• 대한상한금궤의학회지
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• v.7 no.1
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• pp.29-43
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• 2015

Objective : The purpose of this paper is to report the improvement of 3 patients with uterine fibroid treated by herb medication based on Shanghanlun disease pattern identification diagnostic system. Methods : According to 'Disease Pattern Identification Diagnostic System based on Shanghanlun Provisions', they were diagnosed with Taeyang-byung, Yangmyung-byung. They took different herb medications more than 8 weeks according to their diagnosis. The size of uterine fibroid was estimated by ultrasonography. Results : The size of uterine fibroid reduced from 3.94cm to 2.55cm on first patient, 5.20cm to 4.86cm on second patient, 12.63cm to 7.77cm on third patient. Conclusions : Herb medication not only reduced the size of uterine fibroid but also improved symptoms such as dysmenorrhea, vaginal bleeding, pelvic discomfort, fatigue. In addition, this is the first case report treating the uterine fibroid with herb medication of shanghanlun in Korea.

• Clinical and Experimental Reproductive Medicine
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• v.19 no.2
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• pp.175-179
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• 1992

The factors involved in the initial neoplastic transformation and subsquent growth of uterine fibroid are poorly understood. The reduction in uterine fibroid volume associated with the chronic administration of the mechanisms mediating the decrease in fibroid volume in GnRH-a treated patients are poorly defined. The purpose of this study was to determine the proliferating cell nuclear antigen(PCNA) in fibroid from-women pretreated with GnRH analogue(GnRH-a) compared with controls. Tissue was obtained from 16 premenopausal women with uterine fibroid who received GnRH-a(D-Trp6-GnRH) intramusculary every 28 days for four injections. The mean proliferating index(PI) in patients with uterine fibroids was $2.25{\pm}0.9$, and in controls was $8.82{\pm}1.8$(P<0.001). The proliferating index was not corrleated with the reduction of fibroid volume. In this clinical study, although hypoestrogenism may be the main factor that reduce the volume of fibroid, other factors are also considered to be involved in that process. And the regrowth of uterine fibroid may be affected by increased production of PCNA after stopping GnRH-a.

• Clinical and Experimental Reproductive Medicine
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• v.43 no.1
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• pp.51-53
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• 2016

Uterine fibroids are benign tumors of the myometrium with a diverse range of manifestations. Fibroids can dramatically increase in size during pregnancy due to the increase in estrogen levels. After delivery, the fibroids usually shrink back to their pre-pregnancy size. Uterine myomas may have many complications, including abnormal uterine bleeding, infertility, pressure on nearby organs, degeneration, and malignant transformation. No previous reports have indicated that a fistula may develop between a uterine fibroid and the bowel loops, although previous studies have documented the occurrence of fistulas from the uterus to the bowel following myomectomy or uterine artery embolization performed to treat a myoma. In our case report, we document the rare complication of a fistula occurring between a degenerated myoma in the posterior wall and the ileum 1 week postoperatively in a patient who underwent a Caesarean section but did not have a history of uterine artery embolization.

• The Journal of Korean Obstetrics and Gynecology
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• v.28 no.1
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• pp.147-157
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• 2015

Objectives: We report two cases that have an effective result with Korean traditional medical treatment to two patients who have uterine fibroids, using transabdominal ultrasonography for checking the size of uterine fibroids. Methods: A 44-year-old patient and a 43-year-old patient were treated with an herbal medicine, acupuncture and cupping therapy. We followed up the symptoms and the size of uterine fibroids. Results: The 44-year-old patient was asymptomatic, her size of the uterine fibroid was reduced for 6 months. Also, the 43-year-old patient experienced that the symptoms such as urinary frequency, ovulation pain, heavy bleeding were improved and the size of the uterine fibroid was reduced. Conclusions: This results suggest that Korean traditional medical treatment if effective for both asymptomatic and symptomatic uterine fibroids and ultrasonography is useful for checking the effect of Korean traditional medical treatment. Further case series and studies are warranted.

• Clinical and Experimental Reproductive Medicine
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• v.42 no.4
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• pp.163-168
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• 2015

Objective: To investigate the impact of fibroids on the blood flow of the uterine and subendometrial arteries and in vitro fertilization (IVF) outcomes. Methods: In this study, we analyzed 86 IVF/intracytoplasmic sperm injection (ICSI) cycles in which a gonadotropin-releasing hormone antagonist protocol was used for controlled ovarian stimulation between January 2008 and March 2009. The subjects comprised 86 infertile women with (fibroid group, n=43) or without (control group, n=43) uterine fibroids. Results: Patient characteristics were similar between the fibroid and control groups. The IVF/ICSI outcomes in patients with fibroids were similar to those of patients in the control group. The resistance index (RI) and pulsatile index (PI) of the uterine and subendometrial arteries on the day of embryo transfer were also comparable between the two groups. IVF outcomes and uterine hemodynamics in patients with multiple (${\geq}2$) fibroids were similar to those of patients with a single fibroid. However, clinical pregnancy and implantation rates were significantly lower in patients with fibroids who experienced uterine cavity distortion than in patients with fibroids who had a normal uterine cavity (both p<0.05). The RI and PI of the subendometrial artery were significantly higher on the day of embryo transfer in patients with fibroids who experienced uterine cavity distortion than in patients with fibroids who had a normal uterine cavity (both p<0.05). Conclusion: Fibroids which distorting the uterine cavity might impair the subendometrial artery blood flow clinical pregnancy rate and embryo implantation rate in infertile patients undergoing IVF. Otherwise, IVF outcomes were not influenced by the presence of uterine fibroids.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.1123-1127
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• 2015

Uterine leiomyomas (ULM), are benign tumors of the smooth muscle cells of the myometrium. They represent a common health problem and are estimated to be present in 30-70% of clinically reproductive women. Abnormal angiogenesis and vascular-related growth factors have been suggested to be associated with ULM growth. The angiotensin-I converting enzyme (ACE) is related with several tumors. The aim of this study was to identify possible correlation between ULM and the ACE I/D polymorphism, to evaluate whether the ACE I/D polymorphism could be a marker for early diagnosis and prognosis. ACE I/D was amplified with specific primer sets recognizing genomic DNA from ULM (n=72) and control (n=83) volunteers and amplicons were separated on agarose gels. The observed genotype frequencies were in agreement with Hardy-Weinberg equilibrium ($x^2=2.162$, p=0.339). There was no association between allele frequencies and study groups ($x^2=0.623$; p=0.430 for ACE I allele, $x^2=0.995$; p=0.339 for ACE D allele). In addition, there were no significant differences between ACE I/D polymorphism genotype frequencies and ULM range in size and number ($X^2=1.760;$ p=0.415 for fibroid size, $X^2=0.342;$ p=0.843 for fibroid number). We conclude that the ACE gene I/D polymorphism is not related with the size or number of ULM fibroids in Turkish women. Thus it cannot be regarded as an early diagnostic parameter nor as a risk estimate for ULM predisposition.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.3
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• pp.258-259
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• 2007

Benign metastasizing leiomyoma(BML) is a rare condition affecting women with a history of having undergone hysterectomy or myomectomy for a benign uterine fibroid, that is found to have metastasized to extrauterine sites, usually many years after hysterectomy. 1,2) Patient with BML almost always asymptomatic, although if the lesions are large enough, they can cause compressive symptoms. Among several hypothesis of pathogenesis, most plausible theory is that these tumors represent a true metastatic lesion but are very low-grade sarcoma. 3) Because the tumor is responsive to estrogen, menopause and pregnancy have slowed the growth of these lesion 4) and it seems reasonable to perform hysterectomy in patients with a uterine mass and, at the same time, perform oophorectomy for hormonal control. BML is an unusual cause of diffuse pulmonary nodules which should be considered in females with unexplained nodules and a history of surgery for uterine leiomyoma.

• The Journal of Korean Obstetrics and Gynecology
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• v.19 no.2
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• pp.240-260
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• 2006

Purpose : The objective of this study is to serve guidelines for the investigation and management of uterine myomas with KM therapies. Methods : English-language articles from PubMed and Korean-language articles from the database of the journal of oriental gynecology were reviewed from 2000 to 2005, using the key words 'uterine myoma', 'uterine leiomyoma', 'fibroid', 'uterine artery embolization', 'endometrial ablation', 'myomectomy', and jagungguenjong(子宮筋腫)'. Results and Limits : The areas of clinical practices considered in formulating this guideline are assessment, KM therapies, medical treatments, myolysis, selective artery occlusion, endometrial ablation and surgical therapies including myomectomy and hysterectomy. Implementation of this guideline would optimize the decision-making process of women with uterine myomas and further investigation or therapy of their KM doctors. But we don't have abundant evidences of clinical trials of uterine myoma treated with KM therapy, though we treat or manage that with every-day clinical practices. Moreover cultural gaps between Korea and other western countries make many differences in the attitude to surgical therapies, especially hysterectomy. So it is very difficult to compare W therapies with other therapies. Moreover it is much difficult to estimate cost-effectiveness and benefit of those therapies in QOL. Conclusions : The majority of uterine myoma is asymptomatic and will not require any intervention or further investigation. But unmarried women who wish to marry and get pregnant want to find safe therapy for their asymptomatic uterine myomas. In that case, most of the patients prefer non-surgical therapy to surgical therapy. So KM herbal medicinal therapy is a good alternative method for those patients. For the symptomatic myomas, hysterectomy offers a definitive solution. However, it is not the best solution for women who wish to preserve their uterus. So KM therapy is a good alternative for them. But the predicted benefits of alternative therapies including KM therapy must be carefully weighed against the Possible risks of these therapies. To improve the quality of life of both women with asymptomatic and symptomatic myomas, selecting and treating patients should be done carefully. Moreover, the effect of KM therapy has to evaluated, comparing the possible situation without treatment and the benefit of constant treatment as a health-care system.

• YAKHAK HOEJI
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• v.17 no.2
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• pp.92-102
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• 1973

Hormone이 암발생과 밀접한 관계가 있음은 이미 1935년대에 밝혀진 바 있다. 즉 lacassagne은 estrogen이 토끼 자궁벽의 fibromyomatous transformation에 영향을 준다고 하였다. Nelson는 guinea-pig를 시험동물로 해서 estrogen을 장기투여한 결과 uterine fibroids가 수발됨을 확인한 이래, 유발됨을 확인한 이래, 이러한 hormone이 암발생의 장기요인이 됨으리 밝히게 되었다. 이러한 업적은 Lipschutz에 의해 더욱 수식되었다. 이러한 업적의 결과가 여러편의 종설로 발표되었다. 즉 Lacassagne, Zuckerman, Burrows등, Gardner는 각기 종설을 발표하여 이를 확증하기에 이르렀다. 한편 각개 hormone, 그중에서도 sex-hormone의 opposite action은 Steinach등 및 Sand에 의해 밝혀졌고 거세백서에 estrogen을 투여했을때 유기되는 vaginal mucosa의 epidermization이 testosterone의 투여에 의해 급속히 소진됨을 Currier 일파가 증명하였고 estrogen에 의해 유발된 웅백서 부속성선의 조직변성이 androgen의 동시투여의 소실됨이 homone에 의해 유발된 neoplastic에 대해 유효하리하는 것은 백명한 일이고 이러한 사실은 현재 실시로 허다히 이용되고 있는 것이다.

• Development and Reproduction
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• v.11 no.3
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• pp.205-217
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• 2007

As an initial step toward better understanding of the molecular mechanism of estrogen-dependent growth in myoma, an optimal primary cell culture condition has been developed and examined by this study. Myoma and myometrium were cultured by two different methods. Culture stability and $E_2$-responsiveness in stable culture were studied. The culture of digested tissue pieces(Method 2) was found to be a stable culture method for the myoma and myometrium showing a favorable response to estrogen. mRNA expression of PR, IGF-1 and IGF-1 receptor genes was enhanced by $E_2$. The gene responses to $E_2$ were higher in myoma compared with myometrium. Moreover, these responses were more expressive in tissues than in the surrounding cells in primary culture of normal myometrium and myoma, implying a vital role of cell communication through the extracellular matrix in maintaining the estrogen-responsiveness. The development of an improved cell culture system for myoma provides an in vitro tool to further investigate the basis of the tumor formation.