• Title/Summary/Keyword: 자궁

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Adjuvant Postoperative Radiation Therapy for Carcinoma of the Uterine Cervix (자궁경부암의 수술 후 방사선치료)

  • Lee Kyung-Ja;Moon Hye Seong;Kim Seung Cheol;Kim Chong Il;Ahn Jung Ja
    • Radiation Oncology Journal
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    • v.21 no.3
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    • pp.199-206
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    • 2003
  • Purpose: This study was undertaken to evaluate the efficacy of postoperative radiotherapy, and to investigate the prognostic factors for FIGO stages IB-IIB cervical cancer patients who were treated with simple hysterectomy, or who had high-risk factors following radical hysterectomy and pelvic lymph node dissection. Materials and Methods: Between March 1986 and December 1998, 58 patients, with FIGO stages IB-IIB cervical cancer were included in this study. The indications for postoperative radiation therapy were based on the pathological findings, including lymph node metastasis, positive surgical margin, parametrial extension, lymphovascular invasion, invasion of more than half the cervical stroma, uterine extension and the incidental finding of cervix cancer fellowing simple hysterectomy. All patients received external pelvic radiotherapy, and 5 patients, received an additional intracavitary radiation therapy. The radiation dose from the external beam to the whole pelvis was $40\~50$ Gy. Vagina cuff Irradiation was peformed, after completion of the external beam irradiation, at a low-dose rate of Cs-137, with the total dose of $4488\~4932$ chy (median: 4500 chy) at 5 mm depth from the vagina surface. The median follow-up period was 44 months ($15\~108$ months). Results: The 5-yr actuarial local control rate, distant free survival and disease-free survival rate were $98\%,\;95\%\;and\;94\%$, respectively. A univariate analysis of the clinical and pathological parameters revealed that the clinical stage (p=0.0145), status of vaginal resection margin (p=0.0002) and parametrial extension (p=0.0001) affected the disease-free survival. From a multivariate analysis, only a parametrial extension independently influenced the disease-free survival. Five patients ($9\%$) experienced Grade 2 late treatment-related complications, such as radiation proctitis (1 patient), cystitis (3 patients) and lymphedema of the leg (1 patient). No patient had grade 3 or 4 complications. Conclusion: Our results indicate that postoperative radiation therapy can achieve good local control and survival rates for patients with stages IB-IIB cervical cancer, treated with a simple hysterectomy, as well as for those treated with a radical hysterectomy, and with unfavorable pathological findings. The prognostic factor for disease-free survival was invasion of the parametrium. The prognosic factor identified in this study for treatment failure can be used as a selection criterion for the combined treatment of radiation and che motherapy.

Postpartum Reproductive Tract Recovery and Prevalence of Health Problems in Dairy Cows (젖소의 분만 후 생식기의 회복 및 질병 발생 조사)

  • Jeong, Jae-Kwan;Choi, In-Soo;Kang, Hyun-Gu;Jung, Young-Hun;Hur, Tai-Young;Kim, Ill-Hwa
    • Journal of Veterinary Clinics
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    • v.32 no.2
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    • pp.168-173
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    • 2015
  • This study estimated the degree of uterine inflammation and resumption of ovarian cyclicity in postpartum dairy cows. In addition, the prevalence of health problems during calving and the postpartum period was investigated. A total of 224 Holstein dairy cows from four dairy farms in Chungcheong Province were used for the study. Uterine discharge was scored on a 0 to 5 rank scale (metricheck score) using a metricheck instrument from 1 to 8 weeks postpartum and uterine cytology (neutrophil level) was examined at 4, 6 and 8 weeks postpartum to evaluate uterine inflammation. Resumption of ovarian cyclicity was evaluated based on progesterone analysis (${\geq}1ng/mL$) at 4, 6 and 8 weeks postpartum. Postpartum disorders were diagnosed by veterinarians in the research team. The metricheck score decreased linearly (p < 0.0001) from weeks 1 ($3.4{\pm}0.1$) to 4 ($2.0{\pm}0.1$) postpartum, and then remained at that level through week 8 postpartum ($1.6{\pm}0.1$, p > 0.05). The neutrophil levels determined by uterine cytology assays also decreased (p < 0.0001) from week 4 ($22.3{\pm}1.8%$) to 6 ($12.1{\pm}1.4%$) postpartum, and then remained at that level through week 8 postpartum ($9.2{\pm}1.4%$, p > 0.05). The proportion of cows exhibiting the ovarian cyclicity increased linearly (p < 0.0001) from weeks 2 (12.1%) to 8 (74.3%) postpartum. The prevalence of dystocia and retained placenta were 20.5% and 30.4%, respectively. The prevalence of ketosis, milk fever, abomasal displacement, septicemic metritis, endometritis, subclinical endometritis, pyometra, and ovarian cysts were 18.8%, 3.6%, 4.0%, 36.2%, 29.5%, 17.0%, 4.5%, and 14.7%, respectively. The prevalence of digestive problems and mastitis were 5.4% and 9.6%, respectively. The prevalence of culling and death were 4.0% and 3.6%, respectively. The prevalence of dystocia, retained placenta, septicemic metritis, endometritis, ovarian cysts, digestive problems, mastitis, and culling differed among farms (p < 0.05 to 0.01). In conclusion, proper examinations for uterine inflammation and ovarian cyclicity during 4 to 8 weeks postpartum are useful clinical tools to maintain herd reproductive health. Dystocia, retained placenta, septicemic metritis, and endometritis were predominant disorders in dairy cows of the survey area.

Studies on the Cyclic AMP Concentration and Uterine Tissue Differentiation During the Early Pregnancy of Rats (초기 임신기간중 흰쥐의 자궁조직 분화와 Cyclic AMP 농도에 관하여)

  • Kim, Sung-Rye;Ryu, Kyung-Za;Cho, Wan-Kyoo
    • Clinical and Experimental Reproductive Medicine
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    • v.11 no.2
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    • pp.41-49
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    • 1984
  • It has been well known that ovarian steroids, estradiol and progesterone play an important role in the endometrial preparation for the implantation process. The present investigation was undertaken to correlate function of ovarian steroids with cAMP concentrations in uterine tissues of rat during the various stages of the preimplantation period. Rats ovariectomized on day 2 were treated with estradiol or/and progesterone on day 3 or on day 4 and cAMP concentrations in uterine tissues were determined by competitive protein - binding assay in control - and steroid treated - ovariectomized rats. The results obtained are as follows; 1. In control rats, cAMP concentrations in uterine tissues were decreased with preimplantation period proceeded whereas cAMP concentrations were increased and showed the highest levels on day 6 in ovariectomized rats. 2. In rats treated with progesterone only or progesterone with estradiol after ovariectomy, cAMP concentrations on day 6 were lower than those of ovariectomized control but higher than those of intact control rats while estradiol only treatment decreased cAMP concentrations on day 3 and day 6, compared with those from intact- and ovariectomized-controls. It is, therefore, concluded that the concentrations of cAMP in uterine tissues were lower in estrogen-treated rats than in ovariectomized rats, suggesting the involvement of cAMP in the regulation of uterine tissue differentiation.

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Alteration in Two-pore Domain K$^+$ Channel Expression in Endometrium of Pregnant Korean Cattle (임신 자궁 내막에서 Two-pore Domain 칼륨 통로의 발현 변화)

  • Choe, Chang-Yong;Tak, Hyun-Min;Kim, Chang-Woon;Han, Jae-Hee;Kang, Da-Won
    • Journal of Embryo Transfer
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    • v.26 no.3
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    • pp.209-214
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    • 2011
  • Endometrium undergoing hormonal change plays important roles in preparation for implantation, fetal growth, and well-being. During pregnancy, cellular remodeling and hormonal changes in endometrium could change two-pore domain K$^+$ channel (K$_{2P}$) expression. This study was performed to identify whether K$_{2P}$ channel expression is changed in endometrium of pregnant Korean cattle, and whether the expression level is modulated by progesterone treatment. We investigated changes in the mRNA and protein expressions of K$_{2P}$ channel in pregnant endometrium using RT-PCR and Western blot analyses. The expression levels of all K$_{2P}$ channel mRNAs tested in this study, except that of TREK-1, were changed in the pregnant endometrium. mRNA levels of TASK-3 and TRAAK were significantly down-regulated, whereas those of TREK-2 and TRESK were up-regulated in the pregnant endometrium. In parallel with the RT-PCR results, Western blot analysis revealed up-regulations of TREK-2 (7.9-fold) and TRESK (2-fold) proteins levels in the pregnant endometrium. In addition, TREK-2 and TRESK protein levels were up-regulated in bovine endometrial cells by progesterone treatment (10 ${\mu}g$/ml). From these results, we suggest that the up-regulation of TREK-2 and TRESK by progesterone may contribute to the regulation of physiological changes during pregnancy.

Regulation of LIF Gene Expression by Interleukin-1 in the Mouse Peri-implantation Embryos and Uterine Endometrial Cells (생쥐의 착상시기 배아와 자궁내막세포에서 IL-1에 의한 LIF 유전자 발현 조절)

  • Lee, Jung-Bok;Kim, Joung-Woul;Oh, Eun-Jeong;Yang, Hye-Young;Ryu, Hyoung-Eun;Lee, Ji-Youn;Gye, Myung-Chan;Yoon, Hyun-Soo;Kim, Moon-Kyoo
    • Clinical and Experimental Reproductive Medicine
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    • v.27 no.2
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    • pp.183-190
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    • 2000
  • 연구목적: 포유류의 착상은 배아가 모체의 자궁벽에 매몰되는 현상으로 부착과 침투 과정을 거쳐 진행되며, 이 과정은 스테로이드 호르몬, 성장인자, 세포점착분자, 그리고 cytokine 등의 상호작용으로 이루어진다. 이 시기에 Interleukin-1 (IL-1)과 leukemia inhibitory factor (LIF) 등이 발현되는 것으로 알려져 있다. 본 실험에서는 이들의 발현이 착상과정에 어떠한 역할을 하는지 그 상관관계를 알아보고자 하였다. 재료 및 방법: 착상 전후의 배아와 자궁내막세포에서 LIF 유전자의 발현양상과 $IL-1{\beta}$와 IL-1 receptor antagonist (IL-1ra)를 처리한 LIF 유전자의 발현양상을 역전사중합효소연쇄반응 (RT-PCR)을 통해 비교하였다. 결과: 배아에서의 LIF 유전자 발현은 in vivo와 in vitro 모두에서 상실기와 포배기에 발현되었고, 자궁내막에서는 임신 1일과 4일째에 발현되었는데, 상실기보다는 포배기에, 그리고 임신 1일보다는 착상시기인 4일째의 자궁내막세포에서 발현양이 많은 것으로 나타났다. 자궁내막세포를 배양한 경우 LIF 유전자는 in vivo에서의 발현양상과 동일하게 임신 1일과 4일에 발현되었으며, 배양액에 $IL-1{\beta}$(500pgml)를 처리하였을 경우 LIF 유전자가 초기 임신 (1~5일) 중 발현되는 것으로 나타났다. 2-세포기 배아의 배양시에 $IL-1{\beta}$를 처리한 경우 8-세포기부터 LIF 유전자가 발현되었으며, 또한 IL-1ea(60 ng/ml)를 배양액에 첨가하였을 경우에는 임신1일째 자궁내막에서는 LIF 유전자가 발현되지 않은 반면, 임신 4일째의 자궁내막세포와 상실기, 포배기 배아 모두에서 LIF 유전자 발현이 감소하는 경향을 보였다. 결론: 이러한 결과는 착상 전후 배아와 자궁내막세포에서 IL-1에 의해 LIF 유전자 발현이 조절되며, 그 결과 착상에 영향을 줄 수 있다는 것을 의미한다. 또한 배아와 자궁내막세포에서 IL-1이 LIF 유전자 발현에 영향을 주는 것으로 보아 착상을 위해 IL-1과 LIF의 상호작용이 중요한 요인이라는 것을 확인할 수 있었다.

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The Efficacy of Letrozole in Women with a Poor Endometrial Response to Clomiphene Citrate (클로미펜에 불량한 자궁내막 발달을 보이는 여성에서 레트로졸의 유용성)

  • Jang, Eun-Jeong;Jee, Byung-Chul
    • Clinical and Experimental Reproductive Medicine
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    • v.37 no.1
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    • pp.73-81
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    • 2010
  • Objective: To examine the efficacy of letrozole in infertile women showing a poor endometrial development at previous ovulation induction cycle by using clomiphene citrate. Methods: Eighteen infertile women were selected who showed a poor endometrial development (endometrial thickness$\leq$6.5 mm) after clomiphene treatment (50~100 mg) as ovulation induction for timed coitus. The mean age of the patients was $30.7{\pm}2.8$ years old and the mean duration of infertility was $33.1{\pm}26.6$ months. The infertility factors were identified as corrected endometriosis (n=1), polycystic ovary syndrome (n=5) and unexplained (n=12). Letrozole was given orally in a dose of 2.5 mg for 5 days starting 3~5 of menstrual cycle. Results: The number of follicles was significantly lower in the letrozole cycle when compared with previous clomiphene cycle ($1.1{\pm}0.3$ vs. $2.2{\pm}1.5$, p=0.011). The endometrial thickness (mm) at the time of triggering or LH surge was significantly greater in the letrozole cycle ($8.4{\pm}1.7$ vs. $5.8{\pm}0.5$, p<0.001). The endometrial pattern 'type C' was significantly higher in the letrozole cycle (94.4% vs. 50%, p=0.036). The pregnancy was achieved in 11.1% of the letrozole cycle. Conclusion: Use of letrozole was associated with more thick and improved endometrium than previous clomiphene cycles in which thin endometrium was identified. Use of letrozole appears to be an effective strategy for second-line treatment in women with inadequate endometrial response to clomiphene.

Gynecologists' perception of High-Intensity Focused Ultrasound as a treatment for uterine leiomyomas (자궁근종의 치료로서 고강도 집속 초음파 치료에 대한 부인과 의사의 인식에 대한 연구)

  • Kim, Nam Kyeong;Choi, Yae Ji;Lee, Yeji;Hwang, Sung Il;Kim, Kidong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.5
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    • pp.221-228
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    • 2021
  • Recently, there has been an increased awareness on the use of High-Intensity Focused Ultrasound (HIFU) as a non-surgical treatment option for leiomyomas. This study aimed to assess gynecologists' perception of HIFU therapy for uterine leiomyomas in Korea. We analyzed questionnaires from 162 Korean gynecologists who provided data on 1) demographics, 2) pattern of practice with respect to leiomyomas, and 3) opinion regarding HIFU therapy for leiomyomas. Of the 162 gynecologists, 2.8 % regarded HIFU as a first-line treatment for leiomyomas. HIFU was only available at the workplace of 19 % of respondents; of these, 58 % had requested the use of HIFU. When asked about their perception of HIFU for treating leiomyomas, only 19 % of the respondents thought that it was effective. The commonest perceived complication was a delay in the adequate treatment of sarcoma (59 %), followed by bowel injury (52 %). The respondents considered HIFU to be suitable in the following circumstances: age between 40 and 49 years, those patients who no longer desired pregnancy, medium-sized (5-6 cm) leiomyomas, and up to 2 leiomyomas. The Korean gynecologists' perception of HIFU as a treatment for leiomyomas is still not favorable. Gynecologists working at hospitals where HIFU is available tended to have a higher positive perception of this treatment. In addition to research involving a large number of gynecologists from multiple countries, a study on the long-term outcomes of HIFU is needed.

The EST Study of the Peri-implanting Porcine Embryos (Peri-implanting 단계의 돼지배아 EST 연구)

  • Kwak, In-Seok
    • Journal of Life Science
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    • v.19 no.5
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    • pp.587-592
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    • 2009
  • A dramatic morphological change of embryos occurs at peri-implantation. Maternal and embryonic cross-talk during this period, initiated by signals from embryo(s), provides signals for maternal recognition of pregnancy and establishing and maintaining the pregnancy. However, the cellular, biochemical and genetic processes that direct embryo remodeling in mammalian species are not well studied or understood. In order to identify potential genes responsible for morphological change and cross-talk between embryo and uterus, an initial EST analysis was performed. A catalog of expressed genes (Transcriptome) from the d12 peri-implanting porcine embryos was constructed. Six clones were chosen from the initial ESTs for elucidation of their expression patterns during embryogenesis in early pregnancy. A number of these genes demonstrated unique expression profiles in a tissue, cell-type, and temporal fashion, indicating dynamic regulation of embryonic and endometrial gene expressions at different stages of pregnancy. Cross-talk between the embryo and endometrium of the pregnant uterus has provided a suitable micro-environment for the embryo's rapid and dramatic morphological changing process at the peri-implantation stage.

Spatholobi Caulis Herbal-acupuncture Solution Induced Apoptosis in Human Cervical Cancer Cells, SNU-17 (계형등 약침액이 자궁경부암 세포주 SUN-17의 세포 사멸에 미치는 효과)

  • Seo, Bo-Myung;Lee, Yoon-Kyung;Lee, Bong-Hyo;Lee, Kyung-Min;Lim, Seong-Chul;Jung, Tae-Young;Seo, Jung-Chul
    • Journal of Acupuncture Research
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    • v.24 no.4
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    • pp.107-113
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    • 2007
  • 목적 : 본 연구는 계혈등 약침액이 자궁경부암 세포주 SNU-17에서 세포 사멸 효과가 있는지 알아보고자 하였다. 방법 : 자궁경부암 세포주 SNU-17에서 세포 사멸의 변화를 관찰하기 위해서 MTT cytotoxicity assay, DAPI staining, TUNEL assay, RT-PCR analysis 방법을 이용하였다. 결과 : 세포독성 검사에서 계혈등 약침액은 자궁경부암 세포주 SNU-17에 농도 의존적으로 세포독성을 나타내었다. 이러한 계혈등 약침액의 세포독성이 세포사별로 인한 것인지 다른 기전에 의한 것인지 알아본 결과 계혈등 약침액에 의한 세포독성은 DAPI staining 과 TUNEL assay에서 세포사멸의 특정적인 소견들을 나타내었다. 계혈등 약침액이 Bax, Caspase-3의 발현에 미치는 영향을 RT-PCR로 관찰한 결과 계혈등 약침액은 Bax, Caspase-3의 발현을 증가시켰다. 결론 : 이상의 결과 계혈등 약침액이 자궁경부암 세포주 SNU-17에서 세포 사멸을 야기하여 자궁경부암의 치료에 유용할 것으로 사료된다.

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Assessment of Radiation Dose for Surrounding Organs and Persons Approaching Patients upon Brachytherapy of Cervical Cancer with $^{192}Ir$ ($^{192}Ir$를 사용한 자궁경부암 치료시 주변 장기 및 근접한 사람의 선량 평가)

  • Kang, Se-Sik
    • Journal of radiological science and technology
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    • v.33 no.3
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    • pp.283-288
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    • 2010
  • In order to evaluate radiation dose on the uterus and surrounding organs during brachytherapy for cervical cancer, of which the frequency of occurrence is high in Korean women, as well as radiation dose on medical staffs in proximity of patients receiving the therapy, a mathematical phantom based on reference Korean was established and the radiation dose was calculated accordingly. For simulation, $^{192}Ir$, which is useful in brachytherapy, was selected as radionuclide. Also, it was presumed that the intensity of initial radiation was 1 Ci. The result indicated the radiation of 4.92E-14 Gy/Ci in the uterus, the source organ. In addition, radiation on people around patient receiving the therapy was found to be 1.24E-07 Sv at a distance of 30 cm.