OBJECTIVETo evaluate the possibility of vaginal hysterectomy for patients with moderately enlarged uterus of benign lesions.

METHODSOne hundred and seventeen women with benign uterine diseases underwent vaginal hysterectomy. These patients were divided into two groups according to uterine weight. Group I contained 60 patients with uterine enlargement to a weight of 200 to 750 g, and group II contained 57 patients with uterine weight of less than 200 g. Uterine morcellation was performed in some cases. The perioperative data in both groups were analyzed.

RESULTSIn group I, 59 cases underwent transvaginal hysterectomy successfully, except 1 case converted to abdominal operation and the uterine morcellation was performed in 21 women. In group II, all patients successfully underwent transvaginal hysterectomy without any assistance of special technique. The mean uterine weight of group I was significantly heavier than that of group II (280.18 +/- 100.40 g vs 146.48 +/- 35.19 g). The mean operating time was significantly longer for group I than that for group II (83.93 +/- 26.26 minutes vs 35.22 +/- 20.55 minutes). There were no significant differences in blood loss and complications between group I and group II. There was no injury of urinary bladder or rectum, and no vaginal vault infection.

CONCLUSIONSVaginal hysterectomy of moderately enlarged uterus can be safely and effectively performed by experienced operators. In some cases, in order to reduce the uterine volume, uterine morcellation should be used to shorten operative time, reduce the bleeding, and lower the postoperative complications.

Female ; Humans ; Hysterectomy, Vaginal ; Organ Size ; Treatment Outcome ; Uterine Diseases ; pathology ; surgery ; Uterus ; pathology

"Cotyledonoid dissecting leiomyoma" or "Sternberg tumor" is a very rare variant of smooth muscle tumors with a distinctive gross appearance. We describe a similar lesion, probably the sixth reported case, comparing its clinicopathological features with those of previous cases. A 26-yr-old nulliparous woman underwent laparotomy for a large pelvic mass replacing the postero-lateral aspect of the uterus with extension into the left pelvic cavity in the form of numerous exophytic congested small nodules. The tumor was removed by resection without hysterectomy after frozen section examination. Histologically, there were variable sized micronodules of benign smooth muscle fascicles, which were separated by fibrous connective tissue with a marked hydropic change and rich vascularity. Immunohistochemical and ultrastructural studies were helpful for confirmation of the smooth muscle nature, but not useful for the definitive diagnosis. Due to bizarre, sarcoma-like gross appearances, this type of lesion should be subjected to frozen section examination in order to avoid overtreatment and preserve the fertility in young women.
Adult ; Female ; Humans ; Immunohistochemistry ; Laparotomy ; Leiomyoma/*diagnosis/*pathology ; Microscopy, Electron ; Uterine Diseases/*diagnosis/*pathology ; Uterine Neoplasms/*diagnosis/*pathology ; Uterus/pathology/ultrastructure

Fourier transformation infrared microspectroscopy (FTIR-MSP) mapping technique can collect the infrared information from micro-samples and scan the tissue slides and cells. The infrared spectral information of pixels from the collected regions is recorded and infrared spectral maps are constructed by computer software. The 2D and 3D mapping images are reflected based on the distributions of absorbance bands. The biochemical compositions, molecular distribution, metabolic changes of tissues and cells are analyzed by the technique due to infrared spectroscopy being sensitive to biomolecules. The article reviews the recent research of FTIR-MSP mapping and explores the future potential value in forensic science practice.
Cervix Uteri/pathology* ; Female ; Forensic Pathology/methods* ; Genital Diseases, Female/pathology* ; Humans ; Spectroscopy, Fourier Transform Infrared ; Uterine Cervical Neoplasms/pathology*

To evaluate the long term effects of an IUD on the human endometrium and find the possible contraceptive mechanism of IUD, histologic, histochemical and ultrastructural studies of human endometrial biopsies from 44 normal controls and 178 IUD wearers were made. Histologic findings included interstitial hemorrhage, inflammatory reaction, hyperplasia, atrophy, focal necrosis and squamous metaplasia. However, all of these findings were either infreqnent or insignificant except for inflammatory reaction. Histochemica1, enzymatic and ultrastructural findings were a1so unremarkable. The most significant finding, was asynchronism between cyclic dating and endometrial histologic dating, showing delayed endometrial maturation in the majority of IUD users. In summary, IUD insertion brings about mild and little histologic alteration in the human endometrium, but the inflammatory reaction and asynchronous endometrial matruation may play some role in the antifertility actifertility action of an IUD.
Adult ; Comparative Study ; Endometriosis/etiology ; Endometriosis/ultrastructure ; Endometrium/ultrastructure* ; Female ; Human ; Intrauterine Devices/adverse effects* ; Middle Age ; Time Factors ; Uterine Diseases/etiology* ; Uterine Diseases/pathology

Adolescent ; Adult ; Breast Neoplasms ; pathology ; Carcinoma ; pathology ; Diagnosis, Differential ; Endothelium, Vascular ; pathology ; Fasciitis ; pathology ; Female ; Hemangiosarcoma ; pathology ; Histiocytoma, Malignant Fibrous ; pathology ; Humans ; Hyperplasia ; pathology ; Leiomyoma ; pathology ; Leiomyosarcoma ; pathology ; Middle Aged ; Soft Tissue Neoplasms ; pathology ; Uterine Neoplasms ; pathology ; Vascular Diseases ; pathology

OBJECTIVE: To investigate the expression of apoptosis related proteins and apoptotic cells on the human ovarian follicles. MATERIALS AND METHODS: Thirty five Formalin-fixed paraffin-embedded human ovarian tissue blocks were selected from the surgical pathology files of the department of pathology, College of Medicine, Yonsei University, for the period from 1996 to 1998. All specimen were from premenopausal women aged from 32~45. Ovarian tissues were collected from the patients performing hysterectomy for benign uterine diseases. Immunohistochemical staining was performed for the detection of DNA fragmented cell, Bcl-2, Bax, Fas and Fas-ligand. RESULTS: Bcl-2 and bax were not expressed on the surrounding cells and oocyte of the primary, primordial and preantral follicles. Fas and Fas-ligand (Fas-L) were not expressed on the surrounding cells on the primordial and primary follicles. But expressed on the surrounding granulosa cells and oocyte in the primordial and primary follicles. In the healthy follicles, Bcl-2 was expressed on the granulosa cells, however, Bax was not expressed. DNA fragmented cells were expressed on the inner granulosa cell layer of atretic follicles. CONCLUSION: Fas, Fas-ligand, and Bax may be responsible for the follicular atresia and Bcl-2 may be involved in the follicular survival in the human ovary.
Apoptosis* ; DNA ; Female ; Follicular Atresia ; Granulosa Cells ; Humans* ; Hysterectomy ; Oocytes ; Ovarian Follicle* ; Ovary ; Pathology ; Pathology, Surgical ; Uterine Diseases

The pathogenesis and therapeutic treatment of intrauterine adhesions (IUAs) remain unsolved, highlighting the need for stable and effective experimental animal models. In this study, uterine electrocoagulation of twenty-one female New Zealand White rabbits was carried out to establish an IUA model. As rabbits have two completely separate uterine horns, each rabbit had its own internal control: one uterine horn was given an electrothermal injury (Group A, n=21), and the contralateral uterine horn received no treatment and served as the control (Group B, n=21). The endometrial morphology, number of endometrial glands, area of endometrial fibrosis, and number of implanted fetuses were compared between the two groups. In Group A, the numbers of endometrial glands on Days 7 and 14 and the number of implanted fetuses were significantly lower than those in Group B (P<0.05, P<0.05, and P<0.01, respectively), while the ratio of the area with endometrial stromal fibrosis to the total endometrial area was significantly increased (P<0.01). These results suggest that this method of electrothermal injury is effective for the establishment of a rabbit IUA model between 7 and 14 d after surgery.
Animals ; Disease Models, Animal ; Electrocoagulation ; Endometrium ; pathology ; Female ; Pregnancy ; Rabbits ; Tissue Adhesions ; etiology ; pathology ; therapy ; Uterine Diseases ; etiology

Endosalpingiosis is a non-neoplastic proliferation of ectopic tubal epithelium. It may be found incidentally or the patients may present with chronic pelvic pain. It may resemble a gynecologic malignancy on imaging findings and clinicians and radiologists should be aware of this benign entity to render a correct diagnosis and to avoid over-treatment. We report here the MR imaging appearance of a case of florid cystic endosalpingiosis.
Adult ; Diagnosis, Differential ; Endometriosis/*diagnosis/pathology/surgery ; Fallopian Tube Diseases/*diagnosis/pathology/surgery ; Female ; Humans ; Magnetic Resonance Imaging/*methods ; Uterine Diseases/*diagnosis/pathology/surgery

Adult ; Female ; Humans ; Lupus Erythematosus, Systemic ; pathology ; physiopathology ; Pelvic Organ Prolapse ; pathology ; physiopathology ; Uterine Diseases ; pathology ; physiopathology ; Uterus ; pathology ; physiopathology ; Young Adult

Adenoma ; metabolism ; pathology ; Biomarkers, Tumor ; metabolism ; Cystadenocarcinoma ; pathology ; Cystitis ; metabolism ; pathology ; Endometriosis ; immunology ; pathology ; Fallopian Tube Neoplasms ; pathology ; Female ; Humans ; Intestines ; pathology ; Keratin-7 ; metabolism ; Male ; Metaplasia ; pathology ; Racemases and Epimerases ; metabolism ; Urinary Bladder Neoplasms ; metabolism ; pathology ; Uterine Diseases ; immunology ; pathology