• Clinical and Experimental Reproductive Medicine
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• v.35 no.1
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• pp.77-82
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• 2008

Objective: This study was performed to investigate the efficacy and safety of radiofrequency (RF) myolysis under transvaginal ultrasound guidance. Methods: Transvaginal RF myolysis had been performed in one hundred nine women with uterine leiomyoma at Chung-Ang University hospital between Dec. 2004 and Mar. 2007. All patients, mean aged $42.8{\pm}5.8$ years, desired their uterine conservation. Patients underwent physical examination, transvaginal pelvic ultrasound for measurement of the lesions preoperatively. Follow up was done at 1 week, 1 month, 3 months, 6 months after RF myolysis by same physician and measurement of size and volume of myoma and improvement of myoma specific symptoms such as menorrhagia and dysmenorrhea were checked at each visit. Results: The mean maximal diameter of myomas treated by RF myolysis was $6.1{\pm}0.5\;cm$ and average time of the procedure was $16.3{\pm}8.5$ minutes. A significant decrease of myoma size and volume was observed at 1 month after myolysis. Mean reduction in maximal diameter was $29.9{\pm}4.8%$ at 1 week (p<0.001), $41.5{\pm}1.5%$ at 1 month (p=0.05), $46.2{\pm}3.9%$ at 3 months (p=0.003), $54.6{\pm}6.1%$ at 6 months (p<0.001) after RF myolysis respectively. Mean reduction in volume was $44.4{\pm}8.3%$ (p=0.001), $68.1{\pm}4.2%$ (p=0.035), 73.9$73.9{\pm}4.8%$ (p=0.042), $84.5{\pm}5.1%$ (p<0.001) at the same follow up period respectively. Significant improvement of symptom was observed at 3 months after RF myolysis. Transient low abdominal pain and prolonged vaginal bleeding were detected in 3 patients each but spontaneously resolved and no serious complication has been noticed or found. Conclusion: This study shows transvaginal RF myolysis could be a safe and effective method to treat uterine leiomyoma, allowing uterine conservation with significant volume reduction and rapid return to normal activity.

• 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.18 no.2
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• pp.189-196
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• 1991

Long-term administration of luteinizing hormone-releasing hormone(LHRH) agonists, through a process of pituitary desensitization and down-regulation of receptors, inhibits the secretion of gonadotropin and sex-steroids and induces a reversible suppression of gonadal activity. This approach can be used as an effective endocrine therapy for some hormone-dependent tumors. We have used D-Trp6-LHRH, a long acting LHRH agonist, for the treatment of eleven patients with uterine leiomyomas, thereafter myomectomy was performed in seven cases and observed the ultrastructural changes of leiomyoma with an electron microscope. The use of LHRH agonist may be effective in reducing the size of a myoma considerably by primarily inducing medical hypophysectomy and would allow easier surgical removal. Electron microscopic findings of myoma cells after the use of LHRH agonist included the following: loss of cristae and swelling nuclear chromatin, perinuclear vacuolation in cytoplasm. Bone mineral density was slightly decreased, however, the difference was not statistically significant.

• The Journal of Korean Obstetrics and Gynecology
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• v.36 no.2
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• pp.101-113
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• 2023

Objectives: The purpose of this case study is to report clinical effectiveness of the Boheo-tang-gagambang with acupuncture, moxa and physiotherapy treatments on the after-effects of myomectomy or hysterectomy. Methods: The subjects of this study were five women who were diagnosed with uterine myoma and underwent myomectomy or hysterectomy. They mainly complained of lower abdominal pain, back pain, and pelvic pain. They received combination treatment of Korean medicine and physiotherapy. The Korean medicine included Boheo-tang-gagambang, acupuncture and moxa. The effects were evaluated through Numeric Rating Scale (NRS). Results: In this study, patient's clinical symptoms, including lower abdominal pain, low back pain, and pelvic pain, improved after hospitalization treatment. Conclusions: This case report shows that the combination treatment of Korean medicine with Boheo-tang-gagambang, acupuncture and moxa may be effective for treating after-effects of myomectomy or hysterectomy.

• Development and Reproduction
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• v.24 no.1
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• pp.1-17
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• 2020

Phthalates and those metabolites have long history in industry and suspected to have deficient effects in development and reproduction. These are well-known anti-androgenic chemicals and many studies have examined the effects of these compounds on male reproduction as toxins and endocrine disruptors. Uterus is a key organ for proper embryo development, successful reproduction, and health of eutherian mammals including women. To understand the effects of the phthalate, the horizontal approach with a whole group of phthalate is best but the known phthalates are huge and all is not uncovered. Di-(2-ethylhexyl) phthalate (DEHP) is the most common product of plasticizers in polymer products and studied many groups. Although, there is limited studies on the effects of phthalates on the female, a few studies have proved the endocrine disrupting characters of DEHP or phthalate mixture in female. An acute and high dose of DEHP has adverse effects on uterine histological characters. Recently, it has been revealed that a chronical low-dose exposing of DEHP works as endocrine disrupting chemicals (EDC). DEHP can induce various cellular responses including the expression regulation of steroid hormone receptors, transcription factors, and paracrine factors. Interestingly, the response of uterus to DEHP is not monotonous and the exposed female has various phenotypes in fertility. These suggest that the exposing of DEHP may causes of histological modification in uterus and of disease in female such as endometriosis, hyperplasia, and myoma in addition to developmental and reproductive toxicity.

• The Journal of Korean Obstetrics and Gynecology
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• v.22 no.4
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• pp.205-214
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• 2009

Purpose: Adenomyosis is the disease caused by ingrowth of lining tissue into the uterine muscle. Final treatment of the disease is hysterectomy but there is a tendency to avoid surgical treatment if possible. And medication often results in relapse and it does not cure completely. This paper introduces the potential of oriental medical treatment for adenomyosis through a case study. Methods: A 31-year-old female patient, suffered from pelvic pain and metrorrhagia, was diagnosed with adenomyosis and uterine myoma. She was put on oriental medical treatment in the ○○ Oriental Hospital for almost three months. We applied herb-medication, acupuncture and moxibustion. Results: Overall condition including the symptoms was relieved after oriental medical treatment Conclusion: Oriental medical treatment alleviates chronic pelvic pain and has an effect against adenomyosis.

• Journal of Chest Surgery
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• v.40 no.11
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• pp.789-792
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• 2007

We report here a case of pulmonary benign metastasizing leiomyoma from the uterus in a 45 year old woman. The patient presented for investigation of multiple pulmonary nodules on a routine chest roentgenogram. The patient had undergone uterine myomectomy due to uterine leiomyoma 10 years earlier. We performed thoracoscopic wedge resection for definitive diagnosis. Histologically, spindle shaped smooth muscle cells appeared between collagen stroma, histology similar to that seen in uterine myoma. The tumor tissue tested positive for estrogen and progesterone receptors. The pathological findings were consistent with benign metastasizing leiomyoma. The patient was in pre-menopause. She received no specific treatment for lung tumors, and we did not found any changes in the lesions after one year follow up without any medication.

• Clinical and Experimental Reproductive Medicine
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• v.37 no.3
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• pp.191-198
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• 2010

Uterine myomas are heterogeneous tumors in composition, size, location, and number; variation in any of these factors could possibly alter the effect on a woman's fertility status. The effect of myomas on fertility has been the subject of many studies. However, a definitive answer is still missing. The location and size of the myomas are the two parameters that influence the success of a future pregnancy. Subserosal myomas seem to have little effect on reproductive outcome. Myomas that compress the uterine cavity with an intramural portion and submucosal myomas significantly reduce pregnancy rates, and should be removed before assisted reproductive techniques are performed. Patients with intramural myomas also may have a poorer reproductive outcome, but the lacks of quality evaluations make this conclusion tenuous at best. Removal of myomas with an intra-cavitary component seems to be of benefit. However there are as yet no data to support myomectomy in the treatment of intramural myomas to improve fertility outcomes. Treatment modality for myomas located at intramural sites should be determined according to clinical status of the patient and doctor's experience.

• Clinical and Experimental Reproductive Medicine
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• v.12 no.1
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• pp.47-70
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• 1985

This study was presented of the 1,872 cases of infertile couples who visited and examined at the sterility clinic of Department of Obstetrics & Gynecology, Seoul National University Hospital from Sept., 1980 to Dec., 1983. Age, duration of infertility, past medical history, and other general factors were analyzed, and the factors responsible for infertility were classified and discussed. Mode of treatment, outcome of pregnancy, pregnancy rate responsible for each factor were also presented. The results were as follows: 1) The infertility was primary in 1,128, or 60.3% and secondary in 744, or 39.7%. 2) The age between 26 and 30 years of age comprised about one half of the total patients. 3) The duration of infertility between 1 and 4 years comprised about three quarters of the total patients, and the mean duration was 3.8 years. 4) The most common medical history in primary infertility was tuberculous disease, and that in secondary infertility was history of previous laparotomy. 5) About two thirds of antecedent pregnancies were abortion. 6) The major etiologic factor of infertility were male factor in 12.3%, tubal factor in 38.8%, ovulatory failure in 25.4%, uterine factor in 8.8%, cervical factor in 5.2%, peritoneal factor in 9.5%, and no demonstrable cause in 11.3%. 7) The types of male factor were azoospermia in 61.6%, oligospermia in 25.8%, low motility in 11.6%, and other abnormality in 1.0%. 8) The types of ovulatory failure were ovarian failure in 7.4%, hypothalamo-pituitary failure in 8.1 %, hypothalamo-pituitary dysfunction (including Polycystic ovarian syndrome) in 30.2%, and hyperprolactinemia in 22.4%. 9) The types of uterine factor were endometrial tuberculosis in 27.5%, uterine synechia in 33.8%, uterine anomaly in 19.7%, myoma and polyp in 9.1 %, and luteal phase defect in 9.9%. 10) The types of peritoneal factor were pelvic adhesion in 80.9% and endometriosis in 19.6%. 11) Surgeries were done in 408 patients, and they were salpingolysis, lysis of extraadnexal adhesion, salpingostomy, fimbrioplasty, ovarian wedge resection for polycystic ovarian disease, tubo-tubal anastomosis, and tubo-uterine implantation in orders. 12) 243 pregnancies were achieved during the infertility work-up, of which livebirth was 46.5%, ectopic pregnancy was 7.4%, spontaneous abortion was 7.8%, and on-going pregnancy or lost to follow-up was 36.2%. 13) Pregnancy rates in various factors were male factor in 18.7%, ovulatory factor in 31.7%, tubal factor in 24.2%, uterine factor in 34.6%, cervical factor in 19.0%, peritoneal factor in 29.0%, combined factors in 10.5%, and unexplained infertility in 37.1%. Pregnancy rate in whole patients was 25.2%.

• Journal of Yeungnam Medical Science
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• v.24 no.1
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• pp.91-96
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• 2007

Extrapelvic endometriosis is a rare disease. The majority of extrapelvic endometriosis cases involve scar tissue following obstetric and gynecologic procedures. We have treated two cases of extrapelvic incisional endometriosis. A 39 year old female patient with cyclic vaginal spotting after laparoscopic assisted vaginal hysterectomy due to uterine myoma and a 35 year old female patient with a painful palpable abdominal mass after cesarean section. Both underwent complete excision and were proven to have endometriosis by pathology. Here we report on both cases and review the medical literatures.