261 results on '"Ovarian Cysts physiopathology"'
Search Results
2. Ovarian reserve and recurrence 1 year post-operatively after using haemostatic sealant and bipolar diathermy for haemostasis during laparoscopic ovarian cystectomy.
- Author
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Chung JPW, Law TSM, Mak JSM, Sahota DS, and Li TC
- Subjects
- Adolescent, Adult, Endometriosis pathology, Endometriosis physiopathology, Endometriosis therapy, Female, Follow-Up Studies, Hemostatic Techniques, Hemostatics therapeutic use, Hong Kong, Humans, Laparoscopy methods, Ovarian Cysts pathology, Ovarian Cysts physiopathology, Ovarian Diseases pathology, Ovarian Diseases physiopathology, Ovarian Diseases therapy, Postoperative Period, Treatment Outcome, Young Adult, Diathermy methods, Gelatin Sponge, Absorbable therapeutic use, Neoplasm Recurrence, Local pathology, Neoplasm Recurrence, Local physiopathology, Ovarian Cysts therapy, Ovarian Reserve drug effects
- Abstract
Research Question: Is there a difference in the ovarian reserve 1 year post-operatively in those who used a haemostatic sealant or bipolar diathermy for haemostasis during laparoscopic ovarian cystectomy for ovarian endometriomas?, Design: This was an extended follow-up observational study of a previous randomized controlled trial where women aged 18 to 40 years with 3-8 cm unilateral or bilateral endometriomas were randomized to receive haemostasis by a haemostatic sealant or bipolar diathermy following ovarian cystectomy. The primary outcome was the ovarian reserve as assessed by antral follicle count (AFC) 1 year post-operatively. Secondary outcomes included the recurrence rate of ovarian endometrioma, the change in anti-Müllerian hormone (AMH) and FSH concentrations, and reproductive outcomes., Results: The significant increase in AFC at 3 months after initial surgery (P = 0.025) in the haemostatic sealant group compared with the diathermy group was sustained at 1 year (P = 0.024) but there was no difference in AMH or FSH concentrations between the groups throughout the follow-up period. The recurrence rate in the FloSeal group was 7.7% (n = 3/39) compared with 22.2% (n = 8/36) in the diathermy group (P = 0.060). The recurrence rate in women who had bilateral lesions was significantly higher than those with unilateral lesions (risk ratio 5.33, interquartile range 1.55-18.38). No difference in reproductive outcomes was found between the two groups., Conclusions: Applying haemostatic sealant after laparoscopic cystectomy of ovarian endometriomas produces a significantly greater improvement in AFC, which was apparent at 3-month follow-up, and was sustained at 1-year follow-up without compromising the recurrence rate., (Copyright © 2021 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2021
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3. Exacerbated mini-puberty of infancy in an ex-extreme preterm girl.
- Author
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Santos MC, Limão S, and Ferreira P
- Subjects
- Diagnosis, Differential, Endometrium diagnostic imaging, Endometrium physiopathology, Estradiol blood, Female, Humans, Infant, Infant, Extremely Premature blood, Luteinizing Hormone blood, Ovarian Cysts blood, Ovarian Cysts physiopathology, Puberty blood, Puberty, Precocious diagnosis, Remission, Spontaneous, Uterine Hemorrhage blood, Uterine Hemorrhage physiopathology, Infant, Extremely Premature physiology, Ovarian Cysts diagnosis, Puberty physiology, Uterine Hemorrhage diagnosis
- Abstract
Vaginal bleeding can occur shortly after delivery in 3%-5% of newborns as a consequence of placental hormone withdrawal . Although usually benign, its differential diagnosis includes central precocious puberty, tumours and other pathological conditions. A girl born at 26 weeks of gestation presented with five episodes of vaginal bleeding, each lasting less than a week, initiated at 4 months of age. Luteinising hormone and oestradiol levels were in the pubertal range. Later, she exhibited breast development, with no other pubertal signs. An ultrasonography test revealed an impregnated endometrium and a right ovarian cyst with 43 mm of diameter. A cranioencephalic MRI was unremarkable. Clinicians adopted expectant management and there was clinical, hormonal and radiological resolution in 3 months. The spontaneous resolution suggested mini-puberty of infancy. This is usually an asymptomatic condition, but to date, four cases of an exacerbated form in extremepremature infants have been reported. Long-term follow-up data are missing.A girl born at 26 weeks of gestation presented with five episodes of vaginal bleeding, each lasting less than a week, initiated at 4 months of age. Luteinising hormone and oestradiol levels were in the pubertal range. Later, she exhibited breast development, with no other pubertal signs. An ultrasonography test revealed an impregnated endometrium and a right ovarian cyst with 43 mm of diameter. A cranioencephalic MRI was unremarkable. Clinicians adopted expectant management and there was clinical, hormonal and radiological resolution in 3 months. The spontaneous resolution suggested mini-puberty of infancy. This is usually an asymptomatic condition, but to date, four cases of an exacerbated form in extremepremature infants have been reported. Long-term follow-up data are missing., Competing Interests: Competing interests: None declared., (© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.)
- Published
- 2020
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4. The Abnormal Ovary: Evolving Concepts in Diagnosis and Management.
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Hack K and Glanc P
- Subjects
- Carcinogenesis pathology, Disease Progression, Female, Humans, Ovarian Cysts diagnostic imaging, Ovarian Cysts pathology, Ovarian Cysts physiopathology, Ovarian Diseases pathology, Ovarian Diseases physiopathology, Ovarian Neoplasms diagnostic imaging, Ovarian Neoplasms pathology, Ovarian Neoplasms physiopathology, Ovary pathology, Ovary physiopathology, Ultrasonography methods, Ovarian Diseases diagnostic imaging, Ovary diagnostic imaging, Ultrasonography standards
- Abstract
Ovarian lesions are common and require a consistent approach to diagnosis and management for best patient outcomes. In the past 20 years, there has been an evolution in the approach to abnormal ovarian lesions, with increasing emphasis on reducing surgery for benign disease, standardizing terminology, assessing risk of malignancy through use of evidence-based scoring systems, and triaging suspicious abnormalities to dedicated oncology centers. This article provides an evidence-based review of how these changes in diagnosis and management of ultrasound-detected abnormal ovarian lesions have occurred. Current recommended practices are summarized. The current literature on transvaginal screening for ovarian cancer also is reviewed and summarized., (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Published
- 2019
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5. Contribution of the VEGF system to the follicular persistence associated with bovine cystic ovaries.
- Author
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Stassi AF, Gasser F, Velázquez MML, Belotti EM, Gareis NC, Rey F, Ortega HH, Salvetti NR, and Baravalle ME
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- Animals, Case-Control Studies, Cattle physiology, Cattle Diseases metabolism, Female, Follicular Cyst genetics, Follicular Cyst metabolism, Follicular Cyst physiopathology, Gene Expression, Ovarian Cysts metabolism, Ovary metabolism, Ovary pathology, Ovulation genetics, Ovulation metabolism, Receptors, Vascular Endothelial Growth Factor metabolism, Receptors, Vascular Endothelial Growth Factor physiology, Vascular Endothelial Growth Factor A metabolism, Cattle Diseases genetics, Cattle Diseases physiopathology, Ovarian Cysts genetics, Ovarian Cysts physiopathology, Ovarian Follicle physiology, Vascular Endothelial Growth Factor A physiology
- Abstract
Cystic ovaries (CO) characterize a disorder frequently found in dairy cattle. However, despite the contributions by several researchers, the mechanism that leads to ovulatory failure has not yet been completely elucidated. Thus, the aim of this study was to examine the mRNA expression of bovine vascular endothelial growth factor (VEGFA)-164, VEGFA-164b and VEGF receptors (VEGFR1 and VEGFR2) by real-time PCR and protein expression by immunohistochemistry, immunofluorescence and Western blot in follicular fluid from dairy cows with spontaneous CO and in an experimental model of follicular persistence induced by prolonged treatment with progesterone. Results showed that both VEGFA isoforms and receptors were coexpressed in granulosa and theca interna cells and in follicular fluid of ovaries from all the groups evaluated. VEGFA-164, VEGFA-164b and VEGFR2 protein expression was higher in theca cells of persistent follicles from group P0 (expected time of ovulation) than in those from dominant follicles (as reference structure) from the control group (p < 0.05). Also, VEGFA-164 expression was higher in theca cells of cysts than in those of dominant follicles of the control group (p < 0.05). In follicular fluid, VEGFA-164 expression was higher in persistent follicles from group P5 (5 days of follicular persistence) than in the control, P0 and P15 groups, and higher in cysts than in dominant follicles from the control group (p < 0.05). This study provides evidence of an altered expression of VEGFA-164, VEGFA-164b and VEGFR2 during the formation of persistent follicles and cysts in cows. Together, these results evidence that early development of CO in cows is concurrent with an altered expression of these growth factors and that these alterations may contribute to the follicular persistence, angiogenic dysregulation and ovulatory failure found in cows with follicular cysts., (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Published
- 2019
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6. Hemodynamic changes detected by Doppler ultrasonography in the ovaries of cattle during early development of cystic ovarian disease.
- Author
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Díaz PU, Belotti EM, Notaro US, Salvetti NR, Leiva CJM, Durante LI, Marelli BE, Stangaferro ML, and Ortega HH
- Subjects
- Animals, Blood Flow Velocity drug effects, Cattle, Cattle Diseases pathology, Cattle Diseases physiopathology, Dairying, Disease Progression, Estrus Synchronization methods, Female, Hemodynamics drug effects, Intrauterine Devices, Medicated veterinary, Ovarian Cysts pathology, Ovarian Cysts physiopathology, Ovarian Follicle diagnostic imaging, Ovarian Follicle drug effects, Ovarian Follicle pathology, Ovary drug effects, Ovary pathology, Progesterone pharmacology, Ultrasonography, Doppler veterinary, Cattle Diseases diagnosis, Hemodynamics physiology, Ovarian Cysts diagnosis, Ovary blood supply, Ovary diagnostic imaging
- Abstract
A common reproductive disease in dairy cattle is Cystic Ovarian Disease. To study its development, there was use of an experimental model of follicular persistence to detect hemodynamic changes occurring in ovaries by using Doppler ultrasonography. After estrous synchronization, control cows received no additional treatment and were evaluated at proestrus (CG), whereas treated cows (PG) received sub-luteal doses of progesterone for 15 days and were evaluated at proestrus, and after 0, 5, 10 and 15 days of follicular persistence. Spectral Doppler was used to evaluate blood flow in the ovarian artery, and power Doppler for evaluation of blood flow in the ovarian parenchyma and follicular wall of persistent and dominant preovulatory follicles. Findings using power Doppler signals indicated there were no differences between groups in the parenchyma of both right (P = 0.455) and left (P = 0.762) ovaries. In contrast, power Doppler signals of blood flow were less in walls of persistent follicles from day 0 to 15 when there was follicular persistence than in dominant follicles of the CG (P < 0.001). Blood flow in ovarian arteries was less (P < 0.05) in diastolic velocity and time averaged maximum velocity in all PG groups than in the CG. Peak systolic velocity was less (P < 0.05) in all PG than in the CG, with the exception of P15 (P > 0.05). These findings indicate there are marked changes in blood irrigation area of walls of persistent follicles during the 15 days of follicular persistence., (Copyright © 2019 Elsevier B.V. All rights reserved.)
- Published
- 2019
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7. Ovarian function after the use of various hemostatic techniques during treatment for endometrioma: protocol for a randomized clinical trial.
- Author
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Araujo RSDC, Maia SB, Baracat CMF, Lima MD, Soares ESS, Ribeiro HSAA, and Ribeiro PAAG
- Subjects
- Anti-Mullerian Hormone blood, Biomarkers blood, Brazil, Endometriosis diagnostic imaging, Endometriosis physiopathology, Female, Humans, Ovarian Cysts diagnostic imaging, Ovarian Cysts physiopathology, Ovarian Follicle diagnostic imaging, Randomized Controlled Trials as Topic, Time Factors, Treatment Outcome, Blood Loss, Surgical prevention & control, Endometriosis surgery, Gynecologic Surgical Procedures adverse effects, Hemostatic Techniques adverse effects, Laparoscopy adverse effects, Ovarian Cysts surgery, Ovarian Reserve
- Abstract
Background: Laparoscopic cystectomy is currently considered the gold standard for the treatment of ovarian endometrioma, resulting in an improvement in symptoms, a lower recurrence rate, and a higher pregnancy rate among infertile patients. However, this treatment is not free from risk, since it is associated with a reduction in ovarian reserve. There is still controversy in the literature regarding whether the cause of the reduction in ovarian reserve is due to damage caused by the coagulation energy during hemostasis or whether the procedure itself is the cause of the damage irrespective of the hemostatic method used. The aim of this study is to compare the effects of different hemostatic methods on the ovarian function of women subjected to laparoscopic surgery for ovarian endometrioma., Methods: An open-label randomized clinical trial to be conducted at the Lauro Wanderley University Hospital between December 2017 and August 2020. Eighty-four patients will be randomly allocated to three groups according to the hemostatic technique used during laparoscopic surgery for ovarian endometrioma: bipolar coagulation; laparoscopic suture; and hemostatic matrix. Ovarian function will be assessed by serum anti-Müllerian hormone measurement and by performing an antral follicle count using ultrasound before surgery and one, three, and six months after surgery. The internal review board of the Medical Sciences Center, Federal University of Paraíba approved the study protocol under reference CAAE 71621717.9.0000.8069., Discussion: Bearing in mind the need for more randomized clinical trials to clarify this issue, we hope to contribute with data that will determine whether there is any difference between hemostatic methods despite the rational use of bipolar energy or whether the procedure itself explains the ovarian damage irrespective of the hemostatic technique used., Trial Registration: ClinicalTrials.gov, NTC03430609 . Registered on XX.10/31/2017. ISRCTN Registry, ISRCTN11469394 . Registered on XX.17/12/2017. Unique Protocol ID: U1111-1203-2508.
- Published
- 2019
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8. Levels of selected cytokines and acute-phase proteins in the serum of dairy cows with cystic ovarian disease and those in follicular and luteal phases of normal ovarian cycle.
- Author
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Brodzki P, Brodzki A, Krakowski L, Dąbrowski R, Szczubiał M, and Bochniarz M
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- Animals, Cattle, Cattle Diseases blood, Female, Follicular Cyst blood, Follicular Cyst physiopathology, Ovarian Cysts blood, Ovarian Cysts physiopathology, Acute-Phase Proteins metabolism, Cattle Diseases physiopathology, Cytokines blood, Estrous Cycle blood, Follicular Cyst veterinary, Ovarian Cysts veterinary
- Abstract
The aim of the study was to evaluate the concentration of selected cytokines (tumor necrosis factor [TNFα], interleukin [IL]-6, IL-10) and acute-phase proteins (APPs; haptoglobin [Hp] and serum amyloid A [SAA]) in the serum of cows with follicular and luteal ovarian cysts and in those in the follicular and luteal phases of a physiological ovarian cycle. The study was conducted on 24 Holstein-Friesian (HF) cows: eight cows in the follicular phase of the cycle; the same cows after 10 days when they were in the luteal phase; eight cows with follicular cysts; and eight cows with luteal cysts. Levels of progesterone, 17β-estradiol, TNF-α, IL-6, IL-10, SAA, and Hp were evaluated in the serum of all examined cows. The concentration of the assessed parameters in the serum was determined using commercially available bovine ELISA kits that were specific for each parameter. The results obtained then showed that values of TNF-α and IL-6 were highest in cows with luteal cysts (p < .001), compared to those with other ovarian structures. The highest level of IL-10 was recorded in cows with two types of ovarian cysts. Furthermore, high values of SAA and Hp were found in cows with two types of cysts; however, these values were higher in cows with follicular cysts. The present study shows that an assessment of the levels of cytokines (pro- and anti-inflammatory) and APPs in the serum may be important in the investigation of the processes underlying the formation and differentiation of ovarian cysts in dairy cows., (Copyright © 2018 Elsevier Ltd. All rights reserved.)
- Published
- 2019
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9. Giant Ovarian Mucinous Cystadenoma Complicating Term Pregnancy.
- Author
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Mishra S, Yadav M, and Walawakar SJ
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- Adult, Female, Humans, Pregnancy, Pregnancy Outcome, Pregnancy Trimester, Third, Breech Presentation diagnosis, Breech Presentation surgery, Cesarean Section methods, Cystadenoma, Mucinous pathology, Cystadenoma, Mucinous physiopathology, Cystadenoma, Mucinous surgery, Ovarian Cysts pathology, Ovarian Cysts physiopathology, Ovarian Cysts surgery, Ovarian Neoplasms pathology, Ovarian Neoplasms physiopathology, Ovarian Neoplasms surgery, Pregnancy Complications, Neoplastic pathology, Pregnancy Complications, Neoplastic physiopathology, Pregnancy Complications, Neoplastic surgery, Salpingo-oophorectomy methods
- Abstract
Huge ovarian cyst are found in less than 1% of all ovarian cyst in pregnancy and are associated with poor feto-maternal outcome. A 28 years old G2P1 with history of normal vaginal delivery 3 years back was referred from local health post with complains of intermittent pain abdomen at 29 weeks. Her scan showed huge ovarian cyst of 18.9×17.6 cm with multiple thick septation. Woman was conservatively managed till term and elective surgery was planned however she presented in labour with breech presentation at 39 weeks and 4days. Emergency lower segment caesarian section along with left sided salpingo-oophorectomy was done along with delivery of 2.5 kg healthy female baby. Histopathology was suggestive of mucinous cystadenoma of ovary. Although antepartum removal of ovarian cyst has been recommended to ensure good pregnancy outcome, expectant management and timed intervention can be adopted for pregnancy with huge ovarian cysts. Keywords: mucinous cystadenoma; ovarian cyst; pregnancy.
- Published
- 2018
10. Vaginal bleeding and a giant ovarian cyst in an infant with 21-hydroxylase deficiency.
- Author
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Şahin NM, Bayramoğlu E, Çetinkaya S, Erdeve ŞŞ, Karaman A, Akdoğan MP, and Aycan Z
- Subjects
- 46, XX Disorders of Sex Development genetics, Adrenal Hyperplasia, Congenital genetics, Amino Acid Substitution, Anti-Inflammatory Agents adverse effects, Anti-Inflammatory Agents therapeutic use, Drug Therapy, Combination adverse effects, Female, Fludrocortisone adverse effects, Fludrocortisone therapeutic use, Gonadotropins therapeutic use, Homozygote, Humans, Hydrocortisone adverse effects, Hydrocortisone therapeutic use, Infant, Newborn, Mutation, Ovarian Cysts pathology, Ovarian Cysts physiopathology, Ovarian Cysts surgery, Ovary pathology, Ovary surgery, Steroid 21-Hydroxylase genetics, Treatment Outcome, Tumor Burden, Uterine Hemorrhage prevention & control, 46, XX Disorders of Sex Development drug therapy, Adrenal Hyperplasia, Congenital drug therapy, Gonadotropins adverse effects, Ovarian Cysts chemically induced, Ovary drug effects, Uterine Hemorrhage etiology
- Abstract
Background: Increased adrenal androgen hormones in congenital adrenal hyperplasia (CAH) can rarely cause giant ovarian cysts in the neonatal period. Although the exact mechanism of the development of ovarian cysts is unknown, it is thought that increased androgen levels stimulate folicle development by increasing follicle stimulating hormone (FSH) levels., Case Presentation: A 16-day-old newborn with ambiguous genitalia was presented to our clinic. Laboratory test results were as follows: sodium: 126 mEq/L, potassium: 5.4 mEq/L, renin: 132 pg/mL, adrenocorticotropic hormone (ACTH): 207 pg/mL, cortisole: 7.8 μg/dL, basal 17OH progesterone: 21 ng/mL, androstenedione: 5.1 ng/mL, testosterone: 1188 ng/dL and dehydroepiandrosterone sulfate (DHEAS)>1500 μg/dL. Karyotype analysis resulted in 46,XX. A homozygous mutation of R356W was detected in the CYP21A2 gene. The classical severe form of salt wasting 21 hydroxylase deficiency was diagnosed and treatment was started with hydrocortisone and fludrocortisone. Good metabolic control was ensured by monthly visits but the baby presented with vaginal bleeding as soiling at 4 months. The cystic lesion which extended to the epigastric area from the pelvis in the midline abdomen, had a size of 90×80×60 mm and medially, thin ovarian parenchyma was detected in ultrasonography., Conclusions: The findings in our patient suggest that a decline in adrenal androgens after glucocorticoid treatment resulted in an increase in gonadotropin levels and the giant cyst is developed by activation of gonadotropin cascade and increased gonadotropin receptors, instead of androgens.
- Published
- 2018
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11. Effect of menstrual phase on the surgical treatment of ovarian cysts.
- Author
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Song T, Kim MK, Kim ML, Jung YW, Yun BS, and Seong SJ
- Subjects
- Adult, Anti-Mullerian Hormone blood, Female, Humans, Laparoscopy methods, Ovarian Cysts blood, Ovarian Cysts physiopathology, Ovarian Reserve, Postoperative Period, Preoperative Period, Time Factors, Treatment Outcome, Blood Loss, Surgical physiopathology, Follicular Phase, Luteal Phase, Ovarian Cysts surgery
- Abstract
This study aimed to determine whether the menstrual cycle affects operative bleeding and postoperative ovarian reserve in patients undergoing laparoscopic ovarian cystectomy. A total of 155 patients who had undergone laparoscopic ovarian cystectomy were classified into the follicular phase (n = 84) and luteal phase (n = 71) of the menstrual cycle. The primary outcome measures were operative blood loss and the rate of decline in ovarian reserve, as calculated by measuring serial serum anti-Müllerian hormone (AMH) levels preoperatively and 3 months postoperatively. No significant difference in the baseline demographics, operative blood loss (p = .984), the rate of decline in ovarian reserve (p = .945), and other surgical outcomes were observed between both the groups. These results demonstrate that the menstrual cycle had no influence on the operative blood loss and ovarian reserve during laparoscopic ovarian cystectomy. Therefore, the menstrual cycle is not an important factor to determine the optimal timing of ovarian cystectomy. Impact statement What is already known on this subject?: The menstrual cycle results in periodic changes in haemostasis and blood flow in the reproductive organs. What do the results of this study add?: These results demonstrate that the menstrual cycle had no influence on the operative blood loss and ovarian reserve during laparoscopic ovarian cystectomy. What are the implications of these findings for clinical practice and/or further research?: The menstrual cycle is not an important factor to determine the optimal timing of ovarian cystectomy.
- Published
- 2017
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12. Management of Endometriomas.
- Author
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Muzii L, Di Tucci C, Di Feliciantonio M, Galati G, Verrelli L, Donato VD, Marchetti C, and Panici PB
- Subjects
- Combined Modality Therapy, Contraceptives, Oral adverse effects, Endometriosis diagnosis, Endometriosis physiopathology, Female, Humans, Ovarian Cysts diagnosis, Ovarian Cysts physiopathology, Ovarian Reserve drug effects, Ovariectomy adverse effects, Ovary physiopathology, Risk Factors, Suction, Treatment Outcome, Contraceptives, Oral therapeutic use, Endometriosis therapy, Laparoscopy adverse effects, Ovarian Cysts therapy, Ovariectomy methods, Ovary drug effects, Ovary surgery
- Abstract
Ovarian endometriomas affect 17 to 44% of women with endometriosis, and are often associated with pelvic pain and infertility. Treatment options include expectant management, medical and/or surgical treatment, and in vitro fertilization and embryo transfer (IVF-ET). The choice of treatment depends mostly on the associated symptoms. In most cases, surgery is the preferred choice, since endometriomas do not respond to medical treatment, which may only treat associated pain. In case of infertility, IVF-ET may be a suitable alternative to surgery, particularly when there is no associated pain. According to the best available scientific evidence, laparoscopic excision of the endometrioma wall should be considered the procedure of choice. Concerns have been raised as to the possibility that surgical excision may damage the ovarian reserve, but recent evidences demonstrate that part of the damage may be due to the presence of the endometrioma itself. Indication to surgical treatment should balance the possible risks of damaging the ovarian reserve with the advantages of surgery in terms of satisfactory pain relief rates and pregnancy rates, and of obtaining tissue specimen for ruling out the rare cases of unexpected ovarian malignancy. A score system to guide the clinician in the decision to perform or withhold surgery is presented., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)
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- 2017
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13. Parity and risk of ovarian cysts: Cross-sectional evidence from the Dongfeng-Tongji cohort study.
- Author
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Mandiwa C, Shen LJ, Tian YH, Song LL, Xu GQ, Yang SY, Liang Y, Yuan J, and Wang YJ
- Subjects
- Age Factors, Aged, Aged, 80 and over, Asian People, China, Decision Making, Female, Humans, Live Birth, Middle Aged, Ovarian Cysts blood, Pregnancy, Risk Factors, Ovarian Cysts epidemiology, Ovarian Cysts physiopathology, Parity physiology
- Abstract
Little is known about the association between parity and the risk of ovarian cysts. The aim of this study was to examine the association between parity and the risk of ovarian cysts among a population of Chinese women. A total of 20 502 women aged 45-86 years from the Dongfeng-Tongji Cohort study completed baseline questionnaires, medical examination and provided baseline blood samples. Participants were categorized into four groups according to parity (one, two, three, and four or more live births). Logistic regression models were used to investigate the association between parity and the risk of ovarian cysts. The prevalence of ovarian cysts in the study population was 4.0% (816/20 502). Increasing parity was associated with decreasing risk of ovarian cysts without adjustment for any covariates and after age-adjusted model (P<0.001). After adjusting for potential confounders, women who had had four or more live births had lower risk of ovarian cysts (OR: 0.51; 95% CI: 0.27-0.96) compared with women who had had one live birth. There was a consistent but non-significant decreased risk of ovarian cysts for women who had had two, and three live births (OR: 0.85; 95% CI: 0.68-1.05) and (OR: 0.84; 95% CI: 0.59-1.20) respectively compared with women who had had one live birth. It was concluded that higher parity was associated with decreasing risk of ovarian cysts in this population of Chinese women. These findings could be helpful in decision making in clinical practice for gynecologists when evaluating women suspected to have ovarian cysts.
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- 2016
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14. Large abdominal cystic masses: Report of seven cases.
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Bolukbas FF, Bolukbas C, Furuncuoglu Y, Tabandeh B, Saglam FY, Iyigun G, Orug T, Ozcan A, and Yapicier O
- Subjects
- Adult, Asymptomatic Diseases, Diagnosis, Differential, Female, Humans, Magnetic Resonance Imaging methods, Middle Aged, Treatment Outcome, Tumor Burden, Ultrasonography methods, Abdominal Cavity diagnostic imaging, Abdominal Cavity pathology, Abdominal Pain diagnosis, Genital Neoplasms, Female diagnosis, Gynecologic Surgical Procedures methods, Mesenteric Cyst diagnosis, Mesenteric Cyst physiopathology, Ovarian Cysts diagnosis, Ovarian Cysts physiopathology
- Abstract
Cystic abdominal tumours are encountered quite often and are diagnosed more frequently due to the availability of better imaging possibilities. Presentation of huge cysts has become rare as most of them are diagnosed and treated early. But we still have patients with enlarged abdominal cysts; majority with cases of serous cystadenomas of the ovary. Absolute diagnosis is only possible with laparotomy and histopathological findings. In this report, seven patients with enlarged gynaecological or mesenteric cystic masses and gastroenterological symptoms are reported. Four of these cases were serous cystadenoma, two were mucinous cystadenoma and one was a paratubal cyst. Gynaecological tumours and mesenteric cysts should not be missed in female patients showing gastrointestinal symptoms.
- Published
- 2016
15. Advancing Urinary Protein Biomarker Discovery by Data-Independent Acquisition on a Quadrupole-Orbitrap Mass Spectrometer.
- Author
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Muntel J, Xuan Y, Berger ST, Reiter L, Bachur R, Kentsis A, and Steen H
- Subjects
- Abdominal Pain diagnosis, Abdominal Pain physiopathology, Biomarkers urine, Child, Female, Humans, Male, Mass Spectrometry methods, Ovarian Cysts diagnosis, Ovarian Cysts physiopathology, Peptide Library, Sensitivity and Specificity, Urinary Tract Infections diagnosis, Urinary Tract Infections physiopathology, Abdominal Pain urine, Data Mining methods, Mass Spectrometry statistics & numerical data, Ovarian Cysts urine, Urinary Tract Infections urine
- Abstract
The promises of data-independent acquisition (DIA) strategies are a comprehensive and reproducible digital qualitative and quantitative record of the proteins present in a sample. We developed a fast and robust DIA method for comprehensive mapping of the urinary proteome that enables large scale urine proteomics studies. Compared to a data-dependent acquisition (DDA) experiments, our DIA assay doubled the number of identified peptides and proteins per sample at half the coefficients of variation observed for DDA data (DIA = ∼8%; DDA = ∼16%). We also tested different spectral libraries and their effects on overall protein and peptide identifications and their reproducibilities, which provided clear evidence that sample type-specific spectral libraries are preferred for reliable data analysis. To show applicability for biomarker discovery experiments, we analyzed a sample set of 87 urine samples from children seen in the emergency department with abdominal pain. The whole set was analyzed with high proteome coverage (∼1300 proteins/sample) in less than 4 days. The data set revealed excellent biomarker candidates for ovarian cyst and urinary tract infection. The improved throughput and quantitative performance of our optimized DIA workflow allow for the efficient simultaneous discovery and verification of biomarker candidates without the requirement for an early bias toward selected proteins., Competing Interests: Notes The authors declare no competing financial interest.
- Published
- 2015
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16. Involvement of PAPP-A and IGFR1 in Cystic Ovarian Disease in Cattle.
- Author
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Rodríguez FM, Colombero M, Amweg AN, Huber E, Gareis NC, Salvetti NR, Ortega HH, and Rey F
- Subjects
- Animals, Cattle, Cattle Diseases etiology, Female, Follicular Fluid chemistry, Gene Expression, Granulosa Cells chemistry, Immunohistochemistry, Ovarian Cysts chemistry, Ovarian Cysts physiopathology, Ovarian Follicle chemistry, Pregnancy, Pregnancy-Associated Plasma Protein-A analysis, Pregnancy-Associated Plasma Protein-A genetics, RNA, Messenger analysis, Receptor, IGF Type 1 analysis, Receptor, IGF Type 1 genetics, Cattle Diseases physiopathology, Ovarian Cysts veterinary, Pregnancy-Associated Plasma Protein-A physiology, Receptor, IGF Type 1 physiology
- Abstract
Cystic ovarian disease (COD) is one of the main causes of infertility in dairy cattle. It has been shown that intra-ovarian factors, such as members of the insulin-like growth factor (IGF) system, may contribute to follicular persistence. The bioavailability of IGF to initiate its response by binding to specific receptors (IGFRs) depends on interactions with related compounds, such as pregnancy-associated plasma protein A (PAPP-A). The aim of this study was to determine IGFR1 and PAPP-A expression both in follicles at different stages of development and in cysts, to evaluate the roles in the etiopathogenesis of COD in cattle. The mRNA expression of PAPP-A was higher in granulosa cells of large tertiary follicles than in cysts, whereas the protein PAPP-A present in the follicular fluid from these follicles showed no differences. Although no PAPP-A mRNA expression was detected in smaller tertiary follicles, in their follicular fluid, this protease was detected in lesser concentration than in cysts. The mRNA expression of IGFR1 was lower in granulosa cells from cystic follicles than in those from tertiary ones. However, the protein expression of this receptor presented the highest levels in cystic structures, probably to increase the possibility of IGF response. The data obtained would indicate that animals with COD have an altered regulation of the IGF system in the ovary, which could be involved in the pathogenesis of this disease in cattle., (© 2015 Blackwell Verlag GmbH.)
- Published
- 2015
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17. Exploratory study of pre-surgical medications with dienogest or leuprorelin in laparoscopic cystectomy of endometrial cysts.
- Author
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Takenaka M, Yano R, Hiraku Y, Shibata M, Hatano K, Yamamoto S, Sato K, Yamamoto K, and Morishige K
- Subjects
- Adult, Anti-Mullerian Hormone blood, Endometriosis drug therapy, Endometriosis physiopathology, Female, Humans, Nandrolone therapeutic use, Ovarian Cysts blood, Ovarian Cysts drug therapy, Ovarian Cysts physiopathology, Ovary pathology, Ovary physiopathology, Visual Analog Scale, Endometriosis surgery, Laparoscopy methods, Leuprolide therapeutic use, Nandrolone analogs & derivatives, Ovarian Cysts surgery
- Abstract
Aim: The aim of this study was to compare the effects of pre-surgical medication with dienogest or leuprorelin on post-surgical ovarian function., Material and Methods: We conducted an exploratory study in two centers in Japan that comprised 30 patients with ovarian endometrial cysts for whom surgical excision was planned. Patients were enrolled and divided into pre-surgical medication groups with dienogest or leuprorelin for 12 weeks. Thereafter, patients were treated by laparoscopic cystectomy. The primary outcome was ovarian function post-surgery, as assessed by serum anti-Müllerian hormone (AMH) level, antral follicle count (AFC) and resumption of menses. Secondary outcome was the effect of pre-surgical medication, as assessed by the size of endometrial cysts and visual analog scale (VAS) score. Serum AMH, AFC, size of endometrial cysts, and VAS scores were measured at baseline (before medication), after medication (1 day before surgery), and at 4 and 12 weeks post-surgery., Results: Serum AMH levels did not change after pre-surgical medication with either dienogest or leuprorelin. Although AMH decreased after surgery, it recovered by 12 weeks post-surgery in both groups with no statistically significant difference. Mean AFC did not change after surgery in either group. Menses returned by 12 weeks post-surgery in all patients except for those who were pregnant. The rate of reduction of endometrial cyst volume did not differ between the groups. Both dienogest and leuprorelin were associated with substantial reductions in VAS scores., Conclusion: There were no statistically significant differences between pre-surgical medication with dienogest and leuprorelin in post-surgical ovarian function. Both medications were effective in reducing endometrial cyst volume and VAS score., (© 2015 The Authors. Journal of Obstetrics and Gynaecology Research © 2015 Japan Society of Obstetrics and Gynecology.)
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- 2015
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18. Synchronization of ovulation with human chorionic gonadotropin in lactating dairy cows with ovarian cysts during heat stress.
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Navanukraw C, Khanthusaeng V, Kraisoon A, Suwannarit D, Jarassaeng C, and Aiumlamai S
- Subjects
- Animals, Cattle, Dairying, Female, Heat Stress Disorders physiopathology, Hot Temperature, Humans, Insemination, Artificial veterinary, Ovarian Cysts physiopathology, Ovary drug effects, Pregnancy, Cattle Diseases physiopathology, Chorionic Gonadotropin administration & dosage, Estrus Synchronization, Heat Stress Disorders veterinary, Lactation, Ovarian Cysts veterinary
- Abstract
A study was conducted during hot season to determine the effect of synchronization of ovulation with human chorionic gonadotropin (hCG) on fertility of lactating dairy cows with ovarian cysts. Non cyclic Holstein dairy cows (n = 80) were stratified by parity and diagnosed as having an ovarian cyst. The cows were further identified as follicular or luteal cysts according to the plasma progesterone (P4) concentration and the cystic image of ultrasonography. Cystic cows were randomly assigned to receive treatments (Ovsynch as the control or Ovsynch plus 3000 IU hCG). All cows were artificially inseminated at 16-18 h after the second gonadotropin releasing hormone injection. Cows supplemented with hCG had a greater number of corpus luteum (1.8 ± 0.2 and 0.8 ± 0.3; P < 0.05) and had greater P4 concentration on day 12 than those control cows (6.3 ± 0.3 and 3.9 ± 0.4 ng/ml; P < 0.05). Concentration of cortisol did not differ between groups of cystic cows. No significant differences were found in overall conception rates between the treatments; however, significantly greater conception rate (P = 0.03) was observed in cows with luteal cysts receiving Ovsynch plus hCG. This study highlights that administration of hCG following the Ovsynch-based timed artificial insemination (AI) is more effective than the control Ovsynch by which the hCG affects corpus luteum (CL) development, P4 concentration, and thus improves conception rate in dairy cows with luteal cysts.
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- 2015
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19. Endometriotic ovarian cysts do not negatively affect the rate of spontaneous ovulation.
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Leone Roberti Maggiore U, Scala C, Venturini PL, Remorgida V, and Ferrero S
- Subjects
- Adult, Endometriosis diagnostic imaging, Endometriosis pathology, Endometrium diagnostic imaging, Endometrium pathology, Female, Follow-Up Studies, Humans, Infertility, Female epidemiology, Infertility, Female etiology, Italy epidemiology, Lost to Follow-Up, Organ Size, Ovarian Cysts diagnostic imaging, Ovarian Cysts pathology, Ovary diagnostic imaging, Pregnancy, Pregnancy Rate, Risk Factors, Severity of Illness Index, Ultrasonography, Endometriosis physiopathology, Ovarian Cysts physiopathology, Ovary physiopathology, Ovulation
- Abstract
Study Question: Do endometriotic ovarian cysts influence the rate of spontaneous ovulation?, Summary Answer: Endometriotic cysts, no matter what their volume, do not influence the rate of spontaneous ovulation in the affected ovary., What Is Known Already: Endometriotic ovarian cysts may negatively affect spontaneous ovulation in the affected ovary., Study Design, Size, Duration: This was a prospective observational study performed between September 2009 and June 2013., Participants/materials, Setting, Methods: This study included women of reproductive age with regular menstrual cycles and unilateral ovarian endometriomas (diameter ≥20 mm) desiring to conceive. Exclusion criteria were: hormonal therapies in the 3 months prior to study entry and previous adnexal surgery. Patients underwent serial transvaginal ultrasound to assess the side of ovulation (for up to six cycles)., Main Results and the Role of Chance: Ovulation was monitored in 1199 cycles in 244 women (age, mean ± SD, 34.3 ± 4.9 years). 55.3% of the patients had left endometriomas and 44.7% had right endometriomas (P = 0.024). The mean (±SD) diameter of the endometriomas was 5.3 cm (±1.7 cm). Ultrasonographically documented ovulation occurred in 596 cycles in the healthy ovary (49.7%; 95% CI, 46.8-52.6%) and in 603 cycles in the affected ovary (50.3%; 95% CI, 47.1-53.2%; P = 0.919). This observation was confirmed in patients with diameter of the cyst ≥4 cm (n = 166) and in those with diameter of the cyst ≥6 cm (n = 45). One hundred and five patients spontaneously conceived (43.0%; 95% CI, 36.7-49.5%)., Limitations, Reason for Caution: The high pregnancy rate reported in this study was observed in a selected population of women with endometriomas and cannot be extrapolated to all patients with endometriosis., Wider Implications of the Findings: Since ovarian endometriomas do not impair spontaneous ovulation, the impact on fertility of surgical excision of ovarian endometriomas should be further investigated., (© The Author 2014. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
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- 2015
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20. Anti-Müllerian hormone reduction after ovarian cyst surgery is dependent on the histological cyst type and preoperative anti-Müllerian hormone levels.
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Lind T, Hammarström M, Lampic C, and Rodriguez-Wallberg K
- Subjects
- Adolescent, Adult, Endometriosis blood, Endometriosis physiopathology, Female, Humans, Multivariate Analysis, Ovarian Cysts pathology, Ovarian Cysts physiopathology, Ovary physiopathology, Postoperative Period, Preoperative Period, Prospective Studies, Young Adult, Anti-Mullerian Hormone blood, Ovarian Cysts blood, Ovarian Cysts surgery
- Abstract
Objective: To investigate changes in serum anti-Müllerian hormone (AMH) concentrations following ovarian cyst surgery, and predictors of these changes., Design: Prospective cohort study with follow up at 3 and 6 months., Setting: University hospital., Population: Women of reproductive age scheduled for ovarian cyst surgery., Methods: Women were recruited between March 2011 and March 2012 (n = 75). Serum AMH concentrations were measured preoperatively and at 3 and 6 months postoperatively., Main Outcome Measures: Changes in AMH after surgery and predictors for these changes., Results: After surgery, median AMH levels decreased significantly from 2.7 μg/L (0.2-16.9) to 1.6 μg/L (0.2-9.9) at 3 months and were still low, 1.6 μg/L (0.2-8.3) at 6 months (both p < 0.001). In patients with unilateral cysts, a significant and more rapid AMH decrease was seen after enucleation of endometriomas (n = 19) vs. dermoid cysts (n = 22) (p = 0.010). The reduction was long-lasting at 6 months. In a multivariate regression analysis, a higher baseline AMH concentration was predictive of AMH reduction at 3 [odds ratio (OR) 1.9, 95% CI 1.1-3.1] and 6 months postoperatively (OR 2.5, 95% CI 1.2-5.2). Women with normal or elevated baseline AMH presented with a significant reduction of -23% and -43% at 3 and 6 months, respectively, whereas women with low or very low AMH had minimal or no changes over time. Patient's age, cyst size, duration of surgery or intraoperative bleeding were not predictive of a postoperative AMH decrease., Conclusions: Reduction of AMH was of greater magnitude and longer duration after enucleation of endometriomas and in women with normal and high preoperative AMH levels., (© 2014 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd. on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).)
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- 2015
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21. Two types of ovarian cortical inclusion cysts: proposed origin and possible role in ovarian serous carcinogenesis.
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Banet N and Kurman RJ
- Subjects
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Autopsy, Biopsy, Calbindin 2 metabolism, Carcinoma, Ovarian Epithelial, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Leukocyte Common Antigens metabolism, Middle Aged, Neoplasms, Cystic, Mucinous, and Serous physiopathology, Neoplasms, Glandular and Epithelial etiology, Neoplasms, Glandular and Epithelial pathology, Neoplasms, Glandular and Epithelial physiopathology, Ovarian Cysts physiopathology, Ovarian Neoplasms physiopathology, Ovary metabolism, Ovary pathology, PAX8 Transcription Factor, Paired Box Transcription Factors metabolism, Receptors, Estrogen metabolism, Receptors, Progesterone metabolism, Retrospective Studies, Young Adult, Carcinogenesis pathology, Neoplasms, Cystic, Mucinous, and Serous etiology, Neoplasms, Cystic, Mucinous, and Serous pathology, Ovarian Cysts classification, Ovarian Cysts pathology, Ovarian Neoplasms etiology, Ovarian Neoplasms pathology
- Abstract
Ovarian cortical inclusion cysts (CICs) have been long regarded as a possible site of origin of epithelial ovarian carcinoma. It has been proposed that they develop from invagination of ovarian surface epithelium (OSE) which then undergoes metaplasia to form mullerian-type tissue and then undergoes neoplastic transformation. Recent studies have challenged this view, at least for high-grade serous carcinoma, proposing that the latter arise from occult carcinomas in the fallopian tube. Although there is compelling evidence supporting this view, it does not account for the origin of all high-grade serous carcinomas. We have postulated that a subset of high-grade serous carcinoma may develop from CICs, but that they are derived from implantation of tubal epithelium when the OSE is disrupted at ovulation. If true, it would be expected that the number of CICs would increase with age and that CICs would not be present before menarche. To test this hypothesis we examined ovaries removed at autopsy for the presence of CICs and correlated their presence with age. In addition, we used immunohistochemistry for PAX8 (mullerian marker) and calretinin (mesothelial marker). CICs were defined as either ciliated (tubal-type, PAX8-positive) or flat (OSE-type, calretinin-positive). As it has been argued that steroid hormones convert mesothelial-derived OSE to mullerian-type tissue, we performed immunohistochemistry for estrogen and progesterone receptors. CICs lined by tubal-type epithelium were found only in postmenarchial women and 20/21 (95%) were PAX8-positive; none of the 5 flat cysts expressed PAX8 but 4/5 (80%) expressed calretinin. Estrogen receptor was expressed in 1 of 21 (5%) ciliated CICs, whereas it was negative in all 5 flat CICs. Progesterone receptor was expressed in 14 of 21 (66%) ciliated CICs, and in none of the 5 flat cysts. The findings suggest that there are 2 types of CICs, 1 from OSE and 1 from tubal epithelium that probably develop at the time of ovulation.
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- 2015
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22. Hormonal composition of follicular fluid from abnormal follicular structures in mares.
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Beltman ME, Walsh SW, Canty MJ, Duffy P, and Crowe MA
- Subjects
- Animals, Female, Horses, Ovarian Cysts physiopathology, Follicular Fluid chemistry, Hormones metabolism, Horse Diseases physiopathology, Insulin-Like Growth Factor Binding Proteins metabolism, Insulin-Like Growth Factor I metabolism, Ovarian Cysts veterinary, Ovarian Follicle physiopathology
- Abstract
The objective was to characterise the hormonal composition of follicular fluid from mares with distinct anovulatory-cystic follicles. Follicular fluid was aspirated from six mares that presented with cystic follicles and from pre-ovulatory follicles of five normal mares (controls). Differences in progesterone, oestradiol, testosterone, IGF-I and IGF binding were analysed using Fisher's exact test. There were greater (P < 0.03) follicular fluid oestradiol concentrations in normal follicles and the testosterone concentration of the cystic fluid was greater (P < 0.05) than that of the normal fluid. There also was a greater (P < 0.03) percentage of IGF-I binding and lower (P < 0.02) IGF-I concentrations in the fluid collected from the cystic structures compared with the fluid from normal follicles. Despite the limited number of animals, the fact that fluid aspirated from cystic follicles had higher testosterone and lower oestradiol concentrations could be of diagnostic value when a practitioner wants to distinguish between a cystic and non-cystic persistent follicle. The research reported here also indicates a likely role for the IGF system in the pathogenesis of the development and maintenance of anovulatory follicular structures in mare ovaries., (Copyright © 2014 Elsevier Ltd. All rights reserved.)
- Published
- 2014
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23. The impact of endometrioma and laparoscopic cystectomy on ovarian reserve and the exploration of related factors assessed by serum anti-Mullerian hormone: a prospective cohort study.
- Author
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Chen Y, Pei H, Chang Y, Chen M, Wang H, Xie H, and Yao S
- Subjects
- Adult, Case-Control Studies, Cystectomy, Endometriosis physiopathology, Endometriosis surgery, Female, Humans, Infertility, Female physiopathology, Infertility, Female surgery, Laparoscopy, Ovarian Cysts physiopathology, Ovarian Cysts surgery, Prospective Studies, ROC Curve, Young Adult, Anti-Mullerian Hormone blood, Endometriosis blood, Infertility, Female blood, Ovarian Cysts blood, Ovarian Reserve
- Abstract
Background: To evaluate the impact of the presence of endometrioma and laparoscopic cystectomy on ovarian reserve as assessed by serum anti-Müllerian hormone (AMH) level. In addition, factors related to the decline in ovarian reserve were analyzed., Methods: From June 2013 to January 2014, we prospectively included 40 women with endometriomas as the study group (group A), 36 women with tubal factor infertilities as control group 1 (group B) and 22 women with the other benign ovarian cysts as control group 2 (group C). The women with ovarian cysts underwent laparoscopic cystectomy. Serum AMH levels were determined preoperatively and at 1 month after surgery., Results: The endometrioma group had lower AMH levels (1.53 ± 1.37 ng/ml) compared with the other benign ovarian cyst group (2.20 ± 1.23 ng/ml) and the tubal factor infertility group (2.82 ± 1.74 ng/ml). The rate of serum AMH decline 1 month after surgery in the endometrioma group (0.62 ± 0.35) was larger than the decline in the other benign ovarian cyst group (0.32 ± 0.30). The preoperative AMH level showed a significant correlation with patient age (group A, r = -0.32; group B, r = -0.54; group C, r = -0.71); there was a statistically significant correlation between the rate of serum AMH decline and endometrioma diameter as well as with the preoperative serum AMH level. In addition, the rate of serum AMH decline was larger for bilateral endometriomas than for unilateral endometriomas, but there was no similar correlation in the other benign ovarian cyst group. The rate of AMH decline after surgery in the subgroup of >7 cm was significantly higher than in the subgroup of ≤7 cm., Conclusions: Ovarian endometriomas per se may damage ovarian reserve, and cystectomy of endometriomas may cause greater damage to ovarian reserve compared with other benign ovarian cysts. The operation-related damage to the ovarian reserve was positively related to whether the endometriomas were bilateral, as well as cyst size (especially for cysts >7 cm), but was negatively related to the preoperative serum AMH level. Age was a negative factor that affected the ovarian reserve.
- Published
- 2014
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24. Nutcracker syndrome in a young female with solitary functional left ovary: a surgical challenge.
- Author
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Bisoi AK, Sahu MK, Chander C N, Agarwala S, and Chauhan S
- Subjects
- Adolescent, Female, Flank Pain etiology, Humans, Laparoscopy, Ovarian Cysts diagnosis, Ovarian Cysts physiopathology, Ovarian Cysts surgery, Ovariectomy methods, Ovary physiopathology, Phlebography methods, Renal Nutcracker Syndrome complications, Renal Nutcracker Syndrome diagnosis, Renal Nutcracker Syndrome physiopathology, Renal Veins diagnostic imaging, Renal Veins physiopathology, Salpingectomy methods, Tomography, X-Ray Computed, Treatment Outcome, Ovarian Cysts complications, Ovary blood supply, Ovary surgery, Renal Nutcracker Syndrome surgery, Renal Veins surgery, Vascular Surgical Procedures adverse effects
- Abstract
Nutcracker syndrome (NCS), a rare clinical entity, when refractory to medical management warrants surgical intervention. In the following discussion, we present a case of NCS which was managed successfully by left renal vein transposition using a decompression shunt., (Copyright © 2014 Elsevier Inc. All rights reserved.)
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- 2014
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25. [Significance of symptom and physical sign to diagnosis of deeply infiltrating endometriosis].
- Author
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Zhang J, Leng J, Dai Y, and Lang J
- Subjects
- Adult, Constipation physiopathology, Dysmenorrhea epidemiology, Dysmenorrhea physiopathology, Dyspareunia epidemiology, Dyspareunia physiopathology, Female, Humans, Laparoscopy, Ovarian Cysts physiopathology, Pain epidemiology, Pain Measurement, Pelvic Pain epidemiology, Pelvic Pain physiopathology, Pelvis, Physical Examination, Retrospective Studies, Sensitivity and Specificity, Vagina, Endometriosis diagnosis, Endometriosis physiopathology, Ovarian Cysts pathology, Pain physiopathology
- Abstract
Objective: To study the significance of pain symptoms and physical signs to diagnosis of deeply infiltrating endometriosis (DIE)., Methods: Totally 500 patients with laparoscopic diagnosis of endometriosis were studied retrospectively and divided into two groups depending on the existance of DIE. The pain symptoms and gynecological physical signs were recorded detail, and the correlation with diagnose of DIE were analyzed., Results: (1) The significance of pain symptoms: the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and OR, 95% CI of each pain symptom were: dysmenorrhae (90.5%, 37.2%, 59.6%, 79.3%, 5.66, 3.46-9.28), chronic pelvic pain (35.2%, 82.6%, 67.4%, 55.4%, 2.58, 1.70-3.91), dyspareunia (46.2%, 80.6%, 70.7%, 59.6%, 3.56, 2.39-5.32), dyschezia (51.0%, 73.7% , 66.5% , 59.5%, 2.91, 2.00- 4.24), respectively. (2) Pelvic physical examination: the sensitivity, specificity, PPV and NPV of each physical sign were: fixed uterine: 73.6%, 71.2%, 79.5%, 64.0%; fixed ovarian cyst: 94.1%, 20.3%, 63.3%, 70.0%; uterosacral ligaments nodule: 47.1%, 97.5%, 96.6%, 54.9%; uterosacral ligaments nodule with tenderness: 81.7%, 75.0%, 83.1%, 73.2%; rectovaginal septum nodule: 32.2%, 100.0%, 100.0%, 49.4%; rectovaginal septum nodule with tenderness: 32.2%, 100.0%, 100.0%, 49.4%; blue nodule in posterior vaginal forni: 14.9%, 100.0%, 100.0%, 43.7%., Conclusions: In the symptoms, the dysmenorrheal has the highest sensitivity and NPV for the diagnosis. And chronic pelvic pain has the highest specificity, and dysparaunia has the highest PPV for the diagnosis. In pelvic vaginal examination, fixed uterine, fixed ovarian cyst and the nodule on uretosarcal ligment and rectovaginal septum with tenderness, the blue lesion on posterior fornix have the strong significance for DIE. So record the symptom detail and careful digital vaginal examination, especially the vaginal-recto-abdominal examination could improve the diagnosis DIE obviously before procedure.
- Published
- 2014
26. Paediatric ovarian lesions--the experience at Starship Children's Hospital, New Zealand.
- Author
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Cribb B, Vishwanath N, and Upadhyay V
- Subjects
- Abdominal Pain diagnosis, Adolescent, Child, Preschool, Diagnosis, Differential, Disease Management, Female, Hospitals, Pediatric statistics & numerical data, Humans, Infant, Newborn, New Zealand epidemiology, Outcome Assessment, Health Care, Ovary pathology, Ovary surgery, Retrospective Studies, Laparotomy methods, Laparotomy statistics & numerical data, Minimally Invasive Surgical Procedures methods, Minimally Invasive Surgical Procedures statistics & numerical data, Ovarian Cysts diagnosis, Ovarian Cysts epidemiology, Ovarian Cysts physiopathology, Ovarian Cysts surgery, Ovarian Neoplasms epidemiology, Ovarian Neoplasms pathology, Ovarian Neoplasms physiopathology, Ovarian Neoplasms surgery, Torsion Abnormality diagnosis, Torsion Abnormality epidemiology, Torsion Abnormality physiopathology, Torsion Abnormality surgery
- Abstract
Aim: To review the experience of paediatric ovarian masses at Starship Children's Hospital (Auckland, New Zealand). Primarily to assess the range of pathology, the presenting features, and the surgical management of these lesions., Methods: A search of the hospital surgical pathology database was carried out to identify patients less than 16 years in whom ovarian tissue was submitted for pathological analysis during the 12 year period from January 2000 to December 2011. A retrospective review of the medical records was carried out., Results: 244 ovarian masses in 219 patients were identified. 99 of these were neoplastic with 19 (7.8%) being malignant and an additional four (1.6%) borderline malignant lesions (borderline epithelial tumours). Mature cystic teratoma was the commonest neoplastic lesion (55.6%). Patients who presented with acute abdominal pain were more commonly found to have non-neoplastic lesions than neoplastic lesions (71.5% vs 46.9%, p<0.0001), and those that presented with a palpable mass were more commonly found to have a neoplastic lesion (24.0% vs 3.3%, p<0.0001). Laparoscopic surgery was performed in 41.6% of all patients. Ovary conserving surgery was performed in 56.6% of all patients, though only 32.3% of patients with neoplastic lesions., Conclusion: This study provides important insight into the range of ovarian pathology encountered in a New Zealand paediatric population. Most of the ovarian lesions in paediatric age groups are benign. Ovarian sparing surgery is recommended. In cases of ovarian torsion, malignancy in this series and in the literature is less than 2%. This review highlights that paediatric surgical units have vast experience to deal with ovarian pathology in paediatric age groups.
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- 2014
27. Detecting ovarian disorders in primary care.
- Author
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Oliver A and Overton C
- Subjects
- CA-125 Antigen blood, Female, Humans, Middle Aged, Ovarian Cysts classification, Ovarian Cysts pathology, Ovarian Cysts physiopathology, Ovarian Neoplasms pathology, Ovarian Neoplasms physiopathology, Polycystic Ovary Syndrome pathology, Polycystic Ovary Syndrome physiopathology, Postmenopause physiology, Premenopause physiology, Primary Health Care standards, Ovarian Cysts diagnosis, Ovarian Neoplasms diagnosis, Polycystic Ovary Syndrome diagnosis
- Abstract
Ovarian cysts occur more often in premenopausal than postmenopausal women. Most of these cysts will be benign, with the risk of malignancy increasing with age. The risk of a symptomatic ovarian cyst in a premenopausal female being malignant is approximately 1:1,000 increasing to 3:1,000 at the age of 50. Ovarian cysts may be asymptomatic but presenting symptoms include pelvic pain, pressure symptoms and discomfort and menstrual disturbance. Functional cysts in particular can be linked with irregular vaginal bleeding or menorrhagia. Ovarian torsion is most common in the presence of an ovarian cyst. Dermoid cysts are most likely to tort. Torsion presents with sudden onset of severe colicky unilateral pain radiating from groin to loin. There may be nausea and vomiting. It is often confused with ureteric colic where the pain is similar but radiates loin to groin. Symptoms which may be suggestive of a malignant ovarian cyst, particularly in the over 50 age group, include: weight loss, persistent abdominal distension or bloating, early satiety, pelvic or abdominal pain and increased urinary urgency and frequency. CA125 levels should be checked in women who present with frequent bloating, feeling full quickly, loss of appetite, pelvic or abdominal pain or needing to urinate quickly or urgently. Symptomatic postmenopausal women, those with a cyst > or = 5 cm, or raised CA125 levels, should be referred to secondary care. Functional cysts, particularly when they are < 5 cm diameter, usually resolve spontaneously without the need for intervention. In premenopausal women simple cysts > or = 5 cm are less likely to resolve and need an annual ultrasound assessment as a minimum.
- Published
- 2014
28. Cystic ovaries in intermittently-suckled sows: follicle growth and endocrine profiles.
- Author
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Gerritsen R, Laurenssen BF, Hazeleger W, Langendijk P, Kemp B, and Soede NM
- Subjects
- Analysis of Variance, Animals, Estradiol metabolism, Female, Luteinizing Hormone metabolism, Time Factors, Lactation physiology, Ovarian Cysts metabolism, Ovarian Cysts physiopathology, Ovarian Follicle growth & development, Swine physiology
- Abstract
This paper presents follicle development and hormone profiles for sows with normal ovulation or cystic follicles during an intermittent-suckling (IS) regime that started at Day 14 of lactation. Sows were subjected to separation from their piglets during blocks of 6h or 12h. In total, 8 out of 52 sows developed cystic follicles; either full cystic ovaries (n=6) or partial ovulation (n=2). Increase in follicle size of these sows was similar to that of normal ovulating sows until pre-ovulatory size at Day 5 after the start of separation, but from then on became larger (P<0.05). LH surge was smaller or absent in sows that developed (partially) cystic ovaries (0.4 ± 0.1 vs 3.6 ± 0.3 ngmL(-1); P<0.01). Peak levels of oestradiol (E2) were similar but high E2 levels persisted in sows that developed (partly) cystic ovaries and duration of oestrus tended to be longer. The risk of developing (partly) cystic ovaries was higher when IS occurred in blocks of 6h versus 12h (33 vs 10%). In conclusion, the appearance of cystic ovaries at approximately Day 20 of ongoing lactation was related to an insufficient LH surge, as is also the case in non-lactating sows.
- Published
- 2014
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29. [Presumed ovarian benign tumors and fertility].
- Author
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Aubard Y and Poirot C
- Subjects
- Cryopreservation methods, Cryopreservation standards, Female, Fertility Preservation methods, Fertility Preservation standards, Humans, Oocytes, Ovarian Cysts complications, Ovarian Cysts surgery, Ovarian Neoplasms complications, Ovarian Neoplasms surgery, Ovary, Fertility physiology, Ovarian Cysts physiopathology, Ovarian Neoplasms physiopathology
- Abstract
We reviewed the studies about fertility-sparing in young patient presenting a benign ovarian tumor. It appears that more than the histologic nature of the ovarian cysts, it is the surgical treatment of the cyst which may decrease fertility. Some good practice of surgical procedures must be kept in mind when one manages a benign ovarian tumor in a young patient wishing to preserve her fertility: surgery should be avoided as much as possible; kystectomy is better than oophorectomy; no radical surgery should be done without pathological certitudes; electrocoagulation must be avoided on the cyst walls. In some situations, fertility is specially endangered: bilateral ovarian cysts, recurrence or strong probability of recurrence (endometriomas), poor ovarian reserve (previous chemo- or radiotherapy, age>35, premature ovarian failure). In these situations, a pre-operative assessment of the ovarian reserve could be useful. Beside the surgical 'good procedures', gamete cryopreservation procedures could be used. Cryopreservation of mature oocytes (after ovarian hyperstimulation) or in vitro mature oocytes (after antral follicle retrieval) can be proposed. Ovarian tissue cryopreservation is another option. Oocyte (or embryos) cryopreservation can be proposed before or after the surgery. The global management of benign ovarian tumors in young patients should be decided between surgeons and specialists in reproductive biology., (Copyright © 2013. Published by Elsevier Masson SAS.)
- Published
- 2013
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30. Removal of unilateral endometriomas is associated with immediate and sustained reduction in ovarian reserve.
- Author
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Urman B, Alper E, Yakin K, Oktem O, Aksoy S, Alatas C, Mercan R, and Ata B
- Subjects
- Adult, Anti-Mullerian Hormone blood, Biomarkers blood, Endometriosis diagnostic imaging, Endometriosis physiopathology, Female, Follicular Phase, Follow-Up Studies, Humans, Laparoscopy, Middle Aged, Organ Sparing Treatments, Ovarian Cysts diagnostic imaging, Ovarian Cysts physiopathology, Ovarian Follicle diagnostic imaging, Ovary diagnostic imaging, Ovary physiopathology, Postoperative Complications blood, Postoperative Complications diagnostic imaging, Primary Ovarian Insufficiency blood, Primary Ovarian Insufficiency diagnostic imaging, Primary Ovarian Insufficiency physiopathology, Severity of Illness Index, Ultrasonography, Young Adult, Endometriosis surgery, Ovarian Cysts surgery, Ovary surgery, Postoperative Complications physiopathology, Primary Ovarian Insufficiency etiology
- Abstract
Endometrioma surgery by stripping the cyst capsule has been associated with a reduction in ovarian reserve. It is still not clear whether the inflicted damage is immediate, sustained over time or associated with the use of electrocautery, nor which marker is more accurately reflects the post-operative reduction in ovarian reserve. This observational study assessed the damage inflicted by endometrioma removal with anti-Müllerian hormone (AMH) concentration and antral follicle count (AFC) pre and post-operatively. Twenty-five women with unilateral endometrioma underwent laparoscopic stripping of the endometrioma cyst capsule. There was a significant decrease both in AMH concentration (24%) and in AFC (11%) 1 month following surgery (P<0.01). At 6months post-operatively, the respective values were 24% and 15% less than preoperatively. AMH concentration and AFC showed no correlation with the use of bipolar electrocautery during surgery. Primordial follicles embedded adjacent to the cyst capsule were found in 61.5% of the specimens. Endometrioma surgery by stripping of the cyst capsule is associated with a significant reduction in ovarian reserve. The reduction is immediate and sustained over time. AMH appears to be a better indicator for post-operative quantification of the ovarian reserve., (Copyright © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.)
- Published
- 2013
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31. Increased levels of oxidative stress markers in the peritoneal fluid of women with endometriosis.
- Author
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Polak G, Wertel I, Barczyński B, Kwaśniewski W, Bednarek W, and Kotarski J
- Subjects
- 8-Hydroxy-2'-Deoxyguanosine, Adolescent, Adult, Biomarkers metabolism, Cysts immunology, Cysts metabolism, Cysts pathology, Cysts physiopathology, Deoxyguanosine metabolism, Dermoid Cyst immunology, Dermoid Cyst metabolism, Dinoprost metabolism, Endometriosis immunology, Endometriosis metabolism, Endometriosis physiopathology, Female, Humans, Middle Aged, Mutation, Ovarian Cysts immunology, Ovarian Cysts metabolism, Ovarian Cysts physiopathology, Ovarian Neoplasms immunology, Ovarian Neoplasms metabolism, Peritoneum immunology, Peritoneum metabolism, Peritoneum pathology, Peritoneum physiopathology, Severity of Illness Index, Young Adult, Ascitic Fluid metabolism, Deoxyguanosine analogs & derivatives, Dinoprost analogs & derivatives, Endometriosis pathology, Ovarian Cysts pathology, Oxidative Stress, Up-Regulation
- Abstract
Objective: To evaluate 8-hydroxy-2-deoxyguanosine (8-OHdG) and 8-isoprostane levels in the peritoneal fluid (PF) of women with endometriosis., Study Design: One hundred and ten women with laparoscopically and histopathologically confirmed endometriosis and, as reference groups, 119 patients with simple serous (n=78) and dermoid (n=41) ovarian cysts were studied. Peritoneal fluid 8-OHdG and 8-isoprostane concentrations were evaluated by enzyme-linked immunosorbent assays., Results: 8-OHdG and 8-isoprostane levels in peritoneal fluid were significantly higher in patients with endometriosis compared with the reference groups. Higher PF 8-OHdG and 8-isoprostane concentrations were observed in patients with advanced stages of endometriosis. A statistically significant positive correlation was found between 8-OHdG and 8-isoprostane levels in peritoneal fluid., Conclusion: Endometriosis induces greater oxidative stress and frequent DNA mutations in peritoneal fluid than nonendometriotic ovarian cysts. The most severe oxidative stress occurs in the peritoneal cavity of women with more advanced stages of the disease., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2013
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32. Cystic ovarian follicles and thyroid activity in the dairy cow.
- Author
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Mutinati M, Rizzo A, and Sciorsci RL
- Subjects
- Animals, Case-Control Studies, Cattle, Cattle Diseases blood, Cattle Diseases pathology, Dairying, Estradiol blood, Female, Infertility, Female blood, Infertility, Female etiology, Ovarian Cysts blood, Ovarian Cysts pathology, Ovarian Cysts physiopathology, Ovarian Follicle pathology, Ovulation Induction, Progesterone blood, Thyroid Hormones blood, Thyrotropin blood, Cattle Diseases physiopathology, Ovarian Cysts veterinary, Thyroid Gland physiopathology
- Abstract
Thyroid activity affects the functionality of the reproductive axis and thyroid dysfunction has been associated with ovarian hyperstimulation syndrome and polycystic ovarian syndrome, in human medicine. This study investigates serum17-
estradiol, progesterone, thyrotropic and thyroid hormone levels, in cyclic dairy cows on heat (Group H) and in dairy cows with ovarian follicular cysts (Group FC). Both 17- estradiol and progesterone serum concentrations were statistically higher in cystic than in cyclic cows (estradiol: 8.51±1.91 vs 6.32±1pg/mL) (progesterone: 0.49±0.17 vs 0.13±0.03ng/mL), whereas TSH and fT4 serum concentrations were statistically lower in cows with cystic ovarian follicles (COF), compared to cyclic ones (TSH: 2.48±1.31 vs 3.56±1.03ng/mL) (fT4: 5.86±1.69 vs 8.63±1.08). fT3 serum levels were similar, in both cystic and cyclic subjects (2.94±0.65 vs 3.02±0.9, respectively). Based on these results it was decided to examine the function of the thyrothropic axis of dairy cows in a similar manner to that conducted on humans. If severe hypothyroidism should be found, a hormone replacement therapy could be attempted in cystic cows refractory to "ordinary" therapies., (Copyright © 2013 Elsevier B.V. All rights reserved.) - Published
- 2013
- Full Text
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33. Endometriomas and assisted reproductive technology.
- Author
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Flyckt R, Soto E, and Falcone T
- Subjects
- Adult, Endometriosis diagnostic imaging, Endometriosis surgery, Female, Fertilization in Vitro, Humans, Infertility, Female etiology, Infertility, Female prevention & control, Organ Sparing Treatments, Ovarian Cysts diagnostic imaging, Ovarian Cysts physiopathology, Ovarian Cysts surgery, Ovary diagnostic imaging, Ovary surgery, Pelvic Pain etiology, Postoperative Complications etiology, Postoperative Complications prevention & control, Postoperative Complications therapy, Practice Guidelines as Topic, Primary Ovarian Insufficiency etiology, Primary Ovarian Insufficiency prevention & control, Primary Ovarian Insufficiency therapy, Recurrence, Severity of Illness Index, Ultrasonography, Endometriosis physiopathology, Infertility, Female therapy, Reproductive Techniques, Assisted
- Abstract
Endometriomas in the assisted reproductive technology patient present a challenging clinical scenario for the infertility specialist. Although surgical management is often pursued in cases of pain or large cyst diameter, patients without such factors must be counseled regarding surgical versus expectant management. Decisions to pursue surgery must be viewed in the context of potentially decreased ovarian reserve and more difficult stimulation for in vitro fertilization. In this article, three distinct cases are presented along with a summary of the most current literature available to guide clinicians in the optimal management of in vitro fertilization patients with endometriomas., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)
- Published
- 2013
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34. [Relationship of pelvic clinic-pathological features and the pain symptoms in ovarian endometrioma].
- Author
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Dai Y, Leng JH, Lang JH, Zhang JJ, Li XY, Shi JH, and Li MH
- Subjects
- Adult, Dysmenorrhea epidemiology, Dysmenorrhea physiopathology, Dyspareunia epidemiology, Dyspareunia physiopathology, Endometriosis surgery, Female, Humans, Laparoscopy, Ovarian Cysts surgery, Pain epidemiology, Pain Measurement, Pelvic Pain epidemiology, Pelvic Pain physiopathology, Retrospective Studies, Endometriosis pathology, Endometriosis physiopathology, Ovarian Cysts pathology, Ovarian Cysts physiopathology, Pain physiopathology
- Abstract
Objective: To study the relationship between the clinic-pathological features and pain symptoms in patients with endometriotic cyst (EM)., Methods: The medical data of symptoms, laparoscopy and pathology examination in 416 patients with endometriosis were studied retrospectively. All cases were divided into two groups on the existence of ovarian endometrioma, including 338 patients in cyst group and 78 cases in non-cyst group. The relationship between clinical symptoms and location and type of endometrioma was studied., Results: (1) Serum CA125 level: the level of CA125 were (61 ± 39) kU/L in cyst group (28 ± 24) kU/L in non-cyst group, which reached statistical difference (P < 0.01). (2) Pathological features: among 338 cases, 34.0% of cyst were on left side (115/338), 26.3% were right side (89/338), and 39.6% were on both side (134/338). And 95.8% (324/338) of cases were combined with the other type of endometriosis, which were 48.5% (164/338) with peritoneal endometriosis, 47.3% (160/338) with deep infiltrating endometriosis (DIE). In cystic patients, the incidences of endometriosis lesion were 13.9% (47/338) on the uterine surface, 38.5% (130/338) on obstruction of cul-de sac, 40.5% (137/338) on utero-sacral ligament of DIE, which were significantly higher than 5.1%, (4/78), 9.0% (7/78) and 28.2% (22/78) in noncyst group. (3) Pain symptom: the incidence and degree of dysmenorrhea and dyschezia had no statistical difference between two groups (P > 0.05), and the incidence of chronic pelvic pain (CPP) of 24.6% (83/338) and dyspareunia of 29.9% (101/338) in the cyst group were significantly lower than 35.9% (28/78) and 44.9% (35/78) in non-cyst group (P < 0.05). The incidence of dysmenorrheal was 85.1% (114/134) in cases with bilateral cyst, which was higher than 74.0% (151/204) in cases with single cyst. The incidence of dysmenorrheal and dyschezia in moderate-severe adhesion was 89.0% (138/155) and 18.7% (29/155), which was significantly higher than 68.8% (126/183) and 8.2% (15/183) in mild adhesion. In the patients cyst existed with DIE, the risk of dysmenorrheal, CPP, dyspareunia, and dyschezia were obviously raised (OR respectively was 5.17, 3.01, 3.05, 2.75)., Conclusions: The endometriotic cyst often co-exists with other type of endometriotic lesions. Ovarian endometrioma was associated with lesion localized on uterine surface, cul-de-sac, sacrum ligament. The risk of all the pain symptoms would be raised when the endometriotic cyst co-exit with the DIE lesions. So the treatment for DIE lesions was as same important as the endometriotic lesions in order to relieve pain symptoms and delay the relapse.
- Published
- 2013
35. Decreased expression of pigment epithelium-derived factor and increased microvascular density in ovarian endometriotic lesions in women with endometriosis.
- Author
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Huang X, Chen L, Fu G, Xu H, and Zhang X
- Subjects
- Actins metabolism, Adult, Biomarkers metabolism, Endometriosis metabolism, Endometriosis physiopathology, Endometrium blood supply, Endometrium cytology, Endometrium metabolism, Female, Humans, Immunohistochemistry, Middle Aged, Ovarian Cysts blood supply, Ovarian Cysts metabolism, Ovarian Cysts pathology, Ovarian Cysts physiopathology, Ovarian Diseases metabolism, Ovarian Diseases physiopathology, Ovary blood supply, Ovary metabolism, Severity of Illness Index, Young Adult, von Willebrand Factor metabolism, Down-Regulation, Endometriosis pathology, Endometrium pathology, Eye Proteins metabolism, Microvessels pathology, Nerve Growth Factors metabolism, Ovarian Diseases pathology, Ovary pathology, Serpins metabolism
- Abstract
Objectives: To determine whether women with endometriosis have altered expression of pigment epithelium-derived factor (PEDF) in ovarian endometriotic lesions as compared to women without endometriosis., Study Design: Ectopic and eutopic and normal endometrial tissues were sampled from 40 women with ovarian endometriosis and 20 control women, respectively. Endometrial PEDF expression and microvascular density (MVD) using an antibody to von Willebrand factor (vWF) and alpha-smooth muscle actin (α-SMA) were evaluated by using immunohistochemical staining., Results: We detected decreased PEDF expression and increased MVD using anti-vWF and -α-SMA in ovarian endometriotic lesions in women with endometriosis compared with the control group. In women with endometriosis, the MVD using anti-vWF and -α-SMA but not PEDF expression in ovarian endometriotic lesions correlated with the size of ovarian endometriotic cysts and the severity of the disease. Moreover, the MVD using anti-vWF was negatively correlated with PEDF expression in control endometrium but not in ovarian endometriotic lesions., Conclusions: Our results suggest that decreased PEDF expression and increased MVD in ovarian endometriotic lesions might play an important role in the pathogenesis of ovarian endometriosis., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2012
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36. Characterization of periostin expression in human endometrium and endometriotic lesions.
- Author
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Shen L, Liu P, Zhang P, Zhang X, and Cui J
- Subjects
- Adult, Endometriosis pathology, Endometriosis physiopathology, Endometrium cytology, Endometrium pathology, Female, Follicular Phase metabolism, Humans, Immunohistochemistry, Luteal Phase metabolism, Middle Aged, Ovarian Cysts pathology, Ovarian Cysts physiopathology, Severity of Illness Index, Stromal Cells cytology, Stromal Cells metabolism, Stromal Cells pathology, Cell Adhesion Molecules metabolism, Endometriosis metabolism, Endometrium metabolism, Menstrual Cycle metabolism, Ovarian Cysts metabolism
- Abstract
Objective(s): To investigate the expression of periostin in the eutopic and ectopic endometrium of women diagnosed as endometriosis and evaluate the role of periostin in the pathogenesis of endometriosis., Study Design: In this study, the expression of periostin was evaluated in the endometrial specimens from 35 women diagnosed as endometriosis and from 30 healthy women. To assess the presence and localization of periostin throughout the menstrual cycle in both eutopic and ectopic endometrium of women with endometriosis, microscopic evaluation was conducted. It was also subsequently compared with normal endometrium., Results: In the eutopic and ectopic endometrium of women with endometriosis, immunoreactivities of periostin increased compared with those of normal endometrium. We also observed a cyclic variation in the eutopic stromal periostin immunoreactivity throughout their menstrual cycle because higher H score values were observed in the proliferative phase than those in the secretory phase., Conclusion(s): These findings indicated that periostin may be involved in the pathophysiology of endometriosis.
- Published
- 2012
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37. Blocking of β-adrenergic receptors during the subfertile period inhibits spontaneous ovarian cyst formation in rats.
- Author
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Fernandois D, Lara HE, and Paredes AH
- Subjects
- Animals, Down-Regulation drug effects, Female, Humans, Menstrual Cycle drug effects, Ovarian Cysts genetics, Ovarian Cysts metabolism, Ovarian Cysts physiopathology, Ovarian Follicle drug effects, Ovarian Follicle metabolism, Ovarian Follicle physiopathology, Rats, Rats, Sprague-Dawley, Receptors, Adrenergic, beta-2 genetics, Receptors, Adrenergic, beta-2 metabolism, Adrenergic beta-2 Receptor Antagonists administration & dosage, Fertile Period drug effects, Ovarian Cysts drug therapy, Propranolol administration & dosage
- Abstract
As aging proceeds, fertility problems arise, and the success rate of in vitro fertilization declines. During reproductive aging, rat ovaries present spontaneous formation of cysts, followed by a concomitant increase in sympathetic nerve activity, causing infertility and cessation of ovarian function. β2-Adrenergic receptors, which are activated by noradrenaline (NA), modify follicular development and steroid secretions; thus, increased nerve activity has been associated with the development and maintenance of cystic structures. The purpose of this work was to block the effect of this sympathetic activity through in vivo administration of propranolol (a β-adrenergic receptor antagonist) to determine whether it delays cyst formation and cessation of the ovarian function in rats that had reached the subfertile period. Propranolol was administrated daily to 8- and 10-month-old rats for 2 months. Estrous cycling activity was monitored by vaginal smear, serum concentration of the steroidal hormones was determined by enzyme-immune assay and morphological analysis of the ovaries was performed using 6 μm tissue slices stained with hematoxylin-eosin. Propranolol increased the number of healthy follicles, the ovulation rate, and levels of serum sexual steroids (androstenedione, testosterone, and estradiol) and recovered estrous cycling activity. It also decreased the number of follicular cysts. These results suggest that the blockade of β-adrenergic receptors recovered ovarian function during reproductive aging. It is suggested that propranolol induces a time-dependent extension of the subfertile window, and it could be used to increase the success rate of fertility programs in aging woman., (© Georg Thieme Verlag KG Stuttgart · New York.)
- Published
- 2012
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38. Candidate mechanisms underlying atypical progesterone profiles as deduced from parameter perturbations in a mathematical model of the bovine estrous cycle.
- Author
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Boer HM, Apri M, Molenaar J, Stötzel C, Veerkamp R, and Woelders H
- Subjects
- Animals, Cattle Diseases physiopathology, Corpus Luteum physiology, Estradiol physiology, Female, Luteolysis physiology, Models, Biological, Ovarian Cysts physiopathology, Ovarian Cysts veterinary, Ovarian Follicle physiology, Ovulation physiology, Cattle physiology, Estrous Cycle physiology, Progesterone physiology
- Abstract
The complex interplay of physiological factors that underlies fertility in dairy cows was investigated using a mechanistic mathematical model of the dynamics of the bovine estrous cycle. The model simulates the processes of follicle and corpus luteum development and its relations with key hormones that interact to control these processes. Several factors may perturb the regular oscillatory behavior of a normal estrous cycle, and such perturbations are likely the effect of simultaneous changes in multiple parameters. The objective of this paper was to investigate how multiple parameter perturbation changes the behavior of the estrous cycle model, so as to identify biological mechanisms that could play a role in the development of cystic ovaries. Cystic ovaries are a common reason for reproductive failure in dairy cows, but much about the causes of this disorder remains unknown. We investigated in which region of the parameter space the model predicts a normal cycle, and when a progesterone pattern occurred with delayed ovulation (indicating a cystic follicle) or delayed luteolysis (indicating a persistent corpus luteum). Perturbation of the initial values for all parameters simultaneously showed 2 specific parameter configurations leading to delayed ovulation or delayed luteolysis immediately. The most important parameter changes in these 2 configurations involve the regulation of corpus luteum functioning, luteolytic signals, and GnRH synthesis, suggesting that these mechanisms are likely involved in the development of cystic ovaries. In the multidimensional parameter space, areas exist in which the parameter configurations resulted in normal cycles. These areas may be separated by areas in which irregular cycle patterns occurred. These irregular patterns thus mark the transition from one stable (normal) situation to another. Interestingly, within a series, there were some cycles with delayed ovulation and some with delayed luteolysis in these patterns. This could represent a situation of resumption of normal cyclicity (e.g., after parturition). In conclusion, the method of parameter perturbation used in the present study is an effective tool to find parameter configurations that lead to progesterone profiles associated with delayed ovulation and delayed luteolysis. Thereby, the model helps to generate hypotheses regarding the underlying cause of the development of cystic ovaries, which could be investigated in future experiments., (Copyright © 2012 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.)
- Published
- 2012
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39. A novel luteinizing hormone/chorionic gonadotropin receptor mutation associated with amenorrhea, low oocyte yield, and recurrent pregnancy loss.
- Author
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Bentov Y, Kenigsberg S, and Casper RF
- Subjects
- Abortion, Habitual physiopathology, Adult, Amenorrhea physiopathology, Amino Acid Sequence, Base Sequence, DNA Mutational Analysis, Exons, Female, Genetic Predisposition to Disease, Heterozygote, Humans, Molecular Sequence Data, Ovarian Cysts genetics, Ovarian Cysts physiopathology, Ovulation drug effects, Ovulation Induction adverse effects, Phenotype, Pregnancy, Treatment Failure, Abortion, Habitual genetics, Amenorrhea genetics, Fertilization in Vitro adverse effects, Mutation, Ovulation genetics, Receptors, LH genetics
- Abstract
Objective: To study the cause for poor oocyte yield, amenorrhea, and recurrent pregnancy loss in a patient undergoing IVF., Design: Case report., Setting: University-affiliated private IVF clinic., Patient(s): A 33-year-old woman with amenorrhea, recurrent ovarian cyst formation, poor oocyte yield, and repeated chemical pregnancies after IVF treatments., Intervention(s): The hCG stimulation test and luteinizing hormone/chorionic gonadotropin receptor (LHCGR) gene sequencing., Main Outcome Measure(s): The presence of LHCGR gene mutations., Result(s): The patient had a markedly abrogated androgen response to 10,000 IU of hCG. A novel heterozygous inactivating mutation in exon 1 of the LHCGR gene was detected. This mutation was superimposed on a common LHCGR polymorphism., Conclusion(s): This novel mutation may provide a potential genetic mechanism for the poor oocyte recovery in some IVF cases. It is the first example of a heterozygous inactivating mutation in the LHCGR gene., (Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)
- Published
- 2012
- Full Text
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40. Transvaginal color Doppler sonography predicts ovarian interstitial fibrosis and microvascular injury in women with ovarian endometriotic cysts.
- Author
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Qiu JJ, Liu MH, Zhang ZX, Chen LP, Yang QC, and Liu HB
- Subjects
- Adult, Case-Control Studies, Female, Fibrosis diagnostic imaging, Humans, Immunohistochemistry, Microvessels diagnostic imaging, Predictive Value of Tests, Regional Blood Flow physiology, Thrombospondin 1 blood, Transforming Growth Factor beta1 blood, Transforming Growth Factor beta1 metabolism, Vagina diagnostic imaging, Endometriosis physiopathology, Microvessels injuries, Ovarian Cysts physiopathology, Ovary blood supply, Ultrasonography, Doppler, Color
- Abstract
Objective: To determine novel predictors of ovarian interstitial fibrosis and microvascular injury associated with ovarian endometriotic cysts (OECs)., Design: Case-control study., Setting: The gynecology unit of an affiliated hospital in China., Population: Women <40 years of age with OECs or benign ovarian tumors (controls)., Methods: Transvaginal color Doppler sonography was performed preoperatively to detect ovarian interstitial flow. Postoperatively, expressions of transforming growth factor-β1 (TGF-β1) and thrombospondin-1 (TSP-1), as well as microvessel density in ovarian interstitial, were analyzed using immunohistochemistry., Main Outcome and Measures: Ovarian interstitial flow and expressions of TGF-β1, TSP-1, and microvessel density., Results: Compared with controls, ovarian interstitial flow in the study group was decreased and arterial spectra indicated significantly higher resistance indices. Microvessel density was reduced, but TGF-β1 and TSP-1 were elevated in the study group. There was a positive correlation between TGF-β1 and TSP-1. There were negative correlations between TGF-β1 and microvessel density, and between TSP-1 and microvessel density. Microvessel density and resistance indices were negatively correlated, whereas the correlations of TGF-β1 and TSP-1 with resistance indices were positive., Conclusions: Resistance indices are consistent with pathological indices. Changes in resistance indices in ovaries with endometriosis are related to interstitial fibrosis and microvascular injury., (© 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.)
- Published
- 2012
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41. When to operate on ovarian cysts in children?
- Author
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Tessiatore P, Guanà R, Mussa A, Lonati L, Sberveglieri M, Ferrero L, and Canavese F
- Subjects
- Adolescent, Age Factors, Algorithms, Child, Child, Preschool, Female, Humans, Infant, Infant, Newborn, Laparoscopy methods, Retrospective Studies, Torsion, Mechanical, Minimally Invasive Surgical Procedures methods, Ovarian Cysts physiopathology, Ovarian Cysts surgery, Ovariectomy methods
- Abstract
Background: Ovarian cysts are rare conditions in the pediatric age group. They are characterized by different clinical presentations and by the need to establish adequate type and timing of treatment in order to prevent complications, such as ovarian necrosis after torsion and infertility. The diagnostic approach should differentiate benign occasional findings, such as follicular cysts, from neoplastic lesions, and functional cysts which can occur either isolated or in the context of McCune-Albright syndrome. Our aim was to review all the patients affected by ovarian pathologies seen in our department in the past 5 years, in order to establish a protocol for the correct management of these conditions., Methods: In the past 5 years we studied 133 patients diagnosed with ovarian lesion. We subdivided the patients into three groups according to age: group A (age <6 months: 66 cases); group B (pre-pubertal patients, age 7 months to 10 years: 10 cases); and group C (pubertal patients, age 11-14 years: 57 cases). We collected historical and clinical data and assigned specific cut-off values in order to perform statistical analysis (Fisher's exact test) comparing the three groups., Results: Ultrasound examination proved to be indispensable in the early detection of ovarian lesions and for identifying the correct treatment. Cyst size, and moreover appearance with ultrasound, were important considerations when selecting the most appropriate therapeutic approach. The larger lesions were found in group B, giving symptoms that required hospitalization (pelvic pain, nausea and vomiting) and leading to increased incidence of postoperative complications. Laparoscopic surgery appeared to be safe and effective for the treatment of ovarian pathologies., Conclusion: The management of ovarian lesions in children must be based on a minimally invasive approach, based on the patient's age and ultrasound findings. Treatment should be conservative, with ovariectomy undertaken only when essential. In adolescents, only cysts larger than 6 cm that do not resolve with estro-progestinic therapy within 6 months should be surgically approached; in infants, any signs of cyst complications must be addressed surgically.
- Published
- 2012
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42. Coexisting peritoneal tuberculosis and endometriosis masquerading as advanced stage ovarian cancer in a postpartum woman: a case report and review of literature.
- Author
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Zhou S, Zhang B, Huang F, Liu J, Zhu D, and Zhao X
- Subjects
- Abdominal Pain etiology, Adult, Ascites etiology, Biopsy, Diagnosis, Differential, Early Diagnosis, Endometriosis complications, Endometriosis pathology, Endometriosis physiopathology, Fatigue etiology, Female, Humans, Laparoscopy, Ovarian Cysts complications, Ovarian Cysts pathology, Ovarian Cysts physiopathology, Ovarian Neoplasms diagnosis, Peritonitis, Tuberculous complications, Peritonitis, Tuberculous pathology, Peritonitis, Tuberculous physiopathology, Pleural Effusion etiology, Postpartum Period, Tuberculosis, Miliary complications, Tuberculosis, Miliary diagnosis, Tuberculosis, Miliary pathology, Tuberculosis, Miliary physiopathology, Endometriosis diagnosis, Ovarian Cysts diagnosis, Peritonitis, Tuberculous diagnosis
- Published
- 2011
- Full Text
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43. Conservative management of a haemorrhagic adnexal cyst in a patient with Type 3 von Willebrand Disease.
- Author
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Boama V and Haynes S
- Subjects
- Abdominal Pain etiology, Adult, Antifibrinolytic Agents therapeutic use, Blood Component Transfusion, Coagulants therapeutic use, Factor VIII therapeutic use, Female, Humans, Ovarian Cysts physiopathology, Rupture, Spontaneous complications, Rupture, Spontaneous physiopathology, Rupture, Spontaneous therapy, Tranexamic Acid therapeutic use, Treatment Outcome, von Willebrand Disease, Type 3 physiopathology, Ovarian Cysts complications, Ovarian Cysts therapy, Uterine Hemorrhage etiology, Uterine Hemorrhage therapy, von Willebrand Disease, Type 3 complications, von Willebrand Disease, Type 3 drug therapy
- Published
- 2011
- Full Text
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44. Effects of laparoscopic surgery on serum anti-Müllerian hormone levels in reproductive-aged women with endometrioma.
- Author
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Lee DY, Young Kim N, Jae Kim M, Yoon BK, and Choi D
- Subjects
- Adult, Biomarkers blood, Endometriosis physiopathology, Female, Follow-Up Studies, Humans, Middle Aged, Organ Sparing Treatments, Ovarian Cysts blood, Ovarian Cysts physiopathology, Ovarian Cysts surgery, Ovarian Diseases physiopathology, Ovariectomy adverse effects, Ovary physiopathology, Patient Dropouts, Postoperative Period, Prospective Studies, Young Adult, Anti-Mullerian Hormone blood, Endometriosis blood, Endometriosis surgery, Laparoscopy adverse effects, Ovarian Diseases blood, Ovarian Diseases surgery, Ovary surgery
- Abstract
A few studies have investigated the effects of laparoscopic cystectomy for endometrioma on ovarian reserve using serum anti-Müllerian hormone (AMH) levels and have shown inconsistent results. This prospective study was performed to estimate early changes in serum AMH after laparoscopic surgery for endometrioma. In 27 women aged 21-46 years who underwent laparoscopic unilateral cystectomy (n = 13) or oophorectomy (n = 14) for endometrioma, we measured pre- and postoperative serum AMH levels at baseline and 1 week, 1 month, and 3 months after surgery. Serial changes in serum AMH levels were analyzed according to the operation type using analysis of variance. Mean levels of serum AMH decreased significantly immediately after surgery and remained for up to 3 months in both operation types (P = 0.002 for cystectomy group and P <0.001 for oophorectomy group). In addition, the serum AMH levels showed similar patterns of change after cystectomy or oophorectomy. In conclusion, laparoscopic ovarian cystectomy for endometrioma appears to decrease serum AMH levels immediately after surgery.
- Published
- 2011
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45. Follicular loss in endoscopic surgery for ovarian endometriosis: quantitative and qualitative observations.
- Author
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Romualdi D, Franco Zannoni G, Lanzone A, Selvaggi L, Tagliaferri V, Gaetano Vellone V, Campagna G, and Guido M
- Subjects
- Adult, Age Factors, Biopsy, Chi-Square Distribution, Endometriosis pathology, Endometriosis physiopathology, Female, Fertility, Humans, Italy, Ovarian Cysts pathology, Ovarian Cysts physiopathology, Ovarian Diseases pathology, Ovarian Diseases physiopathology, Ovarian Follicle pathology, Ovarian Follicle physiopathology, Patient Selection, Prospective Studies, Risk Assessment, Risk Factors, Treatment Outcome, Young Adult, Endometriosis surgery, Laparoscopy adverse effects, Ovarian Cysts surgery, Ovarian Diseases surgery, Ovarian Follicle surgery
- Abstract
Objective: To identify a possible marker of follicular depletion in relation to some histologic parameters of endometriotic cysts., Design: Prospective study., Setting: Università Cattolica del Sacro Cuore, Operative Division of Endocrinological Gynecology., Patient(s): Seventy-seven patients (aged 20-40 years) with endometrioma., Intervention(s): Patients underwent laparoscopic surgery for ovarian endometriosis., Main Outcome Measure(s): After excision of the cyst wall, involuntarily removed follicles were correlated with age at surgery and with intrinsic histologic parameters of the specimen (thickness and composition of capsule; size of cyst)., Result(s): There was a statistically significant relationship between patient age and number of follicles in the histologic section, a statistically significant inverse relationship between size of cyst and number of follicles, and no significant correlation between thickness of the capsule and number of follicles. Fibroblastic-type capsule, most frequently found in younger patients, was associated with removal of a significantly higher number of follicles., Conclusion(s): Our study suggests that patient age and cyst dimension are related to the histologic composition of the capsule, which is a marker of the aggressiveness of the cyst itself., (Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)
- Published
- 2011
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46. The effect of laparoscopic ovarian cystectomy versus coagulation in bilateral endometriomas on ovarian reserve as determined by antral follicle count and ovarian volume: a prospective randomized study.
- Author
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Var T, Batioglu S, Tonguc E, and Kahyaoglu I
- Subjects
- Adult, Embryo Transfer, Endometriosis pathology, Endometriosis physiopathology, Female, Fertilization in Vitro, Humans, Oocyte Retrieval, Ovarian Cysts pathology, Ovarian Cysts physiopathology, Ovarian Follicle pathology, Ovarian Follicle physiopathology, Ovary pathology, Ovary physiopathology, Ovulation Induction, Pregnancy, Pregnancy Rate, Prospective Studies, Time Factors, Treatment Outcome, Turkey, Young Adult, Electrocoagulation adverse effects, Endometriosis surgery, Gynecologic Surgical Procedures adverse effects, Laparoscopy adverse effects, Ovarian Cysts surgery, Ovary surgery
- Abstract
Objective: To evaluate the effect of two different laparoscopic methods on ovarian reserve as determined by antral follicle count (AFC) and ovarian volume in patients with bilateral endometriomas., Design: Randomized prospective study., Setting: Tertiary education and research hospital., Patient(s): Forty-eight patients with bilateral endometriomas., Intervention(s): AFC and ovarian volumes determined before and after surgery; coagulation and cystectomy performed on one randomly selected side of each patient for their endometriomas; in vitro fertilization and embryo transfer., Main Outcome Measure(s): Ovarian reserve damage as determined by AFC and ovarian volume, and number of dominant follicles and retrieved oocytes after controlled ovarian hyperstimulation., Result(s): In vitro fertilization and embryo transfer were performed for 37 of 48 patients. The number of dominant follicles and the retrieved oocytes were assessed after controlled ovarian hyperstimulation. The postprocedural AFC was 3.67±1.26 and 4.75±0.60 after cystectomy and coagulation, respectively. A statistically significantly greater decrease in AFC was found after cystectomy as compared with coagulation. Postprocedural ovarian volumes were 6.27±1.95 and 9.87±2.01 after cystectomy and coagulation, respectively. A decrease in ovarian volume was found after cystectomy when compared with coagulation., Conclusion(s): The decreases in AFC and ovarian volume were found for both coagulation and cystectomy, but the decrease was statistically significantly more frequent in cystectomized ovaries than in coagulated ovaries. Also, in the in vitro fertilization cycles, the ovarian response to ovulation induction was statistically significantly reduced in cystectomized ovaries as compared with coagulated ovaries., (Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.)
- Published
- 2011
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47. Efficacy of laparoscopic stripping for ovarian cysts: histological and clinical findings.
- Author
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Retto G, Santoro G, Sturlese E, De Dominici R, Villari D, Retto A, and Palmara V
- Subjects
- Adolescent, Adult, Female, Humans, Ovarian Cysts physiopathology, Ovary pathology, Young Adult, Laparoscopy, Organ Sparing Treatments, Ovarian Cysts pathology, Ovarian Cysts surgery, Ovary surgery
- Abstract
Aim: The aim of our study was to evaluate the efficacy of the laparoscopic stripping technique on benign ovarian masses with respect to healthy ovarian tissue., Material and Methods: Seventy-six patients between 14 and 40 years of age were enrolled after receiving a diagnosis of mono-lateral ovarian cyst and underwent laparoscopic surgery for cyst excision with the stripping technique. Histological observations of these specimens were then performed and graded on a semiquantitative scale., Results: The 76 samples included 36 endometriotic cysts, 18 dermoid cysts, 12 serous cysts, and 10 mucinous cysts. Only 26 of the endometriomas showed histological evidence of healthy ovarian tissue that, however, differed morphologically from normal ovarian tissue., Conclusion: The laparoscopic stripping technique used for the excision of different ovarian cysts is a practice that safeguards the organ., (© 2011 The Authors. Journal of Obstetrics and Gynaecology Research © 2011 Japan Society of Obstetrics and Gynecology.)
- Published
- 2011
- Full Text
- View/download PDF
48. Sympathetic nerve activity in normal and cystic follicles from isolated bovine ovary: local effect of beta-adrenergic stimulation on steroid secretion.
- Author
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Paredes AH, Salvetti NR, Diaz AE, Dallard BE, Ortega HH, and Lara HE
- Subjects
- Adrenergic beta-Agonists administration & dosage, Animals, Cattle, Cattle Diseases blood, Cattle Diseases metabolism, Cattle Diseases physiopathology, Cell Separation, Estradiol blood, Female, Follicular Phase genetics, Follicular Phase physiology, Humans, Norepinephrine blood, Norepinephrine metabolism, Ovarian Cysts blood, Ovarian Cysts metabolism, Ovarian Cysts physiopathology, Ovarian Follicle innervation, Ovarian Follicle pathology, Ovarian Follicle physiology, Ovary drug effects, Ovary innervation, Ovary metabolism, Ovary pathology, Progesterone blood, Sympathetic Nervous System drug effects, Adrenergic beta-Agonists pharmacology, Cattle Diseases pathology, Gonadal Steroid Hormones metabolism, Ovarian Cysts pathology, Ovarian Follicle drug effects, Sympathetic Nervous System physiology
- Abstract
Cystic ovarian disease (COD) is an important cause of abnormal estrous behavior and infertility in dairy cows. COD is mainly observed in high-yielding dairy cows during the first months post-partum, a period of high stress. We have previously reported that, in lower mammals, stress induces a cystic condition similar to the polycystic ovary syndrome in humans and that stress is a definitive component in the human pathology. To know if COD in cows is also associated with high sympathetic activity, we studied isolated small antral (5 mm), preovulatory (10 mm) and cystic follicles (25 mm). Cystic follicles which present an area 600 fold greater compared with preovulatory follicles has only 10 times less concentration of NE as compared with small antral and preovulatory follicles but they had 10 times more NE in follicular fluid, suggesting a high efflux of neurotransmitter from the cyst wall. This suggestion was reinforced by the high basal release of recently taken-up 3H-NE found in cystic follicles. While lower levels of beta-adrenergic receptor were found in cystic follicles, there was a heightened response to the beta-adrenergic agonist isoproterenol and to hCG, as measured by testosterone secretion. There was however an unexpected capacity of the ovary in vitro to produce cortisol and to secrete it in response to hCG but not to isoproterenol. These data suggest that, during COD, the bovine ovary is under high sympathetic nerve activity that in addition to an increased response to hCG in cortisol secretion could participate in COD development.
- Published
- 2011
- Full Text
- View/download PDF
49. [Neurotrophins and pain in endometriosis].
- Author
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Borghese B, Vaiman D, Mondon F, Mbaye M, Anaf V, Noël JC, de Ziegler D, and Chapron C
- Subjects
- Adult, Brain-Derived Neurotrophic Factor genetics, Endometriosis pathology, Endometrium pathology, Female, Gene Expression, Humans, Nerve Growth Factor genetics, Neurotrophin 3 genetics, Ovarian Cysts pathology, Ovarian Cysts physiopathology, RNA, Messenger analysis, Reverse Transcriptase Polymerase Chain Reaction, Endometriosis physiopathology, Nerve Growth Factors genetics, Nerve Growth Factors physiology, Pain physiopathology
- Abstract
Objectives: To evaluate the expression of five members of the neurotrophins family in ovarian endometriotic cyst (endometrioma) (OMA), compared to eutopic endometrium (EE) and to examine the correlation between the levels of induction and the pain intensity., Patients and Methods: Twelve Caucasian women in luteal phase, operated for painful stage IV endometriosis were assigned to 2 groups according to a total Visual Analog Scale (tVAS) score above 15 or below 10. tVAS takes into account all VAS scores for dysmenorrhea, deep dyspareunia, non cyclic chronic pelvic pain, gastrointestinal and lower urinary symptoms. Samples of OMA and EE were processed by quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) for NGF, BDNF, NT-3, NT-4/5 and NTRK2 mRNA expression. Expression levels in OMA were compared to those in EE on one hand and between two groups of 6 mild painful and 6 highly painful patients on the other., Results: All neurotrophins were significantly higher expressed in OMA than in EE, in particular NGF and BDNF (induction ratios: 20.6 and 9.7, respectively). In contrast, no correlation was observed between induction ratios and pain intensity., Conclusion and Discussion: This is the first study reporting an over-expression of all neurotrophins in endometriosis, as only NGF was previously documented. It confirms the central role of this family in the genesis and modulation of pain in endometriosis. Anti-neurotrophin selective therapy might be a promising way of analgesia in the future., (Copyright 2010 Elsevier Masson SAS. All rights reserved.)
- Published
- 2010
- Full Text
- View/download PDF
50. Heat shock protein patterns in the bovine ovary and relation with cystic ovarian disease.
- Author
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Velazquez MM, Alfaro NS, Dupuy CR, Salvetti NR, Rey F, and Ortega HH
- Subjects
- Animals, Blotting, Western veterinary, Cattle, Chaperonin 60 analysis, Corpus Luteum chemistry, Female, Granulosa Cells chemistry, HSP27 Heat-Shock Proteins analysis, HSP70 Heat-Shock Proteins analysis, HSP90 Heat-Shock Proteins analysis, Immunohistochemistry veterinary, Ovarian Cysts metabolism, Ovarian Cysts physiopathology, Ovarian Follicle chemistry, Ovarian Follicle physiopathology, Theca Cells chemistry, Heat-Shock Proteins analysis, Ovarian Cysts veterinary, Ovary chemistry
- Abstract
The present study was performed to determine how the development of cystic ovarian disease (COD) affecting the ovarian expression of heat shock proteins (HSP) in cows were expressing extrous cycles. HSP27, HSP60, HSP70 and HSP90 were evaluated in different ovarian components by Western blot and semiquantitative immunohistochemical analysis. Greater expression of the HSP27 gene was detected in the granulosa and theca cells of primary, secondary, tertiary and cystic follicles, with decreasing amount in atretic follicles. HSP60, HSP70 and HSP90 showed a similar pattern of immunostaining, with moderate gene expression in primary and secondary follicles, increased expression in tertiary and atretic follicles with the greatest gene expression in cystic follicles. HSP were also localized in the corpus luteum, corpus albicans, interstitial tissue and tunica albuginea. The relative amount of protein in the follicular wall of small and large healthy follicles and cystic follicles as analysed by Western immunoblot was consistent with the immunohistochemical data. We speculate that altered expression of HSP genes decreases apoptosis in the follicular wall and leads to the delayed regression of cystic follicles. This study supports earlier observations suggesting that aberrant HSP gene expression, observed in cells of the cystic follicles, is probably associated with the intra-ovarian component of COD pathogenesis., (Copyright 2009 Elsevier B.V. All rights reserved.)
- Published
- 2010
- Full Text
- View/download PDF
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