, Seddigheh; Delavar, Mouloud Agajani; Andarieh, Maryam Ghanbari

    2014-01-01

    Background: Septate uterus is the most common uterine anomaly and a cause for miscarriage and infertility. Existing data suggested a better reproductive outcome of uterine septum following hysteroscopic septum resection. Objective: Current study was administered to share our experience in hystroscopic septum resection for reproductive outcome following hysteroscopic treatment of uterine septum and specifically focusing on different treatment protocols after hysteroscopic septum resection. Methods& materials: This study was a cross-sectional study based on secondary data that was obtained from medical records of infertile women who had undergone transvaginal hysteroscopy and used different treatment protocols after hysteroscopic correction of uterine septum in Infertility and Reproductive Health Research Center between April 2005 and February 2014. Results: The total number of infertile women underwent hysteroscopy uterine septoplasty was 106. The hysteroscopy septoplasty resulted in an overall pregnancy rate of 67% and a live birth 57.5%. Pregnancy rate for patients who had not male infertility was 92.1%. The chi-square test did not reveal any statistically significant difference in side affect, pregnancy, live birth, abortion, preterm deliveries, and term deliveries rate between these patients either with consistent hormone therapy plus IUD insertion or with alternate hormone therapy plus IUD after hysteroscopic metroplasty. Conclusion: The findings of the present study indicated hysteroscopic septum resection to remove a uterine septum in women with infertility is safe and may be an efficacious procedure. Treatment following hysteroscopic septum resection, either the consistent or the alternate protocol is both beneficial to improve pregnancy rate. PMID:25685079

  15. Risk awareness on uterine cancer among Australian women.

    PubMed

    George, Mathew; Asab, Nihad Abu; Varughese, Elizabeth; Irwin, Matthew; Oldmeadow, Christopher; Hollebone, Keith; Apen, Kenneth; Renner, Stefan

    2014-01-01

    Uterine cancer is the most common invasive gynaecological cancer in Australia. Early detection is a key predictive factor achieved by increasing public awareness and participation in screening. This observational study measures awareness of gynaecological malignancies, particularly uterine, among women in two rural areas of New South Wales, Australia. Patients presenting to gynaecology clinics in January to March 2014 were invited to complete a structured questionnaire. Women with a history of cancer and incomplete questionnaires were excluded. Of the 382 patients invited to participate, 329 (86%) responded with complete feedback. Most respondents were younger than than 50 years (66%) and married with at least 2 children (74%). The majority (94%) of participants had no awareness of uterine cancer and many (46%) were unable to identify common risk factors including obesity, diabetes and hypertension. The ability to identify risk factors was correlated to age, marital status and obesity. The study identifies poor awareness on uterine malignancies in two typical areas of rural Australia. Although external validity is limited by sociological factors, poor awareness of uterine cancer among rural patients in this study represents a valid public health concern. It is imperative to improve awareness of uterine cancer and available screening programs to facilitate early detection and cure.

  16. Identification of uterine leiomyoma-specific marker genes based on DNA methylation and their clinical application

    PubMed Central

    Sato, Shun; Maekawa, Ryo; Yamagata, Yoshiaki; Tamura, Isao; Lee, Lifa; Okada, Maki; Jozaki, Kosuke; Asada, Hiromi; Tamura, Hiroshi; Sugino, Norihiro

    2016-01-01

    Differential diagnosis of uterine leiomyomas and leiomyosarcomas is needed to determine whether the uterus can be retained. Therefore, biomarkers for uterine leiomyomas, and reliable and objective diagnostic methods have been desired besides the pathological diagnosis. In the present study, we identified 12 genes specific to uterine leiomyomas based on DNA methylation. Using these marker genes specific to uterine leiomyomas, we established a hierarchical clustering system based on the DNA methylation level of the marker genes, which could completely differentiate between uterine leiomyomas and normal myometrium. Furthermore, our hierarchical clustering system completely discriminated uterine cancers and differentiated between uterine leiomyosarcomas and leiomyomas with more than 70% accuracy. In conclusion, this study identified DNA methylation-based marker genes specific to uterine leiomyomas, and our hierarchical clustering system using these marker genes was useful for differential diagnosis of uterine leiomyomas and leiomyosarcomas. PMID:27498619

  17. Blood lactate concentration as diagnostic predictors of uterine necrosis and its outcome in dairy cows with uterine torsion

    PubMed Central

    MURAKAMI, Takashi; NAKAO, Shigeru; SATO, Yohei; NAKADA, Satoshi; SATO, Akane; MUKAI, Shuhei; KOBAYASHI, Masanori; YAMADA, Yutaka; KAWAKAMI, Eiichi

    2017-01-01

    In order to determine blood lactate concentrations (bLac) and their validity as a diagnostic marker in bovine uterine torsion, blood samples were taken from 54 Holstein cows with uterine torsion before the correction of torsion. bLac in a group of cows with and without uterine necrosis were 15.0 and 3.0 mmol/l, respectively (P<0.01). Moreover, bLac in a group of dead or culled dams and in that of survived dams were 10.2 and 3.1 mmol/l, respectively (P<0.01). Furthermore, the proposed diagnostic cutoffs for bLac based on ROC analysis for detection of uterine necrosis and poor prognosis in dams were set at >5.0 and >6.5 mmol/l, respectively. These findings suggest that in dairy cows with uterine torsion, an increase in bLac is a diagnostic predictor of uterine necrosis as well as poor prognosis in dams. PMID:28163266

  18. A patient-preference cohort study of office versus inpatient uterine polyp treatment for abnormal uterine bleeding.

    PubMed

    Cooper, Natalie A M; Middleton, Lee; Smith, Paul; Denny, Elaine; Stobert, Lynda; Daniels, Jane; Clark, T Justin

    2016-01-01

    Uterine polyps can cause abnormal bleeding in women. Conventional practise is to remove them under general anaesthesia but advances in technology have made it possible to perform polypectomy in the office setting. We conducted a patient-preference study to explore women's preferences for treatment setting and to evaluate the effectiveness and treatment experience of women undergoing uterine polypectomy. Three hundred ninety-nine women with abnormal uterine bleeding who were found to have uterine polyps at diagnostic hysteroscopy were recruited. Office polypectomies were performed in office hysteroscopy clinics, and inpatient procedures were undertaken in operating theatres. Three hundred twenty-four of 399 (81 %) expressed a preference for office treatment. There was no difference found between office treatment and inpatient treatment in terms of alleviating abnormal uterine bleeding as assessed by patients and in improving disease-specific quality of life. Acceptability was lower and patient pain scores were significantly higher in the office group. When offered a choice of treatment setting for uterine polypectomy, patients have a preference for office over inpatient treatment. Ambulatory gynaecology services should be available within healthcare systems to meet patient demand.

  19. [Intra-uterine device and nulliparous women].

    PubMed

    Trignol-Viguier, N; Blin, E; Marret, H

    2014-06-01

    Intra-uterine device (IUD) is one of the birth control methods, which is available for nulliparous women, even though misconceptions still remain in medical or popular opinion. Only 1.3 % of nulliparous have a IUD as contraception in France while it is the second methods used by all women, after pill. The best contraception is the one chosen by women; however, the choice for a nulliparous of an IUD may be really difficult, despite the increasing number of women wishing to use it. Long-acting reversible contraceptives utilization, including IUD, is probably one of the issues to decrease the unintended pregnancies. An exhaustive and clear information about IUD is necessary to allow an informed and real choice. This prescription must consider contraindications and medical conditions for safe insertion, especially to avoid infection by screening STD (Chlamydia trachomatis and Nesseria gonorrhoeae) in nulliparous women<25 years old. Insertion must be effected with usual precautions and short or SL IUD preferred. Even if side effects such as expulsion, pelvic pains or dysmenorrhea are more frequent by nulliparous, IUD is a first intention choice for contraception to be consider, that women could obtain easily, including in emergency contraception situation.

  20. Cell culture and senescence in uterine fibroids.

    PubMed

    Markowski, Dominique Nadine; Bartnitzke, Sabine; Belge, Gazanfer; Drieschner, Norbert; Helmke, Burkhard Maria; Bullerdiek, Jörn

    2010-10-01

    The in vitro growth of cells from uterine fibroids is characterized by an early onset of senescence. Often, an even lower growth potential than that of matching myometrial cells is noted. Also, the tremendous differences in the expression of the high mobility group protein HMGA2 seen when comparing fibroids of different genetic subtypes are surprisingly not reflected by significant differences in their growth potential in vitro. We aimed to evaluate possible changes of the HMGA2 expression level between the native tissue and cell cultures, so we performed quantitative real-time polymerase chain reaction studies that revealed a marked decrease of the HMGA2 mRNA in culture in those cases with overexpression of HMGA2. In the two cases initially showing the highest expression, it decreased by approximately 97%. Associated with the decrease of HMGA2 was a clearly increased expression of the senescence-associated p19(Arf). Together, these findings explain the similar behavior of cell cultures from fibroids of different genetic subgroups and may also offer an explanation for the early onset of in vitro senescence in these cell cultures.

  1. Automated image analysis of uterine cervical images

    NASA Astrophysics Data System (ADS)

    Li, Wenjing; Gu, Jia; Ferris, Daron; Poirson, Allen

    2007-03-01

    Cervical Cancer is the second most common cancer among women worldwide and the leading cause of cancer mortality of women in developing countries. If detected early and treated adequately, cervical cancer can be virtually prevented. Cervical precursor lesions and invasive cancer exhibit certain morphologic features that can be identified during a visual inspection exam. Digital imaging technologies allow us to assist the physician with a Computer-Aided Diagnosis (CAD) system. In colposcopy, epithelium that turns white after application of acetic acid is called acetowhite epithelium. Acetowhite epithelium is one of the major diagnostic features observed in detecting cancer and pre-cancerous regions. Automatic extraction of acetowhite regions from cervical images has been a challenging task due to specular reflection, various illumination conditions, and most importantly, large intra-patient variation. This paper presents a multi-step acetowhite region detection system to analyze the acetowhite lesions in cervical images automatically. First, the system calibrates the color of the cervical images to be independent of screening devices. Second, the anatomy of the uterine cervix is analyzed in terms of cervix region, external os region, columnar region, and squamous region. Third, the squamous region is further analyzed and subregions based on three levels of acetowhite are identified. The extracted acetowhite regions are accompanied by color scores to indicate the different levels of acetowhite. The system has been evaluated by 40 human subjects' data and demonstrates high correlation with experts' annotations.

  2. A Mouse Model of Uterine Leiomyosarcoma

    PubMed Central

    Politi, Katerina; Szabolcs, Matthias; Fisher, Peter; Kljuic, Ana; Ludwig, Thomas; Efstratiadis, Argiris

    2004-01-01

    We are using an approach that is based on the cre/loxP recombination process and involves a binary system of Cre-producing and Cre-responding transgenic mice to achieve ubiquitous or tissue-specific expression of oncoproteins. To develop mouse models of tumorigenesis, Cre-producers are mated with responder animals carrying a dormant oncogene targeted into the 3′ untranslated region of the locus encoding cytoplasmic β-actin (actin cassette). Production of oncoprotein from a bicistronic message is accomplished in bitransgenic progeny by Cre-mediated excision of a segment flanked by loxP sites that is located upstream from the oncogenic sequence. Widespread Cre-dependent activation and expression of an actin-cassette transgene encoding the T antigens of the SV40 early region (SVER) commencing in embryos was compatible with normal development and did not impair viability. However, at ∼3 months of age, all female animals developed massive uterine leiomyosarcomas, whereas practically all males exhibited enormously enlarged seminal vesicles because of pronounced hyperplasia of the smooth muscle layers. In addition, because of smooth muscle hyperproliferation, marked dilation of the gallbladder was observed in mice of both sexes. To begin exploring aberrant signaling events in the SVER-triggered tumorigenic pathways, we analyzed the expression profile of leiomyosarcomas by DNA microarray analysis. PMID:14695345

  3. Contributions to myometrium study in uterine-tubal junction.

    PubMed

    Neamţu, M C; Neamţu, R L; Avramescu, Elena Taina; Vrabete, Maria; Călina, Lucia Mirela; Mîndrilă, I

    2009-01-01

    Complex coordinated contractions of the tubal musculature are thought to be important for movement of the ovum from the distal end to the proximal end of the tube, while at the same time aiding in the movement of sperm from the proximal end to the distal end of the oviduct. Studies of the anatomy and the physiology of the uterine-tubal junction (UTJ), with a main concern for the muscular pattern and the secretory activity of this part of the tube, in relation with the hormonal and nervous control, can play an important role in understanding and impairment of infertility. Related to these aspects, the purpose of our research is mainly to identify the determining factors in maintaining a morphological and structural balance between contractile items and extracellular matrix items within uterine myometrium, particularly uterine-tubal junction. For this reason, the present study includes analyses of anatomical sections within uterus and uterine tubes extracted from patients during therapeutic surgeries. Thirty anatomical pieces from patients aged 23-37-year-old (uterus and tubes) were used to perform microanatomical sections, 10 pieces for each pathology identified, namely leiomyofibroma, leiomyofibroma with pregnancy, ectopic pregnancies. At the same time, the study proposes a statistic and mathematic analysis of the cases with uterine-tubal junction pathology in Oltenia region within a period of 10 years. The novelty of the study is represented by the identification of certain continuity ratios between myocyte fascicles and average tunica of arteries and arterioles, which explains the existence of "vascular units" determined by myometrial structures. Moreover, the stereo-distribution of "vascular myometrial units" explains the existence of a plexiform cavernous network, which enables many authors to describe numerous barely individualized myometrial tunicas. These units are rich in orthosympathetic vegetative innervations that might be responsible for the unfavorable

  4. Mitral valve regurgitation due to annular dilatation caused by a huge and floating left atrial myxoma

    PubMed Central

    Ersoy, Burak; Yeniterzi, Mehmet

    2015-01-01

    We describe a case of mitral valve annular dilatation caused by a huge left atrial myxoma obstructing the mitral valve orifice. A 50-year-old man presenting with palpitation was found to have a huge left atrial myxoma protruding into the left ventricle during diastole, causing severe mitral regurgitation. The diagnosis was made with echocardiogram. Transoesophageal echocardiography revealed a solid mass of 75 × 55 mm. During operation, the myxoma was completely removed from its attachment in the atrium. We preferred to place a mechanical heart valve after an annuloplasty ring because of severely dilated mitral annulus and chordae elongation. The patient had an uneventful recovery. Our case suggests that immediate surgery, careful evaluation of mitral valve annulus preoperatively is recommended. PMID:26702283

  5. A New Pixels Flipping Method for Huge Watermarking Capacity of the Invoice Font Image

    PubMed Central

    Li, Li; Hou, Qingzheng; Lu, Jianfeng; Dai, Junping; Mao, Xiaoyang; Chang, Chin-Chen

    2014-01-01

    Invoice printing just has two-color printing, so invoice font image can be seen as binary image. To embed watermarks into invoice image, the pixels need to be flipped. The more huge the watermark is, the more the pixels need to be flipped. We proposed a new pixels flipping method in invoice image for huge watermarking capacity. The pixels flipping method includes one novel interpolation method for binary image, one flippable pixels evaluation mechanism, and one denoising method based on gravity center and chaos degree. The proposed interpolation method ensures that the invoice image keeps features well after scaling. The flippable pixels evaluation mechanism ensures that the pixels keep better connectivity and smoothness and the pattern has highest structural similarity after flipping. The proposed denoising method makes invoice font image smoother and fiter for human vision. Experiments show that the proposed flipping method not only keeps the invoice font structure well but also improves watermarking capacity. PMID:25489606

  6. Resection of huge retrosternal goiter through a novel combined cervical and robot-assisted approach.

    PubMed

    Wang, Shumin; Xu, Shiguang; Liu, Bo

    2014-05-01

    A 53-year-old man was referred to our department with a history of cough, especially at night, for 3 months. He was found to have a huge retrosternal goiter. We applied a novel combined cervical and robot-assisted approach to resect this difficult goiter. Using the da Vinci robot system, the intrathoracic part of the goiter was dissected and mobilized completely from the mediastinum to the inlet of the thorax. The dissected part of the goiter was left in the thorax. A right cervical half-collar incision about 6 cm was then performed. The goiter was finally removed from the neck incision. Histopathologic examination reported a multinodular goiter. By the method shown in the case, resection of huge retrosternal goiters through a combined cervical and robot-assisted approach is feasible and safe. This method provides an alternative option to the more invasive traditional approaches.

  7. Huge gastric diospyrobezoars successfully treated by oral intake and endoscopic injection of Coca-Cola.

    PubMed

    Chung, Y W; Han, D S; Park, Y K; Son, B K; Paik, C H; Jeon, Y C; Sohn, J H

    2006-07-01

    A diospyrobezoar is a type of phytobezoar that is considered to be harder than any other types of phytobezoars. Here, we describe a new treatment modality, which effectively and easily disrupted huge gastric diospyrobezoars. A 41-year-old man with a history of diabetes mellitus was admitted with lower abdominal pain and vomiting. Upper gastrointestinal endoscopy revealed three huge, round diospyrobezoars in the stomach. He was made to drink two cans of Coca-Cola every 6 h. At endoscopy the next day, the bezoars were partially dissolved and turned to be softened. We performed direct endoscopic injection of Coca-Cola into each bezoar. At repeated endoscopy the next day, the bezoars were completely dissolved.

  8. Crystallization of a Keplerate-type polyoxometalate into a superposed kagome-lattice with huge channels.

    PubMed

    Saito, Masaki; Ozeki, Tomoji

    2012-09-07

    Crystal structures of two Sr(2+) salts of the Keplerate-type polyoxometalate, [Mo(VI)(72)Mo(V)(60)O(372)(CH(3)COO)(30)(H(2)O)(72)](42-), have been determined by single crystal X-ray diffraction. One compound exhibits a superposed kagome-lattice with huge channels whose diameters measure approximately 3.0 nm, while the arrangement of the Keplerate anions in the other compound approximates to a distorted cubic close packing.

  9. Transcatheter Closure of Bilateral Multiple Huge Pulmonary Arteriovenous Malformations with Homemade Double-Umbrella Occluders

    SciTech Connect

    Zhong Hongshan Xu Ke; Shao Haibo

    2008-07-15

    A 28-year-old man underwent successful transcatheter occlusion of three huge pulmonary arteriovenous malformations (PAVMs) using homemade double-umbrella occluders and stainless steel coils. Thoracic CT with three-dimensional reconstruction and pulmonary angiography were used for treatment planning and follow-up. The diameters of the feeding vessels were 11 mm, 13 mm, and 14 mm, respectively. This report demonstrates the novel design and utility of the double-umbrella occluder, an alternative tool for treatment of large PAVMs.

  10. Human uterine stem/progenitor cells: their possible role in uterine physiology and pathology.

    PubMed

    Maruyama, Tetsuo; Masuda, Hirotaka; Ono, Masanori; Kajitani, Takashi; Yoshimura, Yasunori

    2010-07-01

    The human uterus mainly consists of the endometrium and the outer smooth muscle layer termed the myometrium. The uterus harbours the exceptional and remarkable regenerative ability responsible for cyclical regeneration and remodelling throughout the reproductive life. The uterus must swiftly and cooperatively enlarge to hold the growing foetus during pregnancy. Furthermore, the endometrium, in particular the functionalis layer, must also regenerate, differentiate and regress with each menstrual cycle under hormonal control. Endometrial regeneration from the basal layer is thought to contribute to replacement of the functionalis layer followed by its slough off during menses and parturition. These morphological and functional features of human endometrium can be reproduced in murine models in which severely immunodeficient mice are xenotransplanted with dispersed human endometrial cells under the kidney capsule. The uterine myometrium possesses the similar plasticity of the endometrium. This is demonstrated by multiple cycles of pregnancy-induced enlargement and regression after parturition. It is likely that regeneration and remodelling in the female reproductive tract are achieved presumably through endometrial and myometrial stem cell systems. Recent evidence now supports the existence of these stem cell systems in humans. Here, we will review our current understanding of uterine stem/progenitor cells. We also propose a novel hypothetical model in which stem cell activities explain the physiological remodelling and regeneration of the human uterus and the pathogenesis of gynaecological diseases such as endometriosis.

  11. Tracking the epidemiology of human genes in the literature: the HuGE Published Literature database.

    PubMed

    Lin, Bruce K; Clyne, Melinda; Walsh, Matthew; Gomez, Onnalee; Yu, Wei; Gwinn, Marta; Khoury, Muin J

    2006-07-01

    Completion of the human genome sequence has inspired a new wave of epidemiologic studies on the prevalence of gene variants and their associations with diseases in human populations. In 2001, the Human Genome Epidemiology (HuGE) Network launched the HuGE Published Literature database (HuGE Pub Lit), a searchable, online knowledge base of published, population-based epidemiologic studies of human genes. The database contains links to PubMed articles and can be searched by gene, disease, interacting factor, type of study design or analysis, or any combination of terms in these categories. The search output contains a link to each identified article, along with a table summarizing key features of the reported study. As of September 6, 2005, some 17,665 articles were indexed in the database. Most described gene-disease associations (86%); fewer evaluated gene-gene or gene-environment interactions (17%), the prevalence of gene variants (10%), or genetic tests (3%). Although not comprehensive, this database is a unique tool for epidemiologic researchers and others concerned with the role of genetic variation in population health. Here, the authors provide an overview of the database and its characteristics and uses.

  12. Field investigation of a vibration monitoring wireless sensor network on a huge cantilever structure

    NASA Astrophysics Data System (ADS)

    Zhou, H. F.; Liu, J. L.; Ni, Y. Q.; Zhu, D. P.

    2011-04-01

    To advance wireless structural monitoring systems mature into a reliable substitute to wired structural monitoring systems, efforts should be paid to investigate their in-field performance on real civil structures, especially complex mega structures. This study carries out an investigation into a vibration monitoring wireless sensor network (WSN) for modal identification of a huge cantilever structure. The testbed under study is the New Headquarters of Shenzhen Stock Exchange (NHSSE). One outstanding feature of NHSSE is its huge floating platform, which is a steel truss structure with an overall plan dimension of 98x162 m and a total height of 24 m. It overhangs from the main tower 36 m along the long axis and 22 m along the short axis at a height of 36 m above the ground, making it the largest cantilever structure in the world. Recognizing the uniqueness of this floating platform, the performance of the WSN for ambient vibration measurement of this structure is examined. A preliminary two-point simultaneous acceleration measurement using the WSN is reported in this paper. The preliminary study demonstrates that the WSN is capable of measuring the ambient vibration and identifying the modal properties of a huge cantilever structure.

  13. Effect of uterine size on fertility of lactating dairy cows.

    PubMed

    Baez, Giovanni M; Barletta, Rafael V; Guenther, Jerry N; Gaska, Jerry M; Wiltbank, Milo C

    2016-05-01

    There are multiple reasons for reduced fertility in lactating dairy cows. We hypothesized that one cause of reduced fertility could be the overall size of the reproductive tract, particularly the uterus, given well-established uterine functions in many aspects of the reproductive process. Thus, the objectives of this study were to evaluate the variability in uterine size in primiparous and multiparous dairy cows and to analyze whether there was an association between uterine size and fertility, particularly within a given parity. Lactating Holstein dairy cows (n = 704) were synchronized to receive timed artificial insemination (TAI) on Day 81 ± 3 of lactation by using the Double-Ovsynch protocol (GnRH-7d-PGF-3d-GnRH-7d-GnRH-7d-PGF-56h-GnRH-16h-TAI). At the time of the last injection of PGF, uterine diameter was determined at the greater curvature using ultrasound, uterine length was determined by rectal palpation, and uterine volume was calculated from these two measurements. Blood samples were also taken to measure progesterone to assure synchronization of all cows used in the final analysis (n = 616; primiparous, n = 289; multiparous, n = 327). Primiparous cows had greater percentage pregnant/AI (P/AI) compared to multiparous cows (49.8% vs. 39.1% at 67 days of pregnancy diagnosis, P = 0.009). Diameter, length, and volume of the uterus were larger in multiparous than in primiparous cows (P < 0.001). For multiparous cows, uterine diameter and volume were smaller in cows that became pregnant compared to cows that were not pregnant to the TAI with a similar tendency observed in primiparous cows. Logistic regression and quartile analysis also showed that as uterine volume increased, there was decreased P/AI in either primiparous or multiparous cows. Thus, there is a negative association between uterine size and fertility in lactating dairy cows with a larger uterus associated with reduced fertility, particularly for multiparous cows.

  14. Role of nuclear progesterone receptor isoforms in uterine pathophysiology

    PubMed Central

    Patel, Bansari; Elguero, Sonia; Thakore, Suruchi; Dahoud, Wissam; Bedaiwy, Mohamed; Mesiano, Sam

    2015-01-01

    BACKGROUND Progesterone is a key hormonal regulator of the female reproductive system. It plays a major role to prepare the uterus for implantation and in the establishment and maintenance of pregnancy. Actions of progesterone on the uterine tissues (endometrium, myometrium and cervix) are mediated by the combined effects of two progesterone receptor (PR) isoforms, designated PR-A and PR-B. Both receptors function primarily as ligand-activated transcription factors. Progesterone action on the uterine tissues is qualitatively and quantitatively determined by the relative levels and transcriptional activities of PR-A and PR-B. The transcriptional activity of the PR isoforms is affected by specific transcriptional coregulators and by PR post-translational modifications that affect gene promoter targeting. In this context, appropriate temporal and cell-specific expression and function of PR-A and PR-B are critical for normal uterine function. METHODS Relevant studies describing the role of PRs in uterine physiology and pathology (endometriosis, uterine leiomyoma, endometrial cancer, cervical cancer and recurrent pregnancy loss) were comprehensively searched using PubMed, Cochrane Library, Web of Science, and Google Scholar and critically reviewed. RESULTS Progesterone, acting through PR-A and PR-B, regulates the development and function of the endometrium and induces changes in cells essential for implantation and the establishment and maintenance of pregnancy. During pregnancy, progesterone via the PRs promotes myometrial relaxation and cervical closure. Withdrawal of PR-mediated progesterone signaling triggers menstruation and parturition. PR-mediated progesterone signaling is anti-mitogenic in endometrial epithelial cells, and as such, mitigates the tropic effects of estrogen on eutopic normal endometrium, and on ectopic implants in endometriosis. Similarly, ligand-activated PRs function as tumor suppressors in endometrial cancer cells through inhibition of key

  15. Magnetic Resonance Elastography of Uterine Leiomyomas: A Feasibility Study

    PubMed Central

    Stewart, Elizabeth A.; Taran, F. Andrei; Chen, Jun; Gostout, Bobbie S.; Woodrum, David A.; Felmlee, Joel P.; Ehman, Richard L.

    2010-01-01

    Objective To determine the feasibility of performing in vivo magnetic resonance elastography (MRE) for uterine leiomyoma. Design Pilot study Setting Academic Medical Center Patients Six subjects planning surgical excision of uterine leiomyomas. Intervention MRE prior to planned surgery Main Outcome Measures Achieving an appropriate phase signal to noise ratio (PSNR) in the leiomyoma to allow assessment of leiomyoma elasticity in kilo pascals (kPa). Results MRE was successful in all subjects for uteri ranging from 100 to over 1000 grams. Subjects had body mass indices (BMIs) ranging from 23.0 to 38.0 kg/m2. Appropriate PSNR ranging from 5.45 to 42.28 were achieved for leiomyomas in all subjects. Mean elasticity of uterine leiomyomas ranged from 3.95 to 6.68 kPa. Conclusion(s) MRE is a feasible technique for studying the in vivo mechanical properties of uterine leiomyomas and demonstrates significant heterogeneity in elasticity between lesions. Further work is necessary to optimize the technique and understand the clinical utility of this technique for women with uterine leiomyomas. PMID:20633880

  16. Prognostic features of surgical stage I uterine carcinosarcoma.

    PubMed

    Ferguson, Sarah E; Tornos, Carmen; Hummer, Amanda; Barakat, Richard R; Soslow, Robert A

    2007-11-01

    Uterine carcinosarcomas (CSs) are aggressive neoplasms, with 5-year overall survival (OS) rates of less than 35%. They are customarily separated into types harboring either heterologous or homologous mesenchymal elements, but the prognostic significance of this finding is controversial. Our goal was to study clinicopathologic features of possible prognostic relevance in surgical stage I uterine CS. A retrospective clinical and histopathologic review was performed for all women diagnosed with surgical stage I uterine CS. These tumors were compared with stage I high-grade endometrial (HGEm) carcinomas for clinical outcomes. There were 42 cases of surgical stage I uterine CS identified between January 1990 and January 2004. The disease-free survival and OS rates for patients with stage I CS were significantly worse compared with stage I HGEm (P=0.001; P=0.01). The median disease-free survival for patients with heterologous CS was 15 months and had not been reached for women with homologous CS (P=0.001). The 3-year OS rates were 45% versus 93% in women with heterologous compared with homologous stage I CS (P<0.001). The 3-year OS rates for homologous CS and HGEm were both >90%. Homologous stage I CSs have survival outcomes that are similar to HGEm. This further supports the concept that homologous stage I CSs are carcinomas with sarcomatoid features, not sarcomas. More importantly, the presence of heterologous sarcomatous elements is a powerful negative prognostic factor in surgical stage I uterine CS.

  17. Modeling embryo transfer into a closed uterine cavity.

    PubMed

    Yaniv, Sarit; Jaffa, Ariel J; Elad, David

    2012-11-01

    Embryo transfer (ET) is the last manual intervention after extracorporeal fertilization. After the ET procedure is completed, the embryos are conveyed in the uterus for another two to four days due to spontaneous uterine peristalsis until the window time for implantation. The role of intrauterine fluid flow patterns in transporting the embryos to their implantation site during and after ET was simulated by injection of a liquid bolus into a two-dimensional liquid-filled channel with a closed fundal end via a liquid-filled catheter inserted in the channel. Numerical experiments revealed that the intrauterine fluid field and the embryos transport pattern were strongly affected by the closed fundal end. The embryos re-circulated in small loops around the vicinity where they were deposited from the catheter. The transport pattern was controlled by the uterine peristalsis factors, such as amplitude and frequency of the uterine walls motility, as well as the synchronization between the onset of catheter discharge and uterine peristalsis. The outcome of ET was also dependent on operating parameters such as placement of the catheter tip within the uterine cavity and the delivery speed of the catheter load. In conclusion, this modeling study highlighted important parameters that should be considered during ET procedures in order to increase the potential for pregnancy success.

  18. Embolization of Uterine Arteriovenous Malformations Associated with Cyanotic Congenital Heart Disease

    SciTech Connect

    Wijesekera, N. T. Padley, S. P.; Kazmi, F.; Davies, C. L.; McCall, J. M.

    2009-09-15

    Uterine arteriovenous malformation (AVM) is a rare cause of vaginal bleeding and miscarriage. We report two cases of uterine AVMs in patients with a history of complex congenital heart disease, an association that has not been previously described. Both patients were treated by selective uterine artery embolization, a minimally invasive therapy that has revolutionized the management of uterine AVMs, thus offering an alternative to conventional hysterectomy.

  19. Monochorionic twin delivery after conservative surgical treatment of a patient with severe diffuse uterine adenomyosis without uterine rupture

    PubMed Central

    Kwack, Jae Young; Jeon, Su-Bun; Kim, Keuna; Lee, Soo-Jeong

    2016-01-01

    A 31-year-old nulliparous woman with severe diffuse uterine adenomyosis, which replaced nearly the whole uterine myometrium, visited our hospital due to severe dysmenorrhea, menorrhagia, and a desire to have a baby. The patient had a history of two spontaneous abortions. Laparotomic adenomyomectomy with transient occlusion of uterine arteries (TOUA) was performed safely and the patient tried in vitro fertilization and achieved a intrauterine twin pregnancy after recovery time of the operation. At 31+6 weeks of gestation, a male neonate baby weighing 1,620 g and a male neonate baby weighing 1,480 g were born by transverse lower segment cesarean delivery. There was no complication after the operation. The babies were discharged after receiving routine neonatal intensive care for neonatal respiratory distress syndrome. Adenomyomectomy with TOUA technique would be an option for conservative surgical treatment in patients with severe diffuse whole uterine adenomyosis. This is the first report of twin pregnancy after diffuse whole uterine adenomyomectomy with TOUA. PMID:27462599

  20. Home uterine monitoring: a case of telemedicine failure?

    PubMed

    Urquhart, Christine; Currell, Rosemary

    2010-09-01

    The aim of the article is to explore and explain some of the controversies around home uterine monitoring, using a socio-technical interaction networks (STIN) approach. A Cochrane systematic review identified 15 included studies. A critique of these studies, using the eight components of the STIN framework, illustrated very clearly the different assumptions made about the purpose of home uterine monitoring, and helped to explain the different outcomes. The final mapping stage suggested that systems architecture choices included that of the role of monitoring support, to complement patient education or to enhance education for provider and patient. A similar choice concerned the type and extent of patient-care-provider contacts to be used. Using the STIN framework provided a useful perspective on the telemedicine aspects of home uterine monitoring, providing value beyond the systematic review conclusions alone.

  1. Influence of preovulatory estradiol on conceptus survival and uterine glucose transporter expression

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Glucose is an essential component of uterine secretions, and is delivered into the uterine lumen by glucose transporters. We have previously reported increased concentrations of glucose in uterine flushes of cows that exhibited estrus. Our objective in the present study was to determine the effects...

  2. Development and Characterization of Uterine Glandular Epithelium Specific Androgen Receptor Knockout Mouse Model.

    PubMed

    Choi, Jaesung Peter; Zheng, Yu; Skulte, Katherine A; Handelsman, David J; Simanainen, Ulla

    2015-11-01

    While estrogen action is the major driver of uterine development, androgens acting via the androgen receptor (AR) may also promote uterine growth as suggested by uterine phenotypes in global AR knockout (ARKO) female mice. Because AR is expressed in uterine endometrial glands, we generated (Cre/loxP) uterine gland epithelium-specific ARKO (ugeARKO) to determine the role of endometrial gland-specific androgen actions. However, AR in uterine gland epithelium may not be required for normal uterine development and function because ugeARKO females had normal uterine development and fertility. To determine if exogenous androgens acting via AR can fully support uterine growth in the absence of estrogens, the ARKO and ugeARKO females were ovariectomized and treated with supraphysiological doses of testosterone or dihydrotestosterone (nonaromatizable androgen). Both dihydrotestosterone and testosterone supported full uterine regrowth in wild-type females while ARKO females had no regrowth (comparable to ovariectomized only). These findings suggest that androgens acting via AR can promote full uterine regrowth in the absence of estrogens. The ugeARKO had 50% regrowth when compared to intact uterine glands, and histomorphologically, both the endometrial and myometrial areas were significantly (P < 0.05) reduced, suggesting glandular epithelial AR located in the endometrium may indirectly modify myometrial development. Additionally, to confirm Cre function in endometrial glands, we generated uge-specific PTEN knockout mouse model. The ugePTEN knockout females developed severe endometrial hyperplasia and therefore present a novel model for future research.

  3. Experimental investigations in hamsters and rabbits with DNA extracted from human uterine tumors.

    PubMed

    Nastac, E; Athanasiu, P; Predescu, E; Stoian, M; Hozoc, M; Perju, A

    1980-01-01

    Experimental inoculation of a DNA preparation extracted from a fragment of non-irradiated human uterine cervix carcinoma was followed by the appearance of neoplasia in four hamsters and of lymphosarcoma in one rabbit. Similar DNA preparations obtained from three cases of irradiated human uterine cervix carcinoma and from a human uterine fibroma proved to have no biological activity.

  4. Placental accommodations for transport and metabolism during intra-uterine crowding in pigs

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Litter size and birth weights are limited by uterine capacity, defined as the ability of the uterus to maintain the appropriate development of some number of conceptuses. Uterine capacity is the result of the combined effects of uterine, placental and embryo/fetal function. The number of living conc...

  5. Patient Presentation and Management of Labial Ulceration Following Uterine Artery Embolization

    SciTech Connect

    Gonsalves, Carin Franciosa, Stefan V.; Shah, Suken; Bonn, Joseph; Wu, Christine

    2007-11-15

    Uterine artery embolization is a safe and effective procedure for the treatment of symptomatic uterine fibroids. Nontarget embolization of adjacent internal iliac artery branches is a reported complication of uterine artery embolization. The following report describes the presentation and management of ulcerations of the labium minora due to nontarget embolization of the internal pudendal artery.

  6. MR Venography of Deep Veins: Changes with Uterine Fibroid Embolization

    SciTech Connect

    Katsumori, Tetsuya Kasahara, Toshiyuki; Tsuchida, Yoko; Nara, Yoshinori

    2009-03-15

    Deep veins (DVs) can be compressed by a uterus enlarged with fibroids. The purpose of this study was to assess the degree of luminal narrowing of DVs caused by a myomatous uterus, and the change in DV narrowing in women with symptomatic fibroids after embolization using time-of-flight (TOF)-magnetic resonance venography (MRV). Twenty-nine consecutive women with symptomatic uterine fibroids underwent TOF-MRV and pelvic MRI before and 4 months after embolization. Based on the TOF-MRV, we evaluated the luminal narrowing of three DVs, including the inferior vena cava, and the bilateral common and external iliac veins, and divided the findings into three grades. The scores for each DV were added for each patient (lowest, 0; highest, 6). DV scores and symptom severity (SS) scores were compared between the baseline and 4 months after embolization using the paired t-test. The relationship between DV scores and uterine volume was investigated using Pearson's test. DV scores decreased significantly, from 1.52 {+-} 1.70 at baseline to 0.93 {+-} 1.56 at 4 months after embolization (p = 0.004). The uterine volume decreased from 948 {+-} 647 mL at baseline to 617 {+-} 417 mL at 4 months after embolization (p < 0.001). DV score correlated with uterine volume (r = 0.856, p < 0.001). SS scores decreased from 54.5 {+-} 14.6 at baseline to 26.8 {+-} 15.4 at 4 months after embolization (p < 0.001). In conclusion, the degree of luminal narrowing of DVs caused by a uterus with fibroids is correlated with the uterine volume. Uterine artery embolization may induce an improvement of luminal narrowing of DVs due to a reduction of the myomatous uterus volume.

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

    PubMed

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

    2014-06-01

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

  8. Spontaneous Uterine Perforation Caused by Pyometra: A Case Report

    PubMed Central

    Yousefi, Zohreh; Sharifi, Noorieh; Morshedy, Maryam

    2014-01-01

    Introduction: Pyometra is an accumulation of purulent material or pus in the uterine cavity. Spontaneous perforation of uterus by pyometra is rare. This is a clinical presentation and management of a spontaneous perforation of uterine caused by pyometra. Case Presentation: This is a case report on spontaneously perforated associated with pyometra secondary to cervical malignancy. The patient underwent exploratory laparotomy with total hysterectomy and bilateral salpingo-oophorectomy. Conclusions: Spontaneous rupture of pyometra duo to cervical cancer in cases of acute abdomen in elderly patients should be considered. PMID:25593714

  9. Transvaginal Ultrasound for the Diagnosis of Abnormal Uterine Bleeding.

    PubMed

    Wheeler, Karen C; Goldstein, Steven R

    2017-03-01

    Transvaginal ultrasound is the first-line imaging test for the evaluation of abnormal uterine bleeding in both premenopausal and postmenopausal women. Transvaginal ultrasound can be used to diagnose structural causes of abnormal bleeding such as polyps, adenomyosis, leiomyomas, hyperplasia, and malignancy, and can also be beneficial in making the diagnosis of ovulatory dysfunction. Traditional 2-dimensional imaging is often enhanced by the addition of 3-dimension imaging with coronal reconstruction and saline infusion sonohysterography. In this article we discuss specific ultrasound findings and technical considerations useful in the diagnosis of abnormal uterine bleeding.

  10. Bacterial complications of postpartum uterine involution in cattle.

    PubMed

    Földi, J; Kulcsár, M; Pécsi, A; Huyghe, B; de Sa, C; Lohuis, J A C M; Cox, P; Huszenicza, Gy

    2006-12-01

    The bacterial contamination of the postpartum uterus is a frequent finding which by itself does not disturb the anatomical and histological restoration of tubular genital tract. The improper balance between uterine infection and the intrauterine antimicrobial self-defence mechanisms, however, often results in complications, such as puerperal metritis, clinical endometritis, pyometra and subclinical endometritis. After reviewing the bacteriology of uterine involution, and the predisposing factors for its bacterial complications, this paper defines the different clinical forms, and summarizes their pathology, furthermore, the recent progress in diagnostic considerations and principles of current treatments for these diseases of bovine genitals.

  11. Uterine angioleiomyoma: A rare variant of uterine leiomyoma--A case report and literature review.

    PubMed

    Diwaker, Preeti; Pradhan, Dinesh; Garg, Garima; Bisaria, Dipti; Gogoi, Kamakhya; Mohanty, Sambit K

    2015-01-01

    Uterine angioleiomyoma (AL) is an extremely rare variant of leiomyoma and only 15 cases have been reported till date. Herein we present a case of AL of the uterus in a 39-year-old multiparous female with polymenorrhagia and pain abdomen. A pelvic ultrasonogram showed a large heterogeneously hypoechoic intramural nodule in the posterior myometrium. The patient underwent a total abdominal hysterectomy. Histological examination of the nodule revealed a moderately cellular spindle cell tumor composed of interlacing fascicles of spindle to plump cells swirling around the thick walled vessels. No hypercellularity, pleomorphism, mitotic figures, or necrosis was identified. The spindle to plump cells showed strong and diffuse immunoreactivity for smooth muscle actin, desmin and progesterone receptor, focal and weak positivity for CD10 and estrogen receptor and were negative for CD34 and HMB-45. The Ki-67 labeling index was low (1%). A diagnosis of AL was offered. The patient is on follow up for over 10 months and is asymptomatic.

  12. Design of a superluminal ring laser gyroscope using multilayer optical coatings with huge group delay.

    PubMed

    Qu, Tianliang; Yang, Kaiyong; Han, Xiang; Wu, Suyong; Huang, Yun; Luo, Hui

    2014-11-18

    We propose and analyze a superluminal ring laser gyroscope (RLG) using multilayer optical coatings with huge group delay (GD). This GD assisted superluminal RLG can measure the absolute rotation with a giant sensitivity-enhancement factor of ~10(3); while, the broadband FWHM of the enhancement factor can reach 20 MHz. This superluminal RLG is based on a traditional RLG with minimal re-engineering, and beneficial for miniaturization according to theoretical calculation. The idea of using GD coatings as a fast-light medium will shed lights on the design and application of fast-light sensors.

  13. Huge capacity fiber-optic sensing network based on ultra-weak draw tower gratings

    NASA Astrophysics Data System (ADS)

    Yang, Minghong; Bai, Wei; Guo, Huiyong; Wen, Hongqiao; Yu, Haihu; Jiang, Desheng

    2016-03-01

    This paper reviews the work on huge capacity fiber-optic sensing network based on ultra-weak draw tower gratings developed at the National Engineering Laboratory for Fiber Optic Sensing Technology (NEL-FOST), Wuhan University of Technology, China. A versatile drawing tower grating sensor network based on ultra-weak fiber Bragg gratings (FBGs) is firstly proposed and demonstrated. The sensing network is interrogated with time- and wavelength-division multiplexing method, which is very promising for the large-scale sensing network.

  14. Surgical Repair of Huge Left Ventricular Pseudoaneurysm After Sutureless Repair of Free Wall Rupture.

    PubMed

    Díez-Villanueva, Pablo; Sarraj, Anas; Navarrete, Gonzalo; Salamanca, Jorge; Pozo, Eduardo; Reyes, Guillermo; Alfonso, Fernando

    2017-02-01

    Left ventricular pseudoaneurysm (LVPsA) is a rare complication after sutureless patch repair of left ventricular free wall rupture (LVFWR), with few cases reported in the literature so far. We present the case of a young patient who early developed a huge LVPsA and moderate mitral regurgitation after sutureless patch repair for LVFWR after undergoing a successful Dor procedure using the "triple empanada patch technique" to exclude the LVPsA, remodel the left ventricle, and address the moderate mitral regurgitation. Serial echocardiograms during follow-up are strongly recommended, even in patients with successful patch repair, to facilitate timely diagnosis and management.

  15. Huge malignant phyllodes breast tumor: a real entity in a new era of early breast cancer.

    PubMed

    Testori, Alberto; Meroni, Stefano; Errico, Valentina; Travaglini, Roberto; Voulaz, Emanuele; Alloisio, Marco

    2015-02-27

    Phyllodes tumor is an extremely rare tumor of the breast. It occurs in females in the third and fourth decades. The difficulty in distinguishing between phyllodes tumors and benign fibroadenoma may lead to misdiagnosis. Lymph node involvement is rarely described in phyllodes tumors; for this reason, sentinel node biopsy may be warranted. We present a case of a 33-year-old woman affected by huge tumor of the right breast with ulceration in the skin with a rapid tumor growth and with omolateral axillary metastasis.

  16. Huge metastability in high-Tc superconductors induced by parallel magnetic field

    NASA Astrophysics Data System (ADS)

    Dias, R. G.; Silva, J. A.

    2003-03-01

    We present a study of the temperature-magnetic-field phase diagram of homogeneous and inhomogeneous superconductivity in the case of a quasi-two-dimensional superconductor with an extended saddle point in the energy dispersion under a parallel magnetic field. At low temperature, a huge metastability region appears, limited above by a steep superheating critical field Hsh and below by a strongly reentrant supercooling field Hsc. We show that the Pauli limit Hp for the upper critical magnetic field is strongly enhanced due to the presence of the Van Hove singularity in the density of states. The formation of a nonuniform superconducting state is predicted to be very unlikely.

  17. Totally laparoscopic gastrectomy for early gastric cancer accompanied by huge hiatal hernia: A case report.

    PubMed

    Hagiwara, Chie; Yajima, Kazuhito; Iwasaki, Yoshiaki; Oohinata, Ryouki; Yuu, Ken; Ishiyama, Satoshi; Amaki, Misato; Nakano, Daisuke; Yamaguchi, Tatsuro; Matsumoto, Hiroshi; Takahashi, Keiichi

    2016-02-01

    We herein present a case in which we used a totally laparoscopic approach for early gastric cancer accompanied by a huge hiatal hernia. An 80-year-old Japanese woman was referred with a chief complaint of dysphagia. A clinical diagnosis of early gastric cancer, T1b (SM) N0M0, stage IA, accompanied by hiatal hernia, was made. Distal gastrectomy with D1 plus lymphadenectomy was carried out. After the gastrectomy, the hernial sac was excised and the hernial orifice was closed. Reconstruction using the Roux-en-Y method was selected. The postoperative course was uneventful and she was discharged on postoperative day 10.

  18. Design of a superluminal ring laser gyroscope using multilayer optical coatings with huge group delay

    PubMed Central

    Qu, Tianliang; Yang, Kaiyong; Han, Xiang; Wu, Suyong; Huang, Yun; Luo, Hui

    2014-01-01

    We propose and analyze a superluminal ring laser gyroscope (RLG) using multilayer optical coatings with huge group delay (GD). This GD assisted superluminal RLG can measure the absolute rotation with a giant sensitivity-enhancement factor of ~103; while, the broadband FWHM of the enhancement factor can reach 20 MHz. This superluminal RLG is based on a traditional RLG with minimal re-engineering, and beneficial for miniaturization according to theoretical calculation. The idea of using GD coatings as a fast-light medium will shed lights on the design and application of fast-light sensors. PMID:25403698

  19. Spontaneous regression of a huge subligamentous extruded disc herniation: short report of an illustrative case.

    PubMed

    Gezici, Ali Riza; Ergün, Rüçhan

    2009-10-01

    Herniated nucleus pulposus (HNP) is a common cause of radicular and low-back pain. Although some patients need surgical intervention because of prolonged intolerable leg pain, the majority heal with conservative treatment. Recently, with the advent of imaging diagnostic methods, there is an increasing interest in the phenomenon of spontaneous resorption of the HNP. We presented a case of lumbar HNP at the L4-L5 level in which clinical improvement was associated with a significant decrease in size of a huge subligamentous extruded disc herniation, documented on serial magnetic resonance imaging (MRI) scans.

  20. Huge low-frequency dielectric response of (Nb,In)-doped TiO2 ceramics

    NASA Astrophysics Data System (ADS)

    Wu, Y. Q.; Zhao, X.; Zhang, J. L.; Su, W. B.; Liu, J.

    2015-12-01

    The (Nb,In)-doped TiO2 ceramics have drawn considerable attention as a type of promising giant-permittivity dielectric materials in recent years. However, a significant controversy concerning the giant dielectric mechanism currently exists, and clarifying it is vitally important from both scientific and technological viewpoints. This letter reports the results of a systematical comparison study, where two kinds of (Nb,In)-doped TiO2 ceramics with a substantial difference in dielectric loss are used. Dielectric properties and complex impedance are investigated over a broad frequency band of 3 mHz-110 MHz. A huge low-frequency dielectric response in addition to the giant dielectric relaxation appearing above 1 MHz is observed for both kinds of (Nb,In)-doped TiO2 ceramics in dielectric dispersion. The huge dielectric response observed in the low frequency range can be ascribed to a non-ohmic electrode-contact, and the dielectric relaxation appearing above 1 MHz can be attributed to an internal barrier layer capacitance effect. An electrical equivalent circuit model suggested can well describe the observed dielectric properties and electrical behaviors.

  1. Carcinoma ex pleomorphic adenoma in the oral cavity: a huge oral cavity mass with neck metastasis.

    PubMed

    Hong, Hyun Jun; Byeon, Hyung Kwon; Bae, Seong Hoon; Park, Ah Young; Choi, Eun Chang; Choi, Hong-Shik

    2013-11-01

    Carcinoma ex pleomorphic adenoma (CEPA) is a rare, aggressive, poorly understood malignancy. In CEPA, an epithelial malignancy develops in association with a primary or recurrent benign pleomorphic adenoma. Carcinoma ex pleomorphic adenoma is very difficult to identify before surgery because the clinical presentation of many cases is similar to that of pleomorphic adenomas. The risk for malignancy increases with the duration of a mixed tumor. Treatment of CEPA must be individualized on the basis of the tumor location, involvement of adjacent structures, histologic subtype, and grade. The authors recently experienced a case of CEPA arising in the oral cavity with neck metastasis. The patient was a 70-year-old man presenting a huge mass that was present for 20 years and that slowly grew on the left side of the neck. We treated it with a total excision with wide margins and neck dissection. There was no recurrence during the follow-up period of 5 years up until now. We present a case of an unusually huge CEPA in the oral cavity.

  2. Simulation of pedestrian crowds’ evacuation in a huge transit terminal subway station

    NASA Astrophysics Data System (ADS)

    Lei, Wenjun; Li, Angui; Gao, Ran; Hao, Xinpeng; Deng, Baoshun

    2012-11-01

    As modernized urban rail transportation, subways are playing an important role in transiting large passenger flows. Passengers are in high density within the subway during rush hours. The casualty and injury will be tremendous if an accident occurs, such as a fire. Hence, enough attention should be paid on pedestrian crowds’ evacuation in a subway. In this paper, simulation of the process of pedestrian crowds’ evacuation from a huge transit terminal subway station is conducted. The evacuation process in different cases is conducted by using an agent-based model. Effects of occupant density, exit width and automatic fare gates on evacuation time are studied in detail. It is found that, with the increase of the occupant density, the evacuation efficiency would decline. There is a linear relationship between occupant density and evacuation time. Different occupant densities correspond to different critical exit widths. However, the existence of the automatic fare gates has little effect on evacuation time and tendency. The current results of this study will be helpful in guiding evacuation designs of huge underground spaces.

  3. Does Size Really Matter? Analysis of the Effect of Large Fibroids and Uterine Volumes on Complication Rates of Uterine Artery Embolisation

    SciTech Connect

    Parthipun, A. A. Taylor, J.; Manyonda, I.; Belli, A. M.

    2010-10-15

    The purpose of this study was to determine whether there is a correlation between large uterine fibroid diameter, uterine volume, number of vials of embolic agent used and risk of complications from uterine artery embolisation (UAE). This was a prospective study involving 121 patients undergoing UAE embolisation for symptomatic uterine fibroids at a single institution. Patients were grouped according to diameter of largest fibroid and uterine volume. Results were also stratified according to the number of vials of embolic agent used and rate of complications. No statistical difference in complication rate was demonstrated between the two groups according to diameter of the largest fibroid (large fibroids were classified as {>=}10 cm; Fisher's exact test P = 1.00), and no statistical difference in complication rate was demonstrated according to uterine volume (large uterine volume was defined as {>=}750 cm{sup 3}; Fisher's exact test P = 0.70). 84 of the 121 patients had documentation of the number of vials used during the procedure. Patients were divided into two groups, with {>=}4 used defined as a large number of embolic agent. There was no statistical difference between these two groups and no associated increased risk of developing complications. This study showed no increased incidence of complications in women with large-diameter fibroids or uterine volumes as defined. In addition, there was no evidence of increased complications according to quantity of embolic material used. Therefore, UAE should be offered to women with large fibroids and uterine volumes.

  4. 21 CFR 884.2730 - Home uterine activity monitor.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Home uterine activity monitor. 884.2730 Section 884.2730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... the clinic. The HUAM system comprises a tocotransducer, an at-home recorder, a modem, and a...

  5. 21 CFR 884.2730 - Home uterine activity monitor.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Home uterine activity monitor. 884.2730 Section 884.2730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES... the clinic. The HUAM system comprises a tocotransducer, an at-home recorder, a modem, and a...

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

    PubMed

    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.

  7. Uterine Tissue Engineering and the Future of Uterus Transplantation.

    PubMed

    Hellström, Mats; Bandstein, Sara; Brännström, Mats

    2016-12-19

    The recent successful births following live donor uterus transplantation are proof-of-concept that absolute uterine factor infertility is a treatable condition which affects several hundred thousand infertile women world-wide due to a dysfunctional uterus. This strategy also provides an alternative to gestational surrogate motherhood which is not practiced in most countries due to ethical, religious or legal reasons. The live donor surgery involved in uterus transplantation takes more than 10 h and is then followed by years of immunosuppressive medication to prevent uterine rejection. Immunosuppression is associated with significant adverse side effects, including nephrotoxicity, increased risk of serious infections, and diabetes. Thus, the development of alternative approaches to treat absolute uterine factor infertility would be desirable. This review discusses tissue engineering principles in general, but also details strategies on how to create a bioengineered uterus that could be used for transplantation, without risky donor surgery and any need for immunosuppression. We discuss scaffolds derived from decellularized organs/tissues which may be recellularized using various types of autologous somatic/stem cells, in particular for uterine tissue engineering. It further highlights the hurdles that lay ahead in developing an alternative to an allogeneic source for uterus transplantation.

  8. Age and nursing affect the neonatal porcine uterine transcriptome

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The lactocrine hypothesis for maternal programming of neonatal development was proposed to describe a mechanism through which milk-borne bioactive factors, delivered from mother to nursing offspring, could affect development of tissues, including the uterus. Porcine uterine development, initiated be...

  9. Uterine glutathione reductase activity: modulation by estrogens and progesterone.

    PubMed

    Díaz-Flores, M; Baiza-Gutman, L A; Pedrón, N N; Hicks, J J

    1999-10-29

    The aim of this study was to determine whether glutathione reductase activity in uterine tissue is regulated by sex hormones. In spayed rats uterine glutathione reductase was significantly increased by exogenous estrogen (P< 0.01), progesterone (P< 0.01) or estrogen plus progesterone (P<0.01). When enzyme activity is expressed per mg protein, daily administration of estrogen or progesterone induces a progressive increase of this enzyme between 24 to 48 h or 24 to 72 h of treatment, respectively. Whereas the combination of both steroids causes an earlier and higher increase in glutathione reductase activity at 24 h of treatment. Estradiol singly or in combination with progesterone induced the highest protein concentration in the uterus. Whereas uterine DNA concentration is only significantly affected by estradiol. Our results suggest that uterine glutathione reductase is regulated by estradiol and progesterone and may be involved in maintaining levels of reduced glutathione in the uterus. This compound may be required for control of the redox state of thiol groups and in detoxification reactions involving H2O2 and electrophylic substances. The antioxidant action of estrogens is partially due to the stimulation of glutathione reductase.

  10. Dietary melatonin alters uterine artery hemodynamics in pregnant holstein heifers

    Technology Transfer Automated Retrieval System (TEKTRAN)

    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...

  11. Computer models to study uterine activation at labour.

    PubMed

    Sharp, G C; Saunders, P T K; Norman, J E

    2013-11-01

    Improving our understanding of the initiation of labour is a major aim of modern obstetric research, in order to better diagnose and treat pregnant women in which the process occurs abnormally. In particular, increased knowledge will help us identify the mechanisms responsible for preterm labour, the single biggest cause of neonatal morbidity and mortality. Attempts to improve our understanding of the initiation of labour have been restricted by the inaccessibility of gestational tissues to study during pregnancy and at labour, and by the lack of fully informative animal models. However, computer modelling provides an exciting new approach to overcome these restrictions and offers new insights into uterine activation during term and preterm labour. Such models could be used to test hypotheses about drugs to treat or prevent preterm labour. With further development, an effective computer model could be used by healthcare practitioners to develop personalized medicine for patients on a pregnancy-by-pregnancy basis. Very promising work is already underway to build computer models of the physiology of uterine activation and contraction. These models aim to predict changes and patterns in uterine electrical excitation during term labour. There have been far fewer attempts to build computer models of the molecular pathways driving uterine activation and there is certainly scope for further work in this area. The integration of computer models of the physiological and molecular mechanisms that initiate labour will be particularly useful.

  12. Selection for uterine capacity improves lifetime productivity of sows

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Selection for 11 generations for uterine capacity (UC) increased litter size in gilts by 1.6 more fully formed pigs at birth compared to an unselected control line (CO) despite averaging 1 less ova shed. Our objective was to quantify line-by-parity interactions and characterize litter performance tr...

  13. Reduced Uterine Perfusion Pressure (RUPP) Model of Preeclampsia in Mice

    PubMed Central

    Fushima, Tomofumi; Sekimoto, Akiyo; Minato, Takahiro; Ito, Takuya; Oe, Yuji; Kisu, Kiyomi; Sato, Emiko; Funamoto, Kenichi; Hayase, Toshiyuki; Kimura, Yoshitaka; Ito, Sadayoshi; Sato, Hiroshi; Takahashi, Nobuyuki

    2016-01-01

    Preeclampsia (PE) is a pregnancy-induced hypertension with proteinuria that typically develops after 20 weeks of gestation. A reduction in uterine blood flow causes placental ischemia and placental release of anti-angiogenic factors such as sFlt-1 followed by PE. Although the reduced uterine perfusion pressure (RUPP) model is widely used in rats, investigating the role of genes on PE using genetically engineered animals has been problematic because it has been difficult to make a useful RUPP model in mice. To establish a RUPP model of PE in mice, we bilaterally ligated ovarian vessels distal to ovarian branches, uterine vessels, or both in ICR-strain mice at 14.5 days post coitum (dpc). Consequently, these mice had elevated BP, increased urinary albumin excretion, severe endotheliosis, and mesangial expansion. They also had an increased incidence of miscarriage and premature delivery. Embryonic weight at 18.5 dpc was significantly lower than that in sham mice. The closer to the ligation site the embryos were, the higher the resorption rate and the lower the embryonic weight. The phenotype was more severe in the order of ligation at the ovarian vessels < uterine vessels < both. Unlike the RUPP models described in the literature, this model did not constrict the abdominal aorta, which allowed BP to be measured with a tail cuff. This novel RUPP model in mice should be useful for investigating the pathogenesis of PE in genetically engineered mice and for evaluating new therapies for PE. PMID:27187738

  14. Successful pregnancy after treatment with ulipristal acetate for uterine fibroids.

    PubMed

    Monleón, Javier; Martínez-Varea, Alicia; 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.

  15. Maternal obesity drives functional alterations in uterine NK cells

    PubMed Central

    Perdu, Sofie; Castellana, Barbara; Kim, Yoona; Chan, Kathy; DeLuca, Lauren; Beristain, Alexander G.

    2016-01-01

    Over one-fifth of North American women of childbearing age are obese, putting these women at risk for a variety of detrimental chronic diseases. In addition, obesity increases the risk for developing major complications during pregnancy. The mechanisms by which obesity contributes to pregnancy complications and loss remain unknown. Increasing evidence indicates that obesity results in major changes to adipose tissue immune cell composition and function; whether or not obesity also affects immune function in the uterus has not been explored. Here we investigated the effect of obesity on uterine natural killer (uNK) cells, which are essential for uterine artery remodeling and placental development. Using a cohort of obese or lean women, we found that obesity led to a significant reduction in uNK cell numbers accompanied with impaired uterine artery remodeling. uNK cells isolated from obese women had altered expression of genes and pathways associated with extracellular matrix remodeling and growth factor signaling. Specifically, uNK cells were hyper-responsive to PDGF, resulting in overexpression of decorin. Functionally, decorin strongly inhibited placental development by limiting trophoblast survival. Together, these findings establish a potentially new link between obesity and poor pregnancy outcomes, and indicate that obesity-driven changes to uterine-resident immune cells critically impair placental development. PMID:27699222

  16. Triplex Doppler evaluation of uterine arteries in cyclic and pregnant domestic cats.

    PubMed

    Pereira, B S; Freire, L M P; Pinto, J N; Domingues, S F S; Silva, L D M

    2012-01-01

    The aims were to determine resistance index (RI) and pulsatility index (PI) in the uterine arteries of cyclic and pregnant domestic cats comparing the left and right uterine horns, as well as the majority or minority uterine horns, based on fetus number per horn; to determine the presence or absence of an early diastolic notch (EDN) in the uterine artery of pregnant queens. Ten domestic cats were followed during one cycle and one pregnancy until 63rd days after mating. The estrous cycle length was 16 ± 9.57 days. The uterine horn with the highest number of fetuses (majority uterine horn - MUH) presented 2.0 ± 1.0 fetus and the lower (minority uterine horn - miUH) presentes 0.78 ± 0.67 fetus. There were no differences in indexes between uterine arteries during the cycles and pregnancies. The RI and PI of MUH were lower than miUH (P<0.05). Uterine artery of the MUH presented lower indexes than miUH during the acceptance period (P<0.05). On D14 of pregnancy, uterine artery presented reductions in both indexes for the miUH. On D56, the PI was reduced in the miUH. The indexes depended on the week of pregnancy. EDN was present on the uterine arteries of all cats until D35, but disappeared by D49. The blood flow varied according to the category of horn.

  17. In vivo measurements of uterine cavities in 795 women of fertile age.

    PubMed

    Kurz, K H; Tadesse, E; Haspels, A A

    1984-06-01

    The uterine sound length, the functional length of the cervix including the zone of internal cervical os and the fundus transversal were determined in 795 fertile women in vivo using a measuring device, the Cavimeter. The functional cavity length was calculated by subtracting the functional length of the cervix from the uterine sound length. With growing parity, the uterine length and width increase, but with advance in age, the uterine cavity changes are not so distinct. The wide ranges found by the investigation demonstrate the individuality of the uterine cavity and the desire to measure it prior to fitting an IUD. The use of adapted IUDs according to the size of the uterine cavity leads to a remarkable reduction of side effects, particularly expulsion, bleeding and cramps caused mainly by dimensional incompatibility. Therefore prefit uterine cavity measurement can lead to better efficacy of IUDs, increased rates of acceptance and higher continuation rates.

  18. Characterization of uterine leukocyte infiltration in gilts after artificial insemination.

    PubMed

    Rozeboom, K J; Troedsson, M H; Crabo, B G

    1998-11-01

    The objective of this study was to characterize the uterine leukocyte influx after artificial insemination (AI). After detection of oestrus with a boar at intervals of 1.5 h, seventy-two gilts were randomly assigned to a 2 x 3 x 4 factorial arrangement. AI was performed with 100 ml extended semen containing 5 x 10(9) spermatozoa (semen; n = 36) or 100 ml VSP semen extender (extender; n = 36) at one of three times after detection of oestrus: 12, 24 or 36 h (n = 24/time). The uterus was lavaged at 6, 12, 18 or 24 h (n = 18/time) after AI to determine the total number of uterine leukocytes. In addition, uterine lavage was performed on nine untreated gilts immediately after the detection of oestrus to establish a baseline number of leukocytes. The leukocyte response in all samples consisted predominately (92-99%) of polymorphonuclear neutrophilic granulocytes (PMNs). The mean number of PMNs recovered from the uteri of gilts treated with semen was greater than in gilts treated with extender and in untreated gilts (P < 0.01). The greatest number of PMNs in semen-treated gilts was found 12 h after AI (P < 0.01), and this number was sustained for 24 h. In contrast, the number of uterine PMNs recovered from extender-treated gilts reached a peak at 6 h and had declined by 12 h after AI (P < 0.05). It was concluded that an extensive influx of PMNs into the uterus is a normal sequence to AI. The consequences and importance of semen-induced uterine leukocytosis needs further investigation.

  19. Outcomes After Unilateral Uterine Artery Embolization: A Retrospective Review

    SciTech Connect

    Bratby, M. J.; Hussain, F. F.; Walker, W. J.

    2008-03-15

    Purpose. Bilateral uterine artery embolization (UAE) is considered necessary to provide effective treatment for symptomatic uterine fibroids. Occasionally, only unilateral embolization is performed, and this study evaluates these outcomes. Materials and Methods. As part of a prospective observational study of more than 1600 patients treated with UAE since 1996, there have been 48 patients in whom unilateral embolization has been performed. This study retrospectively reviews clinical response as assessed by our standard questionnaire and radiological response assessed by either magnetic resonance imaging or ultrasound. Results. Two principal groups emerged: the largest, where only the dominant unilateral arterial supply was electively embolized (30 patients); and the second, where there was technical failure to catheterize the second uterine artery as a result of anatomical constraints (12 patients). Favorable clinical response with a reduction in menorrhagia at 1 year was seen in 85.7% (18/21) of those patients with a dominant arterial supply to the fibroid(s). In contrast, in those patients where there was technical failure to embolize one uterine artery, there was a high rate of clinical failure requiring further intervention in 58.3% (7/12). Comparison of the technical failure group with the dominant uterine artery group demonstrated a statistically significant (Fisher's exact test) difference in the proportion of patients with evidence of persistent fibroid vascularity (p < 0.001) and requiring repeat intervention (p < 0.01). Conclusion. We conclude that unilateral UAE can achieve a positive clinical result in the group of patients where there is a dominant unilateral artery supplying the fibroid(s), in contrast to the poor results seen following technical failure.

  20. A huge malignant peripheral nerve sheath tumor with hepatic metastasis arising from retroperitoneal ganglioneuroma.

    PubMed

    Meng, Z H; Yang, Y S; Cheng, K L; Chen, G Q; Wang, L P; Li, W

    2013-01-01

    Ganglioneuromas (GNs) are the rarest and most benign of the neuroblastic tumors. We experienced a case of huge retroperitoneal GN which differentiated into malignant peripheral nerve sheath tumors (MPNST) with hepatic metastasis. The tumor was located in the upper right quarter of the abdomen and pressed the right lobe of the liver, which was initially misdiagnosed as a liver carcinoma. The tumor shared blood supply with the right liver lob and had rich blood supplies from the abdominal aorta, renal artery and hepatic artery. It was also associated with skin pigment and recurrence shortly following resection. Our finding demonstrated that MPNST is a potent invasive malignant tumor and metastasis earlier with very poor prognosis.

  1. Successful hybrid treatment for huge visceral artery aneurysms with contained rupture complicating segmental arterial mediolysis.

    PubMed

    Kimura, Yasutoshi; Ito, Toshiro; Imamura, Masafumi; Hirata, Koichi

    2015-12-01

    Segmental arterial mediolysis (SAM) is a rare arteriopathy that can cause acute abdomen. This report describes the case of a 31-year old male suffering from huge visceral aneurysms with contained rupture. We established a treatment strategy using a hybrid procedure that consisted of endovascular and surgical techniques for these splenic, common hepatic artery and coeliac axis aneurysms related to SAM. The patient was successfully treated with aorto-superior mesenteric artery bypass followed by endovascular aortic stent grafting to interrupt inflow to coeliac aneurysms, and distal splenopancreatectomy with en bloc resection of those aneurysms. We conclude that this hybrid procedure consisting of endovascular and surgical techniques is useful and is a safe treatment option for SAM-related visceral aneurysms.

  2. Syringomyelia Associated with a Huge Retrocerebellar Arachnoid Cyst: A Case Report

    PubMed Central

    Hue, Sung Baek; Kwon, Soon Chan; Lyo, In Uk; Sim, Hong Bo

    2015-01-01

    Occasionally, a posterior fossa arachnoid cyst can induce compression of the spinal cord and cause syringomyelia. Here, we report the case of a 29-year-old man with both progressive shoulder pain and gait disturbance, who was found to have a huge retrocerebellar arachnoid cyst associated with syringomyelia. Accordingly, posterior fossa decompression and arachnoid cyst excision were performed. Post-operative MRI showed a marked reduction in the size of the arachnoid cyst and syringomyelia. The patient's symptoms were clearly improved compared to before surgery. In our view, treatment in such patients should focus on decompressing the foramen magnum and include the removal of the coexistent arachnoid cyst walls, which appear to be the crucial factor in development of syringomyelia. In this report, we discuss the pathogenic mechanisms underlying syringomyelia-associated retrocerebellar arachnoid cyst and review the current literature on this topic. PMID:26512273

  3. A surface site interaction point methodology for macromolecules and huge molecular databases.

    PubMed

    Oliver, Antoni; Hunter, Christopher A; Prohens, Rafel; Rosselló, Josep L

    2017-03-15

    Determining the position and magnitude of Surface Site Interaction Points (SSIP) is a useful technique for understanding intermolecular interactions. SSIPs have been used for the prediction of solvation properties and for virtual co-crystal screening. To determine the SSIPs for a molecule, the Molecular Electrostatic Potential Surface (MEPS) is first calculated using ab initio methods such as Density Functional Theory. This leads to a high cost in terms of computation time and is not compatible with the analysis of huge molecular databases. Herein, we present a method for the fast estimation of SSIPs, which is based on the MEPS calculated from MMFF94 atomic partial charges. The results show that this method can be used to calculate SSIPs for large molecular databases with a much higher speed than the original ab initio methodology. © 2017 Wiley Periodicals, Inc.

  4. Role of huge geometric circular structures in the reproduction of a marine pufferfish.

    PubMed

    Kawase, Hiroshi; Okata, Yoji; Ito, Kimiaki

    2013-01-01

    We report that male pufferfishes (Torquigener sp., Tetraodontidae) constructed large geometric circular structures on the seabed that played an important role in female mate choice. Males dug valleys at various angles in a radial direction, constructing nests surrounded by radially aligned peaks and valleys. Furthermore, they created irregular patterns in the nest comprising fine sand particles. The circular structure not only influences female mate choice but also functions to gather fine sand particles in nests, which are important in female mate choice. Strangely enough, the males never reuse the nest, always constructing a new circular structure at the huge cost of construction. This is because the valleys may not contain sufficient fine sand particles for multiple reproductive cycles.

  5. Role of Huge Geometric Circular Structures in the Reproduction of a Marine Pufferfish

    PubMed Central

    Kawase, Hiroshi; Okata, Yoji; Ito, Kimiaki

    2013-01-01

    We report that male pufferfishes (Torquigener sp., Tetraodontidae) constructed large geometric circular structures on the seabed that played an important role in female mate choice. Males dug valleys at various angles in a radial direction, constructing nests surrounded by radially aligned peaks and valleys. Furthermore, they created irregular patterns in the nest comprising fine sand particles. The circular structure not only influences female mate choice but also functions to gather fine sand particles in nests, which are important in female mate choice. Strangely enough, the males never reuse the nest, always constructing a new circular structure at the huge cost of construction. This is because the valleys may not contain sufficient fine sand particles for multiple reproductive cycles. PMID:23811799

  6. [A case of huge abscess extended from anterior neck to left lung and lateral chest wall].

    PubMed

    Ikeya, T; Tsuda, M; Hara, H; Koyama, S; Sugiyama, S; Misaki, T

    1997-11-01

    62-year-old woman admitted our hospital with pain of left upper extremity from the left chest and dysphasia. Chest X-ray showed the huge mass shadow in the left lung field. Diabetes mellitus and inflammatory reaction such as high fervor, leukocytosis, CRP and ESR accentuation were recognized. Conservative therapy was done at first, but mass shadow on X-ray increased, and swelling appeared from the neck to the left lateral chest wall. And the same site appeared like subcutaneous emphysema. Computed Tomography showed mass shadow which was enlarged and spread in lung parenchyma and left chest wall with bubble image. Incision and open drainage was performed for the left chest wall but origin bacteria was detected in neither anaerobic nor aerobic culture of pus. Inflammation and mass shadow of left upper lung field have decreased gradually. The patient discharged without bronchoalveolar fistula. Abscess extending from the neck or chest wall with diabetes mellitus is very rare.

  7. PIMADb: A Database of Protein–Protein Interactions in Huge Macromolecular Assemblies

    PubMed Central

    Mathew, Oommen K.; Sowdhamini, Ramanathan

    2016-01-01

    Protein–protein interactions play a very important role in the process of cellular functionality. Intricate details about the interactions between the proteins in a macromolecular assembly are important to understand the function and significance of protein complexes. We are reporting about a database of protein–protein interactions in huge macromolecular assemblies (PIMADb) that records the intrinsic details of 189,532 interchain interactions in 40,049 complexes from the Protein Data Bank. These details include the results of the quantification and analysis of all the interactions in the complex. The availability of interprotomer interaction networks can enable the design of point mutation experiments. PIMADb can be accessed from the URL: http://caps.ncbs.res.in/pimadb PMID:27478368

  8. Handling of huge multispectral image data volumes from a spectral hole burning device (SHBD)

    NASA Astrophysics Data System (ADS)

    Graff, Werner; Rosselet, Armel C.; Wild, Urs P.; Gschwind, Rudolf; Keller, Christoph U.

    1995-06-01

    We use chlorin-doped polymer films at low temperatures as the primary imaging detector. Based on the principles of persistent spectral hole burning, this system is capable of storing spatial and spectral information simultaneously in one exposure with extremely high resolution. The sun as an extended light source has been imaged onto the film. The information recorded amounts to tens of GBytes. This data volume is read out by scanning the frequency of a tunable dye laser and reading the images with a digital CCD camera. For acquisition, archival, processing, and visualization, we use MUSIC (MUlti processor System with Intelligent Communication), a single instruction multiple data parallel processor system equipped with the necessary I/O facilities. The huge amount of data requires the developemnt of sophisticated algorithms to efficiently calibrate the data and to extract useful and new information for solar physics.

  9. Huge Left Atrial Myxoma and Concomitant Silent Coronary Artery Disease in a Young Man

    PubMed Central

    Gennari, Marco; Rubino, Mara; Andreini, Daniele; Polvani, Gianluca; Agrifoglio, Marco

    2016-01-01

    Severe but silent coronary artery disease may rarely exist in young patients with a low-risk profile but with a family history of coronary artery disease. We describe the case of a 33-year-old Caucasian male with progressive shortness of breath caused by a huge left atrial myxoma who was diagnosed to have significant coronary artery disease in the preoperative assessment. After investigations, the patient underwent resection of the left atrial tumor and coronary artery bypass grafting (CABG) with a successful outcome. Even in the case of a young male, it may be prudent to investigate silent coronary artery disease in the presence of cardiovascular risk factors and family history of coronary artery disease. The learning objective of this case is to debate about the usefulness of a preoperative coronary study even in the young population with cardiac nonischemic pathologies (ie, valve pathology, cardiac tumors, etc.). PMID:28096692

  10. The Diabetic foot: A global threat and a huge challenge for Greece

    PubMed Central

    Papanas, N; Maltezos, E

    2009-01-01

    The diabetic foot continues to be a major cause of morbidity, posing a global threat. Substantial progress has been now accomplished in the treatment of foot lesions, but further improvement is required. Treatment options may be classified into established measures (revascularisation, casting and debridement) and new modalities. All therapeutic measures should be provided by specialised dedicated multidisciplinary foot clinics. In particular, the diabetic foot is a huge challenge for Greece. There is a dramatic need to increase the number of engaged foot care teams and their resources throughout the country. It is also desirable to continue education of both physicians and general diabetic population on the magnitude of the problem and on the suitable preventative measures. At the same time, more data on the prevalence and clinical manifestations of the diabetic foot in Greece should be carefully collected. Finally, additional research should investigate feasible ways of implementing current knowledge in everyday clinical practice. PMID:20011082

  11. Single-port video-assisted thoracoscopic surgery for a huge epiphrenic esophageal diverticulum

    PubMed Central

    2017-01-01

    Epiphrenic esophageal diverticulum is uncommon disease, which is defined as the herniation of the mucosa and submucosa through the muscle layers of the esophageal wall in distal third of the esophagus. Traditionally, thoracotomy has been the preferred surgical approach. Recently, many surgeons have attempted minimally invasive surgeries for epiphrenic esophageal diverticula. They reported that minimally invasive surgery (MIS) for epiphrenic esophageal diverticula was a safe and feasible approach which had many advantages. There are various options of surgical approaches for MIS of epiphrenic diverticula. However, the best surgical approach remains uncertain. We report the case of a huge epiphrenic esophageal diverticulum, which was successfully treated by single-port video-assisted thoracoscopic surgery (VATS). PMID:28203430

  12. Tiny grains give huge gains: nanocrystal-based signal amplification for biomolecule detection.

    PubMed

    Tong, Sheng; Ren, Binbin; Zheng, Zhilan; Shen, Han; Bao, Gang

    2013-06-25

    Nanocrystals, despite their tiny sizes, contain thousands to millions of atoms. Here we show that the large number of atoms packed in each metallic nanocrystal can provide a huge gain in signal amplification for biomolecule detection. We have devised a highly sensitive, linear amplification scheme by integrating the dissolution of bound nanocrystals and metal-induced stoichiometric chromogenesis, and demonstrated that signal amplification is fully defined by the size and atom density of nanocrystals, which can be optimized through well-controlled nanocrystal synthesis. Further, the rich library of chromogenic reactions allows implementation of this scheme in various assay formats, as demonstrated by the iron oxide nanoparticle linked immunosorbent assay (ILISA) and blotting assay developed in this study. Our results indicate that, owing to the inherent simplicity, high sensitivity and repeatability, the nanocrystal based amplification scheme can significantly improve biomolecule quantification in both laboratory research and clinical diagnostics. This novel method adds a new dimension to current nanoparticle-based bioassays.

  13. Bioinspired oil strider floating at the oil/water interface supported by huge superoleophobic force.

    PubMed

    Liu, Xueli; Gao, Jun; Xue, Zhongxin; Chen, Li; Lin, Ling; Jiang, Lei; Wang, Shutao

    2012-06-26

    Oil pollution to aquatic devices, especially to those oil-cleaning devices and equipment-repairing robots during oil spill accidents, has drawn great attention and remains an urgent problem to be resolved. Developing devices that can move freely in an oil/water system without contamination from oil has both scientific and practical importance. In nature, the insect water strider can float on water by utilizing the superhydrophobic supporting force received by its legs. Inspired by this unique floating phenomenon, in this article, we designed a model device named "oil strider" that could float stably at the oil/water interface without contamination by oil. The floating capability of the oil strider originated from the huge underwater superoleophobic supporting force its "legs" received. We prepared the micro/nanohierarchical structured copper-oxide-coated copper wires, acting as the artificial legs of oil strider, by a simple base-corrosion process. The surface structures and hydrophilic chemical components of the coatings on copper wires induced the huge superoleophobic force at the oil/water interface, to support the oil strider from sinking into the oil. Experimental results and theoretical analysis demonstrate that this supporting force is mainly composed of three parts: the buoyancy force, the curvature force, and the deformation force. We anticipate that this artificial oil strider will provide a guide for the design of smart aquatic devices that can move freely in an oil/water system with excellent oil repellent capability, and be helpful in practical situations such as oil handling and oil spill cleanup.

  14. Frequent CCNE1 amplification in endometrial intraepithelial carcinoma and uterine serous carcinoma.

    PubMed

    Kuhn, Elisabetta; Bahadirli-Talbott, Asli; Shih, Ie-Ming

    2014-07-01

    Uterine serous carcinoma accounts for only 10% of all uterine epithelial cancers, but is the leading cause of death among them. The pathogenesis of this aggressive neoplasm has been largely elusive until recently, when comprehensive genome-wide analyses of uterine serous carcinoma have been performed. Among amplified cancer-related genes, CCNE1, encoding for cyclin E1, is frequently amplified in uterine serous carcinoma. In the current study we applied fluorescence in situ hybridization (FISH) to determine CCNE1 copy number in uterine serous carcinoma and concurrent endometrial intraepithelial carcinoma, the noninvasive component of uterine serous carcinoma, and the results were correlated with clinicopathological and molecular features. We found that 20 (45%) of 44 uterine serous carcinomas and 11 (41%) of 27 endometrial intraepithelial carcinomas showed CCNE1 amplification. Overall, we found high concordance in CCNE1 copy number in concurrent uterine serous carcinoma and endometrial intraepithelial carcinoma pairs (P-value=0.0003). No correlation was observed between CCNE1 copy number and clinicopathological features, as well as common mutations previously reported in uterine serous carcinoma. In summary, we confirm that amplification of CCNE1 is a frequent molecular genetic change in uterine serous carcinoma. Moreover, the identification of CCNE1 amplification in many endometrial intraepithelial carcinomas suggests that this genetic event occurs early during tumor progression.

  15. Uterine natural killer cell partnerships in early mouse decidua basalis.

    PubMed

    Felker, Allison M; Croy, B Anne

    2016-10-01

    The decidua basalis of developing mouse implantation sites is highly enriched in CD45(+) leukocytes. In intact, syngeneically mated C57BL/6 decidua basalis examined at gestation day 8.5 by whole-mount in situ immunohistochemistry, leukocyte, but not trophoblast, conjugations were reported. Nothing is known regarding time course, frequency, composition, or importance of physiologic decidual CD45(+) cell pairing. In this study, we confirmed the presence of anti-CD54(+)/anti-CD11a(+) immune synapses in CD45(+) decidual cell conjugates and characterized their cellular heterogeneity. Conjugated cell pairs were virtually absent before implantation (virgin and gestation days 3.5 and 4.5), were infrequent at gestation day 5.5, but involved 19% of all CD45(+) cells by gestation day 8.5, then declined. By gestation day 8.5, almost all CD45(+) cells coexpressed CD31, and 2 CD45(+)CD31(+) cells composed most conjugates. Conjugation partners were defined for 2 nonoverlapping uterine natural killer cell subsets (Ly49C/I (+)/Dolichos biflorus agglutinin lectin(-) and Ly49C/I(-)/Dolichos biflorus agglutinin lectin(+)). Ly49C/I(+) uterine natural killer cells were the major subset from before mating up to gestation day 6.5. At gestation day 5.5/6.5, uterine natural killer cell conjugates involving Ly49C/I (+) cells were more abundant. By gestation day 8.5/9.5, Dolichos biflorus agglutinin lectin(+) uterine natural killer cells were the dominant subset with Dolichos biflorus agglutinin lectin(+)/Dolichos biflorus agglutinin lectin(+) homologous conjugates and Dolichos biflorus agglutinin lectin(+)/Dolichos biflorus agglutinin lectin(-) heterologous conjugates dominating uterine natural killer cell pairings. At gestation day 6.5, both Ly49C/I(+)/CD45(+) and Dolichos biflorus agglutinin lectin(+)/CD45(+) heterologous conjugate pairs strongly engaged antigen-presenting cells (CD11c(+), CD68(+), or major histocompatibility complex class II(+)). By gestation day 8.5, dominant partners of

  16. Validation of color Doppler ultrasonography for evaluating the uterine blood flow and perfusion during late normal pregnancy and uterine torsion in buffaloes.

    PubMed

    Hussein, Hassan A

    2013-04-15

    The aim of this study was to verify the efficacy of color Doppler ultrasonography for diagnosis of degree and duration of uterine torsion in buffaloes. In Assiut province/Upper Egypt, 65 buffaloes (37 with uterine torsion, 28 with normal late pregnancy) were examined clinically and using Doppler ultrasonography. The Doppler indices including resistance index (RI), pulsatility index (PI), time-averaged maximum velocity (TAMV), and blood flow volume (BFV) in the arteries ipsilateral to the uterine torsion (IPUT) and in arteries contralateral to the uterine torsion (COUT) were recorded. Methods of correction were documented along with dam and calf survival. Torsion was recorded postcervically with vaginal involvement in 35/37 (94.6%) of the cases. The degrees of uterine torsion were light and high in 9/37 (24.3%) and 28/37 (75.7%) of the cases, respectively (P = 0.001). Right uterine torsion was present in 36/37 (97.3%) of the cases (P = 0.0001). Pulsatility index, RI, TAMV, and BFV in IPUT and COUT did not differ significantly (P > 0.05) in normal late pregnancy. The PI and RI in IPUT were significantly higher (P < 0.01) than in COUT, and the TAMV and BFV in IPUT were less (P < 0.001) than that in COUT in uterine torsion. The PI and RI of torsion cases in IPUT were higher (P < 0.001) than that in normal pregnancy. Time-averaged maximum velocity and BFV in torsion cases were lower (P < 0.01) than that of normal pregnancy in IPUT. There was approximately 50% of RI and PI higher than in light degree uterine torsion in IPUT (P < 0.001). Consequently, TAMV and BFV were greatly lower (P < 0.0001) than that in light degree in IPUT. Pulsatility index and RI were positively correlated (r = 0.856; P < 0.001) with the duration and degree of the uterine torsion, and TAMV and BFV were negatively correlated (r = -0.763; P < 0.001). In all cases of uterine torsion the uterine flow velocity waveform showed high systolic flow and absence of early diastolic flow and poor uterine and

  17. Ovine Surgical Model of Uterine Space Restriction: Interactive Effects of Uterine Anomalies and Multifetal Gestations on Fetal and Placental Growth1

    PubMed Central

    Meyer, Katie M.; Koch, Jill M.; Ramadoss, Jayanth; Kling, Pamela J.; Magness, Ronald R.

    2010-01-01

    Intrauterine growth restriction (IUGR) is observed in conditions with limitations in uterine space (e.g., uterine anomalies and multifetal gestations). IUGR is associated with reduced fetal weight, organ growth, and a spectrum of adult-onset diseases. To examine the interaction of uterine anomalies and multifetal gestations, we developed a surgical uterine space restriction model with a unilateral uterine horn ligation before breeding (unilateral surgery). Placentas and fetuses were studied on Gestational Day (GD) 120 and GD 130 (term = 147 days). Unilateral surgery decreased placentome numbers in singleton and twin pregnancies (25% and 50%, respectively) but not unilateral triplets. Unilateral surgery decreased total placentome weight in twin pregnancies (decreased 24%). Fetuses categorized as uterine space restricted (unilateral twin and both groups of triplets) had 51% fewer placentomes per fetus and a 31% reduction in placentomal weight per fetus compared to the nonrestricted group (control singleton, unilateral singleton, and control twin). By GD 130, uterine space-restricted fetuses exhibited decreased weight, smaller crown-rump, abdominal girth, and thoracic girth as well as decreased fetal heart, kidney, liver, spleen, and thymus weights. Lung and brain weights were unaffected, demonstrating asymmetric IUGR. At GD 130, placental efficiency (fetal weight per total placentomal weight) was elevated in uterine space-restricted fetuses. However, fetal arterial creatinine, blood urea nitrogen, and cholesterol were elevated, suggesting insufficient placental clearance. Maternal-to-fetal glucose and triglycerides ratios were elevated in the uterine space-restricted pregnancies, suggesting placental nutrient transport insufficiency. This model allows for examination of interactive effects of uterine space restriction-induced IUGR on placental adaptation and fetal organ growth. PMID:20574052

  18. Psychological Factors in 155 Patients with Functional Uterine Bleeding

    PubMed Central

    Dutton, W. A.

    1965-01-01

    One hundred and fifty-five women with functional uterine bleeding were studied to evaluate the importance of concomitant psychological disorders. Psychological illnesses were diagnosed in 128 patients (82.6%), most of which arose from problems directly related to sexual or reproductive functions. The remaining 27 patients (17.4%) were different in that they were psychologically stable and all but two were at puberty or approaching the menopause. Histological studies of endometrial samples from 135 of these patients indicated little evidence of abnormal sex hormone activity; 77 (57%) showed normal secretory phase endometrium and 32 (23.7%), proliferative phase endometrium. The remaining 26 (19.2%) showed evidence of some endocrine dysfunction, 15 such specimens being obtained from psychologically stable patients. It is probable that psychological disturbances are the principal cause of functional uterine bleeding during the prime reproductive years. The psychological component of the illness is the most important and determines the ultimate prognosis. PMID:14261152

  19. Uterine Tumour Resembling Ovarian Sex Cord Tumour- A Rare Entity

    PubMed Central

    Ilhan, Tolgay Tuyan; Gül, Ayhan; Ugurluoglu, Ceyhan; Çelik, Çetin

    2016-01-01

    Uterine Tumour Resembling Ovarian Sex-Cord Tumours (UTROSCTs) are an extremely rare type of uterine body tumours arising from the endometrial stroma. Epidemiology, aetiology, pathogenesis, management and natural history of UTROSCTs are still a question of debate, as there is little available data in the literature. Although rare, the possibility of UTROSCTs should be kept in mind, when a patient presents with abnormal bleeding and an enlarged uterus. UTROSCTs appear dirty white/cream-coloured, gelatinous, well-circumscribed mass with smooth surface on macroscopic examination. We present a rare case of endometrial stromal tumour with sex-cord-like differentiation which was successfully treated by hysterectomy with bilateral salpingo-oophorectomy. The clinical manifestations, pathologic characteristics, diagnosis and management of these tumours are reviewed here. PMID:28208949

  20. Urinary selenium excretion in patients with cervical uterine cancer.

    PubMed

    Navarrete, M; Gaudry, A; Revel, G; Martínez, T; Cabrera, L

    2001-02-01

    In this work, we report on a relationship between urinary selenium and the development of cervical uterine cancer. A simple chemical method was developed to concentrate trace amounts of selenium from relatively large urine samples by use of small activated carbon filters. When these filters are irradiated with thermal neutrons, selenium can be determined either by 77mSe (t1/2 = 17.5 s) or 75Se (t1/2 = 120 d). In this article, we report the results for 82 urine samples from women with cervical uterine cancer in several stages of development and from healthy controls. These results show a statistically significant increase of selenium excretion in cancer patients as compared to controls. Urinary selenium excretion is highest for patients in the intermediate stages of the disease.

  1. Uterine prolapse with associated rupture in a Podengo bitch.

    PubMed

    Payan-Carreira, R; Albuquerque, C; Abreu, H; Maltez, L

    2012-08-01

    A case of uterine prolapse coexisting with uterine horn rupture in a 3-year-old Portuguese Podengo bitch, which is an uncommon occurrence, is described. The female was presented with a history of recent parturition, with delivery of four healthy puppies that were normally tended and nursed. The situation developed after an uneventfully pregnancy, and no direct causative factor was identified. The duration of the prolapse was unknown, but considered to be recent because of the swollen reddish appearance of the tubular everted mass. No foetus was found in the uterus or the abdominal cavity. The female was presented in good physical condition, without signs of shock or haemorrhage. During surgical treatment, the uterus was replaced to its normal position followed by ovary-hysterectomy at 12 h from admittance.

  2. Spontaneous Regression of Uterine Arteriovenous Malformations with Conservative Management

    PubMed Central

    Oishi, Sugiko; Akamine, Kozue; Heshiki, Chiaki

    2017-01-01

    Uterine arteriovenous malformation (AVM) can cause massive hemorrhage and is often treated with uterine artery embolization (UAE), which may lead to ovarian insufficiency. Thus, avoiding UAE should be considered, particularly in women undergoing fertility treatments. We present three women diagnosed with postmiscarriage AVM on color Doppler by transvaginal ultrasound imaging. They had no genital bleeding and a small mass, measuring 16–22 mm. If estradiol was >300 pg/mL when AVM was diagnosed, then a gonadotropin-releasing hormone agonist was administered. All three women underwent follow-up observation, revealing spontaneous mass disappearance. To avoid ovarian insufficiency risk with UAE, conservative management and close follow-up observation should be considered in patients with AVM without bleeding, particularly during the fertility treatment. PMID:28299220

  3. [Radiotelemetric studies of uterine motility in cows with acute endometritis].

    PubMed

    Kostov, I

    1980-01-01

    Thirty two cows with postpartum complication were radiotelemetrically studied to register uterine motility. The results were compared with those of the control group of 42 cows with normal calving and no complications. Enhanced uterine reactivity to oxytocin and other agents was established in all cows with complications in the postpartum period. It is manifested in the spring also by intensified motor activity of the uterus. Motor activity of the uterus is hardly registered during to summer months in cows with normal peurperium and complications following day 2 of calving. No essential difference was found in estradiol-17 beta content in the blood plasma of both groups of cows. Body temperature rises in cows with postpartum complications.

  4. Biochemical evidence for programmed cell death in rabbit uterine epithelium.

    PubMed Central

    Rotello, R. J.; Hocker, M. B.; Gerschenson, L. E.

    1989-01-01

    Uterine epithelial cell proliferation, differentiation, and death are known to be regulated by estrogen and progesterone. The authors investigated a specific pattern of cell death called apoptosis, or programmed cell death, which is biochemically characterized by a specific pattern of DNA degradation. DNA isolated from endometrium of ovariectomized pseudopregnant rabbits showed a pattern of DNA cleavage at internucleosomal locations. In comparison, DNA from the endometrium of non-ovariectomized animals, as well as several other organs, did not exhibit that pattern. This biochemical evidence supports previous and present morphologic data and correlates with it. Under the experimental conditions used, only the uterine epithelial compartment of the endometrium shows apoptotic cell death, which is absent in the stromal compartment. Images Figure 1 Figure 2 PMID:2923180

  5. Partial reactivation of a huge deep-seated ancient rock slide: recognition, formation mechanism, and stability

    NASA Astrophysics Data System (ADS)

    Tang, Minggao; Xu, Qiang; Li, Yusheng; Huang, Runqiu; Rengers, Niek; Zhu, Xing

    2016-08-01

    About 18 years ago, a large-scale discontinuous layer in properties and colour was found in the new Fengjie town at the shore of the Three Gorges Reservoir area in China. There are many resettled residents and buildings on the sloping area, the safety of which is potentially affected by this layer, so it has become the focus of attention. Before this study started there were two viewpoints regarding the origin of this layer. One was that is was from a huge ancient slide and the other was that is was from a fault graben. In order to find out how it was formed and to be able to carry out a stability analysis of the slope the authors have carried out a research program, including geological field investigations and mapping, a deep drilling hole, a geotechnical centrifuge model test, and a simulation analysis. The results of the research led to the conclusion that the layer is the sliding plane of a huge deep-seated ancient rock slide, which we called the Sanmashan landslide. An important argument for the conclusion is the recognition of a regional compressive tectonic stress field in this area, which cannot lead to the formation of a fault graben because it needs a tensional tectonic stress field. Moreover, numerous unique geological features, sliding marks, and other relics of the ancient slide have been discovered in the field. The formation process of the ancient slide could be repeated in a large geotechnical centrifuge model test. The test shows that a deformation and failure process of "creep-crack-cut" has occurred. The type of the ancient slide can be classified as a "successive rotational rock slide". Finally, the role of seepage in the stability of the Sanmashan landslide has been analysed. Our final conclusions are that, during rainfall and filling-drawdown cycles in the Three Gorges Reservoir, the Sanmashan landslide as a whole is dormant and stable and the secondary landslides in the toe area of the slope are presently stable but can be reactivated. This

  6. Response of adenocarcinoma of the uterine cervix to chemoradiotherapy

    PubMed Central

    KAIDAR-PERSON, ORIT; YOSEFIA, SAWSAN; ABDAH-BORTNYAK, ROXOLYANA

    2015-01-01

    The aim of the current retrospective study was to investigate the response of advanced cervical adenocarcinoma (AC) to definitive chemoradiotherapy. Uterine cervical cancer is one of the most common cancer types among females, with squamous cell carcinoma (SQCC) being the most prevalent histological type. The incidence of cervical AC and its variants has markedly increased in recent decades. The current understanding with regard to the treatment of cervical cancer has been established through studies in which the majority of the patients suffered from SQCC, while only a limited number of studies have focused on the treatment of AC. Therefore, the optimal treatment for uterine cervical AC remains unclear. In the present study, data were collected from the medical files of patients who were diagnosed with advanced uterine cervical AC and treated with chemoradiotherapy between 1998 and 2013. Data were also collected from a group of patients with SQCC for comparison with AC patients in terms of response and survival. A total of 68 uterine cervical cancer cases were included, including 29 AC patients and 39 SQCC patients. Compared with the SQCC subgroup, a higher number of AC patients required surgery following chemoradiotherapy due to a lack of response to the initial treatment (5% vs. 31%, respectively; P=0.0065). After a median follow-up period of 10 years, patients with AC exhibited shorter overall survival (7.4 years vs. 11 years for AC and SQCC groups, respectively; P=0.01). Differences in recurrence (40.7% vs. 34.4%; P=0.79) and disease-free interval (1.2 years vs. 2 years; P=0.11) were not statistically significant. The results indicated that cervical AC is less responsive to chemoradiotherapy compared with SQCC. PMID:26137148

  7. [Current Status and Perspective of Chemoradiotherapy for Uterine Cervical Cancer].

    PubMed

    Toita, Takafumi; Ariga, Takuro; Kasuya, Goro; Hashimoto, Seiji; Maemoto, Hitoshi; Heianna, Joichi; Kakinohana, Yasumasa; Murayama, Sadayuki

    2015-10-01

    Fifteen years has passed since the NCI announced the clinical importance of concurrent chemoradiotherapy (CCRT) in radiotherapy for patients with locoregionally advanced uterine cervical cancer. Numerous clinical trials have been performed to further improve the outcomes of CCRT. In addition to investigations of chemotherapeutic regimens and schedules, adaptation of novel radiotherapy methods such as image-guided brachytherapy (IGBT) and intensity-modulated radiotherapy (IMRT) is encouraged in CCRT for cervical cancer.

  8. Choriocarcinoma with Uterine Rupture and Shock: A Rare Case Report

    PubMed Central

    Agarwal, Manika; Pyrbot, Jupirika; Singh, A.S.

    2015-01-01

    Choriocarcinoma is a rare neoplasm and a malignant form of gestational trophoblastic disease. Choriocarcinoma is frequently preceded by a complete mole, ectopic pregnancy, nonmolar intrauterine abortion, and uncommonly by a partial mole. It is treated medically with chemotherapeutic drugs usually. However, we managed to save a life with appropriate and timely surgical intervention in a case of choriocarcinoma who presented with uterine rupture, haemoperitoneum, anaemia and hypovolemic shock. The patient underwent exploratory laparotomy and hysterectomy followed by systemic chemotherapy. PMID:26557535

  9. Etilefrine and amezinium reduce uterine blood flow of pregnant guinea pigs.

    PubMed

    Hohmann, M; Künzel, W

    1989-02-01

    Etilefrine and Amezinium are used during pregnancy to prevent hypotension and fetal growth retardation. The effect of these drugs on uterine blood flow (UBF), uterine vascular resistance (UVR) and fetal growth are, however, unknown. 31 guinea pigs were injected daily with Etilefrine (3 X 0.14 mg/kg) and Amezinium (0.14 mg/kg) from day 30 to day 60. Uterine blood flow was measured with radioactive-labeled microspheres. Uterine vascular resistance was calculated from arterial blood pressure and uterine blood flow. 10 guinea pigs treated with 0.9% sodium chloride served as controls. As a response to Etilefrine and Amezinium, UBF fell by 68 and 48%, respectively, accompanied by an increase in UVR. The fetal weight decreased only slightly. It is concluded that long-term application of anti-hypotensive drugs may be hazardous to uterine blood flow and fetal growth.

  10. [Uterine rupture in a patient with bicornuate uterus at 12 weeks of amenorrhea: about a case].

    PubMed

    Itchimouh, Sanaa; Khabtou, Karima; Mahdaoui, Sakher; Boufettal, Houssine; Samouh, Naima

    2016-01-01

    The incidence of uterine malformations affecting reproduction is difficult to assess. Their identification requires a specific assessment (hysterosalpingography, hysteroscopy, laparoscopy). Spontaneous fertility can be affected depending on the type of uterine abnormality. All these abnormalities can affect the evolution of pregnancy causing early and late miscarriage, ectopic pregnancy, threat of premature labour, premature labour, vascular pathologies during pregnancy and inadequate intra-uterine growth. Bicornuate uterus is the most common uterine malformation and represents about half of all uterine anomalies The occurrence of this type of pregnancy is associated with an increased risk of maternal mortality, but early diagnosis and proper monitoring can lead pregnancies to term on malformed uterus. Ultrasound screening should allow for a systematic identification of such cases in order to take the necessary preventive measures. We report a case of uterine rupture in a patient with unicervical bicornuate uterus at 12 weeks of amenorrhea.

  11. Fetal arthrogryposis secondary to a giant maternal uterine leiomyoma.

    PubMed

    Vila-Vives, José María; Hidalgo-Mora, Juan José; Soler, Inmaculada; Rubio, Juan; Quiroga, Ramiro; Perales, Alfredo

    2012-01-01

    Arthrogryposis multiplex congenital is a rare condition defined as contractures in multiple joints at birth due to disorders starting in fetal life. Its etiology is associated with many different conditions and in many instances remains unknown. The final common pathway to all of them is decreased fetal movement (fetal akinesia) due to an abnormal intrauterine environment. Causes of decreased fetal movements may be neuropathic abnormalities, abnormalities of connective tissue or muscle, intrauterine vascular compromise, maternal diseases, and space limitations within the uterus. When the cause of arthrogryposis is space limitations in uterus, the most common etiology is oligohydramnios. The same can result from intrauterine tumours as fibroids, although to our knowledge there are only two papers reporting cases of fetal deformities related to uterine leiomyomas. We describe a well-documented exceptional case of arthrogryposis associated with the presence of a large uterine fibroid. It could illustrate the importance of a careful and appropriate assessment of uterine fibroids before and in the course of a pregnancy considering that they can cause both serious maternal and fetal complications.

  12. PIBF positive uterine NK cells in the mouse decidua.

    PubMed

    Bogdan, Agnes; Berta, Gergely; Szekeres-Bartho, Julia

    2017-02-01

    Though uterine NK cells (u NK cells) contain cytotoxic granules, and selectively over- express the genes of perforin and granzymes, during normal pregnancy, they are not cytotoxic. Progesterone is indispensable for the establishment and maintenance of pregnancy both in humans and in mice. Mouse uterine NK cells do not express the classical progesterone receptor, yet progesterone affects the recruitment and function of uterine NK cells, the latter partly via the Progesterone-Induced Blocking Factor (PIBF). We demonstrated PIBF positive granulated cells in the mouse decidua. The aim of this study was to characterize these cells by lectin immunohistochemistry and anti-perforin reactivity. PIBF+ granulated cells were absent from the deciduae of alymphoid mice, but appeared in the decidua of those that had been reconstituted with bone marrow from male BALB/c mice. PIBF+ granulated cells bound the DBA lectin, suggesting their NK cell nature, and also contained perforin, which co-localized with PIBF in the cytoplasmic granules. In anti-progesterone treated mice all of the PIBF+ cells were perforin positive at g. d. 12.5, in contrast to the 54% perforin positivity of PIBF+ cells in untreated mice.

  13. Use of cyanoacrylate glue for the closure of uterine incisions.

    PubMed

    Basaran, Mustafa; Vural, Mehmet; Irkorucu, Oktay; Gul, Mesut

    2009-01-01

    Closure of uterine incisions in a variety of gynecological procedures, specifically in myomectomy operations, is associated with significant hemorrhage. Excessive suturing to control bleeding may have negative effects on wound healing and might increase peritoneal adhesions. Moreover, difficulty of handling uterine tissue in laparoscopic procedures is not only a factor for suboptimal closure and inadequate control of bleeding but also a significant factor for surgeons for choosing laparotomy over laparoscopic approach. Cyanoacrylates are a group of molecules used as industrial adhesives. Newer cyanoacrylates are widely used in medicine. These agents are excellent biological adhesives due to strong adhesive action, hemostatic action, and antibacterial properties. Moreover, the presence of blood and tissue fluids enhances the activity of cyanoacrylates. In this study, 2-octyl cyanoacrylate, polypropylene, and polyglactin 910 sutures were compared in terms of adhesive strength, control of hemorrhage and postoperative intraabdominal adhesions in a rat model. Wound healing was excellent in all groups. Cyanoacrylates were associated with significantly lower total adhesion scores. This is the first report proposing the use of cyanoacrylates in gynecologic surgeries with supporting evidence for clinical use. Cyanoacrylates might be the first choice for the closure of uterine incisions and for the control of hemorrhage especially in laparoscopic procedures.

  14. Treatment of early uterine sarcomas: disentangling adjuvant modalities

    PubMed Central

    Zagouri, Flora; Dimopoulos, Athanasios-Meletios; Fotiou, Stelios; Kouloulias, Vassilios; Papadimitriou, Christos A

    2009-01-01

    Uterine sarcomas are a rare group of neoplasms with aggressive clinical course and poor prognosis. They are classified into four main histological subtypes in order of decreasing incidence: carcinosarcomas, leiomyosarcomas, endometrial stromal sarcomas and "other" sarcomas. The pathological subtype demands a tailored approach. Surgical resection is regarded as the mainstay of treatment. Total abdominal hysterectomy and bilateral salpingo-oophorectomy represents the standard treatment of uterine sarcomas. Pelvic and para-aortic lymph node dissection in carcinosarcomas is recommended, given their high incidence of lymph node metastases, and may have a role in endometrial stromal sarcomas. Adjuvant radiation therapy has historically been of little survival value, but it appears to improve local control and may delay recurrence. Regarding adjuvant chemotherapy, there is little evidence in the literature supporting its use except for carcinosarcomas. However, more trials are needed to address these issues, especially, their sequential application. Patients with uterine sarcomas should be referred to large academic centers for participation in clinical trials. PMID:19356236

  15. Excitation-contraction coupling in voltage clamped uterine smooth muscle

    PubMed Central

    Mironneau, Jean

    1973-01-01

    1. The relationship between ionic currents and contraction has been investigated in uterine strips of pregnant rat by means of a double sucrose gap apparatus combined with an optical method which permits the measurement of the contraction of the small muscular bundle where potential and current are recorded. 2. Effects of duration, size and frequency of imposed potentials upon contraction have been studied. The uterine muscle shows summation and tetanus phenomena. Tension elicited by depolarizing pulses of different durations and amplitudes can be considered as made of two components. 3. The first component of the contraction evoked by short depolarizing steps (about 50 ms) depends on the slow inward current. This contraction is abolished by manganese and lanthanum ions and by compound D 600. The amplitude of the tension can be related to the external calcium concentration and consequently to the calcium influx. The slow inward current is supposed to release a part of the bound calcium without excluding, however, a direct activation of myofibrils. 4. The second component of the contraction is observed in manganese containing solution with depolarizations longer than 200 ms and without inward current. Such a component of tension suggests the possibility of release of calcium from intracellular stores which could be located in the sarcoplasmic membrane of the uterine smooth muscle. PMID:4796671

  16. Glandular epithelial AR inactivation enhances PTEN deletion-induced uterine pathology.

    PubMed

    Choi, Jaesung Peter; Zheng, Yu; Handelsman, David J; Simanainen, Ulla

    2016-05-01

    Phosphatase and tensin homolog (PTEN) deletion induces uterine pathology, whereas androgen actions via androgen receptor (AR) support uterine growth and therefore may modify uterine cancer risk. We hypothesized that the androgen actions mediated via uterine glandular epithelial AR could modify PTEN deletion-induced uterine pathology. To test our hypothesis, we developed uterine glandular epithelium-specific PTEN and/or AR knockout mouse models comparing the uterine pathology among wild-type (WT), glandular epithelium-specific AR inactivation (ugeARKO), PTEN deletion (ugePTENKO), and the combined PTEN and AR knockout (ugePTENARKO) female mice. The double knockout restricted to glandular epithelium showed that AR inactivation enhanced PTEN deletion-induced uterine pathology with development of intraepithelial neoplasia by 20 weeks of age. In ugePTENARKO, 6/10 (60%) developed intraepithelial neoplasia, whereas 3/10 (30%) developed only glandular hyperplasia in ugePTENKO uterus. No uterine pathology was observed in WT (n=8) and ugeARKO (n=7) uteri. Uterine weight was significantly (P=0.002) increased in ugePTENARKO (374±97 mg (mean±s.e.)) compared with WT (97±6 mg), ugeARKO (94±12 mg), and ugePTENKO (205±33 mg). Estrogen receptor alpha (ERα) and P-AKT expression was modified by uterine pathology but did not differ between ugePTENKO and ugePTENARKO, suggesting that its expressions are not directly affected by androgens. However, progesterone receptor (PR) expression was reduced in ugePTENARKO compared to ugePTENKO uterus, suggesting that PR expression could be regulated by glandular epithelial AR inactivation. In conclusion, glandular epithelial AR inactivation (with persistent stromal AR action) enhanced PTEN deletion-induced uterine pathology possibly by downregulating PR expression in the uterus.

  17. Use of a uterine pessary to prevent infection of the uterus of the cow after parturition.

    PubMed

    Dobson, D P; Noakes, D E

    1990-08-11

    A uterine pessary containing penicillin, streptomycin, formosulphathiazole and ethinyloestradiol, was assessed for its efficacy in reducing the frequency and severity of uterine infections in cows after parturition. Fifteen pluriparous Holstein Friesian cows had pessaries inserted into the uterus within 24 hours after calving. Compared with 14 similar untreated cows there were significant reductions in the number infected by Actinomyces pyogenes and in the number exhibiting abnormal uterine discharges.

  18. Fluctuation of the water environmental carrying capacity in a huge river-connected lake.

    PubMed

    Wang, Hua; Zhou, Yiyi; Tang, Yang; Wu, Mengan; Deng, Yanqing

    2015-03-30

    A new method, with the non-fully mixed coefficient (NFMC) considered, was put forward to calculate the water environmental carrying capacity (WECC) for huge river-connected lakes, of which the hydrological conditions always vary widely during a year. Poyang Lake, the most typical river-connected lake and the largest freshwater lake in China, was selected as the research area. Based on field investigations and numerical simulation, the monthly pollutant degradation coefficients and non-fully mixed coefficients of different lake regions were determined to explore the WECCs of COD, TN and TP of Poyang Lake in a common water year. It was found that under the hydrological conditions of a common water year the total WECCs of COD, TN and TP in the lake were respectively 181.9 × 104 t, 33.3 × 104 t and 1.86 × 104 t. Due to the varied lake water volume and self-purification ability, an evident temporal fluctuation of WECCs in Poyang Lake was observed. The dry seasons were characterized by a higher NFMCs but lower WECCs owing to the lower water level and degradation ability. Variation coefficients of COD and TN WECC were close to each other, of which the average level was about 58.5%, a little higher than that of TP.

  19. Crystal structure of Clostridium botulinum whole hemagglutinin reveals a huge triskelion-shaped molecular complex.

    PubMed

    Amatsu, Sho; Sugawara, Yo; Matsumura, Takuhiro; Kitadokoro, Kengo; Fujinaga, Yukako

    2013-12-06

    Clostridium botulinum HA is a component of the large botulinum neurotoxin complex and is critical for its oral toxicity. HA plays multiple roles in toxin penetration in the gastrointestinal tract, including protection from the digestive environment, binding to the intestinal mucosal surface, and disruption of the epithelial barrier. At least two properties of HA contribute to these roles: the sugar-binding activity and the barrier-disrupting activity that depends on E-cadherin binding of HA. HA consists of three different proteins, HA1, HA2, and HA3, whose structures have been partially solved and are made up mainly of β-strands. Here, we demonstrate structural and functional reconstitution of whole HA and present the complete structure of HA of serotype B determined by x-ray crystallography at 3.5 Å resolution. This structure reveals whole HA to be a huge triskelion-shaped molecule. Our results suggest that whole HA is functionally and structurally separable into two parts: HA1, involved in recognition of cell-surface carbohydrates, and HA2-HA3, involved in paracellular barrier disruption by E-cadherin binding.

  20. Huge undifferentiated carcinoma of the pancreas with osteoclast-like giant cells.

    PubMed

    Jo, Sungho

    2014-03-14

    Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells (OGCs) is very rare, less than 1% of all pancreatic malignancies, and shows worse prognosis than that of invasive ductal adenocarcinoma of the pancreas. We present a case of en bloc resection for a huge undifferentiated carcinoma with OGCs that invaded the stomach and transverse mesocolon. A 67-year female was admitted for left upper quadrant pain and computed tomography demonstrated a mass occupying the lesser sac and abutting the stomach and pancreas. There were no distant metastases and the patient underwent subtotal pancreatectomy with splenectomy, total gastrectomy, and segmental resection of the transverse colon. Histopathological examination confirmed an 11 cm-sized undifferentiated carcinoma of the pancreas with OGCs. Immunohistochemical staining revealed reactivity with pan-cytokeratin in adenocarcinoma component, with vimentin in neoplastic multi-nucleated cells, with CD45/CD68 in OGCs, and with p53 in tumor cells, respectively. The patient had suffered from multiple bone metastases and survived 9 mo after surgery. This case supports the ductal epithelial origin of undifferentiated carcinoma with OGCs and early diagnosis could result in favorable surgical outcomes. Investigations on the surgical role and prognostic factors need to be warranted in this tumor.

  1. Synovial sarcoma presenting with huge mediastinal mass: a case report and review of literature

    PubMed Central

    2013-01-01

    Background Synovial sarcoma presenting in the mediastinum is exceedingly rare. Furthermore, data addressing optimal therapy is limited. Herein we present a case where an attempt to downsize the tumor to a resectable state with chemotherapy was employed. Case presentation A 32 year female presented with massive pericardial effusion and unresectable huge mediastinal mass. Computed axial tomography scan - guided biopsy with adjunctive immunostains and molecular studies confirmed a diagnosis of synovial sarcoma. Following three cycles of combination Ifosfamide and doxorubicin chemotherapy, no response was demonstrated. The patient refused further therapy and had progression of her disease 4 months following the last cycle. Conclusion Synovial sarcoma presenting with unresectable mediastinal mass carry a poor prognosis. Up to the best of our knowledge there are only four previous reports where primary chemotherapy was employed, unfortunately; none of these cases had subsequent complete surgical resection. Identification of the best treatment strategy for patients with unresectable disease is warranted. Our case can be of benefit to medical oncologists and thoracic surgeons who might be faced with this unique and exceedingly rare clinical scenario. PMID:23800262

  2. Computational AstroStatistics: fast and efficient tools for analysing huge astronomical data sources

    NASA Astrophysics Data System (ADS)

    Nichol, Robert C.; Chong, S.; Connolly, A. J.; Davies, S.; Genovese, C.; Hopkins, A. M.; Miller, C. J.; Moore, A. W.; Pelleg, D.; Richards, G. T.; Schneider, J.; Szapudi, I.; Wasserman, L.

    I present here a review of past and present multi-disciplinary research of the Pittsburgh Computational AstroStatistics (PiCA) group. This group is dedicated to developing fast and efficient statistical algorithms for analysing huge astronomical data sources. I begin with a short review of multi-resolutional kd-trees which are the building blocks for many of our algorithms. For example, quick range queries and fast N-point correlation functions. I will present new results from the use of Mixture Models (Connolly et al. 2000) in desity estimation of multi-color data from the Sloan Digital Sky Survey (SDSS). Specifically, the selection of quasars and the automated identification of X-ray sources. I will also present a brief overview of the False Discovery Rate (FDR) procedure (Miller et al. 2001) and show how it has been used in the detection of "Baryon Wiggles" in the local galaxy power spectrum and source identification in radio data. Finally, I will look forward to new research on an automatied Bayes Network anomaly detector and the possible use of the Locally Linear Embedding algorithm (LLE; Roweis & Saul 2000) for spectral classification of SDSS spectra.

  3. Unexpected Huge Dimerization Ratio in One-Dimensional Carbon Atomic Chains.

    PubMed

    Lin, Yung-Chang; Morishita, Shigeyuki; Koshino, Masanori; Yeh, Chao-Hui; Teng, Po-Yuan; Chiu, Po-Wen; Sawada, Hidetaka; Suenaga, Kazutomo

    2017-01-11

    Peierls theory predicted atomic distortion in one-dimensional (1D) crystal due to its intrinsic instability in 1930. Free-standing carbon atomic chains created in situ in transmission electron microscope (TEM)1-3 are an ideal example to experimentally observe the dimerization behavior of carbon atomic chain within a finite length. We report here a surprisingly huge distortion found in the free-standing carbon atomic chains at 773 K, which is 10 times larger than the value expected in the system. Such an abnormally distorted phase only dominates at the elevated temperatures, while two distinct phases, distorted and undistorted, coexist at lower or ambient temperatures. Atom-by-atom spectroscopy indeed shows considerable variations in the carbon 1s spectra at each atomic site but commonly observes a slightly downshifted π* peak, which proves its sp(1) bonding feature. These results suggest that the simple model, relaxed and straight, is not fully adequate to describe the realistic 1D structure, which is extremely sensitive to perturbations such as external force or boundary conditions.

  4. Distributed data organization and parallel data retrieval methods for huge laser scanner point clouds

    NASA Astrophysics Data System (ADS)

    Hongchao, Ma; Wang, Zongyue

    2011-02-01

    This paper proposes a novel method for distributed data organization and parallel data retrieval from huge volume point clouds generated by airborne Light Detection and Ranging (LiDAR) technology under a cluster computing environment, in order to allow fast analysis, processing, and visualization of the point clouds within a given area. The proposed method is suitable for both grid and quadtree data structures. As for distribution strategy, cross distribution of the dataset would be more efficient than serial distribution in terms of non-redundant datasets, since a dataset is more uniformly distributed in the former arrangement. However, redundant datasets are necessary in order to meet the frequent need of input and output operations in multi-client scenarios: the first copy would be distributed by a cross distribution strategy while the second (and later) would be distributed by an iterated exchanging distribution strategy. Such a distribution strategy would distribute datasets more uniformly to each data server. In data retrieval, a greedy algorithm is used to allocate the query task to a data server, where the computing load is lightest if the data block needing to be retrieved is stored among multiple data servers. Experiments show that the method proposed in this paper can satisfy the demands of frequent and fast data query.

  5. Surgery and Chemotherapy With or Without Chemotherapy After Surgery in Treating Patients With Ovarian, Fallopian Tube, Uterine, or Peritoneal Cancer

    ClinicalTrials.gov

    2016-10-18

    Recurrent Uterine Corpus Cancer; Recurrent Fallopian Tube Cancer; Recurrent Ovarian Cancer; Recurrent Primary Peritoneal Cancer; Stage IIIA Uterine Corpus Cancer; Stage IIIA Fallopian Tube Cancer; Stage IIIA Ovarian Cancer; Stage IIIA Primary Peritoneal Cavity Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIB Fallopian Tube Cancer; Stage IIIB Ovarian Cancer; Stage IIIB Primary Peritoneal Cavity Cancer; Stage IIIC Uterine Corpus Cancer; Stage IIIC Fallopian Tube Cancer; Stage IIIC Ovarian Cancer; Stage IIIC Primary Peritoneal Cavity Cancer; Stage IV Fallopian Tube Cancer; Stage IV Ovarian Cancer; Stage IV Primary Peritoneal Cavity Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer

  6. Midterm Results after Uterine Artery Embolization Versus MR-Guided High-Intensity Focused Ultrasound Treatment for Symptomatic Uterine Fibroids

    SciTech Connect

    Froeling, V. Meckelburg, K. Scheurig-Muenkler, C. Schreiter, N. F. Kamp, J. Maurer, M. H. Beck, A. Hamm, B. Kroencke, T. J.

    2013-12-15

    Purpose: To compare the rate of reintervention and midterm changes in symptom severity (SS) and Total health-related quality of life (HRQoL) scores after uterine artery embolization (UAE) and magnetic resonance-guided high-intensity focused ultrasound (MR-g HIFU) for symptomatic uterine fibroids. Methods: Eighty women (median age 38.3 years), equally eligible for MR-g HIFU and UAE who underwent one of both treatments between 2002 and 2009 at our institution, were included. The primary end point of the study was defined as the rate of reintervention after both therapies. The secondary outcome was defined as changes in SS and Total HRQoL scores after treatment. SS and Total HRQoL scores before treatment and at midterm follow-up (median 13.3 months) were assessed by the uterine fibroid symptom and quality-of-life questionnaire (UFS-QoL) and compared. Results: The rate of reintervention was significantly lower after UAE than after MR-g HIFU (p = 0.002). After both treatments, SS and Total HRQoL scores improved significantly from baseline to follow-up (UAE: p < 0.001, p < 0.001; MR-g HIFU: p = 0.002, p < 0.001). Total HRQoL scores were significantly higher after UAE than after MR-g HIFU (p = 0.032). Changes in the SS scores did not differ significantly for both treatments (p = 0.061). Conclusion: UAE and MR-g HIFU significantly improved the health-related quality of life of women with symptomatic uterine fibroids. After UAE, the change in Total HRQoL score improvement was significantly better, and a significantly lower rate of reintervention was observed.

  7. Massive multicystic dilatation of the uterine wall with myometrial venous thrombosis during pregnancy.

    PubMed

    Uotila, J; Dastidar, P; Martikainen, P; Kirkinen, P

    2004-09-01

    We present a pregnancy complicated by multicystic dilatation of the uterine wall during the second trimester, leading to massive uterine distension, anemia and preterm Cesarean section. The cystic changes detected by ultrasound and magnetic resonance imaging involved the whole uterine wall surrounding the entire amniotic cavity. Histopathological examination revealed the benign nature of the cystic changes, which represented dilated and thrombosed venous lacunae. Disturbed venous drainage, combined with local thrombosis, was likely to have led to the collection of a large volume of blood in the uterine wall and the subsequent multicystic change of the myometrium.

  8. Postnatal exposure to a progestin does not prevent uterine adenogenesis in domestic dogs

    PubMed Central

    Ponchon, Tamara; Lopez Merlo, Mariana; Faya, Marcela; Priotto, Marcelo; Barbeito, Claudio

    2016-01-01

    To assess the effects of a single supraphysiological postnatal administration of a progestogen on uterine glands in dogs, 10 females were randomly assigned to a medroxyprogesterone acetate 35 mg (MPA; n = 6) or placebo (n = 4) group within the first 24 h of birth. The safety of the treatment was also evaluated. A transient mild clitoris enlargement appeared in MPA-treated females. Microscopic postpubertal uterine assessment revealed the presence of uterine glands in all cases without significant differences in the area occupied by the glands per µm2 of endometrium nor in the height of the uterine epithelium. PMID:27051347

  9. Uterine rupture and septic peritonitis following dystocia and assisted delivery in a Great Dane bitch.

    PubMed

    Humm, Karen R; Adamantos, Sophie E; Benigni, Livia; Armitage-Chan, Elizabeth A; Brockman, Daniel J; Chan, Daniel L

    2010-01-01

    A Great Dane bitch was treated for presumed primary uterine inertia with repeated doses of oxytocin and manually assisted whelping. She was diagnosed with uterine rupture and septic peritonitis the following day. The uterine rupture is hypothesized to have occurred as a result of the management strategy used to treat dystocia. The dog underwent ovariohysterectomy, and the septic peritonitis was managed with open peritoneal drainage. The dog recovered well and was discharged 5 days later. No previous reports of canine uterine rupture associated with manual intervention appear to have been published. This report highlights the potential dangers involved in such an approach.

  10. Effect of Tramadol on Rabbit Uterine Contractile Activity Induced in Late Pregnancy.

    PubMed

    Yakovleva, A A; Nazarova, L A; Prokopenko, V M; Pavlova, N G

    2017-01-01

    Effect of Tramadol infusion (5 mg/ml) on oxytocin-induced uterine contractile activity was studied in chronic experiment on female rabbits with different degrees of biological readiness for parturition. In case of sufficient biological readiness for parturition, Tramadol did not change the number of uterine contractions, but increased the amplitude and duration of each contraction against the background of increased creatine phosphate consumption by the myometrium. At the same time, Tramadol infusion to females without biological readiness for partirition suppressed induced uterine contractile activity by reducing the amplitude of each uterine contraction.

  11. Uterine Microbiota Progression from Calving until Establishment of Metritis in Dairy Cows

    PubMed Central

    Jeon, Soo Jin; Vieira-Neto, Achilles; Gobikrushanth, Mohanathas; Daetz, Rodolfo; Mingoti, Rodolfo D.; Parize, Ana Carolina Brigolin; de Freitas, Sabrina Lucas; da Costa, Antonio Nelson Lima; Bicalho, Rodrigo C.; Lima, Svetlana; Jeong, K. Casey

    2015-01-01

    The objective of this study was to evaluate the progression of the uterine microbiota from calving until establishment of metritis. Uterine swabs (n = 72) collected at 0, 2, and 6 ± 2 days postpartum (dpp) from 12 metritic and 12 healthy cows were used for metagenomic sequencing of the 16S rRNA gene on the Illumina MiSeq platform. A heat map showed that uterine microbiota was established at calving. The microbiota changed rapidly from 0 to 6 ± 2 dpp, with a decrease in the abundance of Proteobacteria and an increase in the abundance of Bacteroidetes and Fusobacteria, which were dominant in metritic cows. Uterine microbiota composition was shared; however, metritic and healthy cows could be discriminated using relative abundance of bacterial genera at 0, 2, and 6 ± 2 dpp. Bacteroides was the main genus associated with metritis because it was the only genus that showed significantly greater abundance in cows with metritis. As the abundance of Bacteroides organisms increased, the uterine discharge score, a measure of uterine health, worsened. Fusobacterium was also an important genus associated with metritis because Fusobacterium abundance increased as Bacteroides abundance increased and the uterine discharge score worsened as the abundance increased. The correlation with uterine discharge score and the correlation with Bacteroides or Fusobacterium showed that other bacteria, such as Helcoccocus, Filifactor, and Porphyromonas, were also associated with metritis. There were also bacteria associated with uterine health, such as “Candidatus Blochmannia,” Escherichia, Sneathia, and Pedobacter. PMID:26150453

  12. Partial regeneration and reconstruction of the rat uterus through recellularization of a decellularized uterine matrix.

    PubMed

    Miyazaki, Kaoru; Maruyama, Tetsuo

    2014-10-01

    Despite dramatic progress in infertility treatments and assisted reproduction, no effective therapies exist for complete loss of uterine structure and/or function. For such patients, genetic motherhood is possible only through gestational surrogacy or uterine transplantation. However, many ethical, social, technical and safety challenges accompany such approaches. A theoretical alternative is to generate a bioartificial uterus, which requires engineering of uterine architecture and appropriate cellular constituents. Here, rat uteri decellularization by aortic perfusion with detergents produced an underlying extracellular matrix together with an acellular, perfusable vascular architecture. Uterine-like tissues were then regenerated and maintained in vitro for up to 10 d through decellularized uterine matrix (DUM) reseeding with adult and neonatal rat uterine cells and rat mesenchymal stem cells followed by aortic perfusion in a bioreactor. Furthermore, DUM placement onto a partially excised uterus yielded recellularization and regeneration of uterine tissues and achievement of pregnancy nearly comparable to the intact uterus. These results suggest that DUM could be used for uterine regeneration, and provides insights into treatments for uterine factor infertility.

  13. Mid-term Clinical Results and Patient Satisfaction After Uterine Artery Embolization in Women with Symptomatic Uterine Fibroids

    SciTech Connect

    Smeets, Albert J.; Lohle, Paul N. M. Vervest, Harry A. M.; Boekkooi, P. Focco; Lampmann, Leo E.H.

    2006-04-15

    Purpose. To evaluate the mid-term clinical results and patient satisfaction following uterine artery embolization (UAE) in women with symptomatic fibroids. Methods. Between August 1998 and December 2002, 135 patients had UAE for symptomatic uterine fibroids. All patients were asked to fill in a questionnaire. Questions were aimed at changes in bleeding, pain, and bulk-related symptoms. Symptoms after UAE were scored as disappeared, improved, unchanged or worsened. Adverse events were noted, such as vaginal dryness and discharge, menopausal complaints or fibroid expulsion. Patient satisfaction after UAE was assessed. Patient satisfaction of women embolized with polyvinyl alcohol (PVA) particles was compared with satisfaction of women embolized with calibrated microspheres. Results. The questionnaire was returned by 110 of 135 women (81%) at a median time interval of 14 months following UAE. In 10 women additional embolization or hysterectomy had been performed. Of the 110 responders, 86 (78%) were satisfied with the result of UAE. The proportion of satisfied women was higher in the group embolized with calibrated microspheres than in women embolized with PVA, although this difference was not statistically significant (p = 0.053). Conclusion. UAE in women with symptomatic uterine fibroids leads to improvement of symptoms and patient satisfaction is good in the vast majority after a median follow-up period of 14 months.

  14. Complications associated with insertion of intrauterine pressure catheters: an unusual case of uterine hypertonicity and uterine perforation resulting in fetal distress after insertion of an intrauterine pressure catheter.

    PubMed

    Rood, Kara M

    2012-01-01

    Insertion of intrauterine pressure catheters is a routine procedure performed in labor and delivery departments, with few associated complications. There are several reports of maternal and neonatal morbidity associated with the use of intrauterine pressure catheters and their rare adverse outcomes. We report an unusual case of uterine hypertonicity resulting in fetal distress, immediately after the placement of an intrauterine pressure catheter. An emergent Cesarean section was performed for fetal distress and revealed a 5 cm vertical rent in the posterior lower uterine segment. The uterine perforation was repaired intraoperatively. Mother and infant did well and were discharged home on postoperative day four.

  15. Copper and zinc concentrations in the uterine fluid and blood serum during the bovine estrous cycle.

    PubMed

    Alavi-Shoushtari, Sayed Mortaza; Asri Rezaie, Siamak; Pak, Mozhgan; Alizadeh, Sajad; Abedizadeh, Roya; Khaki, Amir

    2012-01-01

    To investigate uterine and serum copper (Cu) and zinc (Zn) concentrations variation during the bovine estrus cycle , 232 blood and genital tract samples were collected from the abattoir in Urmia. The phase of the estrous cycle was determined by the examination of the ovaries and the uterine tonicity. Of the 46 samples selected for use in the study, 13 were pro-estrus, 10 estrus, 8 metestrus, and 15 diestrus. The uterus was incised and uterine fluid was collected by gentle scraping of the uterine mucosa with a curette. The total mean (± SEM) Cu concentrations in serum and uterine fluid samples, determined by spectrophotometry, were 66.1± 6.5 and 171.3 ± 33.2µg dL(-1) respectively, which were significantly different, while total mean serum and uterine fluid Zn concentrations were 91.9 ± 5.4 and 291.6 ± 23.4 µg dL(-1), which also showed a significant difference. The mean serum Cu values in different phases of the estrous cycle were not significantly different, while uterine fluid Cu content in pro-estrus and diestrus were significantly higher than those in estrus and metestrus, and were also significantly higher than those of the serum samples. The mean Zn value of serum samples at different stages of the cycle was not significantly different. The mean Zn value of the uterine fluid samples was also not significantly different in different stages, but in pro-estrus, metestrus, and in diestrus they were highly significantly different from those of the serum. These results showed that Cu concentrations in the uterine fluid vary at different stages of the cycle and are higher than those in the blood serum, but, the uterine Zn content does not vary during the estrous cycle and is much higher than those in the serum, that seems to be due to the secretory action of the uterine mucosa.

  16. Endovascular Treatment of the Huge Dissecting Aneurysms Involving the Basilar Artery by the Internal Trapping Technique: Technical Note

    PubMed Central

    Mu, Shi-Qing; Yang, Xin-Jian; Li, You-Xiang; Jiang, Chu-Han; Wu, Zhong-Xue

    2015-01-01

    Background: The endovascular strategy of the huge dissecting aneurysms involving the basilar artery (BA) is controversial and challenging. This study was to investigate the clinical and angiographic outcomes of the treatment of the huge dissecting aneurysms involving the BA by the internal trapping (IT) technique. Methods: We retrospectively studied 15 patients with the huge dissecting aneurysms involving the BA treated by the IT technique between September 2005 and September 2014 in Department of Interventional Neuroradiology of Beijing Tiantan Hospital. Clinical and angiographic data were reviewed and evaluated. Results: All patients were treated by the IT technique. That meant the dissecting artery and aneurysm segments were completed occlusion. After the procedure, the angiography demonstrated that all the dissecting artery and aneurysm segments were completed occlusion. Follow-up angiography was performed at 3–6 months or 12–18 months after the endovascular treatment (median 8 months), 14 patients had a good recovery. Re-canalization occurred in one patient whose aneurysm involved in bilateral vertebral arteries and the two third of the middle-lower BA. After the second treatment, the patient died by the ventricular tachycardia. Conclusions: The IT technique is a technically feasible and safe alternative for the treatment of BA dissecting aneurysms, but it is not necessarily the safest or most definitive treatment modality. The ideal treatment of the huge dissecting aneurysms involving the BA remains debatable and must be investigated on a case-by-case basis. PMID:26168833

  17. Endoscopic curettage and bone grafting of huge talar bone cyst with preservation of cartilaginous surfaces: surgical planning.

    PubMed

    Lui, Tun Hing

    2014-12-01

    Open curettage and bone grafting of the huge talar cysts may need extensive soft tissue dissection or even different types of malleolar osteotomy to access the lesion. Arthroscopic approach can minimize soft tissue dissection or the need for malleolar osteotomy. Careful pre-operative planning of the portal sites allows endoscopic curettage and bone grafting of the lesions with preservation of the articular surfaces.

  18. Uterine Artery Embolization for Ureteric Obstruction Secondary to Fibroids

    SciTech Connect

    Mirsadraee, Saeed; Tuite, David; Nicholson, Anthony

    2008-11-15

    This case series examines the safety and efficacy of uterine artery embolization (UAE) in the treatment of obstructive nephropathy caused by large fibroids. Between 2004 and 2007, 10 patients referred with symptomatic uterine fibroids that were found to be causing either unilateral (7 patients) or bilateral (3 patients) hydronephrosis were treated by UAE. Presenting complaints included menorrhagia, dysmenorrhea, bulk symptoms, loin pain, postobstructive atrophy, and mild renal impairment. All had posterior intramural dominant fibroids >11 cm in maximum sagittal diameter and uterine volumes between 3776 and 15,625 ml. Outcome measures at between 12 and 36 months included procedural success, repeat intervention, relief of symptoms, resolution of hydronephrosis, stable renal function and size, and avoidance of hysterectomy. In all cases the cause of renal obstruction was confirmed to be a giant fibroid compressing the ureter at the pelvic brim. In all cases UAE was technically successful, though two patients required a repeat procedure. In eight patients hydronephrosis resolved and the obstruction was relieved, though two still had some bulk symptoms not requiring further treatment. Renal function improved or was stable in all cases. Renal size was stable in all cases. Where menorrhagia was part of the symptom complex it was relieved in all cases. Two patients diagnosed as having postobstructive atrophy of one kidney underwent retrograde ureteric stenting on the nonatrophied side prior to UAE. This was unsuccessful in one of the cases due to the distortion caused by the fibroid. Despite improvement in hydronephrosis this patient underwent hysterectomy at 7 months after a renogram demonstrated persistent obstruction at the pelvic brim. In the second patient a double pigtail stent was inserted with difficulty and eventually removed at 8 months. This patient has had stable renal function and size for 3 years post-UAE. We conclude that UAE is safe and effective in

  19. The Role of Adjuvant Radiation in Uterine Sarcomas

    SciTech Connect

    Sampath, Sagus; Schultheiss, Timothy E.; Ryu, Janice K.; Wong, Jeffrey Y.C.

    2010-03-01

    Purpose: To determine clinical and pathological factors significant for overall survival (OS) and local-regional failure-free survival (LRFFS) in uterine sarcoma as they relate to adjuvant radiotherapy (AR). Methods and Materials: A retrospective analysis of 3,650 patients with uterine sarcoma was conducted using the National Oncology Database, a proprietary database of aggregated tumor registries owned by Impac Medical Systems (Sunnyvale, CA). Adjuvant radiotherapy was defined as postoperative external beam radiation to the pelvis, with or without brachytherapy. Prognostic factors were identified by multivariate analysis (MVA) using the Cox proportional hazards model. The Kaplan-Meier method was used to estimate survival, with significant differences (p < 0.05) determined using the log-rank test. Results: The median follow-up time was 59 months, with a 5-year OS of 37%. Significant prognostic factors for OS were stage, race/ethnicity, grade, age, histology, lymph node status, and surgical treatment (p < 0.01 for all factors). Use of AR was not predictive for OS. For nonmetastatic cancer patients receiving definitive surgery (n = 2,206), the 5-year LRFFS was 87%. In this group, stage, grade, histology, and AR were prognostic for LRFFS (p < 0.05), with AR associated with improved outcome compared with surgery alone (hazard ratio = 0.4, p < 0.001). Patients with carcinosarcoma, endometrial stromal sarcoma, leiomyosarcoma, poorly differentiated tumors, and negative lymph nodes had reduced local-regional failure (LRF) with AR (log-rank, p < 0.05 for all). Conclusion: In the largest retrospective analysis of uterine sarcoma published thus far, AR conferred a 53% reduction in the risk of LRF at 5 years. Use of AR may have broader indications than what are currently accepted in clinical practice.

  20. Multispectral imaging of organ viability during uterine transplantation surgery

    NASA Astrophysics Data System (ADS)

    Clancy, Neil T.; Saso, Srdjan; Stoyanov, Danail; Sauvage, Vincent; Corless, David J.; Boyd, Michael; Noakes, David E.; Thum, Meen-Yau; Ghaem-Maghami, Sadaf; Smith, J. R.; Elson, Daniel S.

    2014-02-01

    Uterine transplantation surgery has been proposed as a treatment for permanent absolute uterine factor infertility (AUFI) in the case of loss of the uterus. Due to the complexity of the vasculature correct reanastomosis of the blood supply during transplantation surgery is a crucial step to ensure reperfusion and viability of the organ. While techniques such as fluorescent dye imaging have been proposed to visualise perfusion there is no gold standard for intraoperative visualisation of tissue oxygenation. In this paper results from a liquid crystal tuneable filter (LCTF)-based multispectral imaging (MSI) laparoscope are described. The system was used to monitor uterine oxygen saturation (SaO2) before and after transplantation. Results from surgeries on two animal models (rabbits and sheep) are presented. A feature-based registration algorithm was used to correct for misalignment induced by breathing or peristalsis in the tissues of interest prior to analysis. An absorption spectrum was calculated at each spatial pixel location using reflectance data from a reference standard, and the relative contributions from oxy- and deoxyhaemoglobin were calculated using a least squares regression algorithm with non-negativity constraints. Results acquired during animal surgeries show that cornual oxygenation changes are consistent with those observed in point measurements taken using a pulse oximeter, showing reduced SaO2 following reanastomosis. Values obtained using the MSI laparoscope were lower than those taken with the pulse oximeter, which may be due to the latter's use of the pulsatile arterial blood signal. Future work incorporating immunological test results will help to correlate SaO2 levels with surgical outcomes.

  1. Uterine environment and pregnancy rate of heifers with elevated plasma urea nitrogen

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Diets high in protein are associated with lower reproductive performance and changes in the uterine environment. The objective of this study was to determine the effect of elevated systemic concentrations of urea nitrogen on the uterine environment and pregnancy success in beef heifers. Heifers (n...

  2. Placenta accreta in a patient with a history of uterine artery embolization for postpartum hemorrhage.

    PubMed

    Kanter, G; Packard, L; Sit, A S

    2013-06-01

    Uterine artery embolization (UAE) is used to treat various conditions from uterine leiomyoma to uncontrollable bleeding. We describe a case of placenta accreta after a prior delivery, which required UAE to control a postpartum hemorrhage. This case highlights the importance of both antenatal evaluation of placentation and heightened precaution for delivery in subsequent pregnancies for women who have undergone this procedure.

  3. Feasibility study on energy prediction of microwave ablation upon uterine adenomyosis and leiomyomas by MRI

    PubMed Central

    Xia, M; Zhi-yu, H; Jian-ming, C; Hong-yu, Z; Rui-fang, X; Yu, Y; Yan-li, H; Bao-wei, D

    2014-01-01

    Objective: To evaluate the feasibility of energy prediction of percutaneous microwave ablation (PMWA) upon uterine leiomyomas and adenomyosis by MRI. Methods: 63 patients (49 patients with 49 uterine leiomyomas and 14 patients with adenomyosis) who underwent ultrasound-guided PMWA treatment were studied during the period from June 2011 to December 2012. Before PMWA, contrast-enhanced MRI (ceMRI) was performed for all of the patients. Based on the signal intensity (SI) of T2 weighted MRI, uterine leiomyomas were classified as hypointense, isointense and hyperintense. During ablation, the output energy of the microwave was set at 50 W, and T11a microwave antennas were used. ceMRI was performed within 7 days after PMWA treatment. Non-perfused volume and energy required per unit volume were analysed statistically. Results: When unit volume of lesions was ablated, uterine adenomyosis needed more energy than did uterine leiomyomas, and hyperintense uterine leiomyomas needed more energy than did hypointense pattern. Conclusions: MRI SI of uterine leiomyomas and uterine adenomyosis can be used to predict PMWA energy. Advances in knowledge: The conclusions indicate that MRI SI can be used to perform pre-treatment planning, which will make the treatment more precise. PMID:24947033

  4. The uterine lumen of the pregnant guinea-pig contains a large macrophage population.

    PubMed

    Sype, W; Lentfer, K; Kimberly, D J; Smith, M K; Van Meter, L; Thornburg, K L

    1989-01-01

    Cellular constituents of the uterine lumen were investigated. Fourteen pregnant sows of 40 + days' gestation were anaesthetized and naturally occurring peritoneal fluid was collected. A uterine horn was delivered and 0.25 ml Gey's solution injected into the uterine lumen to collect free cells. The fluid was aspirated into a syringe and the cells extracted, counted and prepared for phagocytosis experiments and microscopy. The cells were stained with alpha-naphthyl-acetate-esterase (ANAE) to determine the fraction that was non-specific esterase-positive, a feature of mononuclear phagocytes. Differential cells counts were also made. Both uterine and peritoneal compartments yielded large numbers of cells (greater than 10(6)/ml). Peritoneal fluid cells were 47 +/- 6 per cent (SD) macrophages and 49 +/- 6 per cent eosinophils (the remainder being 'other' cells); 47 +/- 6 per cent also stained positively for ANAE. Uterine cells were 78 +/- 12 per cent macrophages, the remainder being mostly lymphocytes (18 +/- 11 per cent); 85 +/- 13 per cent stained positively with ANAE. Electron microscopy of the uterine cells confirmed that most had morphology consistent with being mononuclear phagocytes. Uterine and peritoneal cells phagocytized carbon particles and yeast cells when incubated at 37 degrees C. The origin and role of this macrophage population is unknown but uterine lumenal macrophages may be present to remove antigen-antibody complexes thus facilitating uptake of maternally derived IgG by the fetal yolk sac.

  5. Adenoid Cystic Carcinoma of the Uterine Cervix: A Report of 2 Cases

    PubMed Central

    Kharmoum, Jinane; Ech-Charif, Soumaya; El Khannoussi, Basma

    2017-01-01

    Adenoid cystic carcinoma is malignant tumor that exceptionally occurs in the uterine cervix. It is mostly seen in postmenopausal women and has an aggressive clinical course. We report two cases of an adenoid cystic carcinoma associated with a high grade squamous intraepithelial lesion and invasive squamous cell carcinoma of the uterine cervix and discuss briefly its clinical and pathological characteristics. PMID:28348909

  6. Different dosages of mifepristone versus enantone to treat uterine fibroids

    PubMed Central

    Liu, Chongdong; Lu, Qi; Qu, Hong; Geng, Li; Bian, Meilu; Huang, Minli; Wang, Huilan; Zhang, Youzhong; Wen, Zeqing; Zheng, Shurong; Zhang, Zhenyu

    2017-01-01

    Abstract Background: To evaluate the efficacy and safety of 10 mg and 25 mg mifepristone per day compared with 3.75 mg enantone in treating uterine fibroids. Methods: This is a Multicenter randomized controlled trial. A total of 501 subjects with symptomatic uterine fibroids were enrolled and randomized into the group of 10mg, 25mg mifepristone and 3.75 enantone (with 307, 102 and 92 subjects respectively), with 458 subjects completed the treatment. Three months of daily therapy with oral mifepristone (at a dose of either 10 mg or 25 mg) or once-monthly subcutaneous injections of enantone (at a dose of 3.75 mg) were used. Change in volume of the largest uterine fibroid was the primary efficacy variable, and secondary efficacy variables included changes in anemia and relevant symptom. Safety evaluation included the analyses of adverse events, laboratory values, and relevant endometrial changes. Results: After three months of treatment, the mean volume of the largest leiomyoma was significantly reduced by mifepristone 10 mg or 25 mg or enantone 3.75 mg (40.27%, 42.59% and 44.49% respectively) (P < 0.0001). Percentage change from baseline in largest leiomyoma volume was not statistically significant among the three groups (P = 0.1057). Most of the patients in all groups experienced amenorrhea after the treatment. There were also significant elevations in red blood cell count, hemoglobin and hematocrit (P < 0.0001), and significant reductions in prevalence of dysmenorrhea, pelvic pressure, non-menstrual abdominal pain (P < 0.0001) in each group, while no significant difference among the three groups. All study medications are well-tolerated, and no serious adverse event was reported. Treatment-related adverse event rate was significantly lower in mifepristone 10 mg group, compared to Enantone 3.75 mg group (13.59% vs. 32.58%, P = 0.0002). In both mifepristone groups, estradiol levels were maintained in the premenopausal range, whereas

  7. Might uterus transplantation be an option for uterine factor infertility?

    PubMed

    Akar, Münire Erman

    2015-01-01

    Current data on uterus allotransplantation research has been reviewed and summarized. Over the past 15 years, progress in uterus transplantation research has increased dramatically. As a consequence, the first pregnancy and delivery following uterus allotransplantation in rats have been reported. The technique has been better defined. Although clinical pregnancy and delivery following uterus allotransplantation has been reported in humans, there are still many questions to be answered before clinical application. Gestational surrogacy still remains an important option for being a genetic parent in selected cases with uterine factor infertility.

  8. Diverse functions of uterine proteoglycans in human reproduction (review).

    PubMed

    Kitaya, Kotaro; Tada, Yoshihiro; Hayashi, Terumi; Taguchi, Sagiri; Funabiki, Miyako; Nakamura, Yoshitaka; Yasuo, Tadahiro

    2012-06-01

    Proteoglycans (PGs) are a group of heavily glycosylated proteins that are present throughout the mammalian body and are involved in a wide variety of biological phenomena, including structural maintenance, tissue remodeling, molecular presentation, cell adhesion and signal transmission. Previous studies have revealed an increasing number of roles for PGs in human reproduction. Several PGs are currently utilized or regarded as biomarkers for the diagnosis of certain pathological uterine conditions associated with infertility and obstetrical complications. The aim of this review was to discuss the involvement of PGs in the human uterus in reproductive biology and pathophysiology.

  9. Multiscale forward electromagnetic model of uterine contractions during pregnancy

    PubMed Central

    2012-01-01

    Background Analyzing and monitoring uterine contractions during pregnancy is relevant to the field of reproductive health assessment. Its clinical importance is grounded in the need to reliably predict the onset of labor at term and pre-term. Preterm births can cause health problems or even be fatal for the fetus. Currently, there are no objective methods for consistently predicting the onset of labor based on sensing of the mechanical or electrophysiological aspects of uterine contractions. Therefore, modeling uterine contractions could help to better interpret such measurements and to develop more accurate methods for predicting labor. In this work, we develop a multiscale forward electromagnetic model of myometrial contractions during pregnancy. In particular, we introduce a model of myometrial current source densities and compute its magnetic field and action potential at the abdominal surface, using Maxwell’s equations and a four-compartment volume conductor geometry. To model the current source density at the myometrium we use a bidomain approach. We consider a modified version of the Fitzhugh-Nagumo (FHN) equation for modeling ionic currents in each myocyte, assuming a plateau-type transmembrane potential, and we incorporate the anisotropic nature of the uterus by designing conductivity-tensor fields. Results We illustrate our modeling approach considering a spherical uterus and one pacemaker located in the fundus. We obtained a travelling transmembrane potential depolarizing from −56 mV to −16 mV and an average potential in the plateau area of −25 mV with a duration, before hyperpolarization, of 35 s, which is a good approximation with respect to the average recorded transmembrane potentials at term reported in the technical literature. Similarly, the percentage of myometrial cells contracting as a function of time had the same symmetric properties and duration as the intrauterine pressure waveforms of a pregnant human myometrium at term

  10. New Directions in the Epidemiology of Uterine Fibroids

    PubMed Central

    Laughlin, Shannon K.; Schroeder, Jane C.; Baird, Donna Day

    2013-01-01

    Although uterine leiomyomata (fibroids) have been the leading indication for hysterectomy in the United States for decades, the epidemiologic data on fibroid prevalence and risk factors is limited. Given the hormonal dependence of fibroids, most earlier studies focused on reproductive or hormonal factors. Recent analyses have extended that focus to other areas. We present previously unpublished data on the association between reproductive tract infections that highlights the need for more detailed studies. Our review suggests that metabolic, dietary, stress, and environmental factors may also play a role in fibroid development. PMID:20414843

  11. Regulation of the uterine contractile apparatus and cytoskeleton

    PubMed Central

    Morgan, Kathleen G

    2007-01-01

    Parturition at term, the end stage of a successful pregnancy occurs as a result of powerful, co-ordinated and periodic contractions of uterine smooth muscle (myometrium). To occur in a propitious manner, a high degree of control over the activation of a myometrial cell is required. We review the molecular mechanisms and structural composition of myometrial cells that may contribute to their increased contractile capacity at term. We focus attention on pathways that lead to the activation of filamentous networks traditionally labeled ‘contractile’ or ‘cytoskeletal’ yet draw attention to the fact that functional discrimination between these systems is not absolute. PMID:17582796

  12. Epidemiology of Uterine Fibroids – From Menarche to Menopause

    PubMed Central

    Wise, Lauren A.; Laughlin-Tommaso, Shannon K.

    2015-01-01

    Uterine leiomyomata (UL) have a substantial impact on women's health, but relatively few studies have identified opportunities for primary prevention of these neoplasms. Most established risk factors are not modifiable, including premenopausal age, African ancestry, age at menarche, and childbearing history. The main challenge in studying UL is that a large proportion of tumors are asymptomatic. Herein, we review the epidemiology of UL from published studies to date. We highlight the advantages of ultrasound screening studies and the ways in which their innovative methods have helped clarify the etiology of disease. We conclude with a discussion of promising new hypotheses. PMID:26744813

  13. Uterine rupture due to invasive metastatic gestational trophoblastic neoplasm.

    PubMed

    Bruner, David I; Pritchard, Amy M; Clarke, Jonathan

    2013-09-01

    While complete molar pregnancies are rare, they are wrought with a host of potential complications to include invasive gestational trophoblastic neoplasia. Persistent gestational trophoblastic disease following molar pregnancy is a potentially fatal complication that must be recognized early and treated aggressively for both immediate and long-term recovery. We present the case of a 21-year-old woman with abdominal pain and presyncope 1 month after a molar pregnancy with a subsequent uterine rupture due to invasive gestational trophoblastic neoplasm. We will discuss the complications of molar pregnancies including the risks and management of invasive, metastatic gestational trophoblastic neoplasia.

  14. Uterine Rupture Due to Invasive Metastatic Gestational Trophoblastic Neoplasm

    PubMed Central

    Bruner, David I.; Pritchard, Amy M.; Clarke, Jonathan

    2013-01-01

    While complete molar pregnancies are rare, they are wrought with a host of potential complications to include invasive gestational trophoblastic neoplasia. Persistent gestational trophoblastic disease following molar pregnancy is a potentially fatal complication that must be recognized early and treated aggressively for both immediate and long-term recovery. We present the case of a 21-year-old woman with abdominal pain and presyncope 1 month after a molar pregnancy with a subsequent uterine rupture due to invasive gestational trophoblastic neoplasm. We will discuss the complications of molar pregnancies including the risks and management of invasive, metastatic gestational trophoblastic neoplasia. PMID:24106538

  15. Epidemiology of Uterine Fibroids: From Menarche to Menopause.

    PubMed

    Wise, Lauren A; Laughlin-Tommaso, Shannon K

    2016-03-01

    Uterine leiomyomata (UL) have a substantial impact on women's health, but relatively few studies have identified opportunities for primary prevention of these neoplasms. Most established risk factors are not modifiable, including premenopausal age, African ancestry, age at menarche, and childbearing history. The main challenge in studying UL is that a large proportion of tumors are asymptomatic. Herein, we review the epidemiology of UL from published studies to date. We highlight the advantages of ultrasound screening studies and the ways in which their innovative methods have helped clarify the etiology of disease. We conclude with a discussion of promising new hypotheses.

  16. Casein hydrolysate for uterine infection treatment: a patent evaluation (WO2011132191).

    PubMed

    Cozza, Giorgio

    2012-05-01

    Metritis, endometritis and pyometra are common uterus inflammatory diseases, occurring mainly in the early postpartum period of livestock and farm animals. These infections are primarily associated with contamination of the reproductive tract, in particular uterine. Uterine infections bring to uterine and cervical involution as well as sub-fertility; the high economic loss, due to costs for treatment, milk withdrawal, reduced reproductive performance and premature culling, clearly demonstrate that uterine health in the postpartum period requires substantial medical veterinary attention. A wide variety of therapies for endometritis have been reported, including mainly antibiotics administered either by systemic or local somministration. Here, the patent application WO/2011/132191, which describes an alternative treatment for uterine infection, using casein peptides, is evaluated and discussed.

  17. Delayed presentation of uterine perforation with ovary migration after dilatation and curettage.

    PubMed

    Su, Shili; Tao, Guowei; Dong, Baihua; Shi, Linlin; Dong, Jianchun

    2015-01-01

    We present a rare but serious uterine perforation. A 31-year-old woman was referred to our department for hyperechogenic mass in uterus on ultrasonography after Dilation and curettage (D&C) for the adherent placenta and retained products of conception. Transvaginal ultrasound examination showed that a mass with several follicles measuring 35×29 mm was seen emanating from the right posterior wall of the uterine cavity, and there was absence of the myometrial tissue. A hysteroscopy and laparoscopy showed a uterine perforation with ovary incarceration. The ovary was rehabilitated, and the uterine perforation site was incised. D&C can not be performed when delayed presentation of uterine perforation with migration of an extrauterine organ is suspected, particularly, some of them are asymptomatic after a difficult intrauterine operation.

  18. Effect of exogenous ovarian steroids on the uterine luminal prostaglandins in ovariectomised mares with experimental endometritis.

    PubMed

    Watson, E D; Stokes, C R; Bourne, F J

    1988-05-01

    Prostaglandins (PGs) F and E2 were measured in lavage fluid from the uterus of ovariectomised mares after experimental induction of uterine inflammation. Treatment with progesterone alone, or progesterone followed by oestradiol, significantly increased the concentrations of these PGs in the lavage compared with mares treated with oestradiol or control mares. Ovarian steroids, therefore, influenced uterine PG synthesis in response to an inflammatory stimulus. To determine whether the uterine lavage procedure might contribute to the concentrations of prostaglandins in the lavage, the procedure was also performed on six intact mares. With the exception of washings obtained at luteolysis, uterine concentrations of PGF (measured as the plasma metabolite 15-keto-13,14-dihydro PGF2 alpha) had returned to prewashing levels within 30 minutes of the start of uterine lavage. Lavage was therefore unlikely to have influenced the concentrations of prostaglandins in the lavage fluid.

  19. Uterine cervical cancer with brain metastasis as the initial site of presentation.

    PubMed

    Sato, Yumi; Tanaka, Kei; Kobayashi, Yoichi; Shibuya, Hiromi; Nishigaya, Yoshiko; Momomura, Mai; Matsumoto, Hironori; Iwashita, Mitsutoshi

    2015-07-01

    Brain metastasis from uterine cervical cancer is rare, with an incidence of 0.5%, and usually occurs late in the course of the disease. We report a case of uterine cervical cancer with brain metastasis as the initial site of presentation. A 50-year-old woman with headache, vertigo, amnesia and loss of appetite was admitted for persistent vomiting. Contrast enhanced computed tomography showed a solitary right frontal cerebral lesion with ring enhancement and uterine cervical tumor. She was diagnosed with uterine cervical squamous cell carcinoma with parametrium invasion and no other distant affected organs were detected. The cerebral lesion was surgically removed and pathologically proved to be metastasis of uterine cervical squamous cell carcinoma. The patient underwent concurrent chemoradiotherapy, followed by cerebral radiation therapy, but multiple metastases to the liver and lung developed and the patient died 7 months after diagnosis of brain metastasis.

  20. Early Programming of Uterine Tissue by Bisphenol A: Critical Evaluation of Evidence from Animal Exposure Studies

    PubMed Central

    Suvorov, Alexander; Waxman, David J.

    2015-01-01

    Exposure to Bisphenol A (BPA) during the critical window of uterine development has been proposed to program the uterus for increased disease susceptibility based on well-documented effects of the potent xenoestrogen diethylstilbestrol. To investigate this proposal, we reviewed 37 studies of prenatal and/or perinatal BPA exposure in animal models and evaluated evidence for: molecular signatures of early BPA exposure; the development of adverse uterine health effects; and epigenetic changes linked to long-term dysregulation of uterine gene expression and health effects. We found substantial evidence for adult uterine effects of early BPA exposure. In contrast, experimental support for epigenetic actions of early BPA exposure is very limited, and largely consists of effects on Hoxa gene DNA methylation. Critical knowledge gaps were identified, including the need to fully characterize short-term and long-term uterine gene responses, interactions with estrogens and other endogenous hormones, and any long-lasting epigenetic signatures that impact adult disease. PMID:26028543

  1. Application of detergents or high hydrostatic pressure as decellularization processes in uterine tissues and their subsequent effects on in vivo uterine regeneration in murine models.

    PubMed

    Santoso, Erna G; Yoshida, Keita; Hirota, Yasushi; Aizawa, Masanori; Yoshino, Osamu; Kishida, Akio; Osuga, Yutaka; Saito, Shigeru; Ushida, Takashi; Furukawa, Katsuko S

    2014-01-01

    Infertility caused by ovarian or tubal problems can be treated using In Vitro Fertilization and Embryo Transfer (IVF-ET); however, this is not possible for women with uterine loss and malformations that require uterine reconstruction for the treatment of their infertility. In this study, we are the first to report the usefulness of decellularized matrices as a scaffold for uterine reconstruction. Uterine tissues were extracted from Sprague Dawley (SD) rats and decellularized using either sodium dodecyl sulfate (SDS) or high hydrostatic pressure (HHP) at optimized conditions. Histological staining and quantitative analysis showed that both SDS and HHP methods effectively removed cells from the tissues with, specifically, a significant reduction of DNA contents for HHP constructs. HHP constructs highly retained the collagen content, the main component of extracellular matrices in uterine tissue, compared to SDS constructs and had similar content levels of collagen to the native tissue. The mechanical strength of the HHP constructs was similar to that of the native tissue, while that of the SDS constructs was significantly elevated. Transmission electron microscopy (TEM) revealed no apparent denaturation of collagen fibers in the HHP constructs compared to the SDS constructs. Transplantation of the decellularized tissues into rat uteri revealed the successful regeneration of the uterine tissues with a 3-layer structure 30 days after the transplantation. Moreover, a lot of epithelial gland tissue and Ki67 positive cells were detected. Immunohistochemical analyses showed that the regenerated tissues have a normal response to ovarian hormone for pregnancy. The subsequent pregnancy test after 30 days transplantation revealed successful pregnancy for both the SDS and HHP groups. These findings indicate that the decellularized matrix from the uterine tissue can be a potential scaffold for uterine regeneration.

  2. Bidimensional and Doppler ultrasonographic evaluation of postpartum uterine involution in the queen.

    PubMed

    Blanco, P G; Rodríguez, R; Batista, P R; Barrena, J P; Arias, D O; Gobello, C

    2015-07-01

    The aim of this study was to describe bidimensional and Doppler ultrasonographic changes of uterine involution during normal feline puerperium. Secondary, the postpartum vaginal discharge was described. Twelve pregnant female cats were included in this study. After queening, vulvar discharge was grossly and microscopically examined daily. Bidimensional and Doppler ultrasonographic examinations of the uterus were performed on Days -4 to -2, 4, 11, 18, and 25 from parturition. Total uterine diameter, uterine wall thickness, uterine lumen contents, peak systolic velocity, end diastolic velocity, and resistance index of uterine arteries were measured. The cats presented serosanguineous vulvar discharge for a mean of 3 ± 1 days after parturition, and the cytology revealed 70% to 80% of erythrocytes, which progressively decreased up to Day 13. Immediately after parturition, there were less than 20% neutrophils, and this percentage gradually diminished to 0% to 1% at the end of the study. Uterine total diameter diminished up to Day 25 (P < 0.01), when ultrasonographic uterine dimensions were similar to that of anestrus. A progressive decrease of uterine wall thickness (P < 0.05), uterine lumen contents (P < 0.01), peak systolic velocity (P < 0.01), and end diastolic velocity (P < 0.01) was found throughout the study period. Conversely, resistance index increased during the first week after parturition (P < 0.01). It is concluded that the uterine artery blood flow progressively decreased during the first 25 days after parturition, which was associated with the bidimensional ultrasonographic regression of the organ. Although lochial discharge disappeared far before ultrasonographic involution, cytologic findings further corroborated the duration of this regression process.

  3. Abnormal uterine bleeding as a presenting symptom is related to multiple uterine leiomyoma: an ultrasound-based study

    PubMed Central

    Fonseca-Moutinho, José Alberto; Barbosa, Lígia Silva; Torres, Daniel Gonçalves; Nunes, Sara Morgado

    2013-01-01

    Purpose To determine the prevalence of uterine leiomyomas, diagnosed by ultrasound, in a private health care setting located in the central eastern region of Portugal, and to explore the demographic and clinical factors related to diagnosis and symptomatology. Patients and methods The files of 624 patients attending a private clinic in Covilhã, Portugal, from January 2 to December 31, 2010 were retrieved for evaluation. Pelvic ultrasound record, age, weight, height, age at menarche, number of pregnancies and deliveries, marital status, menstrual cycles characteristic, and contraceptive method at consultation were included in the analysis. Results Uterine leiomyoma (UL) was diagnosed by ultrasonography in 161 (25.8%) patients. A single UL was diagnosed in 80 (49.7%) patients. In 79 (49.1%) patients, the largest leiomyoma had a dimension <20 mm. Prevalence of UL was age dependent: at 11.0% for women 20–39 years old; 45.4% for those aged 40–59 years; and 19.5% for women 60 years or older. Metrorrhagia was the most distressing presenting symptom. When menorrhagia was the presenting symptom, the probability of having an ultrasound diagnosis of UL was 73.3%. Metrorrhagia or menorrhagia, as presenting symptom, was significantly related to the ultrasound diagnosis of multiple ULs. Conclusion UL was especially prevalent in women aged between 40 and 59 years. Patients with multiple ULs had significantly more abnormal uterine bleeding. In patients with menorrhagia or metrorrhagia, special attention should be taken in searching for the presence of multiple ULs during ultrasound. PMID:24194648

  4. Dichotomous Saturn in infrared images: huge northern hexagon against smaller southern hurricane

    NASA Astrophysics Data System (ADS)

    Kochemasov, G.

    2007-08-01

    Saturn's polar dichotomy was observed as color hues: gold south and azure north. Now infrared images of NASA/JPL/University of Arizona allow to see substantial structural differences of two polar regions. First was observed a large centered on the south pole hurricane 8000 km across with a central eye about 1500 km across (PIA08333). Then on the northern night hemisphere was observed a huge centered on the pole hexagon about 25000 km across (PIA09186). The dichotomous structure of celestial bodies is their first characteristic feature marked as Theorem 1 of the wave planetology [1, 2, 3 & others]. Origin of this ubiquitous feature is due to an interference of warping waves 1 of four directions appearing in any rotating body (but all bodies rotate!) moving in elliptical orbit with periodically changing accelerations (I. Kepler has shown that all planetary bodies move in such orbits) [3]. The fundamental warping inertia-gravity wave 1 has overtones of which wave 2 - the first overtone is most prominent in structures of celestial bodies. It makes tectonic sectors superimposed on tectonic dichotomy (e.g., continents and secondary oceans of Earth; the Pacific basin is the primary ocean - one of the dichotomous segments of Earth). Interfering waves tend to produce in globes geometrical figures according to their lengths. Thus, wave 1 makes tetrahedron, wave 2 octahedron, wave 4 cube. Naturally, significant gravity of relatively large bodies (more than 400 to 500 km across) "smashes" this would -be figures in favor of a sphere. What is left, it is axes and planes of symmetry of this figures and perching but obliterated vertices (e.g., the Pamirs-Hindukush and antepodean to it the Easter Island). A tetrahedron - the simplest polyhedron of Plato - has three faces narrowing to a vertex and widening to a fourth face. Thus, tetrahedron is a dichotomous body because cut amidst any of its 4 axes it always has an opposition of a vertex (contraction) to a face (expansion). Traces

  5. Climate change adaptation accounting for huge uncertainties in future projections - the case of urban drainage

    NASA Astrophysics Data System (ADS)

    Willems, Patrick

    2015-04-01

    Hydrological design parameters, which are currently used in the guidelines for the design of urban drainage systems (Willems et al., 2013) have been revised, taking the Flanders region of Belgium as case study. The revision involved extrapolation of the design rainfall statistics, taking into account the current knowledge on future climate change trends till 2100. Uncertainties in these trend projections have been assessed after statistically analysing and downscaling by a quantile perturbation tool based on a broad ensemble set of climate model simulation results (44 regional + 69 global control-scenario climate model run combinations for different greenhouse gas scenarios). The impact results of the climate scenarios were investigated as changes to rainfall intensity-duration-frequency (IDF) curves. Thereafter, the climate scenarios and related changes in rainfall statistics were transferred to changes in flood frequencies of sewer systems and overflow frequencies of storage facilities. This has been done based on conceptual urban drainage models. Also the change in storage capacity required to exceed a given overflow return period, has been calculated for a range of return periods and infiltration or throughflow rates. These results were used on the basis of the revision of the hydraulic design rules of urban drainage systems. One of the major challenges while formulating these policy guidelines was the consideration of the huge uncertainties in the future climate change projections and impact assessments; see also the difficulties and pitfalls reported by the IWA/IAHR Joint Committee on Urban Drainage - Working group on urban rainfall (Willems et al., 2012). We made use of the risk concept, and found it a very useful approach to deal with the high uncertainties. It involves an impact study of the different climate projections, or - for practical reasons - a reduced set of climate scenarios tailored for the specific type of impact considered (urban floods in our

  6. About 500-yr interval of huge and widespread paleotsunamis along the Sanriku coast, northern Honshu, Japan

    NASA Astrophysics Data System (ADS)

    Haraguchi, T.; Toda, S.; Tsutsumi, H.; Meghraoui, M.; Ferry, M.; Takada, K.

    2012-12-01

    sample recovered from Ozuchi Bay, central Sanriku coast, instead preserved more frequent 22 units of tsunami deposits and associated perturbations during the past 8,000 years, including the 869 A.D. event. It suggests that shoal inside bays can well preserve the sediments of tsunamis, even smaller events. A prominent tendency found in the sequence of tsunami units is a sudden change of recurrence intervals from 500-800 years to 70-150 years at 2,000 y.B.P., which might be associated with a sudden bathymetry change. It may also implies that only huge tsunamis occurred every 500-800 years left sediments inside the bay, which is consistent with the results from onshore surveys.

  7. Thermotolerance of human myometrium: implications for minimally invasive uterine therapies

    NASA Astrophysics Data System (ADS)

    Thomas, Aaron C.; Grisez, Brian T.; McMillan, Kathleen; Chill, Nicholas; Harclerode, Tyler P.; Radabaugh, Rebecca; Jones, Ryan M.; Coad, James E.

    2013-02-01

    Endometrial ablation has gained significant clinical acceptance over the last decade as a minimally invasive treatment for abnormal uterine bleeding. To improve upon current thermal injury modeling, it is important to better characterize the myometrium's thermotolerance. The extent of myometrial thermal injury was determined across a spectrum of thermal histories/doses (time-temperature combinations). Fresh extirpated human myometrium was obtained from 13 subjects who underwent a previous scheduled benign hysterectomy. Within two hours of hysterectomy, the unfixed myometrium was treated in a stabilized saline bath with temperatures ranging from 45-70 °C and time intervals from 30- 150 seconds. The time-temperature combinations were selected to simulate treatment times under 2.5 minutes. A total of six such thermal matrices, each comprised of 45 time-temperature combinations, were prepared for evaluation. The treated myometrium was cryosectioned for nitro blue tetrazolium (NBT) staining to assess for thermal respiratory enzyme inactivation. Image analysis was subsequently used to quantitatively assess the stained myometrium's capacity to metabolize the tetrazolium at each time-temperature combination. This colorimetric data was then used as marker of cellular viability and determine survival parameters with implications for developing minimally invasive uterine therapies.

  8. The ovarian and uterine arteries in the chinchilla (Chinchilla lanigera).

    PubMed

    Cevik-Demirkan, A; Ozdemir, V; Demirkan, I

    2010-03-01

    The purpose of this study was to describe arteries supplying the ovaries and uterus in the chinchilla. Five healthy adult female chinchillas were used. In order to reveal the arterial network by dissecting under a stereoscopic microscope, latex coloured with red ink was injected through the common carotid artery. The ovaries of the chinchilla are supplied by the arteriae ovaricae which formed end-to-end anastomoses with the cranial termination of the arteria uterina. Soon after leaving the aorta abdominalis, the arteriae ovaricae extended 2-3 mm caudolaterally, then released 1 branch and extended caudally and bifurcated into 2 further branches. One of these supplied branches to fat tissue. The other branch coursed caudally and anastomosed with the arteria circumflexa ilium profunda and dispersed into fat tissue. The arteria ovarica further subdivided into 2 rami ovaricae. The origins of the uterine arteries were exclusively from the left arteria iliaca externa. The arteria uterina gave a branch to the arteria umbilicalis and consecutive branches which supplied to the ureter, urinary bladder and cranial aspects of the vagina. It also gave rise to 2-3 branches to the cervix and further supplied 10-12 meandering branches to the uterine horns. The arteria uterina gave rise to many tortuous arteries to the uterus and provided 2 further branches to the ovary.

  9. Abdominal sling surgery--artificial sacro-uterine ligament.

    PubMed

    Draca, Petar; Miljković, Stamenko; Jakovljević, Branislava

    2002-01-01

    Abdominal sling surgery is defined as attachment of either the connective tissue graft (fascia lata) or some synthetic material (Mersilene) to the anterior wall of the exposed vaginal vault following total hysterectomy or to the posterior wall of the uterine cervix in total and subtotal uterine prolapse, whereas the other end is attached to the anterior longitudinal ligament extending along the anterior surface of the vertebrae. Our analysis comprised 45 operations: 20 cases of vaginal vault prolapse following vaginal hysterectomy; 7 cases of vaginal vault prolapse following HTA: 2 cases of prolapse following subtotal hysterectomy; 3 cases of nondefined TH; 2 cases following Burch operation; 1 following Kocher; 1 following Manchester, 1 following Neugebauer-Le Fort operation in which HTA was performed 2 times. Abdominal sling operation was associated with the following surgical procedures: sling in 13 cases, sling + douglasorrhaphy in 16 cases, sling + douglasorrhaphy + colpoperineoplastics in 6 cases, sling + colpoperineoplastics in 9 cases and sling + marshall marcetti in 1 case. Recurrence of enterocele was recorded in 5 patients in whom closure of the douglas pouch had not been performed. This procedure was therefore later included into our approach to the operation. The abdominal sling operation has been a logical and physiologic approach to surgical therapy of genital prolapse, particularly of the vaginal vault prolapse following total hysterectomy. This operation ensures subsequent normal sexual relations.

  10. Prostaglandin concentrations in uterine fluid of cows with pyometra.

    PubMed Central

    Manns, J G; Nkuuhe, J R; Bristol, F

    1985-01-01

    Uterine fluid was obtained from eight clinical cases of pyometra with retained corpus luteum and nine additional samples of fluid were collected from animals slaughtered at an abattoir. These samples, along with uterine flushes from normal cows in their luteal phase were analyzed for prostaglandin of the F (PGF) and E (PGE) groups. Blood samples were also obtained from the clinical cases for analysis of 13,14-dihydro-15-keto PGF (PGFM) the major metabolite of PGF. Pyometrial exudate from clinical cases of abattoir samples had high concentrations of PGF (17.9 ng/mL) and PGE (33.2 ng/mL) and the total amount of PGF and PGE in the uterus was calculated to be several hundred times as great as in normal cows. Furthermore, clinical cases had elevated PGFM in their blood compared to that of controls, which suggests that at least some of the PGF was being absorbed from the uterus. These results are discussed in light of our current understanding of the maternal recognition of pregnancy in cattle. PMID:4075244

  11. Severe Postpartum Hemorrhage from Uterine Atony: A Multicentric Study

    PubMed Central

    Montufar-Rueda, Carlos; Rodriguez, Laritza; Jarquin, José Douglas; Barboza, Alejandra; Bustillo, Maura Carolina; Marin, Flor; Ortiz, Guillermo; Estrada, Francisco

    2013-01-01

    Objective. Postpartum hemorrhage (PPH) is an important cause of maternal mortality (MM) around the world. Seventy percent of the PPH corresponds to uterine atony. The objective of our study was to evaluate multicenter PPH cases during a 10-month period, and evaluate severe postpartum hemorrhage management. Study Design. The study population is a cohort of vaginal delivery and cesarean section patients with severe postpartum hemorrhage secondary to uterine atony. The study was designed as a descriptive, prospective, longitudinal, and multicenter study, during 10 months in 13 teaching hospitals. Results. Total live births during the study period were 124,019 with 218 patients (0.17%) with severe postpartum hemorrhage (SPHH). Total maternal deaths were 8, for mortality rate of 3.6% and a MM rate of 6.45/100,000 live births (LB). Maternal deaths were associated with inadequate transfusion therapy. Conclusions. In all patients with severe hemorrhage and subsequent hypovolemic shock, the most important therapy is intravascular volume resuscitation, to reduce the possibility of target organ damage and death. Similarly, the current proposals of transfusion therapy in severe or massive hemorrhage point to early transfusion of blood products and use of fresh frozen plasma, in addition to packed red blood cells, to prevent maternal deaths. PMID:24363935

  12. Role of TGF-β signaling in uterine carcinosarcoma

    PubMed Central

    Dhar Dwivedi, Shailendra Kumar; McMeekin, Scott D.; Slaughter, Katrina; Bhattacharya, Resham

    2015-01-01

    Uterine carcinosarcomas (UCS) are rare (3-4%) but highly aggressive, accounting for a disproportionately high (16.4%) mortality among uterine malignancies. Transforming growth factor beta (TGFβ) is a multifunctional cytokine that regulates important cellular processes including epithelial-mesenchymal transition (EMT). Existence of biphasic elements and a report demonstrating amplification of TGFβ at 19q13.1 prompted us to investigate the role of TGFβ signaling in UCS. Here we demonstrated the components of TGFβ pathway are expressed and functional in UCS. TGFβ-I induced significant Smad2/3 phosphorylation, migration and EMT responses in UCS cell lines which could be attenuated by the TGFβ receptor I (TGFβR-I) or TGFβ receptor I/II (TGFβR-I/II) inhibitor developed by Eli Lilly and company. Importantly, TGFβ-I induced proliferation was c-Myc dependent, likely through activation of cell cycle. c-Myc was induced by nuclear translocation of nuclear factor of activated T cells (NFAT-1) in response to TGFβ-I. Inhibition of NFAT-1 or TGFβR-I blocked c-Myc induction, cell cycle progression and proliferation in UCS. In corroboration, mRNA levels of c-Myc were elevated in recurrent versus the non-recurrent UCS patient samples. Interestingly, in the absence of exogenous TGFβ the TGFβR-I/II inhibitor enhanced proliferation likely through non-Smad pathways. Thus, inhibition of TGFβR-I could be efficacious in treatment of UCS. PMID:25918253

  13. Influence of uterine inflammation on the estrous cycle in rats.

    PubMed

    Kaneko, Kazuyuki; Aoki, Hajime; Furuichi, Tomohiro; Hatori, Sachiko; Tanimoto, Hanako; Kawakami, Shizuo

    2004-06-01

    To investigate how uterine inflammation affects ovarian activity in rats, endometritis was induced and changes in the length of estrous cycle and serum concentrations of estradiol-17beta (E(2)) and progesterone (P(4)) were examined. A suspension of Staphylococcus aureus (bacterial solution) or iodine solution was infused into the uterine lumen at various estrous phases. When the bacterial solution was infused at estrus, metestrus, or the first day of diestrus, the following diestrus continued for 5 to 12 days. In the case of the iodine solution, regardless of the estrous phase of the infusion, the following diestrus continued for approximately 6 days. E(2) concentration after infusion of each solution did not fluctuate largely and remained at a low concentration (around 5 pg/ml). P(4) concentration was high (35-45 ng/ml) on the day following infusion, but decreased rapidly to base line values within a few days and remained thereafter at a low level (around 5 ng/ml). It is assumed that the endometritis caused by biological or chemical stimulation raises the concentration of P(4) to depress gonadotrophic hormone secretion, and hence this high P(4) concentration might inhibit the growth of ovarian follicles.

  14. Should Deceased Donation be Morally Preferred in Uterine Transplantation Trials?

    PubMed Central

    2016-01-01

    Abstract In recent years much research has been undertaken regarding the feasibility of the human uterine transplant (UTx) as a treatment for absolute uterine factor infertility (AUFI). Should it reach clinical application this procedure would allow such individuals what is often a much‐desired opportunity to become not only social mothers (via adoption or traditional surrogacy arrangements), or genetic and social mothers (through gestational surrogacy) but mothers in a social, genetic and gestational sense. Like many experimental transplantation procedures such as face, hand, corneal and larynx transplants, UTx as a therapeutic option falls firmly into the camp of the quality of life (QOL) transplant, undertaken with the aim, not to save a life, but to enrich one. However, unlike most of these novel procedures – where one would be unlikely to find a willing living donor or an ethics committee that would sanction such a donation – the organs to be transplanted in UTx are potentially available from both living and deceased donors. In this article, in the light of the recent nine‐case research trial in Sweden which used uteri obtained from living donors, and the assertions on the part of a number of other research teams currently preparing trials that they will only be using deceased donors, I explore the question of whether, in the case of UTx, there exist compelling moral reasons to prefer the use of deceased donors despite the benefits that may be associated with the use of organs obtained from the living. PMID:26833553

  15. A Case of Giant Uterine Lipoleiomyoma Simulating Malignancy.

    PubMed

    Karaman, Erbil; Çim, Numan; Bulut, Gülay; Elçi, Gülhan; Andıç, Esra; Tekin, Mustafa; Kolusarı, Ali

    2015-01-01

    Introduction. Uterine leiomyoma is the most common benign pathology in women and lipoleiomyoma is an extremely rare and specific type of leiomyoma. Here, we report an unusual case of giant pedunculated subserous lipoleiomyoma misdiagnosed preoperatively as leiomyosarcoma. Case. A 45-year-old woman admitted to our gynecology outpatient clinic for complaints of abdominal distention, tiredness, and pelvic pain for the last 6 months. Sonography and abdominal magnetic resonance imaging (MRI) showed a giant semisolid mass that filled whole abdominal cavity from pelvis to subdiaphragmatic area. A primary diagnosis of uterine sarcoma or ovarian malignancy was made. On operation, total abdominal hysterectomy with a pedunculated mass of size 30 × 23 × 12 cm and weighing 5.4 kg and bilateral salpingo-oophorectomy were performed. The histopathology revealed a lipoleiomyoma with extensive cystic and fatty degeneration without any malignancy. Discussion. The diagnosis of leiomyoma is done usually with pelvic ultrasound but sometimes it is difficult to reach a correct diagnosis especially in cases of giant and pedunculated lipoleiomyoma that included fatty tissue which may mimick malignancy. Conclusion. Subserous pedunculated giant lipoleiomyoma should be kept in mind in the differential diagnosis of leiomyosarcoma or ovarian malignancy.

  16. [Acute abdomen secondary to spontaneous uterine rupture associated with pyometra].

    PubMed

    Ortiz-Mendoza, Carlos Manuel

    2006-01-01

    A 71-year-old female with rheumatoid arthritis and chronic use of corticosteroids presented to the emergency room with 2 weeks of urinary symptoms, abdominal pain and a mass located in hypo-mesogastrium and both flanks. An X-ray film of the abdomen showed that bowels were displaced by the mass. Laboratory studies showed thrombocytosis (549,000/mm(3)) and leukocytosis (41,800/mm(3)). Several hours after her arrival the patient developed acute abdomen and surgery was indicated. A urinary catheter drained 2100 ml of urine and the abdominal mass was reduced in size but did not disappear. Surgery demonstrated that the urinary bladder covered the fundus and the anterior face of the uterus, where extensive necrosis and a 3-cm perforation were found; 400 ml of foul-smelling pus was drained from the uterine cavity. Due to necrosis, a hysterectomy was performed. The histopathological report indicated necrosis, atrophic cervicitis and endometritis; pus culture developed Escherichia coli and Proteus vulgaris. Despite administration of broad-spectrum antibiotics, the patient developed severe sepsis and died 11 days postoperatively. During a literature review, only one similar case was found. Acute abdomen due to uterine perforation secondary to pyometra and associated with chronic use of corticosteroids is a rare complication.

  17. Uterine artery impedance during the first eight postpartum weeks

    PubMed Central

    Guedes-Martins, L.; Gaio, A. R.; Saraiva, J.; Cunha, A.; Macedo, F.; Almeida, H.

    2015-01-01

    The aim of this study was to construct reference ranges for the uterine artery (UtA) mean pulsatility (PI) and resistance (RI) indices from 1–8 weeks postpartum. A prospective, cross-sectional, and observational study was performed with 320 healthy women from week 1 through week 8 postpartum. UtAs were examined transvaginally using colour and pulsed Doppler imaging, and the means of the right and left values of the PI and RI, as well as the presence or absence of a bilateral protodiastolic notch, were recorded. The 5th, 50th and 95th reference percentile curves for the UtA-PI and UtA-RI were derived using regression models. The adjusted reference intervals uncovered a convergence trend at the week 8 time-point, although impedance was lower at the week 1 time-point in multiparous women compared with primiparous women. The notching prevalence was 22.5% (9/40) at week 1 and 95.0% (38/40) at week 8. The study revealed consistent evidence of a progressive increase of postpartum uterine impedance and provided new average UtA-PI and UtA-RI reference charts for weeks 1 through 8. Multiparity does not change the trend but does impart a lower rate of increase, likely as a consequence of previous vascular structural and functional differences. PMID:25739463

  18. Effects of lubiprostone on human uterine smooth muscle cells.

    PubMed

    Cuppoletti, John; Malinowska, Danuta H; Chakrabarti, Jayati; Ueno, Ryuji

    2008-06-01

    Lubiprostone, a bicyclic fatty acid derivative and member of a new class of compounds called prostones, locally activates ClC-2 Cl(-) channels without activation of prostaglandin receptors. The present study was specifically designed to test and compare lubiprostone and prostaglandin effects at the cellular level using human uterine smooth muscle cells. Effects on [Ca(2+)](i), membrane potential and [cAMP](i) in human uterine smooth muscle cells were measured. 10 nM lubiprostone significantly decreased [Ca(2+)](i) from 188 to 27 nM, which was unaffected by 100 nM SC-51322, a prostaglandin EP receptor antagonist. In contrast 10nM PGE(2) and PGE(1) both increased [Ca(2+)](i) 3-5-fold which was blocked by SC-51322. Similarly, lubiprostone and prostaglandins had opposite/different effects on membrane potential and [cAMP](i). Lubiprostone caused SC-51322-insensitive membrane hyperpolarization and no effect on [cAMP](i). PGE(2) and PGE(1) both caused SC-51322-sensitive membrane depolarization and increased [cAMP](i). Lubiprostone has fundamentally different cellular effects from prostaglandins that are not mediated by EP receptors.

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

    PubMed

    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 < 0.001), 16 (P < 0.01) and 24 (P < 0.01) h after insemination, indicative of MIE and distinguished between different treatments because neutrophil numbers were greater from FTS mares than FTEx mares 8h after challenge. Uterine

  20. Huge magnetoresistive effects using space charge limited current in ZnO /SiO2 system

    NASA Astrophysics Data System (ADS)

    Miyanishi, Shintaro; Yagura, Motoji; Teraguchi, Nobuaki; Shirakawa, Kazuhiko; Sakuno, Keiichi; Murakami, Yoshiteru; Kojima, Kunio; Takahashi, Akira; Ohta, Kenji

    2007-11-01

    Huge magnetoresistive effects were observed in a metal/insulator current-in-plane (CIP) diode feeding space charge limited (SCL) current. The insulator laterally toward opposite gold (Au) electrodes was fabricated on a SiO2 substrate by the standard photolithography method using dry etching. The insulator consisted of a SiO2/ZnO /SiO2/ZnO multilayer sputtered on the substrate. Current-voltage curves showed Ohmic property and SCL current characteristics accompanied by Child-Langmuir and Mott-Gurney laws derived from first order differential calculus. Current-magnetic field curves indicated the huge magnetoresistive effects up to 1010% under the magnetic field of 0.3T at room temperature. The current-magnetic field curves have even symmetry for the applied magnetic field. The Au/insulator CIP diode is abruptly switched between a conducting state and an insulating state by the applied magnetic field.

  1. Huge Congenital Segmental Dilatation of the Sigmoid Colon in a Neonate: A "Rarity to Meet" and a "Challenge to Treat".

    PubMed

    Kaiser, Margarita; Castellani, Christoph; Singer, Georg; Marterer, Robert; Ratschek, Manfred; Till, Holger

    2016-01-01

    Only ten cases of neonatal congenital segmental dilatation (CSD) of the colon have been described so far. We present a full-term female newborn with trisomy 21, ventricular septal defect, and gross abdominal distension. Plain abdominal radiographs revealed a huge cystic lesion occupying the left hemiabdomen. Upon laparotomy on day 4 a CSD of the distal sigmoid and proximal rectum was confirmed and resected. The proximal colon was exteriorized and the distal part closed as a Hartmann pouch. Histology confirmed a huge segmental dilatation of the sigmoid without dysganglionosis or pseudodiverticula, but normal intestinal architecture. After correction of the ventricular septal defect a low rectal end-to-end anastomosis could be performed at an age of 5 months. The postoperative course was uneventful. CSD of the sigmoid colon is extremely "rare to meet" and a "challenge to treat" in the newborn period, but clinical awareness of this entity prompts pediatric surgical success.

  2. Isolated huge aneurysm of the left main coronary artery in a 22-year-old patient with type 1 neurofibromatosis.

    PubMed

    Pontailler, Margaux; Vilarem, Didier; Paul, Jean-François; Deleuze, Philippe H

    2015-03-01

    A 22-year-old patient with neurofibromatosis type 1 presented with acute chest pain. A computed tomography scan and coronary angiography revealed a partially thrombosed huge aneurysm of the left main coronary artery. Despite medical treatment, the patient's angina recurred. The patient underwent a coronary bypass grafting operation and surgical exclusion of the aneurysm. Postoperative imaging disclosed good permeability of the 3 coronary artery bypass grafts and complete thrombosis of the excluded aneurysm.

  3. Sexuality and Body Image After Uterine Artery Embolization and Hysterectomy in the Treatment of Uterine Fibroids: A Randomized Comparison

    SciTech Connect

    Hehenkamp, Wouter J. K. Volkers, Nicole A.; Bartholomeus, Wouter; Blok, Sjoerd de; Birnie, Erwin; Reekers, Jim A.; Ankum, Willem M.

    2007-09-15

    In this paper the effect of uterine artery embolization (UAE) on sexual functioning and body image is investigated in a randomized comparison to hysterectomy for symptomatic uterine fibroids. The EMbolization versus hysterectoMY (EMMY) trial is a randomized controlled study, conducted at 28 Dutch hospitals. Patients were allocated hysterectomy (n = 89) or UAE (n 88). Two validated questionnaires (the Sexual Activity Questionnaire [SAQ] and the Body Image Scale [BIS]) were completed by all patients at baseline, 6 weeks, and 6, 12, 18, and 24 months after treatment. Repeated measurements on SAQ scores revealed no differences between the groups. There was a trend toward improved sexual function in both groups at 2 years, although this failed to reach statistical significance except for the dimensions discomfort and habit in the UAE arm. Overall quality of sexual life deteriorated in a minority of cases at all time points, with no significant differences between the groups (at 24 months: UAE, 29.3%, versus hysterectomy, 23.5%; p = 0.32). At 24 months the BIS score had improved in both groups compared to baseline, but the change was only significant in the UAE group (p = 0.009). In conclusion, at 24 months no differences in sexuality and body image were observed between the UAE and the hysterectomy group. On average, both after UAE and hysterectomy sexual functioning and body image scores improved, but significantly so only after UAE.

  4. The influence of dietary essential fatty acids on uterine C20 and C22 fatty acid composition.

    PubMed

    Howie, A; Leaver, H A; Wilson, N H; Yap, P L; Aitken, I D

    1992-06-01

    The effect of dietary fatty acids on uterine fatty acid composition was studied in rats fed control diet or semi-synthetic diet supplemented with 1.5 microliter/g/day evening primrose oil (EPO) or fish oil (FO). Diet-related changes in uterine lipid were detected within 21 days. Changes of 2- to 20-fold were detected in the uterine n-6 and n-3 essential fatty acids (EFA) and in certain saturated and monounsaturated fatty acids. The FO diet was associated with higher uterine C20 and C22 n-3, and the EPO diet, with higher uterine n-6 fatty acid. High uterine C18:2 n-6 was detected in neutral lipid (NL) of rats fed high concentrations of this fatty acid, but there was little evidence of selective incorporation or retention of C18:2 n-6 by uterine NL. The incorporation of EFA into uterine phospholipids (PL) was greater than NL EFA incorporation, and uterine PL n-3/n-6 ratios showed greater diet dependence. Tissue/diet fatty acid ratios in NL and PL also indicated preferential incorporation/synthesis of C16:1 n-9, and C16:0, and there was greater incorporation of C12:0 and C14:0 into uteri of rats fed EPO and FO. Replacement of 50-60% of arachidonate with n-3 EFA in uterine PL may inhibit n-6 EFA metabolism necessary for uterine function at parturition.

  5. Does fertility treatment increase the risk of uterine cancer? A meta-analysis.

    PubMed

    Saso, Srdjan; Louis, Louay S; Doctor, Farah; Hamed, Ali Hassan; Chatterjee, Jayanta; Yazbek, Joseph; Bora, Shabana; Abdalla, Hossam; Ghaem-Maghami, Sadaf; Thum, Meen-Yau

    2015-12-01

    An ongoing debate over the last two decades has focused on whether fertility treatment in women may lead to an increased risk of developing uterine cancer over a period of time. Uterine cancer (including mainly endometrial carcinoma and the less common uterine sarcoma) is the commonest reproductive tract cancer and the fourth commonest cancer in women in the UK. Our objective was to assess the association between fertility drugs used in the treatment of female infertility (both as an independent therapy and during in vitro fertilization cycles) and the development of uterine cancer. A literature search was performed using Medline, Embase, Cochrane Library and Google Scholar databases for comparative studies until December 2014 to investigate a clinical significance of fertility treatment on the incidence of developing uterine cancer. General and MESH search headings, as well as the 'related articles' function were applied. All comparative studies of 'fertility treatment' versus 'non-fertility treatment' reporting the incidence of uterine cancer as an outcome were included. Uterine cancer incorporated the following terms: uterine cancer, uterine body tumours, uterine sarcomas and endometrial cancers. The primary outcome of interest was the uterine cancer incidence in all 'fertility treatment' versus 'non-fertility treatment' patient groups. Secondary outcomes of interest were: (a) uterine cancer incidence in 'IVF' versus 'non-IVF' patient groups; and (b) uterine cancer incidence according to type of fertility drug used. Odds ratio was the summary statistic. Random-effects modelling, graphical exploration and sensitivity analysis were used to evaluate the consistency of the calculated treatment effect. We included six studies in our final analysis, which comprised 776,224 patients in total. Of these, 103,758 had undergone fertility treatment and 672,466 had not. There was 100% agreement between the two reviewers regarding the data extraction. All the studies

  6. Spatial and molecular cues for cell outgrowth during C. elegans uterine development.

    PubMed

    Ghosh, Srimoyee; Sternberg, Paul W

    2014-12-01

    The Caenorhabditis elegans uterine seam cell (utse) is an H-shaped syncytium that connects the uterus to the body wall. Comprising nine nuclei that move outward in a bidirectional manner, this synctium undergoes remarkable shape change during development. Using cell ablation experiments, we show that three surrounding cell types affect utse development: the uterine toroids, the anchor cell and the sex myoblasts. The presence of the anchor cell (AC) nucleus within the utse is necessary for proper utse development and AC invasion genes fos-1, cdh-3, him-4, egl-43, zmp-1 and mig-10 promote utse cell outgrowth. Two types of uterine lumen epithelial cells, uterine toroid 1 (ut1) and uterine toroid 2 (ut2), mediate proper utse outgrowth and we show roles in utse development for two genes expressed in the uterine toroids: the RASEF ortholog rsef-1 and Trio/unc-73. The SM expressed gene unc-53/NAV regulates utse cell shape; ablation of sex myoblasts (SMs), which generate uterine and vulval muscles, cause defects in utse morphology. Our results clarify the nature of the interactions that exist between utse and surrounding tissue, identify new roles for genes involved in cell outgrowth, and present the utse as a new model system for understanding cell shape change and, putatively, diseases associated with cell shape change.

  7. Real-time characterization of the uterine blood flow in mares before and after artificial insemination.

    PubMed

    Ferreira, J C; Ignácio, F S; Rocha, N S; Thompson, D L; Pinto, C R; Meira, C

    2015-09-01

    The present experiment was divided into two studies to investigate the effect of age and endometrial degeneration on uterine blood flow of mares throughout the immediate post-breeding period. In study 1, uterine blood flow was characterized in mares (n = 7 mares/group) with minimal, moderate or severe endometrial degenerative changes (GI, GII and GIII, respectively). In study 2, the effect of age was investigated using young (≤ 6 years) and old (≥ 15 years) mares (n = 7 mares/group). Uterine vascular perfusion and mesometrial pulsatility index (PI) were evaluated every hour from H0 (moment immediately before AI) to H12. In study 1, a pronounced and transitory increase on uterine vascular perfusion was detected (P < 0.001) between H1 and H3 in the three endometrial groups. In addition, GIII mares had greater (P < 0.05) mesometrial PI than GI mares during the post-breeding period, denoting reduced uterine blood flow. In study 2, a transitory increase on uterine vascular perfusion was also observed in both age groups during the first hour after mating. However, mesometrial PI of young and old mares was similar (P > 0.05) and constant (P > 0.7) through the first 12h after AI. Results demonstrated, for the first time, the immediate changes on uterine vascular perfusion and mesometrial PI in response to semen infusion. Moreover, reduced blood flow of the uterus during the post-breeding period was strongly associated with endometrial degenerative changes in mares, regardless of age.

  8. Ayurvedic intervention in the management of uterine fibroids: A Case series

    PubMed Central

    Dhiman, Kamini

    2014-01-01

    Uterine enlargement is common in reproductive life of a female. Other than pregnancy, it is seen most frequently in the result of leiomyomas. Leiomyomas, are benign smooth muscle neoplasmas that typically originate from the myometrium, due to fibrous consistency and are also called as fibroid. They may be identified in asymptomatic women during routine pelvic examination or may cause symptoms. Typical complaints include pain, pressure sensations, dysmenorrhea or abnormal uterine bleeding. Management of uterine fibroid through surgery is available to meet urgent need of the patient, but challenges remain to establish a satisfactory conservatory medical treatment till date. Hence, it was critically reviewed in the context of Granthi Roga (disease) and treatment protocol befitting the Samprapti Vighatana of Granthi (encapsulated growth) was subjected in patients of uterine fibroids. Seven cases of uterine fibroid were managed by Ayurvedic intervention. Ultrasonography (USG) of the lower abdomen was the main investigative/diagnostic tool in this study. After 7 weeks, patients presented with USG report as absence of uterine fibroid. Ayurvedic formulations Kanchanara Guggulu, Shigru Guggulu, and Haridra Khand are found to be effective treatment modality in uterine fibroid. PMID:26664240

  9. A Validated Normative Model for Human Uterine Volume from Birth to Age 40 Years

    PubMed Central

    Ginbey, Eleanor; Chowdhury, Moti M.; Bath, Louise E.; Anderson, Richard A.; Wallace, W. Hamish B.

    2016-01-01

    Transabdominal pelvic ultrasound and/or pelvic Magnetic Resonance Imaging are safe, accurate and non-invasive means of determining the size and configuration of the internal female genitalia. The assessment of uterine size and volume is helpful in the assessment of many conditions including disorders of sex development, precocious or delayed puberty, infertility and menstrual disorders. Using our own data from the assessment of MRI scans in healthy young females and data extracted from four studies that assessed uterine volume using transabdominal ultrasound in healthy females we have derived and validated a normative model of uterine volume from birth to age 40 years. This shows that uterine volume increases across childhood, with a faster increase in adolescence reflecting the influence of puberty, followed by a slow but progressive rise during adult life. The model suggests that around 84% of the variation in uterine volumes in the healthy population up to age 40 is due to age alone. The derivation of a validated normative model for uterine volume from birth to age 40 years has important clinical applications by providing age-related reference values for uterine volume. PMID:27295032

  10. Mechanistic Study of the Inhibitory Effect of Kaempferol on Uterine Fibroids In Vitro.

    PubMed

    Li, Yanxia; Ding, Zhaoxia; Wu, Chuanzhong

    2016-12-08

    BACKGROUND This study examined the effect of kaempferol on uterine fibroids in vitro and the underlying mechanism, and investigated the potential of kaempferol as a clinical drug for the treatment of uterine fibroids. MATERIAL AND METHODS Uterine fibroid tissue and surrounding smooth muscle tissue were collected for primary culture. Different concentrations of kaempferol (12 μM, 24 μM, and 48 μM) were used to treat the cells for 24, 48, and 72 hours. Ethanol was used in the control group. A CCK-8 colorimetric assay was used to detect cell proliferation. Real-time PCR and immunoblot were used to detect estrogen receptor (ER), insulin-like growth factor-1 (IGF-1), and vascular endothelial growth factor (VEGF) levels in mRNA and protein. RESULTS The differences in proliferation at different time points and concentrations of kaempferol were statistically significant. The inhibitory effect of kaempferol on mRNA levels of ER and IGF, and protein levels of ER, VEGF, and IGF-1 were positively correlated with kaempferol concentration. Changes in kaempferol concentration showed no effect on VEGF mRNA expression. Treatment with kaempferol significantly lowered myocardin levels in uterine fibroid tissue compared to normal uterine smooth muscle (P<0.05). CONCLUSIONS Kaempferol might be used for clinical treatment of uterine fibroids due to its inhibitory effect on the proliferation of uterine fibroids cells.

  11. A progesterone antagonist cannot prevent fetal survival if the uterine horn is incised.

    PubMed

    Tamada, H; Inaba, T; Sawada, T

    1998-12-01

    The fetuses released into the abdominal cavity by uterine incision escape from most physical influences of the uterus. This study examined whether these fetuses require progesterone actions for survival during late pregnancy in rats. A longitudinal incision in one uterine horn (with the other horn intact) together with bilateral ovariectomy (OVX), removal of the main progesterone-production sites, or sham OVX, were performed on day 18 of pregnancy. Thereafter the rats were given daily subcutaneous injections of anti-progesterone RU 486 (10 mg/kg), or vehicle alone, and the fetal survival rate in each uterine horn was examined on day 21. In those controls which received sham OVX plus injections of vehicle, fetal survival rates were more than 80% in both uterine horns. In the other groups, which received sham OVX plus injections of RU 486, or OVX plus injections of vehicle, or OVX plus injections of RU 486, the fetal survival rates in the intact uterine horns were 4%, 0% and 0%, respectively. In the incised uterine horns of these groups, however, the fetal survival rates were 59%, 67% and 56%, respectively. The results suggest that progesterone, which is required for maintaining pregnancy, may not be essential for survival of fetuses released into the abdominal cavity. Progesterone actions unrelated to uterine physical environment are likely to be dispensable for fetal survival during late pregnancy in rats.

  12. Differential expression of uterine NO in pregnant and nonpregnant rats with intrauterine bacterial infection.

    PubMed

    Fang, L; Nowicki, B; Yallampalli, C

    2001-05-01

    Previous studies have demonstrated that nitric oxide (NO) is involved in the uterine host defense against bacterial infection. In nonpregnant rats, NO production in the uterus was shown to be lower, and inducible NO synthase (NOS) expression was undetectable. However, studies in pregnant rats show abundant expression of inducible NOS with significant elevation in NO production in the uterus. We have recently reported that intrauterine Escherichia coli infection caused a localized increase in uterine NO production and inducible NOS expression in the nonpregnant rat. In our present study, we examined whether the uterine NO production, NOS expression, and uterine tumor necrosis factor-alpha protein are increased in pregnant rats with intrauterine pathogenic Escherichia coli infection. Unlike the nonpregnant state, the NO production in the infected uterine horn of pregnant rats was not significantly elevated after bacterial inoculation compared with the contralateral uterine horn. The expression of uterine NOS (types II and III) also did not show significant upregulation in the infected horn. This is in contrast to that in nonpregnant animals, in which type II NOS was induced in the uterus on infection. Moreover, intrauterine infection induced an elevated expression of tumor necrosis factor-alpha protein in the infected horn both of nonpregnant and of pregnant rats. These data suggest that the sequential stimulation of NOS expression, especially the inducible isoform, and generation of uterine NO are lacking during pregnancy despite an elevated tumor necrosis factor-alpha after infection. In summary, NO synthesis response may be maximal at pregnancy, and infection may not further induce the NO system. Present studies, together with our previous report that intrauterine infection-induced lethality in pregnancy rats was amplified with the inhibition of NO, suggest that pregnancy is a state predisposed for increased complications associated with intrauterine infection and

  13. Biodegradable estradiol microspheres do not affect uterine involution or characteristics of postpartum estrus in mares.

    PubMed

    Arrott, C; Macpherson, M; Blanchard, T; Varner, D; Thompson, J; Simpson, B; Bruemmer, J; Vogelsang, S; Fernandez, M; Fleet, T; Burns, P

    1994-08-01

    Quarterhorse mares were used to investigate effects of estradiol-17beta on uterine involution, duration of estrus, interval to ovulation, and fertility achieved by breeding on the first postpartum estrus. On the day of foaling, mares were injected with biodegradable poly (DL-lactide) microspheres containing either 100 mg estradiol-17beta (25 mares) or no drug (27 mares). The treatment period was considered to last for 12 to 15 d. Estrus was determined by teasing mares (n=16) with a stallion. Ovulation was detected by transrectal ultrasonographic examination of ovaries (n=48). On Days 6, 11 and 16 post partum, transrectal ultrasonography was used to measure cross-sectional diameters of the uterine body, uterine horns, and fluid within the uterine lumen (n=28). Uteri were swabbed for bacteriologic culture, and uterine biopsies were obtained from the previously gravid uterine horn on Days 11 and 16 post partum, for assessment of endometritis and morphometric analysis of endometrial histioarchitecture (n=19). Twenty-two mares were bred on foal-heat, and pregnancy was determined by transrectal ultrasonography on 14 to 16 and 30 to 35 d after breeding. With only one exception (diameter of previously gravid uterine horn on Day 11), mean values for all measures of uterine involution did not differ between treatment groups (P > 0.05). No differences were detected between treatment group means for length of estrus or interval to ovulation (P > 0.05). No differences were detected between treatment group liklihoods for recovery of potential bacterial pathogens, presence of endometritis, or presence of intrauterine fluid at 11 or 16 d post partum (P > 0.05). Pregnancy rate of mares treated with estradiol (5 11 ; 45%) was not different from that of control mares (9 11 ; 82%; P > 0.05). Estradiol treatment did not hasten uterine involution, increase duration of estrus, delay ovulation, or increase fertility in these postpartum mares.

  14. Transabdominal color doppler ultrasonography: A relevant approach for assessment of effects of uterine torsion in buffaloes

    PubMed Central

    Devender; Chandolia, Ramesh Kumar; Pandey, Anand Kumar; Yadav, Vishal; Kumar, Parveen; Dalal, Jasmer

    2016-01-01

    Aim: The present study was conducted on advanced pregnant buffaloes suffering from uterine torsion to assess the status of fetus and uterus by transabdominal ultrasonography, and the findings were compared with normal advanced pregnant buffaloes. Materials and Methods: The study was conducted on 20 clinical cases of uterine torsion and 20 normal advanced pregnant buffaloes (control group). The lower ventral area just lateral to linea alba (on both sides of the udder) in standing animals was scanned transabdominally by the two-dimensional convex transducer for various ultrasonographic findings. The data collected were statistically analyzed by “one-way ANOVA” and “independent sample t-test” using computerized SPSS 16.0 software program. Results: Transabdominal ultrasonography revealed dead fetus in 95% uterine torsion cases and proved useful in imaging internal structures of fetuses while no dead fetus was reported in the control group. Size of umbilicus was found significantly decreased (p<0.05) in uterine torsion group in comparison to control animals, but the decrease in placentomal area was marginal (p>0.05) in uterine torsion group. Average thickness of the uterine wall and mean pixel values of fetal fluids (echogenicity) were found significantly increased (p<0.05) in uterine torsion affected buffaloes in comparison to control group. Conclusion: Status of fetus (whether live or dead), internal status of uterus, and its contents could be determined by transabdominal ultrasonography in uterine torsion cases and thus determining the prognosis of the uterine torsion cases before going for further manipulations. This will also help in taking all the precautions to avoid death of the fetus. PMID:27651672

  15. [Abnormal uterine bleeding in women with IUDs submitted to magnetotherapy].

    PubMed

    Semeraro, A; De Castro, G

    1985-01-01

    IUDs are now 1 of the cornerstones of modern contraception. Blood loss, in the form of hemorrhage or spotting, is the most common complication. Between 10%-20% of users exhibit this symptom, which is also the most frequent reason for mandatory removal. The explanations given by various authors to justify the connection between uterine hemorrhage and the IUD are many and often conflicting. In a clinical case in Italy, a 32-year-old patient came in complaining of uterine bleeding. In the long term pathological case history nothing appeared which indicated pathology in the genital region. However, it reported a vertebral fracture for which reason she was fitted with a 2nd copper IUD, which was well tolerated, and caused no intermenstrual spotting. 5 days before her appointment she had started a cycle of magnetotherapy for the vertebral fracture and 3 days later she noticed mild spotting. This is why she sought medical care. It is known that during this therapy, metals found within the magnetic field can become hot. Copper is an excellent electrical conductor, and if it is within a magnetic field it can also become hot. There are 2 possible hypotheses: 1) direct action of the magnetic field on the metal; in fact, a metal immersed in a variable magnetic field acts as if it were made up of many small magnets which modify their orientation at the fringes of the magnetic field, generating internal friction which may alter its temperature; and 2) direct action of the magnetic field on the copper wiring by way of parasite currents, setting up the Joule effect. In this patient, the symptom disappeared 6 days after the termination of physiotherapy. Therefore, it is thought that when there is a uterine hemorrhage for which no plausible explanation can be found, it is advisable to verify whether there has been any magnetotherapy involving the pelvic region. The IUD is the most widely used contraceptive among patients 40 years of age and older and it is mostly this group that may

  16. Pregnancy upregulates large-conductance Ca(2+)-activated K(+) channel activity and attenuates myogenic tone in uterine arteries.

    PubMed

    Hu, Xiang-Qun; Xiao, Daliao; Zhu, Ronghui; Huang, Xiaohui; Yang, Shumei; Wilson, Sean; Zhang, Lubo

    2011-12-01

    Uterine vascular tone significantly decreases whereas uterine blood flow dramatically increases during pregnancy. However, the complete molecular mechanisms remain elusive. We hypothesized that increased Ca(2+)-activated K(+) (BK(Ca)) channel activity contributes to the decreased myogenic tone of uterine arteries in pregnancy. Resistance-sized uterine arteries were isolated from nonpregnant and near-term pregnant sheep. Electrophysiological studies revealed a greater whole-cell K(+) current density in pregnant compared with nonpregnant uterine arteries. Tetraethylammonium and iberiotoxin inhibited K(+) currents to the same extent in uterine arterial myocytes. The BK(Ca) channel current density was significantly increased in pregnant uterine arteries. In accordance, tetraethylammonium significantly increased pressure-induced myogenic tone in pregnant uterine arteries and abolished the difference in myogenic responses between pregnant and nonpregnant uterine arteries. Activation of protein kinase C produced a similar effect to tetraethylammonium by inhibiting BK(Ca) channel activity and increasing myogenic tone in pregnant uterine arteries. Chronic treatment of nonpregnant uterine arteries with physiologically relevant concentrations of 17β-estradiol and progesterone caused a significant increase in the BK(Ca) channel current density. Western blot analyses demonstrated a significant increase of the β1, but not α, subunit of BK(Ca) channels in pregnant uterine arteries. In accordance, steroid treatment of nonpregnant uterine arteries resulted in an upregulation of the β1, but not α, subunit expression. The results indicate that the steroid hormone-mediated upregulation of the β1 subunit and BK(Ca) channel activity may play a key role in attenuating myogenic tone of the uterine artery in pregnancy.

  17. Spontaneous Rupture of Uterine Artery in a 14-Week Pregnant Woman

    PubMed Central

    de Carvalho, João Paulo Mancusi; Severo, Luciano Augusto de Carvalho; de Carvalho, Maria Helena Mancusi; Gomes, Mariano Tamura Vieira; Podgaec, Sergio

    2016-01-01

    We report a case of uterine artery rupture in a woman at 14 weeks' gestation who presented with abdominal pain, tachycardia, and hypotension and underwent a diagnostic laparoscopy. During this procedure, a spontaneous rupture of the left uterine artery was diagnosed and the surgery was converted into a laparotomy. The artery was bound to its origin and to its distal uterine portion. The patient exhibited excellent postoperative recovery and was discharged two days after the surgery. The pregnancy continued without other maternal or fetal complications, and the patient delivered a healthy newborn via cesarean section at 39 weeks of gestation. PMID:27891272

  18. [Uterine rupture without preexisting caesarean section after perforation of the uterus during evacuation].

    PubMed

    Bønnelykke, Astrid; Jeppesen, Ulla; Munk, Anne Cathrine Hoffgaard

    2015-01-26

    Uterine rupture is a serious complication, associated with perinatal and maternal morbidity and mortality. This case report describes uterine rupture in a patient who did not have any previous caesarean section. The patient had acute abdominal pain, hypertonic uterus, blood in the amniotic fluid and abnormal cardiotocographic values. An abruption of the placenta was suspected, and an acute caesarean section was performed during which a rupture in fundus uteri was found. It was later experienced that the patient ten years earlier had suffered a uterine perforation during evacuation after a late abortion.

  19. Small cell neuroendocrine carcinoma of the uterine cervix presenting with syndrome of inappropriate antidiuretic hormone secretion.

    PubMed

    Kim, Do Young; Yun, Hye Jung; Lee, Yong Seok; Lee, Hae Nam; Kim, Chan Joo

    2013-11-01

    Small cell carcinoma of the uterine cervix is rare. It is estimated that 10% of patients with small-cell lung cancer have syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and hyponatremia has been reported to be significantly associated with a poor prognosis. A proportion of small cell carcinoma of the uterine cervix exhibit neuroendocrine characteristics as revealed by immunohistochemistry, However, cases presenting typical symptoms due to SIADH are extremely rare. This report of the SIADH of the uterine cervix is a rare case in the small cell carcinoma of the cervix presenting with tumor-associated paraneoplastic syndrome.

  20. Unilateral uterine torsion secondary to an inflammatory endometrial polyp in the bitch.

    PubMed

    Chambers, Ba; Laksito, Ma; Long, F; Yates, Gd

    2011-10-01

    A 9-year-old bitch was presented because of lethargy and abdominal distension. Abdominal ultrasound revealed an enlarged, fluid-filled uterus and associated mass. Subsequent exploratory laparotomy revealed unilateral uterine torsion involving the mass. Recovery following ovariohysterectomy was uneventful and the histopathological diagnosis was of a benign endometrial inflammatory polyp. Reports of uterine torsion in the English-language literature are reviewed to identify factors associated with the incidence of uterine torsion. The aetiology of the cystic endometrial hyperplasia/pyometra complex and its possible role in the development of inflammatory polypoid lesions in the bitch is also discussed.

  1. Aberrant Ovarian Collateral Originating from External Iliac Artery During Uterine Artery Embolization

    SciTech Connect

    Kwon, Joon Ho; Kim, Man Deuk Lee, Kwang-hun; Lee, Myungsu; Lee, Mu Sook; Won, Jong Yun; Park, Sung Il; Lee, Do Yun

    2013-02-15

    We report a case of a 35-year-old woman who underwent uterine artery embolization (UAE) for symptomatic multiple uterine fibroids with collateral aberrant right ovarian artery that originated from the right external iliac artery. We believe that this is the first reported case in the literature of this collateral uterine flow by the right ovarian artery originated from the right external iliac artery. We briefly present the details of the case and review the literature on variations of ovarian artery origin that might be encountered during UAE.

  2. Managing bleeding, fluid absorption and uterine perforation at hysteroscopy.

    PubMed

    Istre, Olav

    2009-10-01

    Hysteroscopy is the current gold standard for evaluating intrauterine pathology, including submucous fibroids, polyps, hyperplasia and cancer. However, there are still problems and complications connected to hysteroscopy. Fluid overload of 1-2l occurs in approximately 5.2% and >2l in 1% of cases. This article discusses the physiology, implications and treatment of these cases. Uterine perforation is encountered in nearly 1% of cases. We describe the precautions to avoid this perforation and the methods to treat it. The article also discusses excessive bleeding, which occurs in 3% of operative hysteroscopies and describes strategies to avoid and to deal with this complication. Emergency hysterectomy and other surgical interventions are rarely indicated and are seen in 2% of cases. Finally, death due to septicaemia or fluid overload has been reported only very rarely (0.1%). These different complications are discussed in detail.

  3. Uterine Leiomyosarcoma Manifesting as a Tricuspid Valve Mass

    PubMed Central

    Marak, Creticus P.; Ponea, Ana M.; Alappan, Narendrakumar; Shaheen, Shagufta; Guddati, Achuta K.

    2013-01-01

    Uterine leiomyosarcoma is a rare malignancy and carries a poorer prognosis when compared to endometrial carcinoma. It has been observed to metastasize to all the major organs. It presents with symptoms of abdominal distension, vaginal bleeding and may pass unnoticed until an advanced stage in patients with leiomyomas. Surgery is a viable option in patients with disease limited to the uterus, but metastasis to the heart may require surgery to prevent acute and catastrophic complications. The case described here involves metastasis to the tricuspid valve, which caused severe tricuspid regurgitation in the setting of acute pulmonary embolism. Surgical resection restored cardiac function and stabilized the patient. This case illustrates a rare site of metastasis of leiomyosarcoma which required immediate intervention and resulted in a favorable outcome. PMID:23569446

  4. Abnormal uterine bleeding induced by glucocorticoid treatment for pemphigus

    PubMed Central

    Luo, Xiaobo; Feng, Hui; Jiang, Lu; Chen, Qianming

    2016-01-01

    Glucocorticoids are the first-line treatment option for pemphigus. Moreover, abnormal uterine bleeding (AUB) is a rarely reported side effect of glucocorticoid treatment that usually manifests as abnormal and excessive endometrial bleeding; in fact, AUB can be induced by the systemic or topical application of glucocorticoids. In the present report, we describe the cases of 3 patients with pemphigus who developed AUB following glucocorticoid administration. It is important to note that the administration mode of glucocorticoids, and the onset time and duration of AUB differed among these patients. Thus, we propose the following treatment algorithm for AUB following glucocorticoid administration: 1. perform a gynecological and physical examination to exclude organic diseases. 2. continue glucocorticoid treatment. 3. if AUB persists, change the mode of administration of glucocorticoids. 4. if AUB still persists, despite these measures, completely withdraw treatment with glucocorticoids and use non-glucocorticoid treatments. PMID:27570861

  5. Conventional reanastomosis versus laser welding of rat uterine horns.

    PubMed

    Shapiro, A G; Carter, M; Ahmed, A; Sielszak, M W

    1987-04-01

    In this study we compared conventional surgical techniques with those of low-power CO2 lasers (output 140 mW; spot size 0.4 mm) used to weld transected rat uterine horns. On one side a microanastomosis was made by standard surgical technique of 8-0 nylon; the other side was "welded" either after doing the anastomosis with 8-0 sutures or without any anastomotic sutures. Histologic sections obtained from rats' uteri treated with conventional and laser surgery showed that on the laser-treated sutured side there was less necrosis and inflammatory and giant cells. The animals that underwent laser welding without suturing had no necrosis, suppuration, or granulation; giant cells were not present. We conclude that in the tissue from the laser-treated animals, when compared with conventional and laser-with-suture surgery, histologic features indicate healing process by primary intention via an aseptic noninflammatory reaction.

  6. Regional Development of Uterine Decidualization: Molecular Signaling by Hoxa-10

    PubMed Central

    DAS, SANJOY K.

    2014-01-01

    SUMMARY Uterine decidualization, a key event in implantation, is critically controlled by stromal cell proliferation and differentiation. Although the molecular mechanism that controls this event is not well understood, the general consensus is that the factors derived locally at the site of implantation influence aspects of decidualization. Hoxa-10, a developmentally regulated homeobox transcription factor, is highly expressed in decidualizing stromal cells, and targeted deletion of Hoxa-10 in mice shows severe decidualization defects, primarily due to the reduced stromal cell responsiveness to progesterone (P4). While the increased stromal cell proliferation is considered to be an initiator of decidualization, the establishment of a full-grown functional decidua appears to depend on the aspects of regional proliferation and differentiation. In this regard, this article provides an overview of potential signaling mechanisms mediated by Hoxa-10 that can influence a host of genes and cell functions necessary for propagating regional decidual development. PMID:19921737

  7. Regional development of uterine decidualization: molecular signaling by Hoxa-10.

    PubMed

    Das, Sanjoy K

    2010-05-01

    Uterine decidualization, a key event in implantation, is critically controlled by stromal cell proliferation and differentiation. Although the molecular mechanism that controls this event is not well understood, the general consensus is that the factors derived locally at the site of implantation influence aspects of decidualization. Hoxa-10, a developmentally regulated homeobox transcription factor, is highly expressed in decidualizing stromal cells, and targeted deletion of Hoxa-10 in mice shows severe decidualization defects, primarily due to the reduced stromal cell responsiveness to progesterone (P(4)). While the increased stromal cell proliferation is considered to be an initiator of decidualization, the establishment of a full-grown functional decidua appears to depend on the aspects of regional proliferation and differentiation. In this regard, this article provides an overview of potential signaling mechanisms mediated by Hoxa-10 that can influence a host of genes and cell functions necessary for propagating regional decidual development.

  8. Postpartum uterine disease and dairy herd reproductive performance: a review.

    PubMed

    LeBlanc, Stephen J

    2008-04-01

    This paper reviews the causes, impact, treatment, and prevention of retained placenta (RP), metritis, and endometritis in dairy cows. The occurrence of each of these diseases largely depends on immune function in the transition period. Retained placenta affects 5-10% of calvings and greatly increases the risk of metritis and endometritis. More field studies are needed to validate criteria for treatment of metritis, but cows with at least two of RP, fever, dullness, and fetid uterine discharge appear to merit treatment with systemic antibiotics. Clinical endometritis affects 15-20% of cows at 4-6 weeks postpartum; an additional 30-35% have subclinical endometritis between 4 and 9 weeks postpartum. Under specific conditions, treatment of cows with endometritis improved pregnancy rate. Systematic use of prostaglandin F(2alpha) at 5 and 7 weeks postpartum may improve pregnancy rate. The economic benefit of efforts to identify and treat endometritis is herd-specific.

  9. Fatal Pulmonary Embolus After Uterine Artery Fibroid Embolisation

    SciTech Connect

    Hamoda, Haitham; Tait, P.; Edmonds, D. K.

    2009-09-15

    We report a 44-year-old woman who developed a fatal pulmonary embolus after uterine artery fibroid embolisation (UAE). Bilateral UAE was carried out through a single right-femoral artery puncture. The largest fibroid in the anterior fundal wall measured 4.5 cm, and the largest fibroid in the posterior fundal wall measured 6 cm. The appearances after UAE were satisfactory, and the procedure was apparently uneventful. No immediate complications were noted. The patient developed sudden-onset shortness of breath and went into cardiac arrest 19 h after the procedure. Postmortem autopsy confirmed that the cause of a death was a pulmonary embolism. To our knowledge this is the first reported case in the United Kingdom in which death occurred from a pulmonary embolus after UAE.

  10. Evaluation and Management of Adolescents with Abnormal Uterine Bleeding.

    PubMed

    Mullins, Tanya L Kowalczyk; Miller, Rachel J; Mullins, Eric S

    2015-09-01

    The International Federation of Gynecology and Obstetrics and the American Congress of Obstetricians and Gynecologists support the use of new terminology for abnormal uterine bleeding (AUB) to consistently categorize AUB by etiology. The term AUB can be further classified as AUB/heavy menstrual bleeding (HMB) (replacing the term "menorrhagia") or AUB/intermenstrual bleeding (replacing the term "metrorrhagia"). Although many cases of AUB in adolescent women are attributable to immaturity of the hypothalamic-pituitary-ovarian axis, underlying bleeding disorders should be considered in women with AUB/HMB. This article reviews the new terminology for AUB, discusses important relevant features of history and examination, presents the laboratory evaluation of HMB, and describes hormonal (oral contraceptive pills, progestin-only methods, long-acting reversible contraceptives including intrauterine systems), hematologic (tranexamic acid and desmopressin), and surgical management options for AUB/HMB.

  11. Uterine cervical neoplasia prevention in Parque Indigena do Xingu.

    PubMed

    Speck, N M de Góis; Pereira, E R; Schaper, M; Tso, F K; de Freitas, V G; Ribalta, J C L

    2009-01-01

    Results of preventive health measures, diagnosis and treatment applied to Parque Indigena do Xingu native women were studied. Thirty-seven cases of uterine cervical intraepithelial lesions and invasive neoplasias were treated in the local villages without referral to an advanced medical center. LEEPs were carried out in 32 women, three cold knife conizations, one vaginal hysterectomy and one Wertheim Meigs procedure. Results of 53.1% of LEEP surgical procedures did not have margin involvement by the lesions. Bleeding complications were seen in 15.6%. Regular follow-up with two or three cytologic and colposcopic tests in 32 women was carried out. All cases were negative for lesions. Five women were not followed-up due mainly to logistical reasons. Health endeavors adopted in the period 2005-2007 brought about a significant reduction of precursor lesions in this native aboriginal population without screening resources.

  12. Adam12 plays a role during uterine decidualization in mice.

    PubMed

    Zhang, Li; Guo, Weixiang; Chen, Qi; Fan, Xiujun; Zhang, Ying; Duan, Enkui

    2009-12-01

    In mouse, decidualization is characterized by the proliferation of stromal cells and their differentiation into specialized type of cells (decidual cells) with polyploidy, surrounding the implanting blastocyst. However, the mechanisms involved in these processes remain poorly understood. Using multiple approaches, we have examined the role of Adam12 in decidualization during early pregnancy in mice. Adam12 is spatiotemporally expressed in decidualizing stromal cells in intact pregnant females and in pseudopregnant mice undergoing artificially induced decidualization. In the ovariectomized mouse uterus, the expression of Adam12 is upregulated after progesterone treatment, which is primarily mediated by nuclear progesterone receptor. In a stromal cell culture model, the expression of Adam12 gradually rises with the progression of stromal decidualization, whereas the attenuated expression of Adam12 after siRNA knockdown significantly blocks the progression of decidualization. Our study suggests that Adam12 is involved in promoting uterine decidualization during pregnancy.

  13. Admixture mapping of genetic variants for uterine fibroids

    PubMed Central

    Zhang, Kui; Wiener, Howard; Aissani, Brahim

    2015-01-01

    Uterine leiomyoma (UL) are benign neoplasms arising from the smooth muscle cells of the uterus. One of the established risk factors for UL is African American ethnicity. Studies have consistently shown that African Americans have 2-3 times higher risk compared with that of non-Hispanic Whites. However, there is still no adequate explanation for the higher risk among African Americans. To investigate the genetic contribution to the observed difference between the African American and European American populations, we conducted an admixture scan in 525 eligible African American women participants to the NIEHS uterine fibroid study (NIEHS-UFS). In models with no stratification, we found multiple genomic regions showing significant and suggestive evidence of association, with chromosomal band 2q32.2 at rs256552 showing the highest score (Z-score = 7.86, Bonferroni adjusted p-value = 5.5×10-12) consistent with the suggestive evidence reported for this genomic region in the Black Women's Health Study. However, in models stratified by the body mass index (BMI) covariate, chromosomal 1q42.2 was the sole genomic region that consistently showed suggestive associations across the BMI categories tested (Z-scores ≤ -3.96, Bonferroni adjusted p-values ≤ 0.107). In age-stratified models, a significant association was observed in the older category (age > 40) reaching a Z-score of 6.44 (Bonferroni-adjusted p-value = 1.64 × 10-7) at rs256552. The mean percentage of European ancestry among cases was lower than that among controls in the NIEHS-UFS study. However, our study did not show a significant association between mean percentage of European ancestry and UL. PMID:26040208

  14. Ovarian and uterine alterations following forced swimming: An immunohistochemical study

    PubMed Central

    Seyed Saadat, Seyedeh Nazanin; Mohammadghasemi, Fahimeh; Ebrahimi, Hannan; Rafati Sajedi, Hanieh; Chatrnour, Gelayol

    2016-01-01

    Background: Physical exercise is known to be a stressor stimulus that leads to reproductive disruption. Objective: The aim of this study was to evaluate the effect of forced swimming on the uterus and ovaries in mice. Materials and Methods: Adult mice (N=24) were divided into the following three groups: A, control; B, swimming in water (10oC); and C, swimming in water (23oC). Swimmers swam for 5 min daily for 5 consecutive days/ wk during 2 wks. An enzyme linked immunosorbent assay was used to determine serum estradiol, follicle stimulating hormone (FSH) and testosterone levels. Immunohistochemistry was performed to study apoptotic cells or estrogen receptor (ER) expression in uterine epithelial cells and ovaries. ANOVA was used for statistical analysis. Results: Swimming in both groups reduced the serum FSH and estradiol levels (p<0.01) without having a significant effect on the serum testosterone level or percentage of apoptosis in ovarian and uterine tissues (p<0.01) compared with controls. A significant reduction in the number of ERs in the uterus and ovaries, and secondary and graafian follicles were observed in groups B and C compared with controls (p<0.01); however the number of primordial and primary follicles were not significantly changed in the ovaries. Conclusion: Forced swimming of 2 wks duration reduces the serum levels of FSH and estradiol without having effects on apoptosis in the ovaries or uteri of mice. Over a long period of time, forced swimming may have an adverse effect on fertility. PMID:27921086

  15. The intra-uterine device. Part II: technical problems.

    PubMed

    Alexander, I

    1980-10-01

    In discussing the technical problems associated with the IUD, focus is on the basic insertion technique, the technique to use with the various IUDs (Copper 7, Lippes Loop, Copper T models, the Saf-T-coil, and the multiload 250), the timing of the insertion, and removal of the IUD. Bimanual examination of the pelvis must be performed before an IUD is inserted. Prior to starting the insertion, the patient should be given an explanation of what is to be done. As patients are unfamiliar with the appearance of most of the instruments, it is advisable to keep them from view. Having visualized the cervix and fixed the blades of the Cusco speculum in the open position, the cervix can be seized with a single toothed tenaculum or 7 inch Allis forceps. It is generally necessary to steady the cervix with a forcep as it straightens out the canal and uterine flexion. Sounding the uterine cavity will reveal its length and confirm any angulation. On occasion it is impossible to sound the cavity because the internal os is too tight or the endocervical canal has a pinhole external os. Force should be avoided. High fundal placement without perforating the uterus is the objective when inserting any IUD, and this is particularly important with the copper IUDs which depend on a close association of their copper elements to the endometrium. Generally, it is easier to insert a coil towards the end of the period when the cervix is partly dilated and any bleeding that occurs is masked. Insertion following abortion is commonly performed, and encouraging results have been achieved with insertions immediately postpartum. Removal can be done at any time.

  16. Ge-Gen Decoction attenuates oxytocin-induced uterine contraction and writhing response: potential application in primary dysmenorrhea therapy.

    PubMed

    Yang, Lu; Chai, Cheng-Zhi; Yue, Xin-Yi; Yan, Yan; Kou, Jun-Ping; Cao, Zheng-Yu; Yu, Bo-Yang

    2016-02-01

    The uterine tetanic contraction and uterine artery blood flow reduction are possible reasons for primary dysmenorrhea (PD). In the present study, we aimed to evaluate the uterine relaxant effect and the influence on uterine artery blood velocity of Ge-Gen Decoction (GGD), a well-known Chinese herbal formula. In female ICR mice, uterine contraction was induced by oxytocin exposure following estradiol benzoate pretreatment, and the uterine artery blood velocity was detected by Doppler ultrasound. Histopathological examination of the uterine tissue samples were performed by H&E staining. Ex vivo studies demonstrated that oxytocin, posterior pituitary, or acetylcholine induced contractions in isolated mouse uterus. GGD inhibited both spontaneous and stimulated contractions. In vivo study demonstrated that GGD significantly reduced oxytocin-induced writhing responses with a maximal inhibition of 87%. Further study demonstrated that GGD normalized oxytocin-induced abnormalities of prostaglandins F2 alpha (PGF2α) and Ca(2+) in mice. In addition, injection of oxytocin induced a decrease in uterine artery blood flow velocity. Pretreatment with GGD reversed the oxytocin response on blood flow velocity. Histopathological examination showed pretreatment with GGD alleviated inflammation and edema in the uterus when compared with the model group. Both ex vivo and in vivo results indicated that GGD possessed a significant spasmolytic effect on uterine tetanic contraction as well as improvement on uterine artery blood velocity which may involve PGF2α and Ca(2+) signaling, suggesting that GGD may have a clinic potential in PD therapy.

  17. Management of postpartum haemorrhage with uterine balloon tamponade: The way forward.

    PubMed

    Marasinghe, Jeevan P; Du Plessis, Jacobus; Epitawela, Dinesh; Umstad, Mark P

    2015-08-01

    Uterine balloon tamponade has rapidly gained popularity in the management of postpartum haemorrhage. It is a conservative method often utilised before embarking on advanced surgical interventions. The mechanism of action, complications and long-term outcomes are discussed.

  18. Beef heifers with diminished numbers of antral follicles have decreased uterine protein concentrations

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Previous research demonstrated a favorable relationship between the number of follicles detectable in the bovine ovary by ultrasonography and fertility, and bovine females with diminished numbers of antral follicles had smaller reproductive tracts. Therefore, we hypothesized that uterine function w...

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

    PubMed

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

    2010-06-01

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

  20. [Uterine Rupture at 18 Weeks of Pregnancy in the Context of Malformed Uterus].

    PubMed

    Vale-Fernandes, Emídio; Teixeira, Neusa; Cadilhe, Alexandra; Rocha, Maria José

    2016-10-01

    Birth defects of the female genital tract are relatively common and often asymptomatic. Despite the pregnancy outcome can be favorable, adverse obstetric outcomes are described in women with uterine malformations. The authors report the case of an obstetric emergency which enhances the possibility of a very adverse and rare outcome of uterine rupture in a left hemi-cavity of a bicornuate uterus away from the term, at 18 weeks of pregnancy, in a pregnant woman with history of caesarean in the right hemi-cavity and with placenta increta. A malformed uterus with a primitive type cavity has lower distensibility of the wall with the progression of the pregnancy and facilitates the development of abnormal placentation forms, increasing the risk of uterine rupture in the first and second trimesters. The knowledge of the existence of a congenital uterine anomaly in the preconceptional period is of primary importance.

  1. Design and application of a flexible and implantable sensor for detecting uterine musculature contraction.

    PubMed

    Zhao, Gang; Qin, Ling; Yang, Qing; Wu, Shangchun; He, Peiyu

    2009-09-15

    It is very important to obtain the parameters of deformation size and contraction frequency of women's uterine musculature in medical research. This paper proposes a type of sensor for measuring these parameters and analyzes its force situation. The flexibility of the sensor makes it easy for doctors to let the sensor pass through woman's narrow cervix and get to her uterine cavity. The experiment shows that the sensitivity of three coils in the sample sensor achieves 22.38 nH/mm(2) both for left and right coils, 22.84 nH/mm(2) for top coil, which can meet the requirements of sensitivity for testing the contraction situation of uterine musculature. Furthermore, an interface designed in the back end system can display the parameters of deformation size and vivid contraction situation of women's uterine musculature in real-time. The sensor has been applied in some medical fields.

  2. [Diagnostic and therapeutic advantage of IUD's in inborn and post-traumatic uterine anomalies].

    PubMed

    Danezis, J; Soumplis, A; Papathanassiou, Z

    1979-04-01

    Surgery to correct uterine congenital or traumatic abnormalities is not always successful and often dangerous. This article reports on 110 cases of congenital malformations, and traumatic morphological uterine abnormalities leading to synechiae and sterility. The uterine cavity was carefully explored to assess the extent of the malformation, and hysterography done. The proper IUD was selected, inserted, and retained for 3 cycles, after which it was removed and another hysterography done. Comparison of the 2 hysterographies gave not only the exact diagnosis of the type of abnormality, but it showed that the IUD had in 78% of cases satisfactorily corrected the size and/or the morphology of the uterine cavity, to such an extent that several pregnancies were possible.

  3. Epidural Analgesia Versus Patient-Controlled Analgesia for Pain Relief in Uterine Artery Embolization for Uterine Fibroids: A Decision Analysis

    SciTech Connect

    Kooij, Sanne M. van der Moolenaar, Lobke M.; Ankum, Willem M.; Reekers, Jim A.; Mol, Ben Willem J.; Hehenkamp, Wouter J. K.

    2013-12-15

    Purpose: This study was designed to compare the costs and effects of epidural analgesia (EDA) to those of patient-controlled intravenous analgesia (PCA) for postintervention pain relief in women having uterine artery embolization (UAE) for systematic uterine fibroids. Methods: Cost-effectiveness analysis (CEA) based on data from the literature by constructing a decision tree to model the clinical pathways for estimating the effects and costs of treatment with EDA and PCA. Literature on EDA for pain-relief after UAE was missing, and therefore, data on EDA for abdominal surgery were used. Outcome measures were compared costs to reduce one point in visual analogue score (VAS) or numeric rating scale (NRS) for pain 6 and 24 h after UAE and risk for complications. Results: Six hours after the intervention, the VAS was 3.56 when using PCA and 2.0 when using EDA. The costs for pain relief in women undergoing UAE with PCA and EDA were Euro-Sign 191 and Euro-Sign 355, respectively. The costs for EDA to reduce the VAS score 6 h after the intervention with one point compared with PCA were Euro-Sign 105 and Euro-Sign 179 after 24 h. The risk of having a complication was 2.45 times higher when using EDA. Conclusions: The results of this indirect comparison of EDA for abdominal surgery with PCA for UAE show that EDA would provide superior analgesia for post UAE pain at 6 and 24 h but with higher costs and an increased risk of complications.

  4. [Report of a case of congenital vesico-uterine fistula with vaginal atresia associated with an exterior uterine cervix and agenesis of the right kidney].

    PubMed

    Daskalov, I; Sahpazov, M

    1982-01-01

    In a 27-year-old patient with cyclic hematuria a complex congenital malformation was diagnosed: the atresia of the upper third of the vagina and the external uterine cervix, a vesico-uterine fistula, and agenesis of the right kidney. The patient was treated surgically in two phases: first, the vesico-uterine fistula was closed abdominally and then, vaginally, the cervix was lowered down to its normal anatomic site and the external cervical orifice was opened. The postoperative course was normal and the patient was discharged from hospital 20 days after surgery. After 2 months the findings of the follow-up examination were normal, and so were the menstrual cycle and urination.

  5. Uterine Spiral Artery Remodeling: The Role of Uterine Natural Killer Cells and Extravillous Trophoblasts in Normal and High-Risk Human Pregnancies.

    PubMed

    Tessier, Daniel R; Yockell-Lelièvre, Julien; Gruslin, Andrée

    2015-07-01

    The process of uterine spiral artery remodeling in the first trimester of human pregnancy is an essential part of establishing adequate blood perfusion of the placenta that will allow optimal nutrient/waste exchange to meet fetal demands during later development. Key regulators of spiral artery remodeling are the uterine natural killer cells and the invasive extravillous trophoblasts. The functions of these cells as well as regulation of their activation states and temporal regulation of their localization within the uterine tissue are beginning to be known. In this review, we discuss the roles of these two cell lineages in arterial remodeling events, their interaction/influence on one another and the outcomes of altered temporal, and spatial regulation of these cells in pregnancy complications.

  6. Surgical technique for single-port laparoscopy in huge ovarian tumors: SW Kim's technique and comparison to laparotomy

    PubMed Central

    Kim, Jeong Sook; Lee, In Ok; Eoh, Kyung Jin; Chung, Young Shin; Lee, Inha; Lee, Jung-Yun; Nam, Eun Ji; Kim, Sunghoon; Kim, Young Tae

    2017-01-01

    Objective This study aimed to introduce a method to remove huge ovarian tumors (≥15 cm) intact with single-port laparoscopic surgery (SPLS) using SW Kim's technique and to compare the surgical outcomes with those of laparotomy. Methods Medical records were retrospectively reviewed for patients who underwent either SPLS (n=21) with SW Kim's technique using a specially designed 30×30-cm2-sized 3XL LapBag or laparotomy (n=22) for a huge ovarian tumor from December 2008 to May 2016. Perioperative surgical outcomes were compared. Results In 19/21 (90.5%) patients, SPLS was successfully performed without any tumor spillage or conversion to multi-port laparoscopy or laparotomy. There was no significant difference in patient characteristics, including tumor diameter and total operation time, between both groups. The postoperative hospital stay was significantly shorter for the SPLS group than for the laparotomy group (median, 2 [1 to 5] vs. 4 [3 to 17] days; P<0.001). The number of postoperative general diet build-up days was also significantly shorter for the SPLS group (median, 1 [1 to 4] vs. 3 [2 to 16] days; P<0.001). Immediate post-operative pain score was lower in the SPLS group (median, 2.0 [0 to 8] vs. 4.0 [0 to 8]; P=0.045). Patient-controlled anesthesia was used less in the SPLS group (61.9% vs. 100%). Conclusion SPLS was successful in removing most large ovarian tumors without rupture and showed quicker recovery and less immediate post-operative pain in comparison to laparotomy. SPLS using SW Kim's technique could be a feasible solution to removing huge ovarian tumors. PMID:28344959

  7. Feasibility of radiofrequency ablation as an alternative to surgical intervention in patients with huge multiloculated pyogenic liver abscesses

    PubMed Central

    Ke, Shan; Ding, Xue-Mei; Gao, Jun; Wang, Shao-Hong; Kong, Jian; Xu, Li; Sun, Wen-Bing

    2016-01-01

    Abstract This retrospective cohort study investigated the feasibility of radiofrequency (RF) ablation as an alternative to surgical intervention in patients with huge multiloculated pyogenic liver abscesses (PLAs). From August 2010 to April 2016, 83 patients with PLA were admitted to Beijing Chao-Yang Hospital, China. Four of these patients had huge multiloculated PLAs and underwent RF ablation plus antibiotics. The inclusion criteria for RF ablation were as follows: multiloculated PLA confirmed by computed tomography (CT) or magnetic resonance imaging (MRI), widest diameter of the PLA ≥5 cm, failure to respond to or not suitable to treatment with percutaneous drainage (PD), and patient refusal of surgery. The safety and effectiveness of RF ablation were initially assessed. All patients were commenced on antibiotics on admission to our hospital. CT-guided percutaneous catheter drainage was attempted in one patient but was unsuccessful. The main organism isolated from cultures of these patients’ blood or abscess samples was Klebsiella pneumoniae (3/4). RF ablation was performed as soon as eligibility according to the above criteria was established. RF ablation was technically successful in all 4 study patients, all PLAs being completely eradicated. The median duration of fever after RF ablation was 4.5 days. No abscesses recurred; thus, this strategy for managing PLA was 100% successful (4/4). No procedure-related deaths or major complications occurred. One patient had an asymptomatic right pleural effusion that resolved with conservative treatment including albumin infusion and diuretics. Our preliminary data indicate that RF ablation is a safe, feasible, and effective treatment for huge multiloculated PLAs. It should be considered as an alternative treatment for patients who fail to respond to or not suitable for PD plus antibiotics and refuse surgical intervention. PMID:27930527

  8. Uterine Dysfunction in Biglycan and Decorin Deficient Mice Leads to Dystocia during Parturition

    PubMed Central

    Wu, Zhiping; Aron, Abraham W.; Macksoud, Elyse E.; Iozzo, Renato V.; Hai, Chi-Ming; Lechner, Beatrice E.

    2012-01-01

    Cesarean birth rates are rising. Uterine dysfunction, the exact mechanism of which is unknown, is a common indication for Cesarean delivery. Biglycan and decorin are two small leucine-rich proteoglycans expressed in the extracellular matrix of reproductive tissues and muscle. Mice deficient in biglycan display a mild muscular dystrophy, and, along with mice deficient in decorin, are models of Ehlers-Danlos Syndrome, a connective tissue anomaly associated with uterine rupture. As a variant of Ehlers-Danlos Syndrome is caused by a genetic mutation resulting in abnormal biglycan and decorin secretion, we hypothesized that biglycan and decorin play a role in uterine function. Thus, we assessed wild-type, biglycan, decorin and double knockout pregnancies for timing of birth and uterine function. Uteri were harvested at embryonic days 12, 15 and 18. Nonpregnant uterine samples of the same genotypes were assessed for tissue failure rate and spontaneous and oxytocin-induced contractility. We discovered that biglycan/decorin mixed double-knockout dams displayed dystocia, were at increased risk of delayed labor onset, and showed increased tissue failure in a predominantly decorin-dependent manner. In vitro spontaneous uterine contractile amplitude and oxytocin-induced contractile force were decreased in all biglycan and decorin knockout genotypes compared to wild-type. Notably, we found no significant compensation between biglycan and decorin using quantitative real time PCR or immunohistochemistry. We conclude that the biglycan/decorin mixed double knockout mouse is a model of dystocia and delayed labor onset. Moreover, decorin is necessary for uterine function in a dose-dependent manner, while biglycan exhibits partial compensatory mechanisms in vivo. Thus, this model is poised for use as a model for testing novel targets for preventive or therapeutic manipulation of uterine dysfunction. PMID:22253749

  9. Sheep Model for Uterine Transplantation: The Best Option Before Starting a Human Program

    PubMed Central

    Andraus, Wellington; Ejzenberg, Dani; dos Santos, Rafael Miyashiro Nunes; Mendes, Luana Regina Baratelli Carelli; Arantes, Rubens Macedo; Baracat, Edmund Chada; D’Albuquerque, Luiz Augusto Carneiro

    2017-01-01

    OBJECTIVE: This study reports the first four cases of a uterine transplant procedure conducted in sheep in Latin America. The aim of this study was to evaluate the success of uterine transplantation in sheep. METHOD: The study was conducted at Laboratory of Medical Investigation 37 (LIM 37) at the University of São Paulo School of Medicine. Four healthy mature ewes weighing 40-60 kg were used as both the donor and recipient for a transplant within the same animal (auto-transplant). Institutional guidelines for the care of experimental animals were followed. RESULTS: The first two cases of auto-transplant were performed to standardize the technique. After complete uterine mobilization and isolation of the blood supply, the unilateral vascular pedicle was sectioned and anastomosed on the external iliac vessels. After standardization, the protocol was implemented. Procurement surgery was performed without complications or bleeding. After isolation of uterine arteries and veins as well as full mobilization of the uterus, ligation of the distal portion of the internal iliac vessels was performed with subsequent division and end-to-side anastomosis of the external iliac vessels. After vaginal anastomosis, the final case presented with arterial thrombosis in the left uterine artery. The left uterine artery anastomosis was re-opened and flushed with saline solution to remove the clot from the artery lumen. Anastomosis was repeated with restoration of blood flow for a few minutes before another uterine artery thrombosis appeared on the same side. All four animals were alive after the surgical procedure and were euthanized after the experimental period. CONCLUSION: We describe the success of four uterine auto-transplants in sheep models. PMID:28355364

  10. The effect of metritis and subclinical hypocalcemia on uterine involution in dairy cows evaluated by sonomicrometry

    PubMed Central

    HEPPELMANN, Maike; KRACH, Karoline; KRUEGER, Lars; BENZ, Philipp; HERZOG, Kathrin; PIECHOTTA, Marion; HOEDEMAKER, Martina; BOLLWEIN, Heinrich

    2015-01-01

    The objective of this study was to examine the effects of metritis and subclinical hypocalcemia on reduction of uterine size in dairy cows using ultrasonography and sonomicrometry. Four piezoelectric crystals were implanted via laparotomy into the myometrium of the pregnant uterine horn of 12 pluriparous Holstein Friesian cows 3 weeks before the calculated calving date. Sonometric measurements were conducted daily from 2 days before parturition (= Day 0) until Day 14 after calving and then every other day until Day 28. Distances between adjacent crystals were expressed in relation to reference values obtained before calving. The diameter of the formerly pregnant uterine horn was measured using transrectal B-Mode sonography starting on Day 10. Cows were retrospectively divided into the following groups: cows without metritis (M–; n = 7), cows with metritis (M+; n = 5), cows with normocalcemia (SH–; Ca > 2.0 mmol/l on Days 1 to 3; n = 5) and cows with subclinical hypocalcemia (SH+; Ca < 2.0 mmol/l in at least one sample between Days 1 and 3; n = 7). Metritis did not affect (P > 0.05) sonometric measurements, but the diameter of the formerly pregnant horn was larger (P ≤ 0.05) between Days 15 and 21 in M+ cows than in M‒ cows. Reduction in uterine length in hypocalcemic cows was delayed (P ≤ 0.05) between Days 8 and 21 compared with normocalcemic cows, but the uterine horn diameter was not related to calcium status. In conclusion, both diseases affected reduction of uterine size until Day 28. Cows with metritis had a larger uterine diameter, possibly attributable to accumulation of lochia, and cows with subclinical hypocalcemia had delayed reduction of uterine length, presumably related to reduction of myometrial contractility. PMID:26400127

  11. Effect of oxytocin and flunixin meglumine on uterine response to insemination in mares.

    PubMed

    Risco, A M; Reilas, T; Muilu, L; Kareskoski, M; Katila, T

    2009-12-01

    The most probable reason for persistent postbreeding endometritis in mares is weak myometrial contractility. The influence of oxytocin (OT; an ecbolic agent) and flunixin meglumine (FLU; a prostaglandin inhibitor serving as a model for mares with decreased uterine contractility) on uterine response to artificial insemination (AI) was studied in mares with no history of reproductive failure. The mares were treated intravenously with 10 mL saline (Group C, n=10) or 0.01 IU/kg OT (Group OT, n=10) 2, 4, 8, and 25 h after AI. Group FLU (n=11) was treated with 1.1mg/kg FLU 2h after AI and with saline thereafter. The mares received the same treatments in the first and third cycles but were sampled either at 8 or 25 h. The amount of intrauterine fluid (IUF) and edema and the number of uterine contractions were recorded before AI and 10 min after the treatments using transrectal ultrasonography. At 8h after AI, the mares were treated with human chorionic gonadotropin, and, after 8-h or 25-h scans, a 500-mL uterine lavage and a biopsy were performed. Ovulation was confirmed at 48 h and pregnancy 14 to 17 d after AI. No manipulations were done during the second estrus. At 8h after AI, Group FLU had more polymorphonuclear leukocytes (PMNs) in the uterine lavage fluid than did Group OT (P<0.05), but uterine contractions did not differ significantly. At 25 h, the PMN concentrations were low in all groups. Group OT rarely showed IUF. The uterine biopsy specimens of Group FLU showed less inflammation of the stroma but more PMNs in the uterine lumen 8h after AI than that of the control group (P<0.05). The pregnancy rates did not differ between the groups (63% C, 53% OT, and 50% FLU). Oxytocin rapidly and effectively removed IUF and PMNs after AI and thereby shortened the duration of postbreeding inflammation.

  12. Ultrasonographic evaluation of a uterine malignant melanoma presenting as a large pelvic mass.

    PubMed

    Varras, Michail; Kassanos, Demetrios; Tzaida, Olympia; Bournas, Nikolaos; Panagiotopoulos, Nikolaos; Chrelias, Charalambos; Salamalekis, Emmanuel

    2005-10-01

    The uterus is an extremely rare location for a primary or metastatic melanoma. We describe the ultrasonographic appearance of a malignant melanoma of the uterus presenting clinically as a large mass in a 78-year-old woman. Transabdominal sonography revealed a solid uterine mass measuring 13 x 11.5 x 8.5 cm with inhomogeneous echotexture and bright internal echoes. The tumor showed a diffuse spread inside the uterine corpus, and the endometrium was not demonstrated ultrasonographically.

  13. Invasive pulmonary mucormycosis with concomitant lung cancer presented with massive hemoptysis by huge pseudoaneurysm of pulmonary artery.

    PubMed

    Kim, Young Il; Kang, Hyo Cheol; Lee, Ho Sung; Choi, Jae Sung; Seo, Ki Hyun; Kim, Yong Hoon; Na, Juock

    2014-11-01

    Pulmonary mucormycosis is a rare opportunistic invasive fungal infection involving the pulmonary vasculature in immunocompromised patients. Pseudoaneurysm of pulmonary artery in mucormycosis is a rare fatal complication after invasion and rupture of a pulmonary artery. We report a patient with diabetes mellitus and incidental lung cancer who developed massive hemoptysis because of a huge pseudoaneurysm of the left pulmonary artery by mucormycosis. Although the patient had been managed by amphotericin B followed by left pneumonectomy for persistent hemoptysis, he died from septic shock and multiorgan failure after surgery. Histologic analysis of a surgical specimen revealed concomitant squamous cell lung cancer.

  14. Progesterone receptor-mediated regulation of N-acetylneuraminate pyruvate lyase (NPL) in mouse uterine luminal epithelium and nonessential role of NPL in uterine function.

    PubMed

    Xiao, Shuo; Li, Rong; Diao, Honglu; Zhao, Fei; Ye, Xiaoqin

    2013-01-01

    N-acetylneuraminate pyruvate lyase (NPL) catalyzes N-acetylneuraminic acid, the predominant sialic acid. Microarray analysis of the periimplantation mouse uterine luminal epithelium (LE) revealed Npl being the most downregulated (35×) gene in the LE upon embryo implantation. In natural pregnant mouse uterus, Npl expression increased 56× from gestation day 0.5 (D0.5) to D2.5. In ovariectomized mouse uterus, Npl was significantly upregulated by progesterone (P4) but downregulated by 17β-estradiol (E2). Progesterone receptor (PR) antagonist RU486 blocked the upregulation of Npl in both preimplantation uterus and P4-treated ovariectomized uterus. Npl was specifically localized in the preimplantation D2.5 and D3.5 uterine LE. Since LE is essential for establishing uterine receptivity, it was hypothesized that NPL might play a critical role in uterine function, especially during embryo implantation. This hypothesis was tested in the Npl ((-/-)) mice. No significant differences were observed in the numbers of implantation sites on D4.5, gestation periods, litter sizes, and postnatal offspring growth between wild type (WT) and Npl ((-/-)) females from mating with WT males. Npl ((-/-))xNpl ((-/-)) crosses produced comparable little sizes as that from WTxWT crosses. Comparable mRNA expression levels of several genes involved in sialic acid metabolism were observed in D3.5 uterus and uterine LE between WT and Npl ((-/-)), indicating no compensatory upregulation in the D3.5 Npl ((-/-)) uterus and LE. This study demonstrates PR-mediated dynamic expression of Npl in the periimplantation uterus and dispensable role of Npl in uterine function and embryo development.

  15. Chronic stimulation of uterine prostaglandin synthesis during cervical ripening before the onset of labor.

    PubMed

    Keirse, M J; Thiery, M; Parewijck, W; Mitchell, M D

    1983-05-01

    Concentrations of 13,14-dihydro-15-keto-PGF2 alpha (PGFM) were measured in plasma of six carefully selected primigravid women with an unripe cervix at term before and at various intervals after extra-amniotic insertion of a Foley catheter with or without methylhydroxyethylcellulose (Tylose) gel. The procedure caused an acute elevation of PGFM levels within 5 min (P less than 0.025), which was maintained for at least 6 hours in the absence of uterine activation at 179 +/- 32% of the initial values (P less than 0.01). Extra-amniotic administration of Tylose gel caused an increase in PGFM levels which was both higher and more prolonged (greater than 12 hours) than insertion of a Foley catheter alone. The observations indicate that cervical ripening without concomitant uterine activation is associated with an increase in PGFM levels. They also demonstrate that prolonged activation of (intra) uterine prostaglandin synthesis may occur several hours before the onset of labor-like uterine activity. A chance finding further suggests that spontaneous rupture of the membranes too may be preceeded by an increase in (intra) uterine prostaglandin synthesis. In their totality these observations lend strong support to the proposition that an increase in (intra) uterine prostaglandin production is a prerequisite to rather than a consequence of the initiation of labor.

  16. The effect of the space flight environment on mucin production in the mouse uterine tube

    NASA Astrophysics Data System (ADS)

    Svalina, Gorica; Forsman, Allan D.

    2013-06-01

    Numerous studies have indicated that the microgravity environment of space has harmful effects on several tissues throughout the body. Although this phenomenon is well documented, research in this area is still in its relative infancy. This study investigates the effects of space flight on mucin production of the uterine tubes of mice. This study examined the epithelium of the uterine tubes from female mice that were flown on the space shuttle Endeavour for 13 days in August, 2007 and their concomitant controls. The tissue was qualitatively analyzed for the type of mucin produced, i.e., acidic, neutral, acidic/neutral mixture. Further, the tissue was quantitatively analyzed for the amounts of mucins produced by measuring the thickness of the mucin layer for each region of the uterine tube: isthmus, ampulla, and infundibulum. One way ANOVA tests were used to compare mucin thickness between all three sets of animals. Results indicate similar but not identical results between the three regions of the uterine tube. The Baseline tissue had the thickest mucin layer regardless of treatment group. In the ampulla the mucin layer was the thinnest in the Flight tissue, followed by the Ground Control, with the Baseline being the thickest. Analysis of the mucin layer of the infundibulum of the three treatment groups indicated no difference in its thickness between the three regions of the uterine tube. These results indicate a trend toward thinning of the mucin layer of the uterine tube in space flight, but also indicate an influence by the housing environment.

  17. Uterine epithelial cell proliferation and endometrial hyperplasia: evidence from a mouse model.

    PubMed

    Gao, Yang; Li, Shu; Li, Qinglei

    2014-08-01

    In the uterus, epithelial cell proliferation changes during the estrous cycle and pregnancy. Uncontrolled epithelial cell proliferation results in implantation failure and/or cancer development. Transforming growth factor-β (TGF-β) signaling is a fundamental regulator of diverse biological processes and is indispensable for multiple reproductive functions. However, the in vivo role of TGF-β signaling in uterine epithelial cells remains poorly defined. We have shown that in the uterus, conditional deletion of the Type 1 receptor for TGF-β (Tgfbr1) using anti-Müllerian hormone receptor type 2 (Amhr2) Cre leads to myometrial defects. Here, we describe enhanced epithelial cell proliferation by immunostaining of Ki67 in the uteri of these mice. The aberration culminated in endometrial hyperplasia in aged females. To exclude the potential influence of ovarian steroid hormones, the proliferative status of uterine epithelial cells was assessed following ovariectomy. Increased uterine epithelial cell proliferation was also revealed in ovariectomized Tgfbr1 Amhr2-Cre conditional knockout mice. We further demonstrated that transcript levels for fibroblast growth factor 10 (Fgf10) were markedly up-regulated in Tgfbr1 Amhr2-Cre conditional knockout uteri. Consistently, treatment of primary uterine stromal cells with TGF-β1 significantly reduced Fgf10 mRNA expression. Thus, our findings suggest a potential involvement of TGFBR1-mediated signaling in the regulation of uterine epithelial cell proliferation, and provide genetic evidence supporting the role of uterine epithelial cell proliferation in the pathogenesis of endometrial hyperplasia.

  18. Hyaluronic acid membrane for reducing adhesion formation and reformation in the rat uterine horn.

    PubMed

    Yarali, H; Zahradka, B F; Gomel, V

    1994-09-01

    The efficacy of hyaluronic acid (HA) membrane in preventing or reducing intraperitoneal adhesion formation and reformation was evaluated in the rat uterine horn. Forty-seven Wistar rats were employed. Following a measured laser injury on the right uterine horn of each rat, HA membrane was applied to cover the site of injury in 20 (HA membrane group). No membrane was applied in another 20 (control group). The type and extent of adhesions were assessed at relaparotomy. Following microsurgical adhesiolysis at second-look laparotomy, the same animals were randomized to the HA membrane and control groups. The type and extent of adhesion reformation were evaluated at third-look laparotomy. Following a similar injury on the right uterine horn in another seven rats, HA membrane was applied on both uterine horns. A repeat laparotomy was performed three hours later to assess the status of the membrane. The type and extent of adhesion formation and reformation were comparable between the HA membrane and control groups. The HA membrane did not remain on the uterine horn and gelled rapidly. Hyaluronic acid membrane was ineffective in reducing adhesion formation and reformation in the rat uterine horn.

  19. Fumarate hydratase gene mutation in two young patients with sporadic uterine fibroids.

    PubMed

    Kubinova, Kristyna; Tesarova, Marketa; Hansikova, Hana; Vesela, Kamila; Kuzel, David; Mara, Michal

    2013-01-01

    Fumarate hydratase (FH) is a key enzyme of the Krebs cycle. Germline mutations in the FH gene encoding fumarate hydratase cause autosomal dominant syndromes multiple cutaneous and uterine leiomyomata and hereditary leiomyomatosis and renal cell cancer (HLRCC). Few data have been published on the role of FH gene mutation in development of uterine fibroids outside the context of multiple cutaneous and uterine leiomyomata /HLRCC. We report two FH gene mutations, one novel and one previously described, in two young patients with sporadic uterine fibroids and decreased fumarate hydratase activity in lymphocytes. In patient 1, a novel heterozygous mutation c.892G>C was found. In patient 2 we detected heterozygous mutation c.584T>C. Both the patients had a negative family history for renal cancer and cutaneous leiomyomatosis. None of the relatives, however, underwent renal imaging at the time of writing. FH mutation carriers may be easily identified by analysis of fumarate hydratase activity in blood lymphocytes. We suggest performing fumarate hydratase activity or FH mutation screening in women with onset of uterine fibroids in their 20s and family history of uterine fibroids or other HLRCC-associated malignancies.

  20. Effect of ovarian hormones on promotion of bactericidal activity by uterine secretions of ovariectomized mares.

    PubMed

    Watson, E D; Stokes, C R; David, J S; Bourne, F J

    1987-03-01

    The bactericidal and phagocytic activities of blood neutrophils suspended in uterine washings and the mobilization of neutrophils into the uterine lumen were studied in ovariectomized mares receiving oestradiol benzoate (N = 4), progesterone (N = 4) or oily vehicle (N = 4). Uterine lavage was performed sequentially up to 144 h after induction of endometritis by intrauterine infusion of glycogen (1%). There was no significant difference between the 3 groups in speed of mobilization of neutrophils into the uterus in the first 6 h after infusion but there were significantly more uterine luminal neutrophils in progesterone-treated than in oestradiol-treated mares by 24 h after infusion (P less than 0.01). Uterine washings collected from progesterone-treated mares at 0, 24 and 144 h were significantly worse at promoting bactericidal activity by neutrophils than washings from oestradiol-treated and control mares (P less than 0.001). In oestrogen-treated and control mares bactericidal activity had increased by 144 h but in progesterone-treated mares bactericidal activity remained low. Neither treatment nor time affected the ability of washings to opsonize yeast blastospores. Elevated concentrations of progesterone in plasma were therefore associated with decreased bactericidal activity of neutrophils suspended in uterine washings but the generation of C3b in washings did not appear to be affected by hormone treatment.

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

    PubMed

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

    2014-10-01

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

  2. [Prevention and treatment of intra-uterine synechiae: Review of the literature].

    PubMed

    Warembourg, S; Huberlant, S; Garric, X; Leprince, S; de Tayrac, R; Letouzey, V

    2015-04-01

    Intra-uterine adhesions are a major cause of secondary infertility. The prevalence of adhesions is probably underestimated due to the heterogeneity of the symptoms. An exhaustive literature search using search engines MEDLINE, Pubmed, Cochrane library and Web of Science was performed to make a focus on the origins, consequences and methods of prevention of intra-uterine adhesions. Intra-uterine adhesions are likely to occur after any endo-uterine surgery via dysregulated activation of coagulation chain linked to the inflammatory process. Early and late obstetric complications are also recognized as caused by adhesions. The diagnosis is currently performed by hysteroscopy but it remains an invasive procedure even if it can be done with an ambulatory management. Several research approaches inspired by intra-abdominal surgery for the prevention of pelvic adhesions have been developed. However, no current method of prevention has proven its effectiveness in terms of improving spontaneous fertility. The improvement in surgical practices, the design of new intra-uterine medical devices and new research especially in the field of endometrial stem cells can maybe reduce the rate of adhesions end their complications after intra-uterine surgery.

  3. Regulation of uterine progesterone receptors by the nonsteroidal anti-androgen hydroxyflutamide

    SciTech Connect

    Chandrasekhar, Y.; Armstrong, D.T. )

    1991-07-01

    The authors have recently reported that the anti-androgen hydroxyflutamide causes delayed implantation and exhibits antideciduogenic activity in the rat. The present experiments were conducted to examine whether hydroxyflutamide binds to the uterine progesterone receptors and/or alters the progesterone binding sites in the uterus. Cytosol and nuclear fractions from decidualized rat uterus were incubated with (3H)-R5020 without or with increasing concentrations of radioinert R5020, RU486, dihydrotestosterone, or hydroxyflutamide. From the log-dose inhibition curves, the relative binding affinity of both hydroxyflutamide and dihydrotestosterone was less than 0.1% and 2%, compared with R5020 (100%) for displacing (3H)-R5020 bound to uterine cytosol and nuclear fractions, respectively. Injection of estradiol-17 beta (1 microgram/rat) to ovariectomized prepubertal rats induced a 1.85-fold increase in uterine weight by 24 h. Hydroxyflutamide at 2.5 or 5.0 mg did not significantly alter the estrogen-induced increase in uterine weight. Compared to vehicle alone, estrogen induced an approximately 5-fold increase in uterine cytosolic progesterone binding sites. Hydroxyflutamide at both 2.5- and 5.0-mg doses significantly attenuated the estrogen-induced elevation in uterine progesterone binding sites. These studies demonstrate that hydroxyflutamide does not bind with high affinity to progesterone receptors, but suppresses the estrogen-induced elevation in progesterone receptor levels in the uterus.

  4. Growth and metabolism of murine and bovine embryos in bovine uterine flushing-supplemented culture media.

    PubMed Central

    Rondeau, M; Guay, P; Goff, A K; Cooke, G M

    1996-01-01

    The aim of this study was to compare the development and metabolic activity of cultured murine and bovine embryos in 2 standard media (HAM F-10 and RPMI) in the presence or absence of bovine uterine flushings. Murine morulae (n = 653) and day 7 bovine embryos (n = 273) were cultured for 18 h or 36 h in either HAM F-10 or RPMI in the presence or absence of bovine uterine flushings. After culture, the development, quality, and metabolic activity (glucose utilization or methionine uptake and incorporation) of embryos was assessed. It was found that HAM F-10 (without uterine flushings) was a more suitable medium than RPMI for optimal development and metabolism of murine and bovine embryos. Poor quality and development, as well as decreased metabolism, were evident after culture of murine embryos in RPMI; in contrast, this medium had no adverse effects on bovine embryos in culture. Supplementation of HAM F-10 with bovine uterine flushings improved the growth of murine embryos and the protein synthesis (as measured by an increased methionine incorporation) for both murine and bovine embryos. However, supplementation with bovine uterine flushings could not overcome deficiencies of an inappropriate medium (RPMI) for murine embryos. Supplementation of a well-defined culture medium with uterine flushings increased metabolism of embryos in culture, and thus might help to increase pregnancy rates after transfer of such embryos to recipient cows. PMID:8825988

  5. Research on fast Fourier transforms algorithm of huge remote sensing image technology with GPU and partitioning technology.

    PubMed

    Yang, Xue; Li, Xue-You; Li, Jia-Guo; Ma, Jun; Zhang, Li; Yang, Jan; Du, Quan-Ye

    2014-02-01

    Fast Fourier transforms (FFT) is a basic approach to remote sensing image processing. With the improvement of capacity of remote sensing image capture with the features of hyperspectrum, high spatial resolution and high temporal resolution, how to use FFT technology to efficiently process huge remote sensing image becomes the critical step and research hot spot of current image processing technology. FFT algorithm, one of the basic algorithms of image processing, can be used for stripe noise removal, image compression, image registration, etc. in processing remote sensing image. CUFFT function library is the FFT algorithm library based on CPU and FFTW. FFTW is a FFT algorithm developed based on CPU in PC platform, and is currently the fastest CPU based FFT algorithm function library. However there is a common problem that once the available memory or memory is less than the capacity of image, there will be out of memory or memory overflow when using the above two methods to realize image FFT arithmetic. To address this problem, a CPU and partitioning technology based Huge Remote Fast Fourier Transform (HRFFT) algorithm is proposed in this paper. By improving the FFT algorithm in CUFFT function library, the problem of out of memory and memory overflow is solved. Moreover, this method is proved rational by experiment combined with the CCD image of HJ-1A satellite. When applied to practical image processing, it improves effect of the image processing, speeds up the processing, which saves the time of computation and achieves sound result.

  6. [A study of cirrhotic patients with hepatocellular carcinoma and huge splenomegaly who received treatment for hepatocellular carcinoma with concomitant splenectomy].

    PubMed

    Aiyama, Takeshi; Kamiyama, Toshiya; Nakanishi, Kazuaki; Yokoo, Hideki; Taniguchi, Masahiko; Fukumori, Daisuke; Tahara, Munenori; Kakisaka, Tatsuya; Kamachi, Hirofumi; Matsushita, Michiaki; Todo, Satoru

    2010-11-01

    Treatment for hepatocellular carcinoma (HCC) with advanced cirrhosis, especially with hypersplenic thrombocytopenia, will be very difficult. Then we evaluated usefulness of concomitant splenectomy with treatment for patients with HCC, severe cirrhosis and huge splenomegaly. The preoperative mean platelet (Plt) count was 4.6 × 10(4)/µL and the mean longest diameter of spleen on CT was 143.0 mm. The mean Plt count on postoperative days 14 and 28 was 23.1 × 10(4)/µL (p=0.005) and 16.1 × 10(4)/µL (p=0.01), respectively and improved significantly compared with preoperative one. A white blood cell count and serum albumin also improved significantly on postoperative days 14 and 28, respectively. Treatment for recurrent HCC after splenectomy was preformed 2.4 times per patient (transarterial chemoembolization 13 times and radiofrequency ablation 4 times/7 patients). Now 5 patients are alive and the mean survival period was 17.3 months (range 8-38 months). It maybe said that concomitant splenectomy for cirrhotic patients with HCC and huge splenomegaly who need to receive a treatment for HCC was useful in our study, because those patients could receive a treatment for recurrent HCC repeatedly, and that probably contributes to the improvement of prognosis.

  7. The effect of hyaluronic acid (Cicatridine) on healing and regeneration of the uterine cervix and vagina and vulvar dystrophy therapy.

    PubMed

    Markowska, J; Madry, R; Markowska, A

    2011-01-01

    Procedures aimed at the treatment of precancerous lesions and ectopia on the uterine cervix are frequently linked to lesions of anatomical structures. The application of hyaluronic acid (Cicatridine vaginal ovules) promotes accelerated healing of the uterine cervix and acquisition of a normal shape in the uterine cervix canal. Local application of hyaluronic acid in the vagina following radiotherapy due to cancer in the uterine cervix or endometrium favourably affects the healing of post-irradiation lesions in the vagina and improves quality of life. Over 90% of patients responded positively to the application of hyaluronic acid in the form of a cream on dystrophic lesions in the vulva. Hyaluronic acid aids the healing process of post-procedural wounds in the uterine cervix, following radiotherapy applied due to cancer of the uterine cervix, endometrium and in vulvar dystrophy.

  8. [To Push or Not to Push? Reflections on the Uterine Fundal Pressure Application in the Second Stage of Labor].

    PubMed

    Hsieh, Ching-Hsing

    2016-08-01

    Women who undergo vaginal birth apply uterine fundal pressure during the second stage of labor. Uterine fundal pressure is done manually with the practitioner's forearms, elbows, or palms pressed on the uterine fundus at a 30° to 45° angle to the maternal spine in the direction of the pelvis. The pressure is applied in the longitudinal direction. Gentle, firm, and steady pressure is recommended. The various side effects of applying uterine fundal pressure include: uterine rupture, postpartum urinary retention, severe perineal trauma and pain, rib fracture, postpartum dyspareunia, and potential neonatal distress or trauma. Therefore, caution is recommended in the application of uterine fundal pressure. Thus, only well-trained and experienced medical staff or nurses should be allowed to practice this intervention.

  9. Molecular and cytogenetic analysis of chromosome 7 in uterine leiomyoma

    SciTech Connect

    Ishwad, C.; Ferrell, R.E.; Davare, J.

    1994-09-01

    Uterine leiomyomas are benign tumors which arise clonally from smooth muscle cells of the myometrium. Cytogenetic studies of uterine leiomyomas revealed that about 50% have chromosome abnormalities and that deletion 7q is a common finding. This observation suggest the possible location of a growth suppressor gene within the 7q21-q22 region. Molecular genetic analysis of cytogenetically normal tumors has frequently revealed somatic loss of specific tumor suppressor genes detected by loss of heterozygosity in the critical region (RB1 in retinoblastoma and WT1 in Wilms tumor). To test the hypothesis that chromosome region 7q21-q22 contains a growth suppressor gene involved in the development of leiomyomas, we tested 67 leiomyomas for allelic loss of 7q markers spanning the cytogenetically defined critical region. Nineteen tumors with cytogenetically defined 7q deletion and 48 tumors without cytogenetically visible 7q deletion were examined for allelic loss of loci D7S487, D7S440, D7S492, D7S518, D7S471, D7S466 and D7S530. Loss of heterozygosity for one or more of these loci was observed in 14/19 (73.7%) of tumors with deletion 7q and no evidence of allelic loss was observed in tumors without cytogenetic deletion. The tumors with deletion 7q but no loss of 7q21-q22 markers were tumors which were mosaics with only a minority of cells showing chromosome 7q deletion. The critical region of loss is defined by markers D7S518 and D7S471, each showing loss in 56% of informative cases. These markers define a 10cM region of 7q21.2-q22 consistent with the cytogenetically defined smallest region of overlap. These markers exclude loss of the MET oncogene locus and WNT1, the murine mammary tumor virus integration site, from the critical region. These results define a region that is consistently lost in leiomyomas with abnormalities in chromosome 7q and may define the location of a gene involved in the development of a subset of leiomyomas.

  10. Rare case of uterine PEC-oma (perivascular epithelioid cell tumor) recurrence. Case report and literature review.

    PubMed

    Issat, Tadeusz; Maciejewski, Tomasz; Beta, Jarosław; Jakimiuk, J Artur

    2012-07-01

    Perivascular epithelioid cell tumor (PEC-oma) is a rare mesenchymal neoplasm. Literature reports more than 100 cases of PEC-oma, a third of which is of uterine or uterine retroperitoneum origin. The case of a 59-year-old woman presented here is, to the best of our knowledge, the first described fast uterine PEC-oma recurrence of the tumor of the gastrointestinal tract origin. In this text the authors also present literature review concerning this rare female tumor

  11. Well-differentiated mucinous uterine adenocarcinoma predominantly diagnosed as adenoma malignum: a case report with an immunohistochemical analysis.

    PubMed

    Semczuk, Andrzej; Tomaszewski, Jacek; Gogacz, Marek; Obrzut, Bogdan; Rigau, Marina; Lewkowicz, Dorota; Semczuk-Sikora, Anna

    2015-01-01

    Adenoma malignum (AM), also referred to as "minimal deviation adenocarcinoma", is an extremely uncommon variant of highly-differentiated adenocarcinoma of the uterine cervix. The study presented herein describes a case of uterine AM found out after hysteroscopy. An early-stage, well-differentiated mucinous uterine adenocarcinoma was diagnosed post-operatively. A subsequent immunohistochemical assessment of a panel of antibodies was applied, in order to distinguish between female genital tract malignancies.

  12. The uterine peristaltic pump. Normal and impeded sperm transport within the female genital tract.

    PubMed

    Kunz, G; Beil, D; Deiniger, H; Einspanier, A; Mall, G; Leyendecker, G

    1997-01-01

    Rapid as well as sustained sperm transport from the cervical canal to the isthmical part of the fallopian tube is provided by cervico-fundal uterine peristaltic contractions that can be visualized by vaginal sonography. The peristaltic contractions increase in frequency and presumably also in intensity as the proliferative phase progresses. As shown by placement of labeled albumin macrospheres of sperm size at the external cervical os and serial hysterosalpingoscintigraphy (HSSG) sperm reach, following their vaginal deposition, the uterine cavity within minutes. In the early follicular phase a large proportion of the macrospheres remains at the site of application, while a smaller proportion enters the uterine cavity with even a smaller one reaching the isthmical part of the tubes. In the mid-follicular phase of the cycle with increased frequency and intensity of the uterine contractions the proportion of macrospheres entering the uterine cavity as well as the tubes has significantly increased. In the late follicular phase with maximum frequency and intensity of uterine peristalsis the proportion of macrospheres entering the tube increases further at the expense of those at the site of application as well as within the uterine cavity. The transport of the macrospheres into the tube is preferentially directed into the tube ipsilateral to the dominant follicle, which becomes apparent in the mid-follicular phase as soon as a dominant follicle can be identified by ultrasound. Since the macrosphere are inert particles the directed sperm transport into the tube ipsilateral to the dominant follicle is not functionally related to a mechanism such as chemotaxis but is rather provided by uterine contraction of which the direction may be controlled by a specific myometrial architecture in combination with an asymmetric distribution of myometrial oestradiol receptors. Women with infertility and mostly mild endometriosis display on VSUP a uterine hyperperistalsis with nearly

  13. Effect of superovulation on uterine and serum biochemical parameters and its potential association with transferable embryos in Holstein dairy cows

    PubMed Central

    Rasolomboahanginjatovo, Hasina Santatriniaina; Dupras, Raynald; Mills, Louis; Lefebvre, Réjean

    2014-01-01

    The objective of this study was to determine the effects of superovulation (SOV) on serum and uterine biochemical parameters, uterine bacteriology and cytology and number of transferable embryos (TE). Dairy cows were placed on a Presynch/CIDR Synch protocol. The SOV group was superovulated, induced in estrus, and inseminated, whereas the control group was induced in estrus and inseminated without SOV. Uterine bacteriology and cytology and uterine and serum biochemical parameters were measured at day 7 of the estrous cycle to start the SOV protocol, as well as on the day of embryo recovery (DER). The SOV group produced 7.5 ± 6.7 oocytes/embryos, of which 3.4 ± 4.7 were TE. Serum urea and E2 and uterine Glu, CK, LDH, TP, P4 and PGFM in the control group and serum P4 and PGFM and uterine LDH and PGFM in the SOV group were significantly higher (p < 0.01) at DER than day 7. At DER, uterine urea, LDH, PGFM and TP and serum urea, LDH, PGFM, and P4 concentrations were higher (p < 0.01) in the SOV group than the control. There was no significant variation in uterine bacteriology or cytology. Overall, these results infer that SOV affects both serum profile and uterine secretions, and that these changes may influence the number of TE. PMID:24675828

  14. Effects of coitus and the artificial insemination of different volumes of fresh semen on uterine contractions in mares.

    PubMed

    Campbell, M L H; England, G C W

    2006-12-16

    Uterine contractions may play an important role in the transportation of spermatozoa towards the site of fertilisation in the oviduct of mares. M-mode ultrasound was used to measure the number, amplitude and duration of uterine contractions in each uterine horn and the uterine body of oestrous mares for four minutes before and four minutes after either coitus, or the artificial insemination of either 80.0 ml of fresh semen or 10.0 ml of fresh semen. The direction of the uterine contractions in each uterine horn and the uterine body was measured before and after coitus. Coitus and the insemination of 80.0 ml semen significantly increased the total number, mean amplitude and mean duration of contractions in all parts of the uterus. The insemination of 10.0 ml of semen did not affect the total number or the mean duration of contractions in the uterine horns. Their mean amplitude was increased, but largely owing to the results from one mare; it also did not affect the contractions in the uterine body. There was no significant difference between the percentage of contractions moving in a cervicotubal or tubocervical direction after coitus in any part of the uterus examined.

  15. Differential vimentin expression in ovarian and uterine corpus endometrioid adenocarcinomas: diagnostic utility in distinguishing double primaries from metastatic tumors.

    PubMed

    Desouki, Mohamed M; Kallas, Sarah J; Khabele, Dineo; Crispens, Marta A; Hameed, Omar; Fadare, Oluwole

    2014-05-01

    This study aimed to assess the diagnostic value of vimentin expression in differentiating endometrioid adenocarcinoma of primary uterine corpus and ovarian origin. Immunohistochemical analyses for the expression of vimentin in tumoral epithelial cells were performed on 149 endometrioid adenocarcinomas wherein the primary sites were not in question, including whole tissue sections of 27 carcinomas of uterine corpus origin (and no synchronous ovarian tumor), 7 carcinomas of ovarian origin (and no synchronous uterine corpus tumor) and a tissue microarray (TMA) containing 91 primary uterine corpus and 24 primary ovarian carcinomas. We also assessed 15 cases that synchronously involved the uterine corpus and ovary, 15 cases of metastasis to organs/tissues other than uterine corpus or ovary as well as 7 lymph node metastases. Vimentin was negative in 97% (30/31) of primary ovarian carcinomas. In contrast, 82% (97/118) of primary uterine corpus carcinomas were vimentin-positive. Vimentin expression was discordant in 53% of synchronous tumors. The sensitivity and specificity of negative vimentin staining in predicting an ovarian primary were 97% and 82%, respectively, whereas parallel values for positive vimentin staining in predicting a primary uterine tumor were 82% and 97%, respectively. The pattern of vimentin expression in all cases was maintained in their respective regional lymph nodes and distant metastases. In conclusion, ovarian and uterine corpus endometrioid adenocarcinomas have different patterns of vimentin expression. If validated in larger and/or different data sets, these findings may have diagnostic value in distinguishing metastatic lesions from double primary tumors involving both sites.

  16. Etiology and pathogenesis of uterine leiomyomas: a review.

    PubMed Central

    Flake, Gordon P; Andersen, Janet; Dixon, Darlene

    2003-01-01

    Uterine leiomyomas, or fibroids, represent a major public health problem. It is believed that these tumors develop in the majority of American women and become symptomatic in one-third of these women. They are the most frequent indication for hysterectomy in the United States. Although the initiator or initiators of fibroids are unknown, several predisposing factors have been identified, including age (late reproductive years), African-American ethnicity, nulliparity, and obesity. Nonrandom cytogenetic abnormalities have been found in about 40% of tumors examined. Estrogen and progesterone are recognized as promoters of tumor growth, and the potential role of environmental estrogens has only recently been explored. Growth factors with mitogenic activity, such as transforming growth factor- (subscript)3(/subscript), basic fibroblast growth factor, epidermal growth factor, and insulin-like growth factor-I, are elevated in fibroids and may be the effectors of estrogen and progesterone promotion. These data offer clues to the etiology and pathogenesis of this common condition, which we have analyzed and summarized in this review. PMID:12826476

  17. Intrauterine devices and uterine peristalsis: evaluation with MRI.

    PubMed

    Kido, Aki; Togashi, Kaori; Kataoka, Milliam L; Nakai, Asako; Koyama, Takashi; Fujii, Shingo

    2008-01-01

    Intrauterine devices (IUDs) have been viewed as an effective form of contraception. However, the mechanism by which IUDs disturb fertility remains controversial. This study aimed to evaluate the effects of IUDs on uterine contractility using cine MR. Eleven healthy female volunteers of reproductive age bearing IUDs and 12 women not bearing IUDs were evaluated during the periovulatory phase. MR images were obtained with a 1.5-T magnet, acquiring 60 serial images every 3 s via half-Fourier acquisition single-shot turbo spin echo to be displayed on cine mode. Assessments were based on (a) the presence of peristaltic waves, (b) the frequency and direction of peristaltic waves and (c) the extent of peristaltic waves. Static images were evaluated for thickness of the junctional zone (JZ) and myometrium. A fundo-cervical (FC)-directed peristaltic wave was identified in 4 of 11 IUD-bearing subjects and in only 1 of 12 subjects from the control group. FC waves extended through more than half of the thickness of the myometrium. Peristaltic frequency in IUD users (5.0/3 min) was less than that of the control group (6.5/3 min). The JZ and myometrium were significantly thicker in IUD users. FC-directed waves were more often observed in IUD-bearing subjects, which might explain the inhibition of active sperm transport.

  18. Transformation of the rat uterine estrogen receptor after partial purification.

    PubMed

    Nielsen, S; Notides, A C

    1975-02-13

    Warming crude ratuterine cytosol after the addition of [3H] estradiol accelerates the association of the 4-S estrogen-binding protein with a second macromolecule, resulting in the formation of the 5-S estrogen-binding protein. To determine whether the 5-S estrogen-binding protein consists of two similar or dissimilar subunits, uterine cytosol was subjected to a number of fractionation procedures that separate macromolecules by solubility, molecular gel sieving, sedimentation rate, ionic charge, and heat lability. Following each of these methods, the fraction containing the 4-S estrogen-binding protein was incubated at 28 degrees C; each of the these 4-S estrogen-binding protein-containing fractions retained its capacity to completely transform to the 5-S estrogen-binding protein. In samples subjected to partial purification procedures, it was necessary that the buffer contain 40 mM Tris, 60 mM Tris, 60 mM KC1, 1-10 MM dithiothreitol, and 1 M urea at pH 7.4, in order to accomplish the 4-S to 5-S estrogen-binding protein transformation at 25 degrees C. Formation of the 5-S estrogen-binding protein requires association of the 4-Estrogen-binding protein with a molecule identical to or very similar to itself.

  19. Lymphoepithelioma-like carcinoma of the uterine cervix

    PubMed Central

    Yun, Hyun Sil; Lee, Sun Kyung; Yoon, Gun; Kim, Hwi Gon; Lee, Dong Hyung; Na, Yong Jin; Choi, Ook Hwan; Shin, Dong Hoon

    2017-01-01

    Lymphoepithelioma-like carcinoma (LELC) of the uterine cervix is exceedingly uncommon. We herein report a rare case of cervical LELC. A 45-year-old woman was admitted to gynecology department with vaginal bleeding for one month. Liquid-based cytology revealed atypical endometrial cells, not otherwise specified on her cervix. On a hysteroscopy, an endocervical mass was identified and the pathologic result was consistent with poorly differentiated squamous cell carcinoma. Magnetic resonance imaging and positron emission tomography with 2-deoxy-2-[fluorine-18] fluoro-D-glucose integrated with computed tomography revealed a 3.1-cm endocervical mass without distant metastasis or enlarged lymph nodes. The International Federation of Gynecology and Obstetrics stage was IB1. A radical hysterectomy and bilateral pelvic lymph node dissection were performed. The pathologic diagnosis was a poorly differentiated carcinoma, showing features of LELC. She has been followed for 8 months without adjuvant treatment since the surgery, during which time there has been no evidence of tumor recurrence or metastasis. PMID:28217683

  20. Low-cost technology for screening uterine cervical cancer.

    PubMed Central

    Parashari, A.; Singh, V.; Sehgal, A.; Satyanarayana, L.; Sodhani, P.; Gupta, M. M.

    2000-01-01

    We report on an illuminated, low-cost (Rs 1500 (US$ 36)) magnifying device (Magnivisualizer) for detecting precancerous lesions of the uterine cervix. A total of 403 women attending a maternal and child health care clinic who had abnormal vaginal discharge and related symptoms were referred for detailed pelvic examination and visual inspection by means of the device after the application of 5% (v/v) acetic acid. Pap smears were obtained at the same time. The results were compared with those obtained using colposcopy and/or histology. The Magnivisualizer improved the detection rate of early cancerous lesions from 60%, for unaided visual inspection, to 95%. It also permitted detection of 58% of cases of low-grade dysplasia and 83% of cases of high-grade dysplasia; none of these cases were detectable by unaided visual inspection. For low-grade dysplasia the sensitivity of detection by means of the Magnivisualizer was 57.5%, in contrast with 75.3% for cytological examination. However, the two methodologies had similar sensitivities for higher grades of lesions. The specificity of screening with the Magnivisualizer was 94.3%, while that of cytology was 99%. The cost per screening was approximately US$ 0.55 for the Magnivisualizer and US$ 1.10 for cytology. PMID:10994279

  1. Spontaneous Uterine Perforation of Pyometra Presenting as Acute Abdomen

    PubMed Central

    Okuno, Kentaro; Ugaki, Hiromi; Komoto, Yoshiko; Fujimi, Satoshi; Takemura, Masahiko

    2014-01-01

    Pyometra is the accumulation of pus in the uterine cavity, and spontaneous perforation of pyometra resulting in generalized diffuse peritonitis is extremely uncommon. We report a rare case of diffuse peritonitis caused by spontaneous perforation of pyometra. A 66-year-old postmenopausal woman with diffuse abdominal pain and vomiting was admitted to our institution. She had a history of mixed connective-tissue disease and had been taking steroids for 20 years. Under a diagnosis of generalized peritonitis secondary to perforation of the gastrointestinal tract or uterus, supravaginal hysterectomy and bilateral salpingo-oophorectomy were performed. Unfortunately, wound dehiscence and infection occurred during the postoperative course, which were exacerbated by her immunocompromised state. Despite intensive care and a course of antibiotics, the patient died of multiple organ failure resulting from sepsis on the 36th postoperative day. Although correct diagnosis, early intervention, and proper treatment can reduce morbidity and mortality of spontaneous perforation of pyometra, if severe infection occurs, this disease can be life threatening for immunocompromised hosts. PMID:25057420

  2. Spontaneous uterine perforation of pyometra presenting as acute abdomen.

    PubMed

    Kitai, Toshihiro; Okuno, Kentaro; Ugaki, Hiromi; Komoto, Yoshiko; Fujimi, Satoshi; Takemura, Masahiko

    2014-01-01

    Pyometra is the accumulation of pus in the uterine cavity, and spontaneous perforation of pyometra resulting in generalized diffuse peritonitis is extremely uncommon. We report a rare case of diffuse peritonitis caused by spontaneous perforation of pyometra. A 66-year-old postmenopausal woman with diffuse abdominal pain and vomiting was admitted to our institution. She had a history of mixed connective-tissue disease and had been taking steroids for 20 years. Under a diagnosis of generalized peritonitis secondary to perforation of the gastrointestinal tract or uterus, supravaginal hysterectomy and bilateral salpingo-oophorectomy were performed. Unfortunately, wound dehiscence and infection occurred during the postoperative course, which were exacerbated by her immunocompromised state. Despite intensive care and a course of antibiotics, the patient died of multiple organ failure resulting from sepsis on the 36th postoperative day. Although correct diagnosis, early intervention, and proper treatment can reduce morbidity and mortality of spontaneous perforation of pyometra, if severe infection occurs, this disease can be life threatening for immunocompromised hosts.

  3. Characterization of the rat uterine neuromedin U receptor.

    PubMed

    Nandha, K A; Benito-Orfila, M A; Smith, D M; Bloom, S R

    1993-08-01

    Neuromedin U (NmU) is a novel peptide that potently contracts smooth muscle, including rat uterus in vitro. No receptors have so far been demonstrated in any tissue. We have characterized the receptor for NmU in rat uterine membrane preparations. The binding of [125I] rat NmU was saturable, specific, reversible, and time, temperature, and pH dependent. The nonhydrolysable analog of GTP, GTP-gamma-S, reduced binding in a dose-dependent manner, suggesting that the binding site is coupled to a G-protein. Scatchard analysis of saturation binding studies showed a single class of binding site with a maximal binding capacity of 580 +/- 140 fmol/mg membrane protein and a dissociation constant of 0.35 +/- 0.09 nM (n = 3). Rat NmU and NmU-8 (the C-terminal region of the larger molecule) displaced [125I]rat NmU, displaying an IC50 of 1 x 10(-9) M and 6 x 10(-8) M, respectively. Chemical cross-linking studies demonstrated NmU binding sites on the rat uterus to have an M(r) of 48,500. This band was absent in the presence of 0.2 microM NmU. Thus the rat uterus contains specific NmU binding sites through their physiological role awaits identification.

  4. Histopathogenesis of carcinoma in situ of the uterine cervix*

    PubMed Central

    Wahi, P. N.; Kehar, Usha; Mali, S.; Misra, G. D.

    1962-01-01

    Cancer of the cervix is amenable to treatment provided it is diagnosed at the preinvasive stage, and it is therefore imperative to be able to identify cases of symptomless cervical cancer, which invariably presents no visible alteration in the appearance of the mucous membrane. Fortunately, this is possible by study of vaginal smears for exfoliated cells. In view of the ease with which carcinoma of the uterine cervix can be induced in mice and of its similarity to analogous lesions in women, it was thought that study of early cytological and morphological changes in cervical carcinoma of the mouse—especially at the in situ stage—might prove valuable for biological and therapeutic studies of human cervical carcinoma. This paper reports on study of the progressive epithelial changes in the mouse cervix by means of exfoliated cells in vaginal smears and histological examination of the cervical epithelium after intravaginal painting with 3,4-benzpyrene. The authors consider that basal cell hyperplasia and the early grades of dysplasia are reversible if the carcinogenic agent is withdrawn, but that the lesion is likely to be invasive and progressive once the presence of large numbers of squamoid cells indicates that the dysplastic changes involve the superficial layers. ImagesFIG. 1-5FIG. 6-10FIG. 11-15FIG. 16-20FIG. 21-25 PMID:14004393

  5. Diagnostic application of KRAS mutation testing in uterine microglandular proliferations.

    PubMed

    Hong, Wei; Abi-Raad, Rita; Alomari, Ahmed K; Hui, Pei; Buza, Natalia

    2015-07-01

    Microglandular proliferations often pose a diagnostic challenge in small endocervical and endometrial biopsies. Microglandular hyperplasia (MGH) is one of the most common pseudoneoplastic glandular proliferations of uterine cervix, which can closely mimic endometrial adenocarcinomas (EAC) with a microglandular pattern (microglandular EAC). Although MGH is typically characterized by relatively uniform nuclei and rare to absent mitoses, atypical forms with architectural and/or cytologic deviation from the usual morphology have been previously described. Recently, a series of MGH with high mitotic activity has also been documented. Although careful morphological assessment and immunohistochemical workup can resolve the diagnostic dilemma in some cases, additional differential diagnostic tools are needed to separate both the common and atypical variants of MGH from EAC with microglandular pattern. Frequent KRAS mutation has been previously reported in endometrial complex mucinous lesions and endometrial mucinous carcinomas. However, the diagnostic utility of KRAS mutation analysis has not yet been explored in the context of cervical and endometrial microglandular lesions. Twelve mitotically active MGH cases and 15 cases of EAC with microglandular growth pattern were selected for the study. KRAS mutation analysis was performed in all cases by highly sensitive single-strand conformation polymorphism analysis. Clinical history and follow-up data were retrieved from electronic medical records. KRAS mutation was absent in all MGH cases, whereas 9 (60%) of 15 microglandular EAC cases tested positive for KRAS mutation. Our data indicate that KRAS mutation analysis may offer additional discriminatory power in separating benign MGH from EAC with microglandular pattern.

  6. [Management of uterine fibromas. Report of 219 cases].

    PubMed

    Mahbouli, S; Messaoudi, Y; Chandoul, Y; Zayene, H; Messaoudi, F; Basly, M; Messaoudi, L; Chibani, M; Rachdi, R

    2001-10-01

    This study is about 219 uterine fibroma treated surgically between 1994 and 1998. The surgical operation represent 19.1% of the gynecological interventions. The average age of our patients was of 41.7 years with 30.6% of nulliparous. The main motives of consultation were: the confusion of the menstrual cycle in 56.6%, the pelvic pains in 32%, the increase of the volume of the belly in 10% and the infertility in 10% of cases. The surgical indications were dominated by the big size of the womb in 68% of cases and hemorrhagic complications in 57.7% of cases. The myomectomy indicated for women young and avid for pregnancy was realized in 94 cases; 80.8% by abdominal way, 13.8% by hysteroscopic way and 5.3% by coelioscopy. Hysterectomy proposed for women near menopauses was realized in 125 cases: 70.4% by abdominal way and 29.6% by vaginal way. The complications per- and post-operating are rare, represented essentially by the bleeding and the urinary infections.

  7. Current imaging strategies for the evaluation of uterine cervical cancer

    PubMed Central

    Bourgioti, Charis; Chatoupis, Konstantinos; Moulopoulos, Lia Angela

    2016-01-01

    Uterine cervical cancer still remains an important socioeconomic issue because it largely affects women of reproductive age. Prognosis is highly depended on extent of the disease at diagnosis and, therefore, accurate staging is crucial for optimal management. Cervical cancer is clinically staged, according to International Federation of Gynecology and Obstetrics guidelines, but, currently, there is increased use of cross sectional imaging modalities [computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography-CT (PET-CT)] for the study of important prognostic factors like tumor size, parametrial invasion, endocervical extension, pelvic side wall or adjacent/distal organs involvement and lymph node status. Imaging indications also include cervical cancer follow-up, evaluation of tumor response to treatment and selection of suitable candidates for less radical surgeries like radical trachelectomy for fertility preservation. The preferred imaging method for local cervical cancer evaluation is MRI; CT is equally effective for evaluation of extrauterine spread of the disease. PET-CT shows high diagnostic performance for the detection of tumor relapse and metastatic lymph nodes. The aim of this review is to familiarize radiologists with the MRI appearance of cervical carcinoma and to discuss the indications of cross sectional imaging during the course of the disease in patients with cervical carcinoma. PMID:27158421

  8. Prolactin regulation of neonatal ovine uterine gland morphogenesis.

    PubMed

    Carpenter, Karen D; Gray, C Allison; Noel, Sekoni; Gertler, Arieh; Bazer, Fuller W; Spencer, Thomas E

    2003-01-01

    Uterine gland development or adenogenesis in the neonatal ovine uterus involves budding, proliferation, and branching morphogenesis of the glandular epithelium (GE) from the luminal epithelium (LE) between birth (postnatal day or PND 0) and PND 56. This critical developmental event is coincident with increases in serum PRL and expression of long and short PRL receptors specifically in the nascent and proliferating GE. In study one, ewes were treated with a placebo pellet as a control (CX) or a bromocryptine mesylate pellet from PNDs 0-56. On PND 56, the endometrium of bromocryptine mesylate ewes contained fewer glands, particularly in the stratum spongiosum that contained numerous coiled and branched glands in CX uteri. In study two, ewes were treated with saline as a CX or recombinant ovine PRL from PNDs 0-56. Treatment with PRL increased gland number and density on PND 14 and PND 56. In study three, expression of signal transducers and activators of transcription (STAT) 1, 3, and 5 proteins was detected in the developing glands from PNDs 7-56. In study four, Western blot analyses indicated that PRL increased levels of phosphorylated STATs 1 and 5, but not STAT 3, and phosphorylated ERK 1 and 2 MAPKs and c-Jun N-terminal kinase/stress-activated protein kinase proteins in explanted PND 28 ovine uteri. Collectively, results indicate that PRL regulates endometrial adenogenesis in the neonatal ovine uterus.

  9. Experimental platform for intra-uterine needle placement procedures

    NASA Astrophysics Data System (ADS)

    Madjidi, Yashar; Haidegger, Tamás.; Ptacek, Wolfgang; Berger, Daniel; Kirisits, Christian; Kronreif, Gernot; Fichtinger, Gabor

    2013-03-01

    A framework has been investigated to enable a variety of comparative studies in the context of needle-based gynaecological brachytherapy. Our aim was to create an anthropomorphic phantom-based platform. The three main elements of the platform are the organ model, needle guide, and needle drive. These have been studied and designed to replicate the close environment of brachytherapy treatment for cervical cancer. Key features were created with the help of collaborating interventional radio-oncologists and the observations made in the operating room. A phantom box, representing the uterus model, has been developed considering available surgical analogies and operational limitations, such as organs at risk. A modular phantom-based platform has been designed and prototyped with the capability of providing various boundary conditions for the target organ. By mimicking the female pelvic floor, this framework has been used to compare a variety of needle insertion techniques and configurations for cervical and uterine interventions. The results showed that the proposed methodology is useful for the investigation of quantifiable experiments in the intraabdominal and pelvic regions.

  10. Reproductive Outcome of Transcervical Uterine Incision in Unicornuate Uterus

    PubMed Central

    Xia, En-Lan; Li, Tin-Chiu; Choi, Sze-Ngar Sylvia; Zhou, Qiao-Yun

    2017-01-01

    Background: The pregnancy outcome of the unicornuate uterus is associated with an increased risk of miscarriage, cervical incompetence, and a number of obstetric complications. However, at present, there is no accepted treatment method for women with unicornuate uterus, other than expectant measures. The aim of this study was to evaluate the reproductive outcome of transcervical uterine incision (TCUI) in patients with unicornuate uterus. Methods: Thirty-three patients with unicornuate uterus presented to our tertiary center for infertility or miscarriage. All 33 patients underwent TCUI and were followed up for 10–52 months. The pregnancy outcomes (first-trimester miscarriage, second-trimester miscarriage, preterm, term, intrauterine death, ongoing pregnancy, and live birth) before and after TCUI were compared by t-test. Results: Among 31 patients who attempted to conceive after TCUI, twenty conceived including one termination of pregnancy, one second-trimester miscarriage, one ectopic pregnancy, five preterm deliveries, 11 term delivery, and one ongoing pregnancy. There were 16 live births in total. There was significant reduction in the first-trimester miscarriage rate (t = 4.890; P < 0.001), increase in term delivery (t = −3.288; P = 0.002), and live birth rates (t = −4.073; P < 0.001) after TCUI. Conclusion: TCUI appeared to improve the pregnancy outcome in women with unicornuate uterus presenting with infertility or miscarriage. PMID:28139506

  11. Distension of the uterus induces HspB1 expression in rat uterine smooth muscle.

    PubMed

    White, B G; MacPhee, D J

    2011-11-01

    The uterine musculature, or myometrium, demonstrates tremendous plasticity during pregnancy under the influences of the endocrine environment and mechanical stresses. Expression of the small stress protein heat shock protein B1 (HspB1) has been reported to increase dramatically during late pregnancy, a period marked by myometrial hypertrophy caused by fetal growth-induced uterine distension. Thus, using unilaterally pregnant rat models and ovariectomized nonpregnant rats with uteri containing laminaria tents to induce uterine distension, we examined the effect of uterine distension on myometrial HspB1 expression. In unilaterally pregnant rats, HspB1 mRNA and Ser(15)-phosphorylated HspB1 (pSer(15) HspB1) protein expression were significantly elevated in distended gravid uterine horns at days 19 and 23 (labor) of gestation compared with nongravid horns. Similarly, pSer(15) HspB1 protein in situ was only readily detectable in the distended horns compared with the nongravid horns at days 19 and 23; however, pSer(15) HspB1 was primarily detectable in situ at day 19 in membrane-associated regions, while it had primarily a cytoplasmic localization in myometrial cells at day 23. HspB1 mRNA and pSer(15) HspB1 protein expression were also markedly increased in ovariectomized nonpregnant rat myometrium distended for 24 h with laminaria tents compared with empty horns. Therefore, uterine distension plays a major role in the stimulation of myometrial HspB1 expression, and increased expression of this small stress protein could be a mechanoadaptive response to the increasing uterine distension that occurs during pregnancy.

  12. Cephalad-caudad versus transverse blunt expansion of the low transverse uterine incision during cesarean delivery.

    PubMed

    Xodo, Serena; Saccone, Gabriele; Cromi, Antonella; Ozcan, Pinar; Spagnolo, Emanuela; Berghella, Vincenzo

    2016-07-01

    It is imperative to have evidence-based guidelines for cesarean delivery. The aim of this meta-analysis was to evaluate the effectiveness of a cephalad-caudad compared to transverse blunt expansion of the uterine incision to reduce blood loss in women who underwent low-segment transverse cesarean delivery. We therefore performed a systematic search in electronic databases from their inception until March 2016. We included all randomized trials comparing cephalad-caudad versus transverse (control group) blunt expansion of the uterine incision in women who underwent a low transverse cesarean delivery. The primary outcome was postpartum blood loss, defined as the mean amount of blood loss (mL). Two trials (921 women) were analyzed. After the transverse uterine incision in the lower uterine segment with the scalpel, the uterine incision was then bluntly expanded by the designated method. Blunt expansion of the primary incision was derived by placing the index fingers of the operating surgeon into the incision and pulling the fingers apart laterally (transverse group) or cephalad (cephalad-caudad group). Women who were randomized in the cephalad-caudad group had lower: mean of postpartum blood loss, hemoglobin drop and hematocrit drop 24h after cesarean, unintended extension, uterine vessels injury, blood loss >1500mL and need for additional stitches. There was no statistically significant difference in the incidence of blood loss >1000mL, in the operating time and in post-operative pain. In conclusion, expansion of the uterine incision with fingers in a cephalad-caudad direction is associated with better maternal outcomes and, therefore, should be preferred to transverse expansion during a cesarean delivery.

  13. Effects of adlay hull extracts on uterine contraction and Ca2+ mobilization in the rat.

    PubMed

    Hsia, Shih-Min; Kuo, Yueh-Hsiung; Chiang, Wenchang; Wang, Paulus S

    2008-09-01

    Dysmenorrhea is directly related to elevated PGF(2alpha) levels. It is treated with nonsteroid antiinflammatory drugs (NSAIDs) in Western medicine. Since NSAIDs produce many side effects, Chinese medicinal therapy is considered as a feasible alternative medicine. Adlay (Coix lachryma-jobi L. var. ma-yuen Stapf.) has been used as a traditional Chinese medicine for treating dysmenorrhea. However, the relationship between smooth muscle contraction and adlay extracts remains veiled. Therefore, we investigated this relationship in the rat uterus by measuring uterine contraction activity and recording the intrauterine pressure. We studied the in vivo and in vitro effects of the methanolic extracts of adlay hull (AHM) on uterine smooth muscle contraction. The extracts were fractionated using four different solvents: water, 1-butanol, ethyl acetate, and n-hexane; the four respective fractions were AHM-Wa, AHM-Bu, AHM-EA, and AHM-Hex. AHM-EA and its subfractions (175 microg/ml) inhibited uterine contractions induced by PGF(2alpha), the Ca(2+) channel activator Bay K 8644, and high K(+) in a concentration-dependent manner in vitro. AHM-EA also inhibited PGF(2alpha)-induced uterine contractions in vivo; furthermore, 375 microg/ml of AHM-EA inhibited the Ca(2+)-dependent uterine contractions. Thus 375 microg/ml of AHM-EA consistently suppressed the increases in intracellular Ca(2+) concentrations induced by PGF(2alpha) and high K(+). We also demonstrated that naringenin and quercetin are the major pure chemical components of AHM-EA that inhibit PGF(2alpha)-induced uterine contractions. Thus AHM-EA probably inhibited uterine contraction by blocking external Ca(2+) influx, leading to a decrease in intracellular Ca(2+) concentration. Thus adlay hull may be considered as a feasible alternative therapeutic agent for dysmenorrhea.

  14. Lived experiences of women who developed uterine rupture following severe obstructed labor in Mulago hospital, Uganda

    PubMed Central

    2014-01-01

    Background Maternal mortality is a major public health challenge in Uganda. Whereas uterine rupture remains a major cause of maternal morbidity and mortality, there is limited research into what happens to women who survive such severe obstetric complications. Understanding their experiences might delineate strategies to support survivors. Methods This qualitative study used a phenomenological approach to explore lived experiences of women who developed uterine rupture following obstructed labor. In-depth interviews initially conducted during their hospitalization were repeated 3–6 months after the childbirth event to explore their health and meanings they attached to the traumatic events and their outcomes. Data were analyzed using thematic analysis. Results The resultant themes included barriers to access healthcare, multiple “losses” and enduring physical, psychosocial and economic consequences. Many women who develop uterine rupture fail to access critical care needed due to failure to recognise danger signs of obstructed labor, late decision making for accessing care, geographical barriers to health facilities, late or failure to diagnose obstructed labor at health facilities, and failure to promptly perform caesarean section. Secondly, the sequel of uterine rupture includes several losses (loss of lives, loss of fertility, loss of body image, poor quality of life and disrupted marital relationships). Thirdly, uterine rupture has grim economic consequences for the survivors (with financial loss and loss of income during and after the calamitous events). Conclusion Uterine rupture is associated with poor quality of care due to factors that operate at personal, household, family, community and society levels, and results in dire physical, psychosocial and financial consequences for survivors. There is need to improve access to and provision of emergency obstetric care in order to prevent uterine rupture consequent to obstructed labor. There is also

  15. Uterine glycogen metabolism in mink during estrus, embryonic diapause and pregnancy

    PubMed Central

    DEAN, Matthew; HUNT, Jason; MCDOUGALL, Lisa; ROSE, Jack

    2014-01-01

    We have determined uterine glycogen content, metabolizing enzyme expression and activity in the mink, a species that exhibits obligatory embryonic diapause, resulting in delayed implantation. Gross uterine glycogen concentrations were highest in estrus, decreased 50% by diapause and 90% in pregnancy (P ≤ 0.05). Endometrial glycogen deposits, which localized primarily to glandular and luminal epithelia, decreased 99% between estrus and diapause (P ≤ 0.05) and were nearly undetectable in pregnancy. Glycogen synthase and phosphorylase proteins were most abundant in the glandular epithelia. Glycogen phosphorylase activity (total) in uterine homogenates was higher during estrus and diapause, than pregnancy. While glycogen phosphorylase protein was detected during estrus and diapause, glycogen synthase was almost undetectable after estrus, which probably contributed to a higher glycogenolysis / glycogenesis ratio during diapause. Uterine glucose-6-phosphatase 3 gene expression was greater during diapause, when compared to estrus (P ≤ 0.05) and supports the hypothesis that glucose-6-phosphate resulting from phosphorylase activity was dephosphorylated in preparation for export into the uterine lumen. The relatively high amount of hexokinase-1 protein detected in the luminal epithelia during estrus and diapause may have contributed to glucose trapping after endometrial glycogen reserves were depleted. Collectively, our findings suggest to us that endometrial glycogen reserves may be an important source of energy, supporting uterine and conceptus metabolism up to the diapausing blastocyst stage. As a result, the size of uterine glycogen reserves accumulated prior to mating may in part, determine the number of embryos that survive to the blastocyst stage, and ultimately litter size. PMID:25225159

  16. Physiological routes from intra-uterine seminal contents to advancement of ovulation.

    PubMed

    Waberski, Dagmar; Döhring, Anke; Ardón, Florencia; Ritter, Nadine; Zerbe, Holm; Schuberth, Hans-Joachim; Hewicker-Trautwein, Marion; Weitze, Karl Fritz; Hunter, Ronald H F

    2006-08-03

    Whole boar semen or seminal plasma has been demonstrated to advance the time of ovulation in gilts. As a means of clarifying this influence, the contribution of uterine lymphatics and their white cell populations has been examined. After duct visualisation with Evan's blue, lymph was sampled from a mesometrial vessel in eight pre-ovulatory gilts whose uterine lumen was infused simultaneously with whole semen in one ligated horn and saline in the contralateral ligated horn. Lymph was collected from cannulated vessels for periods of up to four hours under general anaesthesia. Thereafter, mesometrial lymph nodes, utero-tubal junction and uterine wall tissues were sampled. The proportion of nucleated cells in the sampled lymph increased towards the end of the collection period, but erythrocytes were found in all instances preventing a meaningful differentiation and identification of leukocytes. Prominent uterine lymph nodes were present in the mesometrium on both sides of the reproductive tract in 7 of 10 gilts. Differences in cellular contents were demonstrated between the side of the tract infused with semen and that infused with saline control. Two of 4 gilts had lower values for CD4 (Cluster Differentiation) and 3 of 6 gilts higher values for MHC II (Major Histocompatibility Complex) markers on the side challenged with semen. In contrast, values remained constant for CD8 but ranged widely for CD18. Immunohistochemical analysis of uterine tissue samples for MHC II+ cells revealed significant differences (P < 0.05) between the control and semen-treated ligated portions of the horns, as well as between the tissue sample of uterine wall and that from the utero-tubal junction, but there were no significant differences for CD4+ cells. It therefore remains plausible that semen-induced cytokines in the uterine lymph undergo counter-current transfer to the ipsilateral ovary and accelerate the final maturation of pre-ovulatory Graafian follicles.

  17. Uterine metastases in ovarian carcinoma: frequency and survival in women who underwent hysterectomy

    PubMed Central

    Chetrit, Angela; Sadetzki, Siegal

    2010-01-01

    Objective Possible reasons for hysterectomy in the initial surgical management of advanced invasive epithelial ovarian carcinoma (EOC) might be a high frequency of uterine involvement and its impact on survival. The aim of the present study was to describe the frequency of uterine involvement and its association with survival in an unselected population of EOC patients who underwent hysterectomy. Methods All incident cases of EOC diagnosed in Israeli Jewish women between March 1994 to June 1999, were identified within the framework of a nationwide case-control epidemiological study. The target population of the present report includes all stage II-IV EOC patients who had a uterus at the time of diagnosis. Of the 822 such patients, 695 fulfilled the inclusion criterion. Excluded were 141 patients for various reasons. The present analysis is based on the remaining 554 patients. Results Uterine involvement was present in 291 (52.5%) of the patients and it was macroscopic in only 78 (14.1%). The serosa was the most common site of isolated metastases. Multivariate analysis showed that advanced stage significantly increased the risk for uterine involvement. The overall median survival with any uterine involvement was significantly lower compared to those with no involvement (38.9 months vs. 58.0 months; p<0.001). Conclusion There is an association between uterine involvement, whether macro- or microscopic, and lower survival even after hysterectomy although residual tumor could not be included in the analysis. Further studies are required to establish whether uterine involvement itself is an unfavorable risk factor or merely a marker of other unfavorable prognostic factors. PMID:20922143

  18. The bitch uterine response to semen deposition and its modification by male accessory gland secretions.

    PubMed

    England, G C W; Russo, M; Freeman, S L

    2013-02-01

    Little is known about the response of the bitch's reproductive tract to semen deposition. In this study, an influx of polymorphonuclear neutrophils (PMNs) into the uterus was detected after artificial insemination, but there was normal fertility. Doppler ultrasonography showed that insemination induced an increase in uterine artery blood velocity and a decrease in the resistance index of short duration, indicating vasodilation. Semen that was extended in fluid from the sperm rich fraction of the ejaculate (seminal plasma, SP), or third fraction of the ejaculate (prostatic fluid, PF), produced a similar magnitude of effect but of longer duration. It was hypothesised that vasodilation following insemination was largely induced by SP and PF which, together with PMN influx, was part of a normal uterine response. Physiological concentrations of PMNs in vitro reduced the ability of spermatozoa to attach to uterine epithelium, most likely as a result of spermatozoa becoming attached to PMNs. However, both SP and PF increased attachment of spermatozoa to the uterine epithelium by reducing sperm attachment to PMNs, and potentially by an additional mechanism that did not involve inhibition of sperm binding to PMNs. These are the first canine studies to document an apparent physiological response by the uterus to semen, associated with uterine artery vasodilation and PMN influx. Moreover, these investigations are the first to demonstrate that canine SF and PF are part of the mechanism for increasing uterine perfusion and that both fluids have a modulatory effect on PMN-induced inhibition of spermatozoal attachment to uterine epithelium, most likely mediated by reduced sperm attachment to PMNs.

  19. Androgens and estradiol-17beta production by porcine uterine cells: In vitro study.

    PubMed

    Franczak, A; Kotwica, G

    2010-01-15

    Porcine (Sus scrofa domestica) uterine slices harvested during both early pregnancy and luteolysis produce steroid hormones. The aim of the present study was to determine (1) which porcine separated uterine cells secrete androgens: androstenedione (A(4)) and testosterone (T), and estradiol-17beta (E(2)) in culture; (2) if the production of A(4), T and E(2) in the uterine cells is regulated by P4 and OT; (3) if uterine tissues expressed cytochrome P450arom gene (CYP19). Uteri were collected on Days 14 to 16 of early pregnancy and the estrous cycle. Enzymatically separated epithelial cells, stromal cells, and myocytes were cultured in vitro for 2, 6, and 12h with control medium, progesterone (P(4); 10(-5) M), oxytocin (OT; 10(-7) M), and both hormones (P(4)+OT). The studied cells secreted A(4), T, and E(2) in vitro. Progesterone served as a substrate for steroid synthesis in the uterine cells. Isolated uterine cells, cultured separately, contributed in equal portion to the basal production of androgens (A(4) and T) during both early pregnancy and luteolysis. In pregnant pigs, the epithelial and stromal cells were rich sources of E(2) compared with myocytes. Myocytes produced E(2) mainly during luteolysis. Pregnant porcine endometrium and myometrium expressed the gene CYP19, which encodes for P450 aromatase, a steroidogenic enzyme. The results indicate an active steroidogenic pathway in porcine uterine cells. The epithelial cells, stromal cells, and myocytes participate in steroid production as an alternative source for their action in pigs.

  20. Comparison of transvaginal ultrasonography and hysteroscopy in the diagnosis of uterine pathologies.

    PubMed

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

    2014-01-01

    A thorough evaluation of the uterine cavity is frequently required in gynecology practice. The aim of this study was to compare the diagnostic values of transvaginal ultrasound examination and hysteroscopy in detecting uterine abnormalities in a group of patients within a range of menopausal status and symptomatology. This study included 285 patients admitted with complaints of abnormal uterine bleeding, postmenopausal bleeding, lower abdominal pain, abnormal vaginal discharge or for a routine gynecological examination. All patients had available transvaginal ultrasonography and hysteroscopy data for evaluation. A biopsy was obtained from all patients during the hysteroscopy session. Sensitivity, specificity, positive predictive value, negative predictive value and likelihood ratio were calculated for both methods and compared, considering the histopathological diagnosis as the gold standard. The mean age of the patients was 49.5±12.9 years (range, 24-89 y). Majority of the patients admitted for abnormal uterine bleeding (n=198, 69.4%). For the diagnosis of polyps of any size, hysteroscopy had better sensitivity (p<0.001), however, specificities did not differ (p=1.0). On the other hand, hysteroscopy did not have a sensitivity advantage over TVU in diagnosing polyps greater than 1 cm (p=0.077), although this time hysteroscopy had better specificity (p<0.001). Combined approach did not offer diagnostic advantage for any of the specific pathologies. Although TVU represents a practical approach for the initial evaluation of uterine pathologies, hysteroscopy seems to offer better diagnostic value for uterine pathologies in general, and uterine polyps in particular.

  1. Transrectal Doppler sonography of uterine blood flow in ewes during pregnancy.

    PubMed

    Beltrame, Renato Travassos; Covre, Carolina; Littig, Lucas Buss; Martins, Amanda de Barros; Quirino, Celia Raquel; Junior, Aylton Bartholazzi; da Costa, Ricardo Lopes Dias

    2017-03-15

    In sheep, there is a lack of information on the behaviour of hemodynamic indices and parameters of blood flow velocity of the uterine artery during pregnancy, making it impossible to determine the real meaning of the values found and their probable relevance in normal physiological or pathological states. The objective of the present study was to evaluate the blood flow velocity parameters and hemodynamic indices of the uterine artery in ewes (18) during pregnancy (33). Based on non-invasive colour Doppler sonography, we evaluated the peak systolic velocity (PS), end diastolic velocity (ED), time-averaged maximum and minimum velocity in a cardiac cycle (TAMAX and TAMEAN), pulsatility index (PI), resistance index (RI), systolic/diastolic ratio (S/D), heart rate (HR), arterial diameter (AD) and the blood flow volume (BFV). Examinations started on day 28 and continued at two-week intervals until parturition. The Doppler parameters and the diameter of the uterine artery underwent significant changes during pregnancy. In the evaluated animals, indices related to resistance of the uterine artery, namely the impedance of blood flow, decreased throughout the initial, middle and late stages of gestation (PI: 1.15, 1.04, 0.97; RI: 0.61, 0.59, 0.57; S/D: 2.68, 2.52, 2.39, respectively) (p < 0.05). In contrast, the contents related to higher uterine irrigation increased during gestation (PS, ED, TAMAX, TAMEAN, HR, AD and BFV) (p < 0.05). No differences were found between the means of the variables in relation to the right and left uterine arteries and between single and multiple pregnancies in the hemodynamic indices. The present study is the first to demonstrate changes in uterine hemodynamics throughout pregnancy in sheep.

  2. Effect of subclinical uterine infection on cervical and uterine involution, estrous activity and fertility in postpartum buffaloes.

    PubMed

    Usmani, R H; Ahmad, N; Shafiq, P; Mirza, M A

    2001-01-15

    Nili-Ravi buffaloes (n=29) that calved normally between August and November and did not develop any clinical reproductive disorder after calving were studied for the incidence of sub-clinical bacterial infection of the uterus and its effects on postpartum reproductive efficiency. The incidence of subclinical uterine infection was 24% (7/29). Involution of the cervix and uterus was slower (P < 0.01) in the infected group than in the normal group (45.6 vs 31.1 days and 46.3 vs 35.8 days), respectively. The mean diameters of cervix and gravid horn on Day 12 post partum and on completion of involution did not differ between buffaloes of the two groups. However, the rate of involution of the cervix and the gravid horn was lower in buffaloes of the infected group (2.2 vs. 2.7 mm/day and 2.6 vs. 3.2 mm/day). The mean interval to first post partum ovulation was similar in buffaloes in the infected (35.5 days) and the normal group (33.8 days). The life span of corpus luteum formed after first ovulation was shorter (11 days) in buffaloes of both groups than that of a normal estrous cycle (15 to 17 days). The incidence of silent ovulation was apparently higher in buffaloes of the infected group (83 vs. 60%) but the difference was not significant. For the first four months after calving, the mean interval to first postpartum estrus was longer in buffaloes of the infected group (73.0 vs. 47.7 days; P < 0.01). Similarly, the average service period was longer in buffaloes of the infected group (91.0 vs. 64.8 days; P < 0.05). The overall pregnancy rate for the first four months after calving did not differ between buffaloes of the two groups. We conclude that subclinical bacterial infection of the postpartum uterus delays the cervical and uterine involution which can, in turn, delay the occurrence of first postpartum estrus and prolong the service period in buffaloes.

  3. Modified single transluminal gateway transcystic multiple drainage technique for a huge infected walled-off pancreatic necrosis: A case report

    PubMed Central

    Minaga, Kosuke; Kitano, Masayuki; Imai, Hajime; Yamao, Kentaro; Kamata, Ken; Miyata, Takeshi; Matsuda, Tomohiko; Omoto, Shunsuke; Kadosaka, Kumpei; Yoshikawa, Tomoe; Kudo, Masatoshi

    2016-01-01

    We report a successful endoscopic ultrasonography-guided drainage of a huge infected multilocular walled-off necrosis (WON) that was treated by a modified single transluminal gateway transcystic multiple drainage (SGTMD) technique. After placing a wide-caliber fully covered metal stent, follow-up computed tomography revealed an undrained subcavity of WON. A large fistula that was created by the wide-caliber metal stent enabled the insertion of a forward-viewing upper endoscope directly into the main cavity, and the narrow connection route within the main cavity to the subcavity was identified with a direct view, leading to the successful drainage of the subcavity. This modified SGTMD technique appears to be useful for seeking connection routes between subcavities of WON in some cases. PMID:27275106

  4. Huge light-enhancement by coupling a Bowtie Nano-antenna's plasmonic resonance to a photonic crystal mode.

    PubMed

    Eter, Ali El; Grosjean, Thierry; Viktorovitch, Pierre; Letartre, Xavier; Benyattou, Taha; Baida, Fadi I

    2014-06-16

    We numerically demonstrate a drastic enhancement of the light intensity in the vicinity of the gap of Bowtie Nano-antenna (BA) through its coupling with Photonic Crystal (PC) resonator. The resulting huge energy transfer toward the BA is based on the coupling between two optical resonators (BA and PC membrane) of strongly unbalanced quality factors. Thus, these two resonators are designed so that the PC is only slightly perturbed in term of resonance properties. The proposed hybrid dielectric-plasmonic structure may open new avenues in the generation of deeply subwavelength intense optical sources, with direct applications in various domains such as data storage, non-linear optics, optical trapping and manipulation, microscopy, etc.

  5. Unenhanced MR Angiography of Uterine and Ovarian Arteries after Uterine Artery Embolization: Differences between Patients with Incomplete and Complete Fibroid Infarction

    SciTech Connect

    Mori, Kensaku; Saida, Tsukasa; Shibuya, Yoko; Takahashi, Nobuyuki; Shiigai, Masanari; Osada, Kayo; Tanaka, Nami; Minami, Manabu

    2012-06-15

    Purpose: To compare the status of uterine and ovarian arteries after uterine artery embolization (UAE) in patients with incomplete and complete fibroid infarction via unenhanced 3D time-of-flight magnetic resonance (MR) angiography. Materials and Methods: Thirty-five consecutive women (mean age 43 years; range 26-52 years) with symptomatic uterine fibroids underwent UAE and MR imaging before and within 2 months after UAE. The patients were divided into incomplete and complete fibroid infarction groups on the basis of the postprocedural gadolinium-enhanced MR imaging findings. Two independent observers reviewed unenhanced MR angiography before and after UAE to determine bilateral uterine and ovarian arterial flow scores. The total arterial flow scores were calculated by summing the scores of the 4 arteries. All scores were compared with the Mann-Whitney test. Results: Fourteen and 21 patients were assigned to the incomplete and complete fibroid infarction groups, respectively. The total arterial flow score in the incomplete fibroid infarction group was significantly greater than that in the complete fibroid infarction group (P = 0.019 and P = 0.038 for observers 1 and 2, respectively). In 3 patients, additional therapy was recommended for insufficient fibroid infarction. In 1 of the 3 patients, bilateral ovarian arteries were invisible before UAE but seemed enlarged after UAE. Conclusion: The total arterial flow from bilateral uterine and ovarian arteries in patients with incomplete fibroid infarction is less well reduced than in those with complete fibroid infarction. Postprocedural MR angiography provides useful information to estimate the cause of insufficient fibroid infarction in individual cases.

  6. Uterine bacterial flora in postpartum Danish Holstein dairy cows determined using DNA-based fingerprinting: correlation to uterine condition and calving management.

    PubMed

    Elkjær, K; Ancker, M-L; Gustafsson, H; Friggens, N C; Waldmann, A; Mølbak, L; Callesen, H

    2013-04-01

    The overall aim of this study was to describe uterine bacterial flora during the postpartum period in Danish Holstein cows using the Terminal Restriction Fragment Length Polymorphism (T-RFLP) method. This method produces a pattern of nucleic acid fragments from the microorganisms present, reflecting the "fingerprint" of the actual microbial flora. As well as characterizing changes in flora with time from calving and between herds, data were examined for strong relations between uterine bacterial flora, calving management and uterine condition. In total 125 Holstein cows from five herds were included, and for each cow calving management was recorded. Cows were clinically examined on average 8 (range 0-19) and 28 (range 22-38) days after calving, and a uterine sample was taken for bacterial identification using T-RFLP. Milk samples were taken weekly for progesterone analysis. Bacteria were found in all cows at both examinations, and the flora was composed of many species, including species not traditionally reported to be present in the bovine uterus. The bacterial composition differed according to days from calving and herd. In all five herds Fusobacterium necrophorum, Pseudomonas/Acinetobacter and Bacteroides/Sphingobacterium/Prevotellaceae were among the most common at both examinations. In four herds there was a percentage decrease of F. necrophorum from first to second examination, and in all herds there was a percentage increase of Pseudomonas/Acinetobacter from first to second examination. No differences in bacterial flora were found between cows with different uterine scores, which were influenced by herd, calving difficulty and retained placenta.

  7. Small investments, huge savings.

    PubMed

    Rose, Ewen

    2015-03-01

    Writing on behalf of the Building & Engineering Services Association (B&ES), Ewen Rose, an experienced journalist specialising in building engineering services, reports on a number of presentations at October's IHEEM Healthcare Estates 2014 conference where the focus was very much on how healthcare estates and facilities and healthcare engineering teams can save energy and cut carbon emissions through more efficient monitoring, and, if necessary, subsequent adjustment, of key HVAC plant. Among the key conclusions were that basic energy efficiency measures could 'shave millions of pounds from NHS estates' running costs', and that hospitals and other healthcare buildings face both 'an air-conditioning legal crisis', and a growing threat from outdoor air pollution.

  8. Correlation of Traditional Point a With Anatomic Location of Uterine Artery and Ureter in Cancer of the Uterine Cervix

    SciTech Connect

    Wang, K.-L.; Yang, Y.-C.; Chao, K. S. Clifford Wu, M.-H.; Tai, H.-C.; Chen, T.-C.; Huang, M.-C.; Chen, J.-R.; Su, T.-H.; Chen, Y.-J.

    2007-10-01

    Purpose: Point A, used for dose specification for intracavitary brachytherapy for cervical cancer, is the point at which the uterine artery and ureter cross. This study assessed compatibility of commonly used traditional point A (TPA) and actual anatomic point A (APA). Methods and Materials: We visualized and placed radiopaque clips at the APA during pelvic and paraaortic lymphadenectomy in 11 patients with cervical carcinoma. Orthogonal and oblique radiographs were obtained after insertion of brachytherapy applicators. We measured the distance between the TPA and APA and estimated the brachytherapy dose to each of the two points. Results: A total of 64 brachytherapy treatments were performed. The mean distances between the TPA and APA were 5.2 {+-} 1.0 cm on the right and 5.4 {+-} 1.1 cm on the left. The estimated brachytherapy doses delivered to the APA as a percentage of the presumed 500-cGy fraction size to the TPA were 35.2% (176.6 {+-} 59.0 cGy) on the right and 30.0% (150.2 {+-} 42.9 cGy) on the left. The marked discrepancy in the position of the two points was not related to individual kinetic variations during brachytherapy treatment, tumor size, or bladder filling. Conclusions: The conventional TPA does not provide an accurate estimate of the APA determined during lymphadenectomy, indicating a need to reevaluate the current practice for determining the brachytherapy prescription for cervical cancer. ( (ClinicalTrials.gov) Identifier, NCT00319462)

  9. Genetic and functional analysis of the bovine uterine microbiota. Part I: Metritis versus healthy cows.

    PubMed

    Bicalho, M L S; Machado, V S; Higgins, C H; Lima, F S; Bicalho, R C

    2017-03-02

    Metritis is a uterine disease that affects 10 to 30% of all lactating dairy cows and has detrimental effects on reproductive performance, milk production, and survival. Data regarding the identity and abundance of bacterial genes governing traits such as virulence, antibiotic resistance, and stress responses could enable identification of previously unknown agents that play a role in metritis pathogenesis. Moreover, such knowledge could lead to the development of improved treatments or preventive methods. Therefore, the objectives of this study were to characterize the uterine microbial population and to differentiate, for the first time, the microbial functional diversity in cows with metritis versus healthy cows. In addition, we aimed to identify relationships between microbial genes and postpartum uterine health. Uterine swabs were collected from 24 cows within 3 to 12 d in milk; 12 cows were diagnosed with metritis and the other 12 were healthy. Metritis was defined as a watery, reddish or brownish uterine discharge having a fetid smell, and rectal temperature greater than 39.5°C. Cows with a clear and viscous uterine discharge, not fetid or mucopurulent, were classified as healthy. Microbial metagenomic DNA from uterine swab samples was subjected to whole-genome shotgun sequencing on the Illumina MiSeq platform (Illumina Inc., San Diego, CA). The MG-RAST server (metagenomic rapid annotations using subsystems technology; http://metagenomics.anl.gov/) and STAMP software (http://kiwi.cs.dal.ca/Software/STAMP) were used to detect statistically significant differences in the abundance of taxonomic and functional features between the uterine microbial metagenomes of metritic and healthy cows. Our results showed an increased abundance of Fusobacteria and Bacteroidetes in metritic cows, confirming the potential role of those 2 taxa in the pathogenesis of metritis. The MG-RAST analysis revealed a significantly higher abundance of genes for protein transport across the

  10. [Studies on relationship between shape of uterine cavity on hysterosalpingography and menstrual disorder].

    PubMed

    Nakamura, M; Douchi, T; Nozaki, M; Yoshimitsu, K; Otsuka, H; Nagata, Y

    1983-07-01

    Eight hundred and twenty five infertility patients were investigated to reassess the association between uterine mild anomaly and menstrual disorder proposed as a new syndrome by Sørensen. A hysterosalpingogram we classified the shape of the uterine cavity into 4 types: Normal uterus, T-shaped uterus, arcuate uterus and others (included septate uterus, bicornuate uterus,--), and also classified the size of the uterine cavity into 3 groups; large uterus, medium-sized uterus and small uterus. After classification of uterine shape and size, menstrual disorder in each patient was reviewed and the correlation between uterine anomaly and menstrual disorder was examined. Five hundred and twenty eight out of 770 patients (68.6%) were assigned to normal uterus, 75(7.9%) to T-shape uterus, 148(19.2%) to arcuate uterus and 19(2.5%) to others. Their incidences of menstrual disorder were 31.4%, 37.2%, 39.2% and 42.1%, respectively, and no significant difference was found among them. There were 55 patients (7.3%) with a large uterus, 655(87.2%) with a medium-sized uterus and 41(5.5%) with a small uterus. The incidences of menstrual disorder were 16.4%, 35% and 34.1%, respectively, and there was significant difference in incidence between large uterus and medium-sized uterus. The uterine fundal depression index (FDI) was used as a parameter to evaluate uterine mild anomaly. The incidences of menstrual disorder were 29.8% in the FDI-0 group, 32.9% in the FDI-1 approximately 10 group, 42.7% in the FDI-11 approximately 20 group, 45.5% in the FDI-21 approximately 30 group and 22.2% in the FDI-over 31 group. However, it was difficult to find a difference in the pregnancy rate or delivery rate among different classifications of uterine shape, size or FDI. From these results, it can be said that mild uterine anomaly is hardly associated at all with menstrual disorder clinically.

  11. Sex Steroids Modulate Uterine-Placental Vasculature: Implications for Obstetrics and Neonatal Outcomes

    PubMed Central

    Maliqueo, Manuel; Echiburú, Bárbara; Crisosto, Nicolás

    2016-01-01

    Adequate blood supply to the uterine-placental region is crucial to ensure the transport of oxygen and nutrients to the growing fetus. Multiple factors intervene to achieve appropriate uterine blood flow and the structuring of the placental vasculature during the early stages of pregnancy. Among these factors, oxygen concentrations, growth factors, cytokines, and steroid hormones are the most important. Sex steroids are present in extremely high concentrations in the maternal circulation and are important paracrine and autocrine regulators of a wide range of maternal and placental functions. In this regard, progesterone and estrogens act as modulators of uterine vessels and decrease the resistance of the spiral uterine arteries. On the other hand, androgens have the opposite effect, increasing the vascular resistance of the uterus. Moreover, progesterone and estrogens modulate the synthesis and release of angiogenic factors by placental cells, which regulates trophoblastic invasion and uterine artery remodeling. In this scenario, it is not surprising that women with pregnancy-related pathologies, such as early miscarriages, preterm delivery, preeclampsia, and fetal growth restriction, exhibit altered sex steroid concentrations. PMID:27199767

  12. High-Intensity Focused Ultrasound (HIFU) in Uterine Fibroid Treatment: Review Study

    PubMed Central

    Mahmoud, Mustafa Z.; Alkhorayef, Mohammed; Alzimami, Khalid S.; Aljuhani, Manal Saud; Sulieman, Abdelmoneim

    2014-01-01

    Summary Background High-intensity focused ultrasound (HIFU) is a highly precise medical procedure used locally to heat and destroy diseased tissue through ablation. This study intended to review HIFU in uterine fibroid therapy, to evaluate the role of HIFU in the therapy of leiomyomas as well as to review the actual clinical activities in this field including efficacy and safety measures beside the published clinical literature. Material/Methods An inclusive literature review was carried out in order to review the scientific foundation, and how it resulted in the development of extracorporeal distinct devices. Studies addressing HIFU in leiomyomas were identified from a search of the Internet scientific databases. The analysis of literature was limited to journal articles written in English and published between 2000 and 2013. Results In current gynecologic oncology, HIFU is used clinically in the treatment of leiomyomas. Clinical research on HIFU therapy for leiomyomas began in the 1990s, and the majority of patients with leiomyomas were treated predominantly with HIFUNIT 9000 and prototype single focus ultrasound devices. HIFU is a non-invasive and highly effective standard treatment with a large indication range for all sizes of leiomyomas, associated with high efficacy, low operative morbidity and no systemic side effects. Conclusions Uterine fibroid treatment using HIFU was effective and safe in treating symptomatic uterine fibroids. Few studies are available in the literature regarding uterine artery embolization (UAE). HIFU provides an excellent option to treat uterine fibroids. PMID:25371765

  13. A Systematic Review of Acquired Uterine Arteriovenous Malformations: Pathophysiology, Diagnosis, and Transcatheter Treatment

    PubMed Central

    Yoon, Daniel J.; Jones, Megan; Taani, Jamal Al; Buhimschi, Catalin; Dowell, Joshua D.

    2015-01-01

    Objective An acquired uterine arteriovenous malformation (AVM) is a rare cause of vaginal bleeding and, although hysterectomy is the definitive therapy, transcatheter embolization (TCE) provides an alternative treatment option. This systematic review presents the indications, technique, and outcomes for transcatheter treatment of the acquired uterine AVMs. Study Design Literature databases were searched from 2003 to 2013 for eligible clinical studies, including the patient characteristics, procedural indication, results, complications, as well as descriptions on laterality and embolic agents utilized. Results A total of 40 studies were included comprising of 54 patients (average age of 33.4 years). TCE had a primary success rate with symptomatic control of 61% (31 patients) and secondary success rate of 91% after repeated embolization. When combined with medical therapy, symptom resolution was noted in 48 (85%) patients without more invasive surgical procedures. Conclusion Low-level evidence supports the role of TCE, including in the event of persistent bleeding following initial embolization, for the treatment of acquired uterine AVMs. The variety of embolic agents and laterality of approach delineate the importance of refining procedural protocols in the treatment of the acquired uterine AVM. Condensation A review on the management of patients with acquired uterine AVMs. PMID:26929872

  14. [Application of TB type thermal balloon endometrial ablation for the treatment of abnormal uterine bleeding].

    PubMed

    Wang, W; Zhai, Y; Zhang, Z H; Li, Y; Zhang, Z Y

    2016-11-08

    Objective: To investigate the clinical efficacy, safety and promotion value of TB type thermal balloon endometrial ablation in the treatment of abnormal uterine bleeding. Methods: Fourty three patients who had received TB type endometrial ablation system for treatment of abnormal uterine bleeding from January, 2015 to January, 2016 in theDepartment of gynecology, Beijing Chaoyang Hospital were enrolled in this study. The intra-operative and post-operative complications and improvement of abnormal uterine bleeding and dysmenorrhea were observed. Results: There were nointra-operative complication occurred, such as uterine perforation, massive hemorrhage or surrounding organ damage. At 6 months after operation, 32 patients developed amenorrhea, 6 developed menstrual spotting, 3 developed menstruation with a small volume and 1 had a normal menstruation. No menstruation with an increased volume occurred. The occurrence of amenorrhea was 76.19% and the response rate was 97.62%.At 6 months after operation, 1 case had no response, 2 cases had partial response and 11 cases had complete response among the 14 cases of pre-operative dysmenorrhea; only 3 cases still had anemia among the 23 cases of pre-operative anemia. Compared with before treatment, patients with dysmenorrhea and anemia both significantly reduced with a statistically significant difference(P<0.01). Conclusion: TB type thermal balloon endometrial ablation has a significant efficacy with high safety for the treatment of abnormal uterine bleeding, which could have clinical promotion practice.

  15. Mechanism of Relaxation Via TASK-2 Channels in Uterine Circular Muscle of Mouse

    PubMed Central

    Hong, Seung Hwa; Sung, Rohyun; Suzuki, Hikaru; Choi, Woong; Park, Yeon Jin; Ji, Ill Woon; Kim, Chan Hyung; Myung, Sun Chul; Lee, Moo Yeol; Kang, Tong Mook; You, Ra Young; Lee, Kwang Ju; Lim, Seung Woon; Yun, Hyo-Yung; Song, Young-Jin; Xu, Wen-Xie; Lee, Sang Jin

    2013-01-01

    Plasma pH can be altered during pregnancy and at labor. Membrane excitability of smooth muscle including uterine muscle is suppressed by the activation of K+ channels. Because contractility of uterine muscle is regulated by extracellular pH and humoral factors, K+ conductance could be connected to factors regulating uterine contractility during pregnancy. Here, we showed that TASK-2 inhibitors such as quinidine, lidocaine, and extracellular acidosis produced contraction in uterine circular muscle of mouse. Furthermore, contractility was significantly increased in pregnant uterine circular muscle than that of non-pregnant muscle. These patterns were not changed even in the presence of tetraetylammonium (TEA) and 4-aminopyridine (4-AP). Finally, TASK-2 inhibitors induced strong myometrial contraction even in the presence of L-methionine, a known inhibitor of stretchactivated channels in myometrium. When compared to non-pregnant myometrium, pregnant myometrium showed increased immunohistochemical expression of TASK-2. Therefore, TASK-2, seems to play a key role during regulation of myometrial contractility in the pregnancy and provides new insight into preventing preterm delivery. PMID:23946696

  16. Uterine blood flow during various stages of pregnancy in dairy buffaloes using transrectal Doppler ultrasonography.

    PubMed

    Varughese, E E; Brar, P S; Dhindsa, S S

    2013-07-01

    Reference data to assess function and perfusion of uteroplacental tissues by assessment of uterine blood flow parameters is not available in buffaloes. The objective of the present study was to assess and quantify blood flow parameters at various stages of gestation. A total of 54 Murrah buffaloes, six animals at every month of gestation, from two months to ten months, were subjected to transrectal Doppler ultrasonography to assess uterine blood flow in both the middle uterine arteries. Resistance and pulsatility indices, velocity and volume of blood flow, diameter of the artery and notch signal were measured for different waveforms. The resistance index value was positively correlated with pulsatility index (r=0.94, P<0.05) but negatively correlated with all other parameters for both arteries, ipsilateral and contralateral to the fetus. With a significant advancement of pregnancy, there was reduction in resistance index with a significant increase in velocity, volume of blood flow and diameter in both arteries. There was a significant increase in the volume and velocity of blood flow (P<0.05) during the last trimester with increased growth demands of the fetus. The notch signal disappeared by 20-24 weeks. Thus, transrectal Doppler ultrasongraphy proved to be a useful non-invasive method to assess the uterine blood flow during pregnancy in buffaloes. This could be a valuable tool to ascertain hemodynamic changes in complicated pregnancy (e.g. abnormalities in uterine blood flow/placenta/fetus) and its extent of deviation from normal.

  17. Increased Urinary Phthalate Levels in Women with Uterine Leiomyoma: A Case-Control Study

    PubMed Central

    Kim, Young Ah; Kho, Younglim; Chun, Kyoung Chul; Koh, Jae Whoan; Park, Jeong Woo; Bunderson-Schelvan, Melisa; Cho, Yoon Hee

    2016-01-01

    We assessed the urinary concentration of 16 phthalate metabolites in 57 women with and without uterine leiomyoma (n = 30 and 27; respectively) to determine the association between phthalate exposure and uterine leiomyoma. To evaluate exposure to di-(2-ethylhexyl) phthalate (DEHP); we calculated the molar sum of DEHP metabolites; ∑3-DEHP (combining mono-(2-ethylhexyl) phthalate (MEHP); mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP); and mono-(2-ethyl-5-oxohexyl) phthalate); ∑4-DEHP (∑3-DEHP plus mono-(2-ethyl-5-carboxypentyl) phthalate); and ∑5-DEHP (∑4-DEHP plus mono (2-(carboxylmethyl)hexyl) phthalate (2cx-MMHP)). The log transformed urinary levels of MEHP; MEHHP; 2cx-MMHP; ∑3-DEHP; ∑4-DEHP; and ∑5-DEHP in the leiomyoma group were significantly higher than those of controls. When we adjusted for age; waist circumference; and parity using multiple logistic regression analyses; we found log ∑3-DEHP (OR = 10.82; 95% CI = 1.25; 93.46) and ∑4-DEHP (OR = 8.78; 95% CI = 1.03; 75.29) were significantly associated with uterine leiomyoma. Our findings suggest an association between phthalate exposure and uterine leiomyoma. However; larger studies are needed to investigate potential interactions between phthalate exposure and uterine leiomyoma. PMID:27983712

  18. A Systematic Review of Acquired Uterine Arteriovenous Malformations: Pathophysiology, Diagnosis, and Transcatheter Treatment.

    PubMed

    Yoon, Daniel J; Jones, Megan; Taani, Jamal Al; Buhimschi, Catalin; Dowell, Joshua D

    2016-03-01

    Objective An acquired uterine arteriovenous malformation (AVM) is a rare cause of vaginal bleeding and, although hysterectomy is the definitive therapy, transcatheter embolization (TCE) provides an alternative treatment option. This systematic review presents the indications, technique, and outcomes for transcatheter treatment of the acquired uterine AVMs. Study Design Literature databases were searched from 2003 to 2013 for eligible clinical studies, including the patient characteristics, procedural indication, results, complications, as well as descriptions on laterality and embolic agents utilized. Results A total of 40 studies were included comprising of 54 patients (average age of 33.4 years). TCE had a primary success rate with symptomatic control of 61% (31 patients) and secondary success rate of 91% after repeated embolization. When combined with medical therapy, symptom resolution was noted in 48 (85%) patients without more invasive surgical procedures. Conclusion Low-level evidence supports the role of TCE, including in the event of persistent bleeding following initial embolization, for the treatment of acquired uterine AVMs. The variety of embolic agents and laterality of approach delineate the importance of refining procedural protocols in the treatment of the acquired uterine AVM. Condensation A review on the management of patients with acquired uterine AVMs.

  19. Fertility and uterine hemodynamic in cows after artificial insemination with semen assessed by fluorescent probes.

    PubMed

    Oliveira, Bruna Marcele; Arruda, Rubens Paes; Thomé, Helder Esteves; Maturana Filho, Milton; Oliveira, Guilherme; Guimarães, Carina; Nichi, Marcílio; Silva, Luciano Andrade; Celeghini, Eneiva Carla Carvalho

    2014-09-15

    Fluorescent probes (propidium iodide, Hoechst 33342, fluorescein isothiocyanate-conjugated Pisum sativum agglutinin, and 5,5',6,6'-tetrachloro-1,1',3,3'-tetraethylbenzimidazolcarbocyanine iodide) were used to simultaneously evaluate the integrity of plasma and acrosomal membranes as well as mitochondrial membrane function in cryopreserved bovine semen and to verify its influence on fertility and postinsemination uterine vascularization. One hundred eighty-two Nellore cows were distributed for artificial insemination (AI) using semen batches separated according to the cell percentage presenting intact plasma membrane, intact acrosome, and high mitochondrial function (IPIAH): group G (44.5% IPIAH, n = 68), group M (23.0% IPIAH, n = 56), and group R (8.5% IPIAH, n = 58). The uterine hemodynamic was evaluated by Doppler sonogram in three periods: 30 hours before AI, 4 and 24 hours after AI were considered the resistance index and the uterine vascularization score. The pregnancy rate of group G (64.7%) was greater (P > 0.05) compared with group R (36.2%), but both did not differ from group M (50.0%). There was no effect (P > 0.05) of semen quality on uterine vascularization. Greater vascularization was noticed 4 hours after AI than 30 hours before and 24 hours after AI. Semen evaluation using fluorescent probes contributes to predicting fertilizing potential of semen. The use of semen with less percentage of IPIAH sperm does not alter uterine hemodynamic in cows.

  20. Magnetic Resonance Angiography of Uterine Artery: Changes with Embolization Using Gelatin Sponge Particles Alone for Fibroids

    SciTech Connect

    Katsumori, Tetsuya Kasahara, Toshiyuki; Kin, Yoko; Ichihashi, Shigeo

    2007-06-15

    Purpose. To assess uterine artery recanalization, together with tumor devascularization, after embolization using gelatin sponge particles alone for fibroids. Methods. Twenty-seven patients underwent uterine artery embolization (UAE) for fibroids using only gelatin sponge particles. The angiographic endpoint of embolization was defined as near stasis of contrast medium in the ascending segment of the uterine artery. All patients underwent contrast-enhanced magnetic resonance angiography (MRA) before and 4 months after UAE, and contrast-enhanced magnetic resonance imaging (CE-MRI) before, 1 week after, and 4 months after UAE. The visualization of the uterine arteries before and 4 months after UAE was assessed using MRA. The infarction rates of the largest tumor were assessed using CE-MRI 1 week after UAE. Results. MRA 4 months after UAE showed 100% (53/53) of the descending and transverse segments, and 88% (43/49) of the ascending segments that had been noted on baseline MRA. The visualization of the ascending segments on MRA 4 months after UAE was identical to that on baseline MRA in 20 of 27 patients (74%). CE-MRI showed complete infarction of the largest tumor in 22 of 27 patients (81%), and 90-99% infarction of the largest tumor in the remaining 5 of 27 patients (19%). Conclusion. Based on the MR study, in most cases uterine artery recanalization occurred, together with sufficient devascularization of fibroids, after UAE using gelatin sponge particles alone.