• Investigative Magnetic Resonance Imaging
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• 제19권3호
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• pp.196-199
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• 2015

Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) syndrome is an uncommon congenital abnormality of the female urogenital tract characterized by the triad of uterine didelphys, obstructed hemivagina, and ipsilateral renal agenesis. A 13-year-old female presented with acute lower abdominal pain. Magnetic resonance imaging (MRI) revealed uterine didelphys, hematometrocolpos, obstructed hemivagina, and right ipsilateral agenesis, consistent with OHVIRA syndrome. Also, a well-defined mass with fluid signal intensity, mimicking adnexal neoplasm was seen in the right lower pelvic cavity adjacent to the posterior wall of the bladder. Vaginal septotomy and drainage of hematometrocolpos were done initially, but unilateral hysterectomy was later performed to relieve the patient's symptoms. The cystic mass in the right lower pelvic cavity was also excised and confirmed as a blind megaureter.

• Clinical and Experimental Reproductive Medicine
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• 제42권3호
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• pp.126-129
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• 2015

Essure (Bayer) received approval from the U.S. Food and Drugs Administration as a permanent non-hormonal contraceptive implant in November 2002. While the use of Essure in the management of hydrosalpinx prior to in vitro fertilization (IVF) remains off-label, it has been used specifically for this purpose since at least 2007. Although most published reports on Essure placement before IVF have been reassuring, clinical experience remains limited, and no randomized studies have demonstrated the safety or efficacy of Essure in this context. In fact, no published guidelines deal with patient selection or counseling regarding the Essure procedure specifically in the context of IVF. Although Essure is an irreversible birth control option, some patients request the surgical removal of the implants for various reasons. While these patients could eventually undergo hysterectomy, at present no standardized technique exists for simple Essure removal with conservation of the uterus. This article emphasizes new aspects of the Essure procedure, as we describe the first known association between the placement of Essure implants and the subsequent development of fluid within the uterine cavity, which resolved after the surgical removal of both devices.

• 한국임상수의학회지
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• 제15권2호
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• pp.307-318
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• 1998

Accuracy of rectal palpation and ultrasonography for differential diagnosis of subestrous dairy trows were investigatedl using the result of pIRsma progesterone assay. The ovaries were examined 2 times of 10 days interval in 520 posearom and postinsemination subestroHs dairy cows, using rectal palpation and B-mode transrectal ultrasonography. The results of rectal palpation, ultrasonographic examination and measurement of plasma progesterone profiles in 520 subestrous dairy cows were silent brat or error of estrus detection 303 (58.3%), persistent corpus luteum 59 (11.3%), follicular cyst 37 (7.1%), luteal cyst 16 (3.1%), inactive ovary 9 (1.7%), granulosa tumor 1 (0.2%), hydmsalphinx 1 (0.2%), endomehris 81 (15.6%), pyometra 12 (2.3%) and mummified fetus 1 (0.2%), respectively. Accuncy of rectal palpation and ultrasonography for diagiosing ovarian disordeir based on plasma progesterone profiles were silent heat or error of estrus detection 80.5% and 96.7%$\boxUl$ persistent corpus luteum 57.6% and 94.9%, follicular cyst 62.5% and 91.9%1 luteal cyst 62.5% and 87.5%, maclive ovary 55.6% and 88.9% and granulosa cell tumor 100% and 100%, respectively. Acnuucy of rectal palpation for diagnosing uterine disorders based on ultrasonography was pyometra 75.0%1 endometritis 51.9% and mummified fetus 100%, respectively. Cbaracteristic ultrasonographic appearances of ovaries in subestrous dairy cows were as follows; Silent heat or error of estrus detection: anechoic follicle or hypoechoic corpus luteum than ovarian stroma was alternately present on Day 0 (first examination) and Day 10. Follicular cyst: uniformly nonechogenic ovarian structure $\geq $ 25 mm in diameter with a wall < 3 mm was present in ipsilateral on Day 0 and Day 10. Luteal cyst: luteal cyst was similar to follicular cysts but thickness of cystic wall was $\geq $ 3 mm. Inactive ovary : structures within ovaries was not present on Day 0 Bnd Day 10. Characteristic uthssonograpsc appearances of uterus in subestrous dairy cows were as follows; Endometritis: characterized by uterine lumen containing fluid in which 'snowy'echogenic particles art suspended. Pyometra: ultrasonographic appearance of pyometra was diffuse echogenic particles distributed in fluid within the distended uterus, and a thickened uterine wall. These results indicated that ultrasonography was practical far diagnosing reproductive disorders. To diagnosing ovarian disorders, ultrasonography should be carried out 2 times of 10 days interval and rndometritis should be differentiated with uterus of luteal phase in normal cycling cows.

• 한국수정란이식학회지
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• 제12권3호
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• pp.229-246
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• 1997

Implantation is a most important biological process during pregnancy whereby conceptus establishes its survival as well as maintenance of pregnancy. During the periimplantation period, both uterine endometriurn and conceptus synthesize and secrete a host of growth factors and cytokines which mediate the actions of estrogen and /or progesterone and also exert their steroid-independent actions. Growth factors expressed by the materno-conceptal unit en masse have important roles in cell migration, stimulation or inhibition of cell proliferation, cellular differentiation, maintenance of pregnancy and materno-conceptal communications in an autorcrine /paracrine manner. The present review focuses on the role of the intrauterine IGF system during periimplantation conceptus development. The IGF system comprises of IGF- I and IGF- II ligands, types I and II IGF receptors and six or more IGF-binding proteins(IGFBPs). IGFs and IGFBPs are expressed and secreted by uterine endometrium with tissue, pregnancy stage and species specificities under the influence of estrogen, progesterone and other growth factor(s). Conceptus also synthesizes components of the IGF system beginning from a period between 2-cell and blastocyst stages. Maternal IGFs are utilized by both maternal and conceptal tissues; conceptus-derived growth factors are believed to be taken up primarily by conceptus. IGFs enhance the development of both maternal and conceptal compartments in a wide range of biological processes. They stimulate proliferation and differentiation of endometrial cells and placental precursor cells including decidual transformation from stromal cells, placental formation and the synthesis of some steroid and protein hormones by differentiated endometrial cells or placenta. It is also well-documented in a number of experimental settings that both IGFs stimulate preimplantation embryo development. In slight contrast to these, prenatal mice carrying a null mutation of IGF and /or IGF receptor gene do not exhibit any apparent growth retardation until after implantation. Reason (s) for this discrepancy between the knock-out result and the in vitro ones, however, is not known. IGFBPs, in general, are believed to inhibit IGF action within the materno-conceptal unit, thereby allowing endometrial stromal cell differentiation as well as dampening ex cessive placental invasion into maternal tissue. There is evidence, however, indicating that IGFBP can enhance IGF action depending on environrnental conditions perhaps by directioning IGF ligand to the target cell. There is also a third possibility that certain IGFBPs and their proteolytic fragments may have their own biological activities independent of the IGF. In addition to IGFBPs, IGFBP proteases including those found within the uterine tissue or lumen are thought to enhance IGF bioavailability by degrading their substrates without affecting their bound ligand. In this regard, preliminary results in early pregnant pigs suggest that a partially characterized IGFBP protease activity in uterine luminal fluid enhances intrauterine IGF bioavailability during conceptus morphological development. In summary, a number of in vitro results indicate that IGFs stimulates the development of the rnaterno-conceptal unit during the periimplantation period. IGFBPs appear to inhibit IGF action by sequestering their ligands, whereas IGFBP proteases are thought to enhance intrauterine bioavailability of IGFs. Much is remaining to be clarified, however, regarding the roles of the individual IGF system components. These include in vivo evidence for the role of IGFs in early conceptus development, identification of IGF-regulated genes and their functions, specific roles for individual IGFBPs, identification and characterization of IGFBP proteases. The intrauterine IGF club house thus will be paying a lot of attention to forthcoming results in above and other areas, with its door wide-open!

• 동의생리병리학회지
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• 제24권5호
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• pp.727-736
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• 2010

This study is about researching mechanistic pattern identification of disease for DongEuiBoGam NaeGyungPyen by analysing with pattern identification of modern Traditional Korean medical patholgy as more logical, systematic and standardized theory. Disease pattern mechanisms of uterine, urine and excrements parts of DongEuiBoGam NaeGyun gPyen in NaeGyungPyen of DongEuiBoGam are these. Menstrual irregularities in DongEuiBoGam can be classified flui d-humor depletion, blood deficiency, qi deficiency, qi stagnation, qi stagnation complicated by heat, blood stasis, blood deficiency complicated by heat, syndrome of heat entering blood chamber, syndrome of cold entering blood chamber. The disease pattern of abdominal pain after menstruation in DongEuiBoGam is blood deficiency complicated by heat, and a dysmenorrhea represents blood stasis with heat, fluid-humor deficiency. Advanced menstruation represent dual heat of the qi and blood, delayed menstruation is blood deficiency. The disease pattern of inhibited urination in DongEuiBoGam can be classified deficiency heat pattern of kidney yin deficiency(yin deficiency with effulgent fire), kidney qi deficiency, yin deficiency with yang hyperactivity, fluid-humor depletion, spleen-stomach dual deficiency, and excess he at pattern of bladder excess heat. The disease pattern of urinary incontinence in DongEuiBoGam can be classified deficiency pattern of kidney-bladder qi deficiency, consumptive disease, lung qi deficiency, kidney yin deficiency(yin deficiency with effulgent fire), kidney yang deficiency and excess pattern of lower energizer blood amassment, bladder excess heat. And most of them are deficiency from deficiency-excess Pattern Identification. The disease pattern of diarrhea in DongEuiBoGam can be classified deficiency pattern of qi deficiency, qi fall, spleen yang deficiency, kidney yang deficiency and so on and excess pattern of wind-cold-summerheat-dampness-fire, phlegm-fluid retention, dietary irregularities, qi movement stagnation. And most of them are deficiency from deficiency-excess Pattern Identification. Like these, this study identify pattern of disease in DongEuiBoGam by mechanism of disease theory.

• The Korean Journal of Pain
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• 제8권1호
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• pp.156-158
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• 1995

Total spinal anesthesia is a well documented serious life threatening complication which results from an attempted spinal or epidural analgesia. We had an accidental total spinal anesthesia associated with a cranial nerve paralysis and an eventual unconsciousness during epidural analgesia. A 45-year-old female with an uterine myoma was scheduled for a total abdominal hysterectomy under the epidural analgesia. A lumbar tapping for the epidural analgesia was performed in a sitting position at a level between $L_{3-4}$, using a 18 gauge Tuohy needle. Using the "Loss of Resistance" technique to identify the epidural space, the first attempt failed; however, the second attempt with the same level and the technique was successful. The epidural space was identified erroneously. However, fluid was dripping very slowly through the needle, which we thought was the fluid from the normal saline which was injected from the outside to identify the space. Then 20 ml of 2% lidocaine was administered into the epidural space. Shortly after the spinal injection of lidocaine, many signs of total spinal anesthesia could be clearly observed, accompanied by the following progressing signs of intracrainal nerve paralysis: phrenic nerve, vagus nerve, glossopharyngeal nerve and trigeminal nerve in that order. Then female was intubated and her respiration was controlled without delay. The scheduled operation was carried out uneventfully for 2 hours and 20 minutes. The patient recovered gradually in th4e reverse order four hours from that time.

• 한국임상수의학회지
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• 제16권2호
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• pp.474-477
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• 1999

A four-year old bitch which showed occasional hemomorragic exudate from the vulva for two weeks after the previous estrus 7 months ago was ovariohysterectomied. About 200m1 of sanguineous fluid was flowed out from the uterus and some scattered blood clots were found in both uterine horns. Hematometra of the bitch which was presumed to occur during the proestrus two weeks ago was thought to progress into early pyometra at the time of diagnosis. To diagnose hematometra, vaginal examination using vaginal speculum or vaginoscope and hematological examination were performed. Radiography and ultrasonography were also proved to be of use to diagnose hematometra. Treatment for hematometra was considered to be the same as for the case of pyometra.

• 한국수의병리학회지
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• 제1권2호
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• pp.149-152
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• 1997

A 13-years and 8-months old Jindo dog showed vomiting and pale red vulvular discharge. At necropsy, the uterus was swollen and endometrium was diffusely thickened by numerous protruding cysts which measured approximately from 0.5 to 1 cm in diameter. On sectioning the cysts exuded pale red watery fluid. histologically the endometrium was thickened and characterized by mild to moderate edema congestion and hemorrhagic foci. The cystic endometrial glands were lined by a single layer of flattened cuboidal or vacuolated columnar epithelium. Occasional dilated glands had traversed through the submucosa into the myometrial region. Afew mixed inflammatory cells infiltrated in the lamina propria. Bacteriologically Escherichia coli was isolated from the uterine contents. Gross and microscopic finding were consistent with cystic endometrial hyperplasia.

• 한국임상수의학회지
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• 제33권6호
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• pp.362-367
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• 2016

The aim of the study was to evaluate ultrasonographic findings, affected age, hematology, blood chemistry and clinical signs according to open or closed cervix in 102 bitches presented for treatment of pyometra. The prevalence of pyometra according to breed was observed in Maltese 22.5%, Yorkshire Terrier 13.7% and Shih Tzu 12.7%. The mean age of dogs was $9.6{\pm}0.3years$, and open cervix pyometra was more prevalent than closed cervix pyometra. Clinical signs included anorexia, vaginal discharge, depression, polyuria/polydipsia, vomiting, and abdominal distension. The concentration of BUN and the activity of ALP in dogs with closed cervix pyometra were significantly higher than those in dogs with open cervix pyometra (p < 0.05). The white blood cell and neutrophils in dogs with closed cervix pyometra were significant higher than those in dogs with open cervix pyometra (p < 0.05). Ultrasonographic findings of the uterus with open or closed cervix pyometra showed variable patterns. The uterine wall was variable in appearance, from thick and irregular to smooth and thin. The uterine wall was thicker in open cervix pyometra than in closed cervix pyometra. The luminal cavity included smaller amount of anechoic fluid in open cervix pyometra than in closed cervix pyometra.

• 한국식품위생안전성학회지
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• 제21권4호
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• pp.258-262
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• 2006

환경호르몬 물질의 생체내에서의 상호작용에 의한 상자 또는 상승 작용을 알아보기 위하여 환경호르몬 물질들을 조합하여 마우스에 처치한 후 생체내에서 생식기의 변화 정도를 조직병리학적으로 관찰하였다. 암컷 ICR마우스에 난소적출술을 실시하고 2주 후에 DEHP, DBP, BPA의 환경호르몬 물질을 단독 또는 두개씩 조합하여 마우스에 피하로 주입하였다. 육안적인 변화에서는 모든 군에서 이상이 관찰 되지 않았으며, 부검 후 자궁의 무게를 측정한 결과에 있어서도 유의적인 변화를 관찰할 수 없었으나, 자궁 내 fluid존재에 있어서는 E2 단독 투여 군과 E2와 함께 투여한 모든 그룹(E2+DEHP, E2+DBP, E2+BPA)에서 관찰되었다. 조직병리학적인 관찰에 있어서는.자궁상피세포, 질 상피세포, 유선의 변화 그리고 난관 직경의 변화를 관찰하였다. 그 결과 민감도에 있어서 가장 유의적인 변화를 보인 항목은 질 상피세포의 변화였으며, 환경호르몬 물질을 두개씩 혼합하여 처치한 그룹에 있어 단독으로 처치한 그룹과 비교 시 변화의 정도가 심한 것이 일부 관찰 되었으나 통계학적으로 유의성을 가지고 있다고 결론을 내리기 는 힘들었다. 결론적으로 환경호르몬물질간의 생체내에서 상가 혹은 상승작용에 대한 명확한 결과는 도출할 수 없었으나, 환경호르몬물질이 생체내 작용하는 데에 있어서 서로 간에 상승작용을 할 수 있다는 가능성은 충분한 것으로 판단되어진다.