Efficacy of Chinese medicine Kuntai capsule combined with sequential estrogen progesterone therapy in treatment of early-onset ovarian dysfunction / 中华全科医师杂志

Clinical data of 102 patients with premature ovarian failure admitted to Zhang Zhongjing Hospital from December 2018 to December 2021 were retrospectively analyzed. Fifty-one patients received (control group), and another 51 patients received Chinse medicine Kuntai capsule in addition to sequential estrogen progesterone therapy(study group); both groups were treated for 3 menstrual cycles. After treatment, the total effective rate of the study group was higher than that of the control group (94.1% (48/51) vs. 72.6% (37/51), χ2=4.07, P=0.044). After treatment, the proportion of patients with mild Kupperman score and serum estradiol level in both groups were increased, and the proportion in study group was higher than that in the control group. The proportion of patients with moderate and severe Kupperman score and the total score decreased after treatment in both groups, and the proportion of patients with moderate Kupperman score in the study group was lower than that in the control group. Serum luteinizing hormone and folliclestimulating hormone levels were significantly decreased, and the levels in study group were lower than those in the control group. The levels of resistance index and PI were significantly decreased after treatment in both group and the study group decrease more markedly (all P<0.05). The peak systolic flow velocity level was increased after treatment in both groups and the study group increased more markedly (all P<0.05). It is suggested that the application of Chinese medicine Kuntai capsule combined with sequential estrogen progesterone therapy can effectively improve the clinical therapeutic effect, stabilize sex hormones, uterine microcirculation and effectively alleviate the condition of patients with premature ovarian failure.

Cistoadenoma volumoso associado a teratoma ovariano maduro, com evolução para pseudomixoma peritoneal: relato de caso / Giant cystadenoma associated with mature ovarian teratoma with progression to pseudomyxoma peritonei: a case report

Massas anexiais representam grande desafio diagnóstico, devido a seu caráter geralmente assintomático¹. Traz-se caso peculiar de paciente que evoluiu com sintomas exuberantes de rápida evolução, situação característica de cistoadenomas, tumores benignos de origem epitelial²,³. Realizada laparotomia, com achados macroscópicos que revelaram conteúdo mucinoso e presença de pelos e neovascularização em seu interior. O anatomopatológico confirmou o diagnóstico de cistoadenoma associado a teratoma ovariano, sendo assim considerado um tumor de colisão ovariana.

Adnexal masses represent a major diagnostic challenge due to its usually asymptomatic characteritcs¹. We present a peculiar case of a patient who evolved with exuberant symptoms of rapid evolution, characteristic of cystadenomas, benign tumors of epithelial origin²,³. Laparotomy was performed, with macroscopic findings that revealed mucinous content and the presence of hairs and neovascularization inside. Pathology confirmed the diagnosis of cystadenoma associated with ovarian teratoma, thus being considered an ovarian collision tumor.

Expression and significance of GLI1 and Shh in the malignant transformation of ovarian endometriosis / 中华妇产科杂志

Objective:To investigate the expression levels and clinical significance of glioma-associated oncogene homolog 1 (GLI1) and sonic hedgehog signaling molecule (Shh) in the malignant transformation of ovarian endometriosis (EM).Methods:The expressions of GLI1 and Shh were detected by real-time reverse transcription (RT)-polymerase chain reaction (PCR) and EnVision method in 50 cases of ovarian EM tissues, 35 cases of atypical endometriosis (aEM) and 50 cases of endometriosis-associated ovarian cancer (EAOC). The expression differences of two molecular markers in the malignant transformation of ovarian EM were compared, and the relationships between two molecular markers and the clinicopathological features and prognosis of EAOC were analyzed.Results:(1) RT-PCR showed that the expression levels of GLI1 mRNA in EM, aEM and EAOC group were 1.77±0.40, 3.54±0.44, and 7.80±0.24, respectively. The expression levels of Shh mRNA were 0.95±0.21, 3.14±0.35, and 5.41±0.31, respectively. GLI1 and Shh mRNA in EAOC group were significantly higher than those in EM and aEM group (all P<0.01), and there were statistically significant differences between EM and aEM group (all P<0.01). The percentages of GLI1 in ovarian EM, aEM and EAOC were 32% (16/50), 57% (20/35), and 66% (33/50), respectively, meanwhile, the positive expression rates of Shh were 20% (10/50), 49% (17/35), and 54% (27/50), respectively (all P<0.01). GLI1 mRNA expression was positively correlated with Shh mRNA expression in EAOC tissues ( r=0.721, P<0.01). The expressions of GLI1 protein were proportionated to Shh protein in EAOC tissues ( r=0.608, P=0.001). (2) The expression of GLI1 was significantly related to the International Federation of Gynecology and Obstetrics (FIGO) stage, cancer antigen 125 (CA 125) levels, lymph node metastasis, and Platinum resistance in EAOC patients (all P<0.05). The expression of Shh were related to FIGO stage and lymph node metastasis in EAOC patients (all P<0.05). Logistic regression analysis showed that GLI1 expression was an independent risk factor for poor prognosis in EAOC patients ( P<0.05). Kaplan-meier survival analysis showed that the overall survival rate of EAOC patients with high GLI1 expression and low GLI1 expression was 12.1% and 35.3%, respectively, with statistical significance ( χ2=10.73, P<0.01). The overall survival rate of EAOC patients with high and low expression of Shh protein was 11.1% and 30.4%, in which there was statistically significant difference ( χ2=3.96, P=0.047). Conclusion:GLI1 and Shh are highly associated with the malignant transformation of ovarian EM, which may play a role in promoting malignant degeneration of ovarian EM, and the high expression of GLI1 and Shh indicates a poor prognosis in EAOC patients.

Combination of GI-RADS and 3D-CEUS for differential diagnosis of ovarian masses

SUMMARY OBJECTIVE The purpose of this study is to evaluate the efficacy of the combination of gynecologic imaging reporting and data system (GI-RADS) ultrasonographic stratification and three-dimensional contrast-enhanced ultrasonography (3D-CEUS) in order to distinguish malignant from benign ovarian masses. METHODS In this study, 102 patients with ovarian masses were examined by both two-dimensional ultrasound(2D-US) and 3D-CEUS. Sonographic features of ovarian masses obtained from 3D-CEUS were analyzed and compared with 2D-US. All patients with ovarian masses were confirmed by operational pathology or long-term follow-up results. RESULTS (1)The Chi-square test and multiple Logistic regression analysis confirmed that there were only eight independent predictors of malignant masses, including thick septa (≥3mm), thick papillary projections(≥7mm), solid areas, presence of ascites, central vascularization, contrast enhancement, distribution of contrast agent, and vascular characteristics of the solid part and their odds ratios which were 5.52, 5.39, 4.94, 4.34, 5.92, 7.44, 6.09, and 7.67, respectively (P<0.05). (2)These eight signs were used to combine the GI-RADS with 3D-CEUS scoring system in which the corresponding value of the area under the curve (AUC) was 0.969, which was superior to using GI-RADS lonely (Z-value=1.64, P<0.025). Using 4 points as the cut-off, the scoring system showed the performance was clearly better than using GI-RADS alone (P<0.05). (3) The Kappa value was 0.872 for two different clinicians with equal experience. CONCLUSIONS The combination of GI-RADS and 3D-CEUS scoring system would be a more effective method to distinguish malignant from benign ovarian masses.

RESUMO OBJETIVO O objetivo deste estudo é avaliar a eficácia da combinação da estratificação por ultrassonografia usando o Sistema de Relatórios e Dados de Imagem Ginecológica (GI-RADS) e ultrassonografia 3D com contraste (3D-CEUS) para diferenciar massas ovarianas benignas de malignas. METODOLOGIA Neste estudo, 102 pacientes com massas ovarianas foram examinadas usando ultrassonografia bidimensional (2D-US) e 3D-CEUS. As características ultrassonográficas das massas ovarianas obtidas com 3D-CEUS foram analisadas e comparadas com de 2D-US. Todos os pacientes com massas ovarianas tiveram o diagnóstico confirmado pelos resultados de patologia cirúrgica ou acompanhamento de longo prazo. RESULTADOS (1) O teste qui-quadrado e a regressão logística múltipla confirmaram a existência de apenas oito preditores independentes de massas malignas, incluindo septos espessos (≥3mm), projeções papilares espessas (≥7mm), áreas sólidas, presença de ascite, vascularização central, aumento de contraste, distribuição do agente de contraste e características vasculares da parte sólida e suas razões de possibilidades (OR), que foram 5,52, 5,39, 4,94, 4,34, 5,92, 7,44, 6,09 e 7.67, respectivamente (P< 0,05). (2) Esses oito preditores foram utilizados para combinar o GI-RADS com o sistema de escores da 3D-CEUS, para o qual o valor correspondente da área sob a curva (AUC) foi de 0,969, superior ao uso exclusivo do GI-RADS (valor de Z = 1,64, P < 0,025). Usando 4 pontos como corte, o sistema de escores mostrou que o desempenho foi muito melhor do que com o uso exclusivo do GI-RADS (P < 0,05). (3) O valor de Kappa foi 0,872, obtido por dois médicos diferentes com igual experiência. CONCLUSÃO A combinação do GI-RADS e do sistema de pontuação da 3D-CEUS é um método mais eficaz para distinguir massas ovarianas benignas de malignas.

Evaluación del efecto de la prasterona en el tratamiento del deseo sexual hipoactivo en mujeres posmenopáusicas / Evaluation of the effect of the Prasterone in the treatment of hypoactive sexual desire in postmenopausal women

Resumen OBJETIVO: Determinar los efectos de la dosis oral diaria de 50 mg de dehidroepiandrosterona en la función sexual de pacientes posmenopáusicas. MATERIALES Y MÉTODOS: Estudio experimental, clínico, prospectivo y longitudinal efectuado en pacientes posmenopáusicas atendidas en el Hospital Juárez de México entre los meses de abril a julio de 2017. La muestra se seleccionó de pacientes posmenopáusicas atendidas por primera vez que cumplieran los criterios de inclusión. Administración de 50 mg de prasterona (Biolaif™) por vía oral cada 24 horas durante 12 meses a las pacientes con protocolo de estudio completo; consulta de seguimiento cada 3 meses. Estadística descriptiva y análisis bidimensional de Friedman. Los estudios estadísticos se realizaron con el programa SPSS versión 22. RESULTADOS: En 29 pacientes se evaluó el índice de función sexual que se incrementó, posterior al tratamiento oral con 50 mg diarios de prasterona, de una media de 10.8 a 28.1, y a 12 meses en 18 pacientes de una media de 10.6 a 29.1. CONCLUSIONES: La disfunción sexual es un problema de salud infradiagnosticado en pacientes posmenopáusicas. La administración oral de prasterona (dehidroepiandrosterona) a dosis de 50 mg al día mejoró todos los dominios del índice de función sexual femenina de todas las pacientes estudiadas con resultados estadísticamente significativos, sin efectos secundarios de hiperandrogenismo.

Abstract OBJECTIVE: To determine the effects of the administration of 50 mg of DHEA orally daily on sexual function of menopausal patients. MATERIALS AND METHODS: We performed an experimental, clinical, prospective and longitudinal study in menopausal patients. We selected the sample from april to july 2017 with menopausal patients who attended for the first time at the clinic who met the inclusion criteria, having a final sample of 29 patients. Patients with a complete study protocol who met the entry criteria were administered 50 mg of prasterone (Biolaif™) orally daily for 12 months, with a follow-up consultation every 3 months. Descriptive statistics were used for the statistical analysis. Also, Friedman's two-dimensional analysis was used. All statistical studies were conducted in the SPSS program, v.22. RESULTS: Sexual Function Index evaluated with 29 patients at 6 months increased from an average of 10.8 to 28.1. At 12 months with 18 patients, after the treatment with 50 mg prasterone orally daily, it increased from an average of 10.6 to 29.1. CONCLUSIONS: Sexual dysfunction is an underdiagnosed health problem in patients over the postmenopausal stage. Administration of prasterone (DHEA) at a dose of 50 mg orally daily improved the domains of Female Sexual Function Index of all our patients with statistically significant results, without side effects of hyperandrogenism.

Survival of gynecological cancers in Turkey: where are we at? / 부인종양

OBJECTIVE: To investigate the 5-year relative survival rates in gynecological cancers diagnosed and treated in Turkey by year 2009 and to compare the results with developed countries. METHODS: Data of patients diagnosed for ovarian, corpus uteri or cervix uteri cancer at year 2009 are collected from 9 national cancer registry centers. Date of deaths are retracted from governmental Identity Information Sharing System (KPS). In order to calculate relative survival rates, national general population mortality tables are obtained from Turkish Statistical Institute (TurkStat). Hakulinen method is used for computing curves by R program. Data for European, Asian and some developed countries were obtained from official web pages. RESULTS: A total of 1,553 patients are evaluated. Among these, 713 (45.9%) are corpus uteri cancers, while remaining 489 (31.5%) are ovarian and 351 (22.6%) are cervix uteri. Five-year overall relative survival rates are 85%, 50%, and 62% for corpus uteri, ovarian, and cervix uteri, respectively. These figures are between 73%–87% for corpus uteri, 31%–62% for ovarian and 61%–80% for cervix uteri in developed countries. Stage is the most important factor for survival in all cancers. Five-year relative survival rates in corpus uteri cancers are 92%, 66%, and 38% for localized, regional, and distant metastatic disease, respectively. These figures are 77%, 57%, and 29% for ovarian; 80%, 50%, and 22% for cervix uteri. CONCLUSION: This is the first report from Turkey giving national overall relative survival for gynecological cancers from a population based cancer registry system.

Clinical outcome analysis of mild-stimulation in poor ovarian responders / 中国医师杂志

Objective To explore the clinical outcomes of different mild-stimulation in poor ovarian responders in vitro culture/intracytoplasmic injection (IVF/ICSI) to provide the evidence for clinical treatment,and investigate clinical parameters including pre-ovulation rate,rate of oocytes retrieved,fertilization rate,good quality embryo rate,and pregnancy rate per cycle.Methods The clinical date of a total 180 IVF cycles of infertile patients undergone from Jan 2013 to May 2016 in medical reprodution center of Xiang Tan Central Hospital.According to the different methods of controlled ovarian hyperstimulation (COH),the cycles were divided into 3 groups:group A with 60 cycles of early five days using clomiphene,group B with 60 cycles of persistent using clomiphene,and group C with 60 cycles using artificial luteal-phase ovarian stimulation protocol.Results The basic situations in three groups were no significant difference (P ＞0.05).Compared to groups B and C,the pre-ovalution rate was more in group A (P ＜ O.05),and the rate of oocytes retrieved,fertilization rate,good quality embryo rate,and preganacy rate per cycle were higher in groups B and C (P ＜ 0.05).The rate of oocytes retrieved,fertilization rate,good quality embryo rate,and preganacy rate per cycle were no significant difference among gourps B and C.The good quality embryo rate and preganacy rate per cycle in groups B and C were higher than group A,and group B was higher than group A (P ＜ 0.05).Conclusions Persistent using clomiphene or persistent using clomiphene in COH could decrease the rate of pre-ovalution,and get more rate of oocytes retrieved,good quality embryo rate,and preganacy rate per cycle.

Dual role for the unfolded protein response in the ovary: adaption and apoptosis

The endoplasmic reticulum (ER) is the principal organelle responsible for several specific cellular functions including synthesis and folding of secretory or membrane proteins, lipid metabolism, and Ca storage. Different physiological as well as pathological stress conditions can, however, perturb ER homeostasis, giving rise to an accumulation of unfolded or misfolded proteins in the ER lumen, a condition termed ER stress. To deal with an increased folding demand, cells activate the unfolded protein response (UPR), which is initially protective but can become detrimental if ER stress is severe and prolonged. Accumulating evidence demonstrates a link between the UPR and ovarian development and function, including follicular growth and maturation, follicular atresia, and corpus luteum biogenesis. Additionally, ER stress and the UPR may also play an important role in the ovary under pathological conditions. Understanding the molecular mechanisms related to the dual role of unfolded protein response in the ovarian physiology and pathology may reveal the pathogenesis of some reproductive endocrine diseases and provide a new guidance to improve the assisted reproductive technology. Here we review the current literature and discuss concepts and progress in understanding the UPR, and we also analyze the role of ER stress and the UPR in the ovary.

Minimally invasive approach of tubo-ovarian abscesses / Tratamento minimamente invasivo dos abcessos tubo-ováricos

PURPOSE: To evaluate the treatment outcome of tubo-ovarian abscesses managed by transvaginal ultrasound-guided aspiration. METHODS: Descriptive analysis of all patients with tubo-ovarian abscesses treated with a minimally invasive procedure, ultrasound-guided drainage, at the Department of Gynecology, Centro Hospitalar Vila Nova de Gaia/Espinho, during a period of 5 years (from June 2009 to June 2014). RESULTS: Twenty-six cases were included in the study. The mean age of the study group was 42.8 years. All patients were submitted to transvaginal ultrasound-guided aspiration and sclerosis with iodated solution, as well as received broad-spectrum intravenous antibiotics. The mean time from admission to drainage was 2.5 days. Cultures for aerobic and anaerobic pathogens were positive in 14 of the 26 cases. A complete response was noted in 23 of the 26 cases. No complications or morbidity were noted as a consequence of the drainage procedures. CONCLUSION: Minimally invasive treatment of tubo-ovarian abscesses by transvaginal ultrasound-guided drainage is an effective and safe approach. .

OBJETIVO: Avaliar os resultados da aspiração transvaginal ecoguiada no tratamento dos abcessos tubo-ováricos. MÉTODOS: Análise descritiva de todas as pacientes com diagnóstico de abcesso tubo-ovárico tratadas com um procedimento minimamente invasivo, drenagem ecoguiada, no Serviço de Ginecologia do Centro Hospitalar Vila Nova de Gaia/Espinho, durante um período de 5 anos (junho de 2009 a junho de 2014). RESULTADOS: Vinte e seis casos foram incluídos neste estudo, com média de idade de 42,8 anos. Todas as pacientes foram submetidas a punção aspirativa transvaginal ecoguiada e esclerose com solução iodada, associada a antibioterapia endovenosa de largo espectro de ação. O tempo médio desde a admissão até o procedimento de drenagem foi de 2,5 dias. Os exames culturais para micro-organismos aeróbicos e anaeróbicos foram positivos em 14/26 casos. Resposta completa com o tratamento instituído ocorreu em 23 dos 26 casos. Não houve registro de complicações ou morbilidade com os procedimentos de drenagem realizados. CONCLUSÃO: O tratamento minimamente invasivo dos abcessos tubo-ováricos, com drenagem transvaginal ecoguiada, constitui uma abordagem terapêutica eficaz e segura. .

Bone marrow mesenchymal stem cell transplantation for treatment of cis-platinum-induced ovarian damage / 中国组织工程研究

BACKGROUND:Chemotherapy drugs can damage the ovarian function in women of childbearing age, and even lead to premature ovarian failure. Therefore, to improve and restore the ovarian function in patients has become an important issue. OBJECTIVE:To explore the therapeutic effect and feasibility of bone marrow mesenchymal stem cel therapy against chemotherapy-induced ovarian damage. METHODS:Rat models of chemotherapy-induced premature ovarian failure were established, and injected with PKH26-labeled bone marrow mesenchymal stem cels. At 15, 30, 45, 60 days after cel transplantation, five rats were selected respectively to detect folicle-stimulating hormone and estradiol levels, and then, the rats were kiled to take the right ovary for pathological examination. The number of ovarian folicles was detected under light microscope. At 30 days after cel transplantation, another two rats were selected to mate with male rats to observe the difference in the reproductive activity. RESULTS AND CONCLUSION:Four of 22 rats (18%) gradualy recovered their estrous cycle after cel transplantation, with the decreased folicle-stimulating hormone level and increased estradiol level. Moreover, the number of folicles was reduced. Al of these indicated that the ability to have children in rats was not damaged.These experimental findings suggest that bone marrow mesenchymal stem cels can partialy improve the ovarian function of rats under chemotherapy.

Características clínicas y metabólicas de síndrome de ovario poliquístico en la ciudad de Temuco / Clinical and metabolic characteristics of polycystic ovary syndrome in the city of Temuco

Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder, its etiologyis multifactorial. It is associated with multiple metabolic abnormalities. Objective: To evaluate statistical association between the clinical characteristics of patients diagnosed with PCOS. Patients and Methods: Descriptive study, 121 patients between 13 and 44 years with PCOS were included, and their clinical characteristics, blood glucose, insulin, lipid profile and calculated HOMA were evaluated. Data was analyzed with Chi2, considering p < 0.05 as statistically significant. Results: Mean age 25,5 years, 12,5 years menarche. 22 percent with a history of abortion. Mean BMI 31,4. Acanthosis nigricans was presented in 58,6 percent. Average Glucose 96,5 mg/dl. Insulin resistance (IR) was found in 79.3 percent. Average HOMA 4,5. 64 percent of patients with IR presented Acanthosis nigricans (p = 0.002).It showed direct relationship between BMI and RI (p 0.000). 38,8 percent had dysglycemia. RI was found in 78,7 percent of patients with dysglycemia (p 0.8). Lipid profile was measured in 78 patients, of whom 40 percent had total cholesterol above 200 mg/dl, 49 percent hypertriglyceridemia and high LDL in 13 percent of cases. Conclusions: The data reported are similar to those reported in the international literature. Ourpopulation has obesity and dyslipidemia figures higher than those reported in national studies. The menarche occurs at a younger age while the prevalence of dyslipidemia and RI is greater than the general population, forming a higher risk group...

Síndrome de teratoma creciente: presentación de un caso / Growing Teratoma Syndrome: A Case Report

El síndrome de teratoma creciente (STC) es una entidad histopatológica rara y está definida por la aparición de un teratoma maduro durante o después de la quimioterapia de un tumor maligno de células germinales no seminomatoso. Hasta la fecha han sido pocos los casos presentados en la literatura mundial. Por la baja incidencia de esta patología, presentamos el caso de una paciente joven con un teratoma inmaduro de ovario tratada con cirugía y quimioterapia, quien desarrolló posteriormente una masa pélvica con resultado histológico de teratoma maduro. El reconocimiento de esta patología es importante para evitar confusiones con el desarrollo de tumores malignos.

Growing teratoma syndrome is a rare histopathologic entity, defined by an enlarged mass of mature teratoma which appears during or after chemotherapy of a malignant nonseminomatous germ cell tumor. Few reported cases in world literature have been reported until today, due to the low incidence of this pathology. We report one patient in our hospital with immature teratoma. This patient was treated with surgical resection and chemotherapy. She had a pelvic mass and histology revealed a mature teratoma. It is important to recognize this pathology in order to avoid confusion with a developing malignancy.

Comparision of in vitro maturation applied in PCOS and non-PCOS patients undergo stimulated and unstimulated protocols / 中华妇产科杂志

Objective To compare the laboratory and clinical results between unstimulated in vitro maturation (IVM) and IVM converted from in vitro fertilization (IVF) in polycystic ovarian syndrome (PCOS) and non-PCOS patients.Methods We divided 591 IVM cycles in the First Affiliated Hospital of Wenzhou Medical Univesity from Jan.2008 to Dec.2013 into 4 groups:group A1B1,PCOS patients underwent unstimulated IVM protocol,240 cycles; group A1B2,PCOS patients underwent IVM converted from conventional stimulated IVF protocol,153 cycles; group A2B1,non-PCOS patients underwent unstimutlated IVM protocol,103 cycles; group A2B2,non-PCOS patient underwent IVM converted from conventional stimulated IVF protocol,95 cycles.Multiple linear regression method and binary logistic regression method were used to assess the influence of PCOS and protocols for IVM on laboratory and clinical outcomes.Results The mean number of oocytes retrieved was positively related with PCOS [partial regression coefficient (B)=3.37,P＜0.01].The maturation rate of oocytes was positively related with hCG-prime prior to oocyte aspiration (B=0.05,P=0.010).High-quality embryo rate was positively related with PCOS and IVM converted from IVF (B=0.08,P=0.010; B=0.09,P=0.001),as well as implantation rate related with them (B=0.07,P=0.010; B=0.10,P＜0.01).PCOS and IVM converted from IVF improved hCG positive (hCG＞10 U/L) rate (OR=1.636,95％CI:1.113-2.204,P＜0.05; OR=1.861,95％CI:1.307-2.649,P＜0.05) and the clinical pregnancy rate (OR=1.507,95％CI:1.041-2.240,P＜0.05; OR=1.881,95％CI:1.312-2.696,P＜0.05).IVM converted from IVF protocol decreased the spontaneous abortion rate (OR=0.490,95％CI:0.245-0.978,P＜0.05).Multiple gestation rate and ectopic pregnancy rate were not affected by PCOS condition and protocol used (P＞0.05).Conclusions PCOS and IVM converted from IVF protocol improved the high-quality embryo rate,implantation rate,hCG positive rate and clinical pregnancy rate.IVM converted from IVF protocol reduced the spontaneous abortion rate.PCOS patients may be more suitable for the IVM treatment.No matter PCOS or non-PCOS patients,IVM converted from IVF protocol had better pregnancy outcome than that of unstimulated cycle.

Analysis of three-dimensional contrast-enhanced ultrasonographic features of corpus luteum hematoma / 中华超声影像学杂志

Objective To analyze three-dimensional contrast-enhanced ultrasonographic(3D-CEUS) features of corpus luteum hematoma,to improve the understanding of the sonographic features of corpus luteum hematoma.Methods 3D-CEUS features of thirty corpus luteum hematoma in twenty-nine cases were analyzed retrospectively and compared with conventional ultrasonography.Results Conventional ultrasonography and 3D-CEUS had statistical differences in the scores of these three parameters of corpus luteum hematoma:the wall(1.20 ± 0.43 vs 2.00 ± 0.00),internal echo(1.77 ± 0.43 vs 1.00 ± 0.00) and whether there being the main blood vessels(1.10 ± 0.31 vs 1.53 ± 0.51) (all P =0.000).Conclusions 3DCEUS can provide valuable information for the differential diagnosis of corpus luteum hematoma.

Diagnostic value of biochemical predictive index in ovarian malignancy.

The aim of the study was to determine if diagnostic performance of CA-125 in ovarian malignancy can be improved by considering age of the patient. The study was a retrospective analysis of the medical records of 306 patients who underwent a CA-125 measurement in our Institute. Of the 306 patients, 31% had malignant ovarian diseases, 45% had benign ovarian diseases, 6% had non-ovarian gynaecological diseases and 18% had non-gynaecological diseases. A positive association was found between age and CA-125 levels in patients with ovarian diseases. Patients were divided into three age groups of 18–37 yrs, 38–56 yrs and 57–74 yrs and were given age scores as 1, 2 and 3 respectively. Biochemical predictive index (BPI) was calculated by multiplying age score and CA-125 value. Among the age groups ranging 38–56 yrs and 57–74 yrs, the CA-125 and BPI values were significantly higher in malignant ovarian diseases compared to benign ovarian diseases. ROC curve analysis revealed a cut-off of 86 for the BPI with the sensitivity, specificity, positive predictive value and negative predictive value as 58%, 78%, 56% and 80% respectively. BPI had better specificity and negative predictive value compared to CA-125, can be used in the screening of ovarian pathology.

Association of Selected Medical Conditions With Breast Cancer Risk in Korea / 예방의학회지

OBJECTIVES: To estimate the effect of medical conditions in the population of Korea on breast cancer risk in a case-control study. METHODS: The cases were 3242 women with incident, histologically confirmed breast cancer in two major hospitals interviewed between 2001 and 2007. The controls were 1818 women each admitted to either of those two hospitals for a variety of non-neoplastic conditions. Information on each disease was obtained from a standardized questionnaire by trained personnel. Odds ratios (ORs) for each disease were derived from multiple logistic regression adjusted for age, age of menarche, pregnancy, age of first pregnancy, and family history of breast cancer. RESULTS: Among all of the incident breast cancer patients, pre-existing diabetes (OR, 1.33; 95% confidence interval [CI], 0.99 to 1.78), hypertension (OR, 1.46; 95% CI, 1.18 to 1.83), thyroid diseases (OR, 1.26; 95% CI, 1.00 to 1.58), and ovarian diseases (OR, 1.70; 95% CI, 1.23 to 2.35) were associated with an increased risk of breast cancer when other factors were adjusted for. In a stratified analysis by menopausal status, pre-existing hypertension (pre-menopause OR, 0.80; 95% CI, 0.48 to 1.34 vs. post-menopause OR, 1.87; 95% CI, 1.44 to 2.43; p-heterogeneity <0.01) and ovarian disease (pre-menopause OR, 4.20; 95% CI, 1.91 to 9.24 vs. post-menopause OR, 1.39; 95% CI, 1.02 to 1.91; p-heterogeneity 0.01) showed significantly different risks of breast cancer. CONCLUSIONS: Our results suggest the possibility that medical conditions such as hypertension affect breast cancer development, and that this can differ by menopausal status. Our study also indicates a possible correlation between ovarian diseases and breast cancer risk.

The ultrasound and endocrine profile and their correlations in obese and non-obese women with polycystic ovary syndrome / 中华医学超声杂志（电子版）

Objective To study the different ultrasonic features in patients of polycystic ovary syndrome (PCOS) with or without obesity based on body mass index (BMI), and to investigate whether certain hormonal factors correlate with ovarian morphology and blood flow, and to discuss the role of ultrasound combined with hormone test in the diagnosis of obese PCOS. Methods One hundred and five women with PCOS were recruited. Patients were divided into two groups according to BMI;obese PCOS group (OB-PCOS, n=32, BMI≥25 kg/m2) and non-obese PCOS (NOB-PCOS, n=73, BMI<25 kg/m2). The ultrasonic parameters of follicle number (FN), ovarian volume (Vol), resistance index (RI) of ovarian stromal blood, RI of uterine artery and serum levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), the ratio of luteinizing hormone and follicle-stimulating hormone (LH/FSH), progesterone (P), estradiol (E2), free testosterone (FT), prolactin (PRL), sex hormoe binding globulin (SHBG), fasting plasma glucose (FPG), fasting insulin (FINS), the extent of insulin resistance and hyperandrogenism (HOMA-IR) were measured and compared. The correlation of the ultrasonic parameters and hormonal factors were analyzed. Results The Vol of OB-PCOS group was significantly higher than NOB-PCOS group [(12.25±4.89) ml vs (10.73±2.30) ml, t=2.20, P < 0.05]. FN and uterine artery RI of OB-PCOS group had a rising trend and RI of ovarian interstitial was on a reducing trend compared with NOB-PCOS group. But the differences were not statistically significant. The levels of FINS and HOMA-IR in OB-PCOS group [(14.82±6.45) mU/L and (3.91±3.30)] were significantly higher than those in NOB-PCOS group [(8.04±4.57) mU/L and (1.64±1.20)] (t=4.87, 3.47, respectively, both P < 0.01). And FSH in NOB-PCOS group was significantly higher than OB-PCOS group [(5.95±1.91) U/L vs (4.65±1.88) U/L, t=-2.77, P<0.01]. In POCS patients, FN was significantly associated with LH/FSH (r=0.35, P<0.01), and FT (r=0.38, P<0.01). Vol was significantly associated with LH/FSH, BMI, HOMA-IR and FPG (r=0.27, P<0.05;r=0.25, P<0.05;r=0.40, P<0.01;r=0.32, P<0.01). RI of ovarian stromal blood flow was significantly associated with SHBG (r=0.28, P<0.05). In OB-POCS group, RI of uterine artery was significantly associated with PRL (r=-0.58, P < 0.05). Vol was significantly associated with HOMA-IR (r=0.47, P < 0.05). In NOB-POCS group, FN was significantly associated with LH/FSH (r=0.33, P<0.05), and FT (r=0. 56, P<0.05). Vol was significantly associated with FT (r=0.31, P < 0.05). Conclusion There are some differences in the ultrasound and endocrine parameters between obese and non-obese PCOS patients, and some correlations exist between them.

Ovarian torsion after controlled ovarian hyperstimulation: 5 cases report and clinical analysis / 中华妇产科杂志

Objective To evaluate the characteristics and treatment of ovary torsion after controlled ovarian hyperstimulation.Methods Between Jan.2008 and Dec.2011,5 cases with ovary torsion who underwent ovarian hyperstimulation were retrospectively studied.Results Five cases presented intermittent lower abdominal from I to 38 days after oocyte retrieval.Enlargement of ovary and decreased or absent venous and/or arterial flow were demonstrated by Doppler sonography.Two torsions at left side,two torsions at right side,and one on bilateral side were observed.Three cases give up embryo transplantation,2 cases were pregnant after surgical treatment.One case with partial torsion was successfully treated with simple conservative treatment.Two cases with complete torsion were performed adnexectomy by laparotomy.One case with complete torsion with early pregnancy was managed by laparoscopic adnexectomy.One case with chemical pregnancy was managed by laparoscopic detorsion for left side and excision for right side.Postoperative pathology of ovary tissue all confirmed haemorrhage and necrosis.Conclusions Ovary torsion might occur after controlled ovarian hyperstimulation.The early management on ovary torsion will be benefit for preserving ovarian function.

Cistoadenoma seroso gigante de ovario: reporte de un caso / Giant ovarian serous cystadenoma: a case report

El cistoadenoma seroso de ovario es un tipo de tumor derivado del epitelio superficial (celómico), formado por áreas quísticas. La razón del predominio de estos tumores en el ovario es un misterio. Se presenta el caso de una paciente con cistoadenoma seroso de ovario; que fue referida al Servicio de Cirugía del Hospital Provincial Docente Dr Antonio Luaces Iraola por presentar un gran aumento del volumen abdominal, de 12 meses de evolución, cuyo diagnóstico fue sospechado por hallazgo de ultrasonografía pélvica; se encontró en la sala de operaciones una tumoración gigante de 10 kg de peso que fue confirmado por anatomopatología como un cistoadenoma seroso de ovario.

Giant ovarian serous cystadenoma is a type of tumor derived from the surface epithelium (celomic), formed by cystic areas. The reason for the prevalence of these ovarian tumors is a mystery. It is reported the case of a patient with ovary serous cystadenoma that was referred to the Surgery Service of the Teaching Provincial Hospital Dr Antonio Luaces Iraola for presenting a large increase volume in abdominal, 12 months evolution, whose diagnosis was suspected by pelvic ultrasonography; a giant of 10 kg was found during surgery and diagnosis was confirmed by histopathology as an ovarian serous cystadenoma.

Edema maciço de ovário / Massive ovarian edema

O edema maciço de ovário é uma condição benigna rara caracterizada pelo aumento tumoral símile do ovário comprometido. As doenças ovarianas de importância cirúrgica da infância não são frequentes e podem ser divididas em lesões neoplásicas, em cistos não neoplásicos e em alterações inflamatórias. Os autores descrevem um caso de edema maciço de ovário em uma paciente de treze anos que referia dor abdominal associada a uma lesão sólido-cística do ovário direito, avaliada como neoplasia pela ultrassonografia. Ao exame macroscópico, o ovário era bocelado e estava aumentado de volume, medindo 9,5×6,0×5,0 cm e apresentando uma lesão sólida com áreas císticas à superfície de corte. O aspecto microscópico fundamental desse processo era a presença de edema acentuado e difuso do estroma, envolvendo folículos, e associado a uma camada cortical com espessamento fibroso superficial. O conhecimento dessa entidade é fundamental para auxiliar no diagnóstico durante a avaliação ultrassonográfica de tumores ovarianos e prevenir tratamentos incorretos.

Massive ovarian edema is a rare benign condition characterized by similar tumor growth of the affected ovary. The ovarian disorders of surgical importance of childhood are not frequent and can be divided into neoplastic lesions, non-neoplastic cysts, and inflammatory alterations. Here the authors describe the case of a massive ovarian edema in a 13-year-old female patient who reported abdominal pain associated with a solid-cystic lesion of the right ovary evaluated as a neoplasm by ultrasonography. The macroscopic examination showed ovary with increased volume, measuring 9.5×6.0×5.0 cm, and presenting a solid lesion with cystic areas at the cutting surface. The key microscopic feature of this process was the presence of pronounced diffuse edema of the stroma, involving follicles and associated with a cortical layer with superficial fibrous thickening. Knowledge of this entity is key in aiding the diagnosis during the ultrasonographic evaluation of ovarian tumors and preventing improper treatments.