No abstract available.
Drug Therapy* ; Humans ; Pseudouridine* ; Trophoblasts*

Adenomyotic cysts are not uncommon disease, but their sizes are mostly lesser 5 mm. Reports of large adenomyotic cyst ( >5 mm ) are vere rary. These large sized hemorrhagic cysts arise from small sized cyst and may be caused by progressive expansion of cyst due to progressive menstrual bleeding. And the active secreting of cystic wall may play a part in making the large cyst. Authors observed a case of large adenomyotic cyst within myometrium occuring in o 39-year-old woman, and she was accompanied with both ovarian endometriomas. The cyst was 3 *3 cm sized, and had chocolate-colored thick viscous contents. Histologically, cystic wall was lined with endometrial type epithelium. Epithelium were composed of single layer columnar, partly ciliated cells. Stroma under glandular epithelium were thin throughout the cyst and resembled morphologically endometrial stroma in endometriosis and had red cells and hemosiderin-laden macrophages in places. We experienced one case of large adenomyotic cyst, so we report the case with a brief review of the concerned literatures.
Adult ; Animals ; Cystectomy* ; Endometriosis* ; Epithelium ; Female ; Hemorrhage ; Humans ; Macrophages ; Mice ; Myometrium*

No abstract available.
Female ; Fertility* ; Pregnancy ; Pregnancy, Ectopic*

PURPOSE: This study was undertaken to evaluate the safety and usefulness of laparoscopic myomectomy compare to abdominal myomectomy in pregnancy outcome through estimating the uterine wall thickness in second, third trimester pregnancy and delivery. MATERIALS AND METHODS: Total number of patients underwent operations for intramural myomectomy in Department of Obstetrics and Gynecology in Chonnam University Hospital was 95. Patients underwent laparoscopic myomectomy(Group A) patients are 42 and abdominal myomectomy (Group B) are 53 patients. Age, parity, size of fibroid, number of fibroid, indications of myomectomy, pregnancy loss, delivery methods and complications during delivery were evaluated. Uterine wall thickness in second and third trimester pregnancy was measured by Aloka SSD-2000 sonography. RESULTS: Mean age of patients was 32.84.6 years in Group A and 32.45.1 years in Group B. Operation time, admission period and postoperative complications were not sinificantly different but operative blood loss was significantly small amount in Group A(p=0.001). Pregnancy rates was 47.6%(20/42) in Group A and 49.1%(26/53) in Group B after surgery(p=0.182). Successful delivery was 80%(16/20) in Group A and 76.9%(20/26) in Group B(p=0.182). Early pregnancy loss was 20%(4/20) in Group A and 19.2%(5/26) in Group B. Therefore pregnancy rates and successful delivery was not significantly different in Group A and B. Complications of pregnancy were premature rupture of membrane, preterm labor, pregnancy induced hypertension. There were no difference between Group A and B. In delivery methods, elective cesarean section was done 15 in Group A and 16 in Group B. Vaginal delivery was done 1 in Group A and 4 in Group B. Early pregnancy loss was 4 in Group A and 6 in Group B. Mean gestational weeks was 38.02.2 in Group A and 38.21.9 in Group B. In operative findings, adhesion was 5 in Group A and 7 in Group B at previous myomectomy site. Only one case was uterine wall thinning in Group B but maternal and fetal conditions were good. Mean uterine wall thickness was 4.2 2.5mm in Group A and 4.0 2.8mm in Group B at 2nd trimester, 4.0 2.7mm in Group A and 3.8 2.5mm in Group B at 3rd trimester, 4.0 2.5mm in Group A and 3.9 2.7mm in Group B at delivery. CONCLUSION: We conclude that pregnancy after laparoscopic myomectomy is safe, useful method comparable to abdominal myomectomy without increased risk of pregnancy loss and complications.
Cesarean Section ; Female ; Gynecology ; Humans ; Hypertension, Pregnancy-Induced ; Jeollanam-do ; Leiomyoma ; Membranes ; Myoma* ; Obstetric Labor, Premature ; Obstetrics ; Parity ; Postoperative Complications ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Pregnancy Trimester, Third ; Rupture

No abstract available.
Pseudouridine*

OBJECTIVE: To evaluate possibility of simplified hysteroscopic operation instead of resectoscopic operation on OPD basis for sumucosal myoma with small pedicle. MATERIALS AND METHODS: On twenty five patients, who diagnosed submucosal myoma with small pedicle by sonohysterogram and diagnostic hysteroscopy, simplified hyteroscopic operations were performed on OPD. Used expanding media was normal saline. At first, pedicle was incised by hysteroscopic scissors and myoma mass was dissected by pushing of scope. After dissection of myoma mass, remained pedicle was cut by hysteroscopic scissors. The bleeding from cut pedicle site was controlled by bipolar coagulation. Cut myoma mass was removed to outside of uterus by ring forceps. However if removal of myoma mass is failed, let it in uterine cavity and it is removed at second-look hysteroscopy 1 month later after degeneration. RESULTS: On 1 of 25 patients, cutting of pedicle was failed due to fundal invisible pedicle on hysteroscopic view. On 20 of 24 patients, pedicles were completely cut. On 12 of these 20 patients, myoma masses were completely removed to outside of uterus by grasping forceps. However on remained 8 of 20 patients, myoma mass was removed easily on second-look hysteroscopy 1 month later due to shrinkage of mass. On 4 of 24 patients, pedicles were not cut completely due to large submucosal myoma. They were removed also easily on second-look hysteroscopy. Postoperative bleeding from cutting pedicle was surprisingly minimal in most cases and moderate bleeding was only in 3 cases. Severe bleeding case was not observed. Preoperative GnRH agonist therapy had not so big benefit due to these minimal to moderate postoperative bleeding. CONCLUSION: Therefore simplified hysteroscopic operation on OPD basis for submucosal myoma with small pedicle should be considered before resectoscopic operation, because this simplified hysteroscopic operation has many benefit economically and psychologically to patients on submucosal myoma with small pedicle. It is better that resectoscopic operation is performed in failed case of this simplified operation.
Gonadotropin-Releasing Hormone ; Hand Strength ; Hemorrhage ; Humans ; Hysteroscopy* ; Linear Energy Transfer ; Myoma ; Surgical Instruments ; Uterus

OBJECTIVE: To estimate the efficacy of GnRH analogue on pain treatment after laparoscopic cystectomy of endometrioma. METHODS: During a 12-month period from March 2000 to February 2001 in Chonnam National University Hospital, Sixty five patients with ovarian cysts were diagnosed as endometrioma by clinical examination, ultrasonogram and serum CA 125 level. The laparoscopic cystectomy was performed and 65 consecutive women were biopsy-proved endometrioma. They were treated with GnRH analogue intramuscular injection every 4 weeks over a period of 6 months after operation. 10-point linear visual analogue scales for pelvic pain were completed pre- and post- treatment at 6 months and 12 months. RESULTS: A total of 96 endometriotic cysts (21 cysts were bilateral) were found in the 65 patients. 65 patients had a pain associated with endometriosis. 40 patients of them complained of a dysmenorrhea, 14 patients for dyspareunia, and 24 patients for non-menstrual pain. At preoperative, the mean pain score was 5.85 +/- 2.28 (mean +/- SD) for dysmenorrhea; for dyspareunia, 5.29 +/- 1.49; for non-menstrual pain, 5.33 +/- 2.10. At 6 months and 12 months, the mean pain score was 3.20 +/- 1.68 and 2.42 +/- 1.9 for dysmenorrhea; for dyspareunia, 3.71 +/- 1.73 and 3.57 +/- 1.79; for non-menstrual pain, 3.63 +/- 2.26 and 3.29 +/- 1.97. The mean pain score for pelvic pain decreased after combined treatment. CONCLUSION: The laparoscopic cystectomy of ovarian endometrioma is an effective treatment for pelvic pain and the combination therapy with GnRH analogue is more useful to relieving pelvic pain after operation.
Cystectomy* ; Dysmenorrhea ; Dyspareunia ; Endometriosis* ; Female ; Gonadotropin-Releasing Hormone* ; Humans ; Injections, Intramuscular ; Jeollanam-do ; Ovarian Cysts ; Pelvic Pain ; Ultrasonography ; Weights and Measures

No abstract available.
Adrenoleukodystrophy*

Microsatellites are short nucleotide repeat sequences present throughout the human genome. Alterations of microsatellites, comprising extra or missing copies of these se quences, have been termed microsatellite instability(MSI, genetic instability, replication errors, RER(+) phenotype). To date, at least four genes involved in DNA mismatch repair, hMSH2, hMLH1, hPMS1 and hPMS2, are thought to account for the observation of microsatellite instability in tumor from Hereditary nonpolyposis colorectal cancer (HNPCC) patients. The genetic defect responsible for the MIN+ phenotype in sporadic colorectal cancer, however, has yet to be clearly delineated. The purpose of this study was to determine the presence of MSI in sporadic cancer and to correlate its occurrence with clinicopathological parameters, we have studied six microsatellite loci by use of polymerase chain reaction amplification and denaturing polyacrylamide gel electrophoresis. We found that 20%(9 of 46 cases) sporadic colorectal cancers showed RER at two or several loci(RER+). Microsatellite instability was associated with location of the tumor in the proximal colon 66%(6 of 9 cases) and with poorly differentiated tumor phenotype 56%(5 of 9 cases). In order to better understand the role of somatic alterations within hMSH2 in the process of colorectal tumorigenesis, we examined the most conserved regions(codon 598~789) of this gene in nine patients with MIN spotadic colorectal cancer. 6 patient of RER(+) colorectal ca. patients had a polymorphism which was a T to C base change in the intron sequence at -6 position of the splice acceptor site at the 5'end of exon 13. This particular sequence variation is a polymorphism rather than a mutation which increase cancer susceptability. These data suggest that the genetic instability is detect ed in some colorectal cancers and play an important role in the pathogenesis of sporadic colorectal cancer.
Carcinogenesis ; Colon ; Colorectal Neoplasms* ; Colorectal Neoplasms, Hereditary Nonpolyposis ; DNA Mismatch Repair ; Electrophoresis, Polyacrylamide Gel ; Exons ; Genome, Human ; Humans ; Introns ; Microsatellite Instability* ; Microsatellite Repeats* ; Phenotype ; Polymerase Chain Reaction ; RNA Splice Sites

Chronic pelvic pain (CPP) is defined as lower abdominal pain lasting for at least 6 months. There are two forms of CPP: cyclic or continuous. The usual cyclic pain is dysmenorrhea. Dysmenorrhea is classified into primary and secondary. The primary dysmenorrhea is painful menstruation without any other pelvic disease. It can be treated by fat-free or omega-3-rich diet, quitting of smoking, nonsteroidal antiinflammatory drugs (NSAIDs), oral contraceptive pills, and long-acting injectable progestins. The most common origin of secondary dysmenorrhea and CPP is endometriosis. The management of pain of endometriosis can be controlled with stepby-step management of the original lesion by medical and surgical treatment, postoperative medical treatment, trigger point injection, NSAIDs, and immune therapy. Other etiologies of CPP are adenomyosis, pelvic congestion syndrome, abnormalities of uterus and ovary, psychological problems, gastrointestinal diseases (e.g. irritable bowel syndrome), urinary diseases (e.g. interstitial cystitis or chronic urethral syndrome), and musculoskeletal diseases. They can be treated by the management of the underlying diseases. The special form of CPP is chronic myofacial syndrome of the abdominal wall, which can be treated by trigger point injection. The other supportive treatments for CPP are laparoscopic adhesiolysis, uterine suspension, laparoscopic uterosacral nerve ablation (LUNA), presacral neurectomy, and hysterectomy. The treatment of CPP is very difficult. Therefore the exact diagnosis of its origin is necessary, and the combination treatment in various aspects is needed.
Abdominal Pain ; Abdominal Wall ; Adenomyosis ; Anti-Inflammatory Agents, Non-Steroidal ; Cystitis, Interstitial ; Diet ; Dysmenorrhea ; Endometriosis ; Estrogens, Conjugated (USP) ; Female ; Gastrointestinal Diseases ; Hysterectomy ; Musculoskeletal Diseases ; Ovary ; Pelvic Pain ; Piperazines ; Progestins ; Smoke ; Smoking ; Trigger Points ; Uterus