Résumé
Endometriosis is a benign gynecologic disease that highly influences women of childbearing age. It is characterized by ectopic endometrial tissue. Primary umbilical endometriosis is a rare condition. It is a benign disease with endometrial tissue in an abnormal site in the navel. It may be accompanied with pain in the navel and a discolored bump. Among all locations with the potential for endometriosis, the navel has less than 1% incidence of primary umbilical endometriosis. In the present study, we reported a rare case of umbilical endometriosis revealed via a biopsy performed for a 49-year-old menopausal woman with the complaint of pain in the navel who underwent surgical excision and a biopsy after a scan.
Résumé
Uterine leiomyoma is the most common benign tumors in females and varies widely in size. Lumbosacral plexopathy is a rare disorder characterized by a sudden onset of leg paresthesia, muscle weakness, and reduction of deep tendon reflexes. This condition usually caused by compression from an abdominal mass, paralysis in mothers during labor, and compression of the lumbosacral plexus by the fetal head during dystocia. This case report presents a 55-year-old woman with a huge uterine myoma and symptoms of weakness of the right leg and gait disturbance. She was diagnosed with lumbosacral plexopathy that resolved after a laparoscopic-assisted total hysterectomy.
Résumé
OBJECTIVE: This study is to compare the baseline characteristics and symptoms between groups with leiomyoma only (group M; myoma group), adenomyosis only (group A; adenomyosis group), and leiomyoma and adenomyosis together (group B; group for both disease). METHODS: Selected patients were who received total abdominal hysterectomy, laparoscopy-assisted vaginal hysterectomy, or total laparoscopic hysterectomy from January 2014 to December 2015, and whose pathology result showed leiomyoma (n=74), adenomyosis (n=27), or both (n=63). Baseline characteristics and symptoms were reviewed from the medical records. Researched characteristics included patients' age, degeneration of leiomyoma, endometrial hyperplasia, endometriosis, weight of the removed uterus, menopause before the surgery, method of the surgery, necessity for blood transfusion before and after the surgery, difference of hemoglobin level before and after the surgery, and number of gravida, para, and abortion. RESULTS: Eleven symptoms were checked. Thirty-eight point four percent of total subject had uterine leiomyoma and adenomyosis at the same time. Number of abortion was higher in the group B. The group B showed a tendency of presenting more menorrhagia, dysfunctional uterine bleeding, acute lower abdominal pain, and urinary frequency. Symptoms related to mass effect seem to be relative to uterine leiomyoma, and symptoms related to menorrhagia seems to be relative to adenomyosis. The group M showed suddenly growing mass symptoms, and was more likely to have massive hemorrhage during the surgery. It is hard to differentiate coexistence of uterine leiomyoma and adenomyosis from each disease. CONCLUSION: Coexistence of two disease exhibits mixed symptoms of each disease, but shows different tendency.
Sujets)
Femelle , Humains , Douleur abdominale , Endométriose intra-utérine , Transfusion sanguine , Hyperplasie endométriale , Endométriose , Hémorragie , Hystérectomie , Hystérectomie vaginale , Léiomyome , Dossiers médicaux , Ménopause , Ménorragie , Méthodes , Métrorragie , Myome , Anatomopathologie , Études rétrospectives , UtérusRésumé
Pelvic organ prolapse (POP) is bulging of one or more of the pelvic organs into the vagina and triggered by multiple causes. It is a very common disorder, especially among older women. POP is characterized by protrusion of the presentation part visible by the naked eye, and problems with urination or bowel movements. POP can be diagnosed based on the onset of symptoms and a pelvic exam, and management options include medical and surgical treatment. Although medical treatment cannot correct the abnormal herniation of the pelvic structures, this can help alleviate symptoms. One of the disadvantages of surgical interventions is recurrence, and advances in surgical techniques have decreased recurrence rates of POP. Therefore, author will explain the gynecology and urology approach and treatment.
Sujets)
Femelle , Humains , Cystocèle , Examen gynécologique , Gynécologie , Prolapsus d'organe pelvien , Rectocèle , Récidive , Miction , Urologie , VaginRésumé
Lack of adequate sleep has become increasingly common in our 24/7 modern society. Reduced sleep has significant health consequences including metabolic and cardiovascular disorders, and mental problems including depression. In addition, although the increase in life expectancy has provided a dream of longevity to humans, the occurrence of osteoporosis is a big obstacle to this dream for both male and female. It is known that insomnia and bone health problems, which are very critical conditions in human life, interestingly, share a lot of pathogenesis in recent decades. Nevertheless, due to another side effects of the synthetic drugs being taken for the treatment of insomnia and osteoporosis, patients have substantial anxiety for the safety of drugs with therapeutic expectation. This review examines the pathogenesis shared by sleep and osteoporosis together and herbal medicine, which has recently been shown to be safe and efficacious in the treatment of both diseases other than synthetic drugs. We suggestions for how to treat osteoporosis. These efforts will be the first step toward enabling patients to have comfortable and safe prescriptions through a wide selection of therapeutic agents in the future.
Sujets)
Femelle , Humains , Mâle , Anxiété , Dépression , Rêves , Science des plantes médicinales , Espérance de vie , Longévité , Ostéoporose , Ordonnances , Troubles de l'endormissement et du maintien du sommeilRésumé
Angioleiomyoma (AL) is a very rare benign tumor that originates from smooth muscle cells and has thick walled vessels. It may be found throughout the body but more frequently occurs in the lower extremities and rarely develops in the head and other parts of the body. This paper presents a case report of giant AL detected in a 33-year-old woman who complained of severe anemia, menorrhagia, and palpable lower abdominal mass. The patient underwent myomectomy and was diagnosed with AL based on the pathological report of mass. The effective treatment for AL is either simple hysterectomy or angiomyomectomy depending on the patient's desire to preserve fertility and symptom.
Sujets)
Adulte , Femelle , Humains , Anémie , Angiomyome , Fécondité , Tête , Hystérectomie , Immunohistochimie , Léiomyome , Membre inférieur , Ménorragie , Myocytes du muscle lisse , UtérusRésumé
Cervical cancer is the third most prevalent cancer in women around the world. Recently in Korea, the incidence of cervical cancer has decreased, but in all stages of cervical intraepithelial neoplasia (CIN), CIN has shown a 91% increase from 1999 to 2008. Persistent human papillomavirus (HPV) infection has been found to be the main cause of cervical cancer. HPV types 16 and 18 have been found in 70% of cervical cancer patients around the world. Cervical cancer screening such as cytology has limitations in terms of sensitivity and specificity. A discussion about the need for the HPV test is becoming active in order to compensate for the limitation of cytology. After the role of HPV in cervical cancer was identified, the importance of HPV detection test as a screening was emphasized. Several tests have been developed and each test has its own advantages and disadvantages, and new test method to overcome the disadvantages is still being developed. Today's guidelines and tests are those you would choose from among the large number of cervical cancer screening guidelines and tests, based on the consideration that the selected guidelines and the test are effective.
Sujets)
Femelle , Humains , Dysplasie du col utérin , Dépistage précoce du cancer , Incidence , Corée , Dépistage de masse , Méthodes , Papillomaviridae , Périménopause , Sensibilité et spécificité , Tumeurs du col de l'utérusRésumé
Endometrial cancer is the most common gynecologic malignancy in developed countries. Clear cell carcinoma typically occurs in the ovaries, and very rarely occurs in the endometrium; it accounts for less than 3% of all endometrial cancers. It is presumed that clear cell carcinomas are of Müllerian duct origin, and an association with exposure to diethylstilbestrol (DES) or other nonsteroidal follicle stimulating hormones has been described. We report a case of a postmenopausal woman who presented with vaginal bleeding without a specific medical history. Under the impression of an endometrial mass, we performed a laparoscopic operation. Pathologic results showed clear cell carcinoma of the endometrium. Depth of invasion was 0.2 cm out of a 0.5 cm total thickness, and the rectal shelf mass was clear cell carcinoma. We report the case with a brief review of the relevant literature.
Sujets)
Femelle , Humains , Adénocarcinome , Pays développés , Diéthylstilbestrol , Tumeurs de l'endomètre , Endomètre , Ovaire , Post-ménopause , Hémorragie utérineRésumé
Uterine serous adenocarcinoma (USC) is rare and invasive cancer. This cancer is more often reported in the ovary, the fallopian tube, and the endometrium than uterine cervix. No matter where the tumor is located, the tumor exhibits similar histological characteristics. So when uterine cancer is proven to be serous adenocarcinoma, it is necessary to see if the tumor originated from ovary or endometrium and invaded the cervix. We report a case of a 73-year-old postmenopausal woman with USC arising near the internal os of endocervical canal, clinically misdiagnosed as uterine cervix cancer.
Sujets)
Sujet âgé , Femelle , Humains , Adénocarcinome , Col de l'utérus , Endomètre , Trompes utérines , Ovaire , Tumeurs du col de l'utérus , Tumeurs de l'utérus , UtérusRésumé
OBJECTIVES: To evaluate the prevalence of premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) of perimenopausal women at a university hospital along with their menstrual characters. METHODS: A questionnaire survey regarding premenstrual symptoms was carried out in 100 perimenopausal women (43 to 53, years). The pattern of menstruation and, the intensity of dysmenorrhea were assessed; and further, the symptoms were classified according to their number, intensity, and persistence. The PMS criteria of American College of Obstetrics and Gynecology (ACOG) and PMDD criteria by American Psychiatric Association (APA) were evaluated. RESULTS: The approximate prevalence of PMS criteria was 95% and that of PMDD criteria was 23%. The most dominant symptoms were 'breast tenderness', 'abdominal bloating', 'and headache'. PMDD was significantly associated with the severity of dysmenorrhea (P = 0.020). There was no significant relation with age, height, weight, body mass index and the cycle of menstruation. CONCLUSION: Most women experience PMS and PMDD, which and have a significant impact on the activity of perimenopause women. However in most women that do not know well about PMS and PMDD. We should educate and inform women of PMS and PMDD, thus helping them increase their quality of life.
Sujets)
Femelle , Humains , Poids , Dysménorrhée , Gynécologie , Menstruation , Obstétrique , Périménopause , Syndrome prémenstruel , Prévalence , Qualité de vie , Enquêtes et questionnaires , Indice de gravité de la maladieRésumé
In gynecology, endosalpingiosis is a benign condition in which the fallopian tube-like epithelium is found outside the fallopian tube. The thirty-four point five percent of endosalpingiosis cases have concurrent endometriosis and 40% of the endosalpingiosis group are in postmenopausal states. In contrast with endometriosis, there are no significant links between infertility, chronic pelvic pain and endosalpingiosis. The symptoms of endosalpingiosis are not yet settled. Endosalpingiosis is almost always an incidental finding; it is commonly found through microscopic examinations, and is then confirmed by pathologists for excision and biopsy. Therefore, the clinical differential diagnosis of an intramural mass is more important for clinicians when discussing further surgery with the patients. We report case of woman who has endosalpingiosis and is presented with vaginal bleeding. We first suspect the disease during physical examination. Under the impression of pelvic mass, laboratory tests and radiological images of contrast enhanced chest computer tomography are taken. Images show multisepted cystic masses in left adnexa. To rule out the pelvic mass, we executed exploratory laparotomy. Pathologic results show endosalpingiosis near the ovary section. But the endosalpingiosis, is not generally considered a pathology, and thus, no treatment is necessary.
Sujets)
Sujet âgé , Femelle , Humains , Biopsie , Diagnostic différentiel , Endométriose , Épithélium , Maladies des trompes de Fallope , Trompes utérines , Gynécologie , Résultats fortuits , Infertilité , Laparotomie , Ménopause , Ovaire , Anatomopathologie , Douleur pelvienne , Examen physique , Thorax , Hémorragie utérineRésumé
To the general public, the Internet is an acceptable method of obtaining information. It also plays an important role in guiding patients and solving their problems. We investigated the clinical characteristics of an Internet website to provide guidelines and tips for consultation. In this retrospective observational study, we analyzed the use of a free public Internet perinatal consultation website provided by the Ministry of Health and Welfare of Korea. We evaluated 2,254 Internet perinatal consultations and assessments of prenatal and obstetrics from August 2006 to December 2009. We evaluated the patients' questions based on Williams' textbook categories and their clinical characteristics. The mean age of patients seeking consultation was 33.9 +/- 13.2 years, and parity was 1.2 +/- 0.5. The most commonly asked questions were about drug safety during pregnancy [20.4%], and questions regarding prenatal care [18.7%] and labor pain [15.4%] were the second and third most commonly asked questions, respectively. The Internet can provide good information to patients. Thus, guidelines regarding pregnancy-related questions and answers should be created. Obstetricians could use our data to identify question tendencies
Sujets)
Humains , Mâle , Femelle , Attitude , Internet , Orientation vers un spécialiste , Grossesse , Études rétrospectivesRésumé
OBJECTIVES: We investigated the relationship between bone mineral density (BMD) and hormone therapy (HT) and its duration in postmenopausal women. METHODS: We performed a retrospective study on 291 postmenopausal women who had their BMD and follow-up BMD measured in a university hospital. We analyzed BMD, HT types and HT duration according to clinical characteristics. RESULTS: The mean age of the study subjects was 53.7 +/- 5.9 years. HT types and HT duration were not statistically related to improvement in BMD (P = 0.956, 0.483). But osteoporosis in patients with hormone therapy improves bone mineral density showed statistical significance (P = 0.001). CONCLUSION: HT types and HT duration did not have any effect on bone mineral density, but further prospective multicenter studies regarding HT should be considered for osteoporosis.
Sujets)
Femelle , Humains , Densité osseuse , Études de suivi , Ostéoporose , Études rétrospectivesRésumé
OBJECTIVES: Phytoestrogen-containing pulse supplements have beneficial effects on postmenopausal symptoms, but how such effects are achieved is unclear. This study investigates the effects of pulse consumption on the menopausal changes in ovariectomized rats. METHODS: Female Sprague-Dawley rats were either sham operated (Sham; n = 3) or surgically ovariectomized (n = 13). The Sham group was fed the regular AIN-93M diet. Ovariectomized group was divided into 3 sub-groups and fed AIN-93M containing soybean (n = 5), mung bean (n = 3), or cowpea (n = 5) for 10 weeks. At the end of the experiment, all rats were sacrificed, and the uterus was harvested, rinsed, and weighed. Expressions of vitamin D receptor (VDR), estrogen receptor (ER) beta, and ezrin in uterus were evaluated by immunohistochemistry. RESULTS: VDR was highly expressed in the uterus of rat, irrespective of ovariectomized state. VDR was more definitely expressed in the uterus of ovariectomized groups than the sham-operated group. There were no significant differences in expression of ER beta. However the expression of ezrin was highly expressed in the cowpea group compared to sham group (P = 0.044). CONCLUSION: This study suggested that legumes diet may concern menopausal changes via VDR and ezrin. The result may partly explain the beneficial effects of VDR on menopausal symptoms. Further study is necessary to study the detailed mechanisms of VDR and ezrin on the menopausal changes in the uterus.
Sujets)
Animaux , Femelle , Humains , Souris , Rats , Protéines du cytosquelette , Régime alimentaire , Oestrogènes , Fabaceae , Ménopause , Rat Sprague-Dawley , Récepteur calcitriol , Salicylamides , Glycine max , Utérus , Vitamine D , VitaminesRésumé
Allogenic peripheral blood stem cell transplantation (Allo-PBSCT) is being used to treat hematological malignancies with increasing frequency. Graft-versus-host disease (GvHD) is a complex complication of PBSCT. A 43-year-old woman came to the gynecology clinic for amenorrhea. She had been diagnosed with acute myeloid leukemia 2 years earlier and treated with induction and consolidation chemotherapy. After developing complete remission, she underwent Allo-PBSCT. When she started chemotherapy, her menstrual cycle completely disappeared. Fourteen months after menopausal hormone replacement therapy, it was discovered that her upper vaginal canal was completely obstructed. The lower vagina had an atrophic appearance. We report a rare case of partial vaginal obstruction as a complication of chronic GvHD and review the literature. We expect that this case report provides an opportunity to remind clinician of the gynecologic complications of GvHD.
Sujets)
Femelle , Humains , Aménorrhée , Chimiothérapie de consolidation , Maladie du greffon contre l'hôte , Gynécologie , Hématocolpos , Tumeurs hématologiques , Hormonothérapie substitutive , Leucémie aigüe myéloïde , Cycle menstruel , Transplantation de cellules souches de sang périphérique , Porphyrines , VaginRésumé
Postpartum hemorrhage is the leading cause of severe maternal morbidity and death. A prompt management of uterine artery embolization [UAE] is important for a good outcome. UAE is generally accepted to be a safe and reliable procedure. To estimate critical patient characteristics influencing the success of UAE for the treatment of emergent primary postpartum hemorrhage. This was a cross sectional study that reviewed 121 patients who were diagnosed primary postpartum hemorrhage between February 2002 and December 2009 at a tertiary treatment center among 4,022 deliveries. We evaluated patient clinical characteristics associated with a successful surgical outcome of UAE. The success rate for UAE was 96%. For two cases, UAE complication was associated with fever [>38.5°C]. Five patients had problems that required admission to the intensive care unit [ICU]. To increase the surgical success rate and lower the number of ICU admissions, the decision to treat primary postpartum hemorrhage using UAE should be based on individual patient clinical findings under the direction of obstetrics staff and an interventional radiologist
Sujets)
Humains , Femelle , Hémorragie de la délivrance/chirurgie , Unités de soins intensifs , Période du postpartum , HystérectomieRésumé
OBJECTIVES: The objective of this study was to assess the efficacy of the Korean fracture-risk assessment tool (FRAX) model for routine application in women who had a general check-up for bone mineral density (BMD). METHODS: This retrospective study was conducted at a university hospital and comprised 343 patients, whose BMD and clinical risk factors were assessed for FRAX calculation. The 10-year probabilities of hip and major osteoporotic fractures were compared with the result of the FRAX(R) tool (http://www.shef.ac.uk/FRAX, web version 3.5) applied to Korean models developed at the World Health Organization Collaborating Center with or without femoral neck bone mineral density. RESULTS: The T-score gradually decreased with increasing age. Additionally, the 10-year probability of a major osteoporotic fracture increased with age. However, the probability of hip fracture showed no correlation with age if BMD was not included in the estimation. CONCLUSION: Previous report on patients whose probability of a proximal femoral fracture were calculated using Korean FRAX models produced a higher score than our data because our data involved a general population. A larger general population is needed to confirm the Korean FRAX model. However, our data provide information for physicians to assess the Korean FRAX model in the general female population.
Sujets)
Femelle , Humains , Densité osseuse , Fractures du fémur , Col du fémur , Hanche , Fractures ostéoporotiques , Études rétrospectives , Facteurs de risque , Organisation mondiale de la santéRésumé
OBJECTIVES: The objective of this study was to assess the efficacy of the Korean fracture-risk assessment tool (FRAX) model for routine application in women who had a general check-up for bone mineral density (BMD). METHODS: This retrospective study was conducted at a university hospital and comprised 343 patients, whose BMD and clinical risk factors were assessed for FRAX calculation. The 10-year probabilities of hip and major osteoporotic fractures were compared with the result of the FRAX(R) tool (http://www.shef.ac.uk/FRAX, web version 3.5) applied to Korean models developed at the World Health Organization Collaborating Center with or without femoral neck bone mineral density. RESULTS: The T-score gradually decreased with increasing age. Additionally, the 10-year probability of a major osteoporotic fracture increased with age. However, the probability of hip fracture showed no correlation with age if BMD was not included in the estimation. CONCLUSION: Previous report on patients whose probability of a proximal femoral fracture were calculated using Korean FRAX models produced a higher score than our data because our data involved a general population. A larger general population is needed to confirm the Korean FRAX model. However, our data provide information for physicians to assess the Korean FRAX model in the general female population.
Sujets)
Femelle , Humains , Densité osseuse , Fractures du fémur , Col du fémur , Hanche , Fractures ostéoporotiques , Études rétrospectives , Facteurs de risque , Organisation mondiale de la santéRésumé
Lichen sclerosus (LS) refers to a benign, chronic, progressive dermatologic condition that primarily causes anogenital lesions in middle aged women. But LS has been identifi ed in patients of all ages including those in the fi rst years of life. The risk of squamous cell carcinoma of the vulva is 4% to 5% in women with LS, and has been reported to be as high as 7% in some reviews. We recently encountered a case of LS in a post-menopausal woman without hormone therapy. To remind clinicians of the neglected issue of LS, we report a case of LS with literature review.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Carcinome épidermoïde , Lichen scléroatrophique , Lichens , Post-ménopause , VulveRésumé
The term rete ovarian cyst has been used mostly in animal pathology. Cysts of the ovarian hilus have been reported in experimental animals, but have not received attention in human beings. In the literature review, most women with these cysts were postmenopausal and the cysts were not malignancy. But, there have been some reports of hormonal imbalance associated with these cysts. This article reports the clinicopatholgical findings of a case of ovarian rete cyst in postmenopausal woman with some literature review.