• Title/Summary/Keyword: Ovarian

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The Efficacy of Estrogen-Progesterone Therapy and Transvaginal Aspiration of Ovarian Cysts (난소 난종 환자에서의 Estrogen-Progesterone 치료 및 질식 난소 낭종 천자에 관한 연구)

  • Moon, S.Y.;Kim, S.H.;Hwang, T.Y.;Shin, C.J.;Kim, J.G.;Lee, J.Y.;Chang, Y.S.
    • Clinical and Experimental Reproductive Medicine
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    • v.16 no.1
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    • pp.57-68
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    • 1989
  • Some infertile patients who need IVF-ET for conception have small ovarian cysts diagnosed in pelvic ultrasonography. It is well known that it is impossible or very difficult to perform controlled ovarian hyperstimulation(COH) for such patients because of the poor ovarian response or the possibility of ovarian hyperstimulation syndrome(OHSS). To remove or to decrease the size of ovarian cysts, estrogen and progesterone (E-P) therapy with oral contraceptives for 2 cycles and transvaginal aspiration of ovarian cysts using transvaginal ultrasonography were performed in 36 IVF-cancelled infertile patients with ovarian cysts from February to October, 1988 at Seoul National University Hospital. Thirty-nine ovarian cysts($32.8{\pm}9.6$mm in mean diameter) were treated with E-P therapy, and their size decreased to $28.2{\pm}11.0mm$ after 1 cycle and significantly to $24.8{\pm}14.7mm$ after 2 cycles. After E-P therapy for 2 cycles, 7(17.9%) ovarian cysts disappeared in ultrasonography, 9(23.1%) decreased in size significantly, 18(46.2%) had no change in size and 5(12.8%) increased in size. Thirty-two ovarian cysts($30.2{\pm}9.7mm$) in 30 patients were aspirated transvaginally, and there was no significant decrease in size after follow-up transvaginal ultrasonography($27.8{\pm}12.5mm$). After transvaginal aspiration, 3(9.4%) ovarian cysts disappeared and 28(87.5%) had no change in size. The mean amount of the transvaginally aspirated cystic fluids was $19.6{\pm}13.2ml$, and there was no malignant cells in aspiration cytology. Four endometrioid cysts, one dermoid cyst and one mucinous cyst could be diagnosed in consideration of the findings of transvaginal ultrasonography and the characteristics and cytology of aspirated fluids. Therefore E-P therapy and transvaginal aspiration of ovarian cysts had made it possible to restart IVF program earlier in the IVF-cancelled patients with ovarian cysts.

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Does Human Epididymis Protein 4 (HE4) Have a Role in Prediction of Recurrent Epithelial Ovarian Cancer

  • Innao, Pedrada;Pothisuwan, Methasinee;Pengsa, Prasit
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4483-4486
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    • 2016
  • Background: Despite the fact that ovarian cancer is the seventh most common cancer in women worldwide and the fifth leading cause of cancer death, It is the most common cause of death due to reproductive cancers in Thailand where epithelial ovarian cancer (EOC) is commonly found. According to a Thai statistical analysis in 2010 by the Department of Medical Services, epithelial ovarian cancer was the sixth most common cancer in Thailand from 2001to 2003.The incidence of 5.1 per 100,000 women per year. Human epididymis protein 4 (HE4) is a novo diagnostic tumor marker for EOC. The combination of HE4 and carcinoma antigen 125 (CA 125) is a tool for detecting epithelial ovarian cancer (EOC) better than using CA 125 alone. Therefore, the researcher is interested in HE4 does have a role to predict recurrent epithelial ovarian cancer. Materials and Methods: The patients who had complete response after diagnosed with epithelial ovarian cancer by pathology, FIGO stage 3 or more had been treated through surgery and chemotherapy at the Sunpasitthiprasong Hospital from June 2014 until March 2016. The patients were followed up every three months, using tumor marker (CA 125, HE4,Carcinoma antigen 19-9) together with other checkup methods, such as rectovaginal examination, CXR every year and other imaging as indication. Afterwards, the data was analyzed for the ability of HE4 to detect recurrence of epithelial ovarian cancer. Results: In 47 patients in this study follow-up for 22 months after complete response treatment from surgery and chemotherapy in epithelial ovarian cancer, 23 had recurrent disease and HE4 titer rising. The patients with recurrent epithelial ovarian cancer demonstrated high levels of both HE4 and CA125 with sensitivity of 91.3% and 52.7% respectively, specificity of 87.5% and 95.6% and positive predictive values of 87.5% and 85.7%. HE4 can predict recurrent epithelial ovarian cancer (p-value=0.02242). Comparing HE4 and CA125 in predicting recurrent epithelial ovarian cancer HE4 had more potential than CA125 (p-value =0.8314). Conclusions: The present study showed HE4 to have a role in predicting recurrent epithelial ovarian cancer and HE4 is potentially better than CA125 as a marker for this purpose.

Ovarian stimulation and liver dysfunction: Is a clinical relationship possible? A case of hepatic failure after repeated cycles of ovarian stimulation

  • Giugliano, Emilio;Cagnazzo, Elisa;Pansini, Giancarlo;Vesce, Fortunato;Marci, Roberto
    • Clinical and Experimental Reproductive Medicine
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    • v.40 no.1
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    • pp.38-41
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    • 2013
  • Liver damage induced by ovarian stimulation has been demonstrated in some cases reported in the literature. However, there has never been a fruitful debate on this topic. The present manuscript tried to fill this gap. We reported a case of a 35-year-old nulliparous woman admitted to our obstetric emergency room for severe pre-eclampsia. She had been subjected to four cycles of controlled ovarian stimulation for intrauterine insemination. At 32 weeks of gestation, she developed severe pre-eclampsia, which led to HELLP syndrome complicated by fatal liver failure. The etiological link between ovarian stimulation and HELLP syndrome is intriguing. Further investigations are needed to understand whether repeated ovarian stimulation may represent a risk factor in pre-eclamptic patients.

Subsequent Oophorectomy and Ovarian Cancer after Hysterectomy for Benign Gynecologic Conditions at Chiang Mai University Hospital

  • Jitkunnatumkul, Aurapin;Tantipalakorn, Charuwan;Charoenkwan, Kittipat;Srisomboon, Jatupol
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.3845-3848
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    • 2016
  • This study was undertaken to determine the incidence of subsequent oophorectomy due to ovarian pathology or ovarian cancer in women with prior hysterectomy for benign gynecologic conditions at Chiang Mai University Hospital. Medical records of women who underwent hysterectomy for benign gynecologic diseases and precancerous lesions between January 1, 2004 and December 31, 2013 at Chiang Mai University Hospital were retrospectively reviewed. The incidence and indications of oophorectomy following hysterectomy were analyzed. During the study period, 1,035 women had hysterectomy for benign gynecologic conditions. Of these, 590 women underwent hysterectomy with bilateral salpingo-oophorectomy and 445 hysterectomy with bilateral ovarian preservation or unilateral salpingo-oophorectomy. The median age was 47 years (range, 11-75 years). Ten women (2.45 %) had subsequent oophorectomy for benign ovarian cysts. No case of ovarian cancer was found. The mean time interval between hysterectomy and subsequent oophorectomy was 43.1 months (range, 2-97 months) and the mean follow-up time for this patient cohort was 51 months (range, 1.3-124.9 months). According to our hospital-based data, the incidence of subsequent oophorectomy in women with prior hysterectomy for benign gynecologic conditions is low and all represent benign conditions.

Clinical Significance of Combined Detection of Serum Tumor Markers in Diagnosis of Patients with Ovarian Cancer

  • Bian, Jing;Li, Bo;Kou, Xian-Juan;Liu, Tian-Zhou;Ming, Liang
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6241-6243
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    • 2013
  • Objective: To explore the predictive value of tumor markers, including cancer antigen 72-4 (CA72-4), cancer antigen 15-3 (CA15-3) and cancer antigen 125 (CA125), in single or combined detection, for the diagnosis of ovarian cancer. Methods: 120 patients diagnosed with ovarian cancer from August 2011 to March 2013 and 80 patients diagnosed with benign ovarian tumors were enrolled in this test, along with 50 health examination women randomly selected from the database as controls. Serum levels of CA72-4, CA15-3 and CA125 in this study were determined by electrochemiluminescence (ECL). Results: Serum levels of CA72-4, CA15-3 and CA125 in ovarian cancer were higher than those in healthy group and benign group (P<0.01).The sensitivity of combined detection of those three tumor markers for diagnosis of ovarian cancer was obviously higher than with single detection with each marker (P<0.01). Conclusions: CA72-4, CA15-3 and CA125 could be a good combination in the diagnosis of ovarian cancer. Patients whose tumor markers continue to increase should be highly suspected of malignancy.

Clinical Practice Guideline for Korean Medicine for Ovarian Cancer (난소암 치료에 대한 한의 임상 가이드라인)

  • Kim, Kyung-Soon;Choi, Hong-Sik;Kim, Seung-Mo;Yoo, Hwa-Seung
    • Journal of Korean Traditional Oncology
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    • v.21 no.2
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    • pp.37-50
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    • 2016
  • Ovarian cancer is the tenth most common cancer in Korean female, and the third most common cancer of female reproductive organ after breast cancer and uterine cervical cancer. In spite of develop of conventional treatment, high modality of ovarian cancer comes from difficulty of an early diagnosis. Recent studies revealed that combining conventional and integrative medical treatment can reduce the adverse effect of surgical operation, chemotherapy and radiotherapy. Also it can improve survival rate, quality of life. However there isn't still a systemic clinical protocol for ovarian cancer in Korean medicine. This study will be helpful to establish clinical practice guidelines of Korean Medicine for ovarian cancer. And further studies on integrative ovarian cancer treatment are needed to build the clinical practice guidelines of ovarian cancer.

A Clinical Study on 1 Case of Secondary Amenorrhea after Ovarian Surgery for Bilateral Endometriomas Diagnosed as Premature Ovarian Failure (한방치료로 호전된 양측성 자궁내막종 수술 후 나타난 조기난소부전 증례보고)

  • Kang, So-Jung;Bae, Kwang-Rok;Lee, Jin-Moo;Hwang, Deok-Sang;Jang, Jun-Bock;Lee, Chang-Hoon
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.2
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    • pp.113-122
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    • 2018
  • Purpose: To report the effect of Korean medical treatments on 1 patient with secondary amenorrhea after ovarian surgery for bilateral endometriomas diagnosed as premature ovarian failure. Methods: The patient who had secondary amenorrhea was treated with Korean medical treatments such as herbal medication, herbal acupuncture and moxibustion therapy, and so forth. Results: After the Korean medical treatments, the patient could have her periods again. And high FSH level was decreased to normal. Conclusions: The case report shows that Korean medical treatment can be an effective option for treating secondary amenorrhea after ovarian surgery for bilateral endometriomas diagnosed as premature ovarian failure.

A Case Report of Primary Ovarian Insufficiency Treated with Korean Medicine Treatment (한의치료로 호전된 조기난소부전 환자 치험 1례 보고)

  • Choi, Su-Ji;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.32 no.4
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    • pp.170-180
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    • 2019
  • Objectives: The purpose of this study is to report the case of Korean medicine treatment on primary ovarian insufficiency. Methods: The patient in this case was 29-year-old female who was diagnosed with primary ovarian insufficiency. She had irregular menstruation and hypomenorrhea more than 6 months. She also suffered from hot flash and vaginal dryness. She was treated over 1 year with Korean medicine treatment, such as herbal medicine, acupuncture, and pharmacopuncture. We assessed the clinical symptoms, menstrual status and serum hormone level during the treatment. Results: After treatment, symptoms of primary ovarian insufficiency were relieved, level of serum FSH decreased and level of serum E2 increased. We maintained the treatment over 1 year and kept follow-up measurements of serum hormone level. Conclusions: This study shows that Korean medicine treatment can be effective in treating primary ovarian insufficiency. The report suggests the long treatment procedure for primary ovarian insufficiency.

Anti-N-methyl-D-aspartate receptor encephalitis associated with ovarian teratoma in Korea: three case reports

  • Lee, Jisun;Kang, Seongwoo;Chang, Hye Jin;Lee, Yong Hee;Son, Joo-Hyuk;Kong, Tae Wook;Chang, Suk-Joon;Hwang, Kyung Joo;Kim, Miran
    • Journal of Yeungnam Medical Science
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    • v.38 no.4
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    • pp.350-355
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    • 2021
  • Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a severe autoimmune paraneoplastic syndrome associated with ovarian teratomas. Most patients develop neurologic symptoms, including psychosis, memory deficits, seizures, or abnormal movements, and experience abdominal pain related to ovarian neoplasm. We present a case report of three patients diagnosed with anti-NMDAR encephalitis accompanied by ovarian teratomas at Ajou University Hospital in Korea. The patients demonstrated a different clinical course of the disease. However, upon diagnosis, all patients underwent surgical removal of the ovarian teratoma followed by intensive immunotherapy. The symptoms progressively improved following treatment. This is a case report of a rare autoimmune anti-NMDAR encephalitis associated with ovarian neoplasms, including immature teratoma.

GBA inhibition suppresses ovarian cancer growth, survival and receptor tyrosine kinase AXL-mediated signaling pathways

  • Gang Wang;Baisha Ouyang;Fang Jing;Xiaoyan Dai
    • The Korean Journal of Physiology and Pharmacology
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    • v.27 no.1
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    • pp.21-29
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    • 2023
  • The poor outcome of advanced ovarian cancer under conventional therapy necessitates new strategies to improve therapeutic efficacy. β-glucosidase (encoded by GBA) is a lysosomal enzyme and is involved in sphingolipids metabolism. Recent studies revealed that β-glucosidase plays a role in cancer development and chemoresistance. In this work, we systematically evaluated the expression and role of GBA in ovarian cancer. Our work demonstrates that inhibition of β-glucosidase has therapeutic potential for ovarian cancer. Gene Expression Profiling Interactive Analysis database, western blot and immunohistochemistry analyses of patient samples demonstrated that GBA mRNA and protein expression levels were significantly increased in ovarian cancer compared to normal tissues. Functional studies using gainof-function and loss-of-function approaches demonstrated that GBA overexpression did not affect growth and migration but alleviated cisplatin's efficacy in ovarian cancer cells. In addition, GBA depletion resulted in growth inhibition, apoptosis induction, and enhancement of cisplatin's efficacy. Of note, we found that GBA inhibition specifically decreased receptor tyrosine kinase AXL level, leading to the suppression of AXL-mediated signaling pathways. Our data suggest that GBA represents a promising target to inhibit AXL signaling and overcome cisplatin resistance in ovarian cancer.