Cistoadenofibroma de ovario / Ovarian cystadenofibroma

El cistoadenofibroma ovárico es un tumor benigno poco frecuente y se caracteriza por un patrón bifásico compuesto por componentes epiteliales y estromales; actualmente se desconocen los factores de riesgo asociados, aunque las mujeres obesas y las menopáusicas que consumen terapia de reemplazo hormonal tienen un mayor riesgo. Se presentó una adolescente de 17 años de edad, evaluada en consulta externa dos años antes, por un quiste de ovario izquierdo; recibió tratamiento hormonal sin resultados satisfactorios. Se le practicaron exámenes de analítica sanguínea y estudios de imagen. Con la administración de anestesia regional epidural continua se realizó anexectomía izquierda, se confirmó mediante estudio histológico, un cistoadenofibroma seroso de ovario. El objetivo del tratamiento en estas pacientes es la remoción quirúrgica completa de la lesión ante el riesgo de malignización; este tratamiento quirúrgico fue fundamental y la evolución fue favorable, tuvo un periodo de recuperación de corta duración y muy positivo.

Ovarian cystadenofibroma is a rare benign tumour characterized by a biphasic pattern made up of epithelial and stromal components; associated risk factors are currently unknown, although obese and menopausal women taking hormone replacement therapy are at increased risk. We present a 17-year-old female adolescent who was evaluated in an outpatient clinic two years earlier due to a left ovarian cyst. She received hormonal treatment without satisfactory results. She underwent blood analysis tests and imaging studies. Left adnexectomy was performed with the administration of continuous epidural regional anesthesia, and a serous ovarian cystadenofibroma was confirmed by histological study. The goal of treatment in these patients is the complete surgical removal of the lesion given the risk of malignancy; this surgical treatment was fundamental and the evolution was favourable. She had a short and very positive recovery period.

Desfechos reprodutivos e de sobrevida em adolescente tratada com cirurgia preservadora de fertilidade por tumor borderline de ovário em estádio avançado: relato de caso e revisão da literatura / Reproductive and survival outcomes in an adolescent treated with fertility- sparing surgery for advanced stage borderline ovarian tumor: case report and review of the literature

Existem poucos dados na literatura sobre os resultados obstétricos e oncológicos de adolescentes com tumores borderline de ovário em estádio avançado trata- das com cirurgia preservadora da fertilidade. Uma adolescente de 15 anos com diagnóstico de tumor borderline de ovário estádio IIIc foi inicialmente tratada com tumorectomia ovariana bilateral e quimioterapia adjuvante com esquema de platina/taxano (seis ciclos). Durante o seguimento, foi submetida a outras três tumorectomias devido a tumor borderline de ovário (duas vezes) e cistadenoma ovariano (uma vez). Outra recidiva de tumor borderline de ovário ocorreu seis anos após o diagnóstico inicial, quando ela estava grávida; foi tratada com tumorecto- mia realizada durante a cesariana. Em sua última consulta ambulatorial, a mulher de 27 anos não apresentava evidência da doença e tinha um filho saudável. Mesmo em estádio avançado, a cirurgia de preservação da fertilidade foi segura e factível nessa paciente com tumor borderline de ovário.

There are few data in the literature regarding obstetric and oncological outcomes of adolescents with advanced-stage borderline ovarian tumors treated with fertility spa- ring surgery. A 15 years old adolescent who was diagnosed with a stage IIIc borderline ovarian tumor, was treated with bilateral ovarian tumorectomies and adjuvant chemotherapy with platinum/taxane regimen (six cycles). During follow up she was submitted to other three tumorectomies due to borderline ovarian tumor(twice) and ovarian cysta- denoma (once). Another borderline ovarian tumorrecurren- ce occurred six years after initial diagnosis, when she was pregnant; treated with tumorectomy performed during ce- sarean section. At her last outpatient visit, the 27-year-old woman had no evidence of disease and a had healthy child. Even at an advanced stage, fertility sparing surgery was safe and feasible in this patient with borderline ovarian tumor.

Gonadal characterization of the Amazonian fish Serrapinnus kriegi (Characidae: Cheirodontinae) / Caracterização gonadal do peixe Amazônico Serrapinnus kriegi (Characidae: Cheirodontinae)

Abstract The knowledge of the testicular and ovarian morphology of a particular fish species is of paramount importance. Such analyze enables the development of studies and techniques aiming the improvement of their reproduction, management, commercialization and even their conservation. This study performed the ovarian and testicular characterization of the ornamental Amazon fish Serrapinnus kriegi. A total of three males and three females had their gonads analyzed by optical microscopy. Females present ovaries filled with oocytes in asynchronous development, indicating partial spawning in the species. Moreover, the micropyle and micropilar cell formation was observed in primary growing oocytes, representing a precocious oocyte development; and the zona radiata in the final vitellogenic oocytes is thicker than other related species, evidencing the development of a better protection to the embryos in function of the waters' turbulence that characterize it spawning sites in the Amazonian streams. The male specimens' present anastomosed tubular testes with unrestricted spermatogonia spread along the entire seminiferous tubules. The present data elucidate the dynamic of spermatogenesis and oogenesis of an ornamental Amazonian species, through the description of the male and female germ cells development.

Resumo O conhecimento da morfologia testicular e ovariana de uma determinada espécie de peixe é de suma importância, pois através destas análises é possível o desenvolvimento de estudos e técnicas visando o melhoramento de sua reprodução, manejo e comercialização e até mesmo auxiliar em sua conservação. Este estudo realizou a caracterização ovariana e testicular do peixe Amazônico ornamental Serrapinnus kriegi. Um total de três machos e três fêmeas tiveram suas gônadas analisadas através de microscopia óptica. As fêmeas apresentam ovários preenchidos por oócitos em desenvolvimento assincrônico, indicando desova parcelada da espécie. Além disso, observou-se a formação de micrópila e célula micropilar em oócitos em crescimento primário, representando o desenvolvimento precoce do oócito; a zona radiata nos oócitos vitelogênicos finais é mais espessa em comparação a outras espécies relacionadas, evidenciando o desenvolvimento de uma melhor proteção aos embriões, em função das águas turbulentas que caracterizam seu local de desova nos córregos amazônicos. Os machos apresentam testículos do tipo tubular anastomosado com espermatogônias irrestritas, espalhadas por todo o túbulo seminífero. Os dados apresentados elucidam a dinâmica da espermatogênese e oogênese de uma espécie de peixe ornamental amazônica, por meio da descrição das células germinativas masculinas e femininas.

Biochemical and immunohistochemical examination of the effects of ephedrine in rat ovary tissue

Purpose: It was aimed to investigate the biochemical and immunohistochemical effects of ephedrine (EPH) in bilateral ovariectomized rats. Methods: Twenty-four Sprague Dawley female rats were divided into three groups: control group: The abdomen was opened and closed without any treatment; ischemia-reperfusion (IR) group: 2 h of ischemia followed by 2 h of reperfusion were allowed to cause IR injury; IR+EPH group: oral EPH solution (5 mg/kg) was administered for 28 days. Results: Biochemical parameters were statistically significant in group comparisons. Increased interleukin-6 (IL-6) expression, degenerative preantral and antral follicle cells and inflammatory cells around blood vessels were seen in IR group. Negative IL-6 expression was observed in seminal epithelial cells, preantral and antral follicle cells in IR+EPH group. While caspase-3 activity increased in granulosa cells and stromal cells in IR group, caspase-3 expression was negative in preantral and antral follicle cells in the germinal epithelium and cortex in IR+EPH group. Conclusion: The effect of apoptosis, which occurs with the signaling that starts in the cell nucleus, caused the cessation of the stimulating effect at the nuclear level after EPH administration, and a decrease in the antioxidative effect in IR damage and inflammation in the apoptotic process.

Mechanism of Liuwei Dihuang Pills in treatment of mice with diminished ovarian reserve based on proteomics / 中国中药杂志

This study aims to investigate the efficacy and possible mechanism of Liuwei Dihuang Pills in the treatment of diminished ovarian reserve(DOR) by using proteomic techniques. Firstly, cyclophosphamide(60 mg·kg~(-1)) combined with busulfan(6 mg·kg~(-1)) was injected intraperitoneally to establish the mouse model of DOR. After drug injection, the mice were continuously observed and the success of modeling was evaluated by the disturbance of the estrous cycle. After successful modeling, the mice were administrated with the suspension of Liuwei Dihuang Pills by gavage for 28 days. At the end of the gavage, four female mice were selected and caged together with males at a ratio of 2∶1 for the determination of the pregnancy rate. Blood and ovary samples were collected from the remaining mice on the next day after the end of gavage. Hematoxylin-eosin(HE) staining and transmission electron microscopy(TEM) were then employed to observe the morphological and ultrastructural changes in the ovaries. The serum levels of hormones and oxidation indicators were measured by enzyme-linked immunosorbent assay. Quantitative proteomics techniques were used to compare the ovarian protein expression before and after modeling and before and after the intervention with Liuwei Dihuang Pills. The results showed that Liuwei Dihuang Pills regulated the estrous cycle of DOR mice, elevated the serum levels of hormones and anti-oxidation indicators, promoted follicle development, protected the mitochondrial morphology of ovarian granulosa cells, and increased the litter size and survival of DOR mice. Furthermore, Liuwei Dihuang Pills negatively regulated the expression of 12 differentially expressed proteins associated with DOR, which were mainly involved in lipid catabolism, inflammatory response, immune regulation, and coenzyme biosynthesis. These differentially expressed proteins were significantly enriched in sphingolipid metabolism, arachidonic acid metabolism, ribosomes, ferroptosis, and cGMP-PKG signaling pathway. In summary, the occurrence of DOR and the treatment of DOR with Liuwei Dihuang Pills are associated with multiple biological pathways, mainly including oxidative stress response, inflammatory response, and immune regulation. "Mitochondria-oxidative stress-apoptosis" is the key to the treatment of DOR by Liuwei Dihuang Pills. YY1 and CYP4F3 may be the key upstream targets that trigger mitochondrial dysfunction and ROS accumulation, and the metabolism of arachidonic acid is the main signaling pathway of drug action.

Effect of Liangfang Wenjing Decoction on expression of key glycolytic enzymes in uterus and ovaries of rats with coagulating cold and blood stasis syndrome / 中国中药杂志

This study aimed to investigate the relationship between coagulating cold and blood stasis syndrome and glycolysis, and observe the intervention effect of Liangfang Wenjing Decoction(LFWJD) on the expression of key glycolytic enzymes in the uterus and ovaries of rats with coagulating cold and blood stasis. The rat model of coagulating cold and blood stasis syndrome was established by ice-water bath. After modeling, the quantitative scoring of symptoms were performed, and according to the scoring results, the rats were randomly divided into a model group and LFWJD low-, medium-and high-dose groups(4.7, 9.4, 18.8 g·kg~(-1)·d~(-1)), with 10 in each group. Another 10 rats were selected as the blank group. After 4 weeks of continuous administration by gavage, the quantitative scoring of symptoms was repeated. Laser speckle flowgraphy was used to detect the changes of microcirculation in the ears and uterus of rats in each group. Hematoxylin-eosin(HE) staining was used to observe the pathological morphology of uterus and ovaries of rats in each group. The mRNA and protein expressions of pyruvate dehydrogenase kinase 1(PDK1), hexokinase 2(HK2) and lactate dehydrogenase A(LDHA) in the uterus and ovaries of rats were examined by real-time quantitative polymerase chain reaction(RT-qPCR) and Western blot, respectively. The rats in the model group showed signs of coagulating cold and blood stasis syndrome, such as curl-up, less movement, thickened veins under the tongue, and reduced blood perfusion in the microcirculation of the ears and uterus, and HE staining revealed a thinning of the endometrium with disorganized arrangement of epithelial cells and a decrease in the number of ovarian follicles. Compared with the model group, the treatment groups had alleviated coagulating cold and blood stasis, which was manifested as red tongue, reduced nail swelling, no blood stasis at the tail end as well as increased blood perfusion of the microcirculation in the ears and uterus(P<0.05 or P<0.01). Among the groups, the LFWJD medium-and high-dose groups had the most significant improvement in coagulating cold and blood stasis, with neatly arranged columnar epithelial cells in uterus, and the number of ovarian follicles was higher than that in the model group, especially mature follicles. The mRNA and protein expressions of PDK1, HK2, LDHA in uterus and ovaries were up-regulated in the model group(P<0.05 or P<0.01), while down-regulated in LFWJD medium-and high-dose groups(P<0.05 or P<0.01). The LFWJD low-dose group presented a decrease in the mRNA expressions of PDK1, HK2 and LDHA in uterus and ovaries as well as in the protein expressions of HK2 and LDHA in uterus and HK2 and PDK1 in ovaries(P<0.05 or P<0.01). The therapeutic mechanism of LFWJD against coagulating cold and blood stasis syndrome is related to the down-regulation of key glycolytic enzymes PDK1, HK2 and LDHA, and the inhibition of glycolytic activities in uterus and ovaries.

Role of histone posttranslational modifications in the regulation of ovarian function / 生理学报

The ovary is the reproductive organ of female mammals, which is responsible for producing mature eggs and secreting sex hormones. The regulation of ovarian function involves the ordered activation and repression of genes related to cell growth and differentiation. In recent years, it has been found that histone posttranslational modification can affect DNA replication, damage repair and gene transcriptional activity. Some regulatory enzymes mediating histone modification are co-activators or co-inhibitors associated with transcription factors, which play important roles in the regulation of ovarian function and the development of ovary-related diseases. Therefore, this review outlines the dynamic patterns of common histone modifications (mainly acetylation and methylation) during the reproductive cycle and their regulation of gene expression for important molecular events, focusing on the mechanisms of follicle development and sex hormone secretion and function. For example, the specific dynamics of histone acetylation are important for the arrest and resumption of meiosis in oocytes, while histone (especially H3K4) methylation affects the maturation of oocytes by regulating their chromatin transcriptional activity and meiotic progression. Besides, histone acetylation or methylation can also promote the synthesis and secretion of steroid hormones before ovulation. Finally, the abnormal histone posttranslational modifications in the development of two common ovarian diseases (premature ovarian insufficiency and polycystic ovary syndrome) are briefly described. It will provide a reference basis for understanding the complex regulation mechanism of ovarian function and further exploring the potential therapeutic targets of related diseases.

Presentación atípica de teratoma quístico maduro gigante en una paciente adolescente: a propósito de un caso / Atypical presentation of a giant mature cystic teratoma in an adolescent patient: A case report

Introducción: El teratoma quístico maduro es un tipo de tumor derivado de las células germinales que aparece en pacientes en edad fértil. La edad más frecuente de aparición de este tipo de tumores es entre los 20 y40 años.Caso clínico: Se presenta el caso de una paciente adolescente de 18 años con masa abdominal gigante de crecimiento abrupto cuya presentación fue atípica dado el tamaño de esta, el cual se manifestó con dolor abdominal agudo.Tratamiento: Se realiza resección de la masa la cual confirma el diagnóstico histopatológico de teratoma quístico maduro.Conclusión: Este tipo de patologías rara vez se presentan con un crecimiento tan exagerado como el caso de la paciente en mención, y la resolución quirúrgica sigue siendo el gold estándar en cuanto al tratamiento.Palabras clave:DeCS: Teratoma, Células germinativas embrionarias, Adolescente, Neoplasias

Introduction: Mature cystic teratoma is a type of tumor derived from germ cells that appears in patients of childbearing age. The most common age at which this type of tumor appearsis 20 to40.Clinical case: The case of an 18-year-old adolescent patient with a giant abdominal mass of abrupt growth is presented, whose presentation was atypical given its size, which manifested with acute abdominal pain Treatment: Amass resection confirmedthehistopathological diagnosis of mature cystic ter-atoma.Conclusion: This type of pathology rarely presents with growth as exaggerated as in the case of the patient mentioned. Surgicalresolution continues to be the gold standard in terms of treatment

Protective effect of nebivolol on rat ovary exposed to deltamethrin toxicity

Purpose: We aimed to investigate the antioxidant activity of nebivolol against possible damage to the ovarian tissue due to the application of deltamethrin as a toxic agent, by evaluating histopathological proliferating cell nuclear antigen (PCNA) and tumor necrosis factor-alpha (TNF-α) signal molecules immunohistochemically. Methods: The animals were divided into three groups as control, deltamethrin and deltamethrin + nebivolol groups. Vaginal smears were taken after the animals were mated and detected on the first day of pregnancy. After the sixth day, deltamethrin (0.5 mL of 30 mg/kg BW undiluted ULV), and 2 mL of sterile nebivolol solution were administered intraperitoneally every day for 6-21 periods. After routine histopathological follow-up, the ovarian tissue was stained with hematoxylin and eosin stain. Results: Control group showed normal histology of ovarium. In deltamethrin group, hyperplasic cells, degenerative follicles, pyknotic nuclei, inflammation and hemorrhagic areas were observed. Nebivolol treatment restored these pathologies. Deltamethrin treatment increased TNF-α and PCNA reaction. However, nebivolol decreased the expression. Conclusions: It was thought that deltamethrin toxicity adversely affected follicle development by inducing degeneration and apoptotic process in preantral and antra follicle cells, and nebivolol administration might reduce inflammation and slow down the apoptotic signal in the nuclear phase and regulate reorganization.

Effects of daidzein on rat ovary against ischemia-reperfusion

Purpose: Our aim was to investigate protective effects of daidzein treatment on ischemia-reperfusion (I/R) injury-induced ovarian tissue by immunohistochemical techniques. Methods: Thirty Sprague Dawley female rats were categorized into three groups as sham, I/R group, and I/R+daidzein groups. Bloods were analyzed for malondialdehyde (MDA), glutathione peroxidase (GSH), and myeloperoxidase (MPO), and ovaries were processed for histological tissue protocol. Results: Both MDA and MPO values were increased in I/R group compared to sham and I/R+daidzein groups. GSH content was increased in I/R+daidzein group compared to I/R groups. In I/R group, theca and follicular cells were degenerated with apoptosis and dilatation and congestion, edema. In I/R+daidzein group, daidzein improved pathologies. In the I/R group, Bax expression was positive with follicular cells, granulosa cells and inflammatory cells. In the I/R+daidzein group, positive Bax reaction was observed in the epithelial, antral, and inflammatory cells. In I/R group, Bcl-2 reaction was in germinative epithelial cells, cells of antral follicle. In the I/R+daidzein group, Bcl-2 expression level was reduced after daidzein treatment. Conclusions: After the I/R procedure, ovarian cells and follicles were degenerated with apoptosis and inflammation. After daidzein treatment, Bax and Bcl-2 signal were decreased. It was observed that daidzein stopped the apoptotic process.

Struma ovarii quístico: reporte de caso y revisión de la literatura / Cystic struma ovarii: case report and literature review

El struma ovarii es un tumor bastante inusual, hallado en el 2,7 % de los teratomas de ovario. Su variedad quística es bastante rara, siendo su diagnóstico diferencial un cistoadenoma de ovario. Se caracteriza por presentar zona sólida con folículos tiroideos con coloide en su interior, y una zona quística tapizada por un epitelio plano a cuboidal, ambos con marcación para TTF1. Presentamos el caso clínico de una paciente que fue remitida a nuestro hospital por presentar una masa a la palpación vaginal. En imágenes se observa la presencia de una masa anexial derecha quística, por lo cual se le realizó una histerectomía radical con salpingooferectomía bilateral. Luego de estudios de patología y de inmunohistoquímica, se llegó a la conclusión que correspondía a un struma ovarii quístico

Struma ovarii is a rather unusual tumor, found in 2.7% of ovarian teratomas. Its cystic variety is quite rare, with its differential diagnosis being an ovarian cystadenoma. It is characterized by the presence of a solid area with thyroid follicles with colloid inside, and a cystic area lined by a flat to cuboidal epithelium, both with TTF1 marking. We describe the case report of a patient referred to our hospital for presenting a mass on vaginal examination. Imaging studies revealed the presence of a right adnexal cystic mass, for which she underwent a radical hysterectomy with bilateral salpingo-oophorectomy. After pathology and immunohistochemistry studies, it was concluded that it corresponded to a cystic struma ovarii

Acupuncture combined with auricular point sticking for girls aged 3-8 years with incomplete precocious puberty: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the efficacy and safety of acupuncture combined with auricular point sticking for girls aged 3-8 years with incomplete precocious puberty (IPP).@*METHODS@#Sixty girls with IPP were randomly divided into an observation group (30 cases, 2 cases dropped off) and a control group (30 cases, 2 cases were eliminated). The girls in the control group were treated with healthy diet and proper exercise for 12 weeks. On the basis of the treatment in the control group, the girls in the observation group were treated with acupuncture combined with auricular point sticking. The acupuncture was applied at Sanyinjiao (SP 6), Guanyuan (CV 4), Guilai (ST 29), etc., the needles were retained for 20 min, acupuncture was given twice a week (once every 3 days). The auricular point sticking was applied at Luanchao (TF2), Neishengzhiqi (TF2), Neifenmi (CO18), Yuanzhong (AT2,3,4i), etc., twice a week. The treatment was given for 12 weeks. Before treatment, after treatment and in follow-up after 12 weeks of treatment completion, the Tanner stage of breast, serum contents of sex hormone (luteinizing hormone [LH], follicle-stimulating hormone [FSH], estradiol [E2]) were observed. The ovarian volume, the number of follicles with diameter>4 mm, and the uterine volume were measured by abdominal color Doppler ultrasound. In addition, the safety of the observation group was evaluated.@*RESULTS@#Compared with before treatment, the Tanner stage of breast in the observation group was improved after treatment and in follow-up (P<0.05); after treatment and in follow-up, the Tanner stage of breast in the observation group was better than that in the control group (P<0.05). Compared with before treatment, the serum levels of LH and E2 in the observation group were increased (P<0.05), and the volume of bilateral ovaries was larger (P<0.05) in follow-up. Compared with before treatment, the serum contents of LH, FSH and E2 in the control group were increased (P<0.05), the volume of bilateral ovaries was larger (P<0.05), and the number of follicles was increased (P<0.05) after treatment and in follow-up. The serum levels of LH, FSH and E2 in the observation group were lower than those in the control group (P<0.05), the volume of bilateral ovaries was smaller than that in the control group (P<0.05), and the number of follicles was lower than that in the control group (P<0.05). Compared with before treatment, the uterine volume in the two groups was larger in follow-up (P<0.05). There was no statistically significant difference between the two groups after treatment and in follow-up (P>0.05). During the treatment, 3 cases in the observation group had slight abdominal pain and subcutaneous blood stasis, without serious adverse reactions.@*CONCLUSION@#Acupuncture combined with auricular point sticking could improve the Tanner stage of breast, reduce the level of sex hormone, slow down the development and maturation of ovary and follicle, and control the degree and speed of sexual development in girls aged 3-8 years with IPP.

Leiomiosarcoma de ovario: A propósito de un caso / Ovarian leiomyosarcoma: About a case

Introducción: El leiomiosarcoma de ovario, es una neoplasia extremadamente rara, forma parte del subgrupo de tumores de músculo liso que constituye menos del 1% en cuanto a tumores de ovario; dentro del mismo se encuentran clasificados el carcinosarcoma, angiosarcoma, fibrosarcoma y leiomiosarcoma, de acuerdo con la literatura revisada se han reportado 63 casos de leiomiosarcoma hasta la actualidad. Caso clínico: Presentamos el caso de una paciente mujer de 53 años; ingresó al área de emergencia por dolor abdominal de gran intensidad, acompañado de distensión abdominal y ortopnea; a la exploración física se palpó una masa poco móvil. La tomografía evidenció la presencia de una masa abdomino-pélvica que se extendió entre el asa intestinal y la raíz del mesenterio; comprimía vejiga, útero y ovarios. Se le realizó una histerectomía, con salpingo ooforectomía derecha, ooforectomía izquierda por medio de laparotomía exploratoria. Los estudios histopatológicos determinaron el diagnóstico de leiomiosarcoma. Fue tratado con cirugía y quimioterapia adyuvante.

Introduction: Ovarian leiomyosarcomas is an extremely rare neoplasm and are part of the subgroup of smooth muscle tumors that constitutes less than 1% in terms of ovarian tumors; within it are classified: carcinosarcoma, angiosarcoma, fibrosarcoma, and leiomyosarcoma, according to the reviewed literature, 63 cases of leiomyosarcoma have been reported to date. Clinical Case: We present the case of a 53-year-old female patient; she was admitted to the emergency area due to severe abdominal pain, accompanied by abdominal distension and orthopnea; Physical examination revealed a large, slightly mobile mass. The tomography showed the presence of an abdominopelvic mass that extended between the intestinal loop and the root of the mesentery; compressed bladder, uterus, and ovaries. She underwent exeresis hysterectomy with right salpingo-oophorectomy and left oophorectomy through exploratory laparotomy. Histopathological studies yielded results of a malignant neoplasm compatible with leiomyosarcoma. She was treated with surgery and adjuvant chemotherapy.

Practical Prediction Model for Ovarian Insufficiency after Radiation / Modelo prático de predição para insuficiência ovariana após radiação

Abstract Objective The present study aimed to develop a useful mathematical model that predicts the age at which premature ovarian insufficiency might occur after teletherapy radiation. A diagnosis of premature or early menopause has physical and psychological consequences, so women may need support and long-term medical follow-up. Methods To correlate ovarian radiation dose with ovarian function, we used the formula described by Wallace et al.: √g(z) = 10(2-0,15z), where "g(z)" and "z" represent oocyte survival rate and the radiation dose (in Gray), respectively. By simulating different ages and doses, we observed a pattern that could be used to simplify the relationship between radiation dose and remaining time of ovarian function. Results We obtained a linear function between ovarian radiation dose and loss of ovarian function (LOF) that is the percentage of decrease in the time to the ovarian failure compared with the time expected for a woman at the same age without irradiation exposition. For patients <40 years old and with ovarian radiation doses < 5 Gy, the equation LOF = 2.70 + (11.08 × Dose) can be applied to estimate the decrease in time to premature ovarian insufficiency. Conclusion The present study reports a practicable theoretical method to estimate the loss of ovarian function. These findings can potentially improve the management and counseling of young women patients submitted to radiotherapy during their reproductive years.

Resumo Objetivo O presente estudo teve como objetivo desenvolver um modelo matemático útil que prediz a idade na qual a insuficiência ovariana prematura pode ocorrer após a radioterapia externa (teleterapia). O diagnóstico de menopausa prematura ou precoce tem consequências físicas e psicológicas; portanto, as mulheres podem precisar de apoio e acompanhamento médico de longo prazo. Métodos Para correlacionar a dose de radiação ovariana com a função ovariana, foi usada a fórmula descrita por Wallace et al.: √g(z) = 10(2-0,15z), na qual "g(z)" e "z" representam a taxa de sobrevivência do oócito e a dose de radiação (em Gray), respectivamente. Ao simular diferentes idades e doses, observamos um padrão que poderia ser usado para simplificar a relação entre a dose de radiação e o tempo restante da função ovariana. Resultados Obtivemos uma função linear entre a dose de radiação ovariana e a perda da função ovariana (LOF, na sigla em inglês) que é a porcentagem de diminuição no tempo até a falência ovariana em relação ao tempo esperado para uma mulher da mesma idade sem exposição à radiação. Para pacientes<40 anos de idade e com doses de radiação ovariana < 5 Gy, a equação LOF = 2,70 + (11,08 × Dose) pode ser aplicada para estimar a redução no tempo até a insuficiência ovariana. Conclusão O presente estudo relata um método teórico viável para estimar a perda da função ovariana. Estes achados podem melhorar potencialmente o manejo e o aconselhamento de pacientes jovens submetidas à radioterapia durante seus anos reprodutivos.

Ovarian Tissue Culture to Preserve Fertility in Transgender Male Patients after Hormonal Treatment / Cultura de tecido ovariano para preservação da fertilidade em pacientes transexuais masculinos após tratamento hormonal

Abstract Objective To evaluate the reproductive and histological characteristics of fresh cultured ovarian tissue from transgender male patients. Methods An in vitro pilot study in which samples were collected during sex reassignment surgery for transgender male patients. The ovarian cortex was cut into fragments of 2 mm, 3mm, and 4 mm, and placed in a 96-well plate suitable for cultivation at days 0, 2, 4, 6, and 8, when the histology was analyzed. Results Stromal hyperplasia was observed in all samples, and it was not associated with the obtainment of primordial or primary follicles. Peripheral reduction in cell count was also a recurrent finding. Primordial and primary follicles were identified with a heterogeneous pattern in fragments from the same patient and from different patients, and follicles in more advanced stages of development (secondary and antral) were not found. There was an association between the diameter of the ovarian fragments and the identification of primary follicles (p=0.036). The number of days in culture was associated with histological signs of tissue damaging in the fragments (p=0.002). The total number of follicles identified in the samples with 2mm in diameter was significantly lower than in those that measured 4mm in diameter (p=0.031). Conclusion A diameter of 4mm is suitable for ovarian tissue culture with the benefit of ease of handling. Even after prolonged exposure to testosterone, the ovarian fragments presented primordial and primary follicles, maintaining viability throughout the days they were exposed to the culture. Freezing the ovarian cortex of transgender patients who will undergo surgery for gender reassignment would be an interesting option, in the future, for the preservation of fertility.

Resumo Objetivo Avaliar as características reprodutivas e histológicas de tecido ovariano cultivado a fresco de pacientes transexuais masculinos. Métodos Estudo experimental in vitro e piloto, no qual amostras foram coletadas durante a cirurgia de redesignação de sexo para pacientes transexuais masculinos. O córtex ovariano foi cortado em fragmentos de 2mm, 3mm, e 4mm, e colocado em placa de 96 poços própria para cultivo nos dias 0, 2, 4, 6 e 8, quando a histologia foi analisada. Resultados Hiperplasia estromal foi observada em todas as amostras, e não esteve associada à obtenção de folículos primordiais ou primários. A redução periférica no número de células também foi um achado recorrente. Folículos primordiais e primários foramidentificados com padrão heterogêneo emfragmentos domesmo paciente e em fragmentos de pacientes diferentes, não sendo encontrados folículos em estágios mais avançados de desenvolvimento (secundários e antrais). Houve associação entre o diâmetro dos fragmentos ovarianos e a identificação dos folículos primários (p=0,036). O número de dias de cultura esteve associado a sinais histológicos de lesão tecidual nos fragmentos (p=0,002). O número total de folículos identificados nas amostras de 2mm de diâmetro foi significativamente menor do que nas de 4mm de diâmetro (p=0,031). Conclusão O diâmetro de 4mm parece ser mais adequado para a cultura de tecido ovariano com a vantagem de fácil manejo. Mesmo após exposição prolongada à testosterona, os fragmentos ovarianos apresentavam folículos primordiais e primários, e manteve a viabilidade ao longo dos dias de exposição à cultura. No futuro, o congelamento da cortical do ovário de pacientes transgêneros que se submeterão à cirurgia de redesignação sexual poderia ser uma opção interessante para a preservação da fertilidade.

Extirpación laparoscópica de quiste paraovárico gigante en pediatría / Laparoscopic removal of giant paraovarian cyst in pediatrics

El quiste paraovárico se desarrolla en el ligamento ancho, entre la trompa de Falopio y el ovario. Son estructuras redondeadas de pared lisa, llenas de líquido seroso, que se ubican en el mesosálpinx, el ligamento ancho o sobre la propia trompa uterina. Tienen una incidencia aproximada de 1 en 1 500 0002 son frecuentes en la tercera y cuarta década de la vida; raramente se presentan en la edad pediátrica. Generalmente, son benignos y tiene un crecimiento lento y progresivo, suelen ser asintomáticos por lo que el diagnóstico suele ser incidental. En casos de quistes de gran volumen, los síntomas son dolor pélvico o la tumoración ab-dominal. Usualmente son diagnosticados clínicamente y se confirman por imágenes ultrasonográficas. La importancia de este caso es la poca frecuencia de estos tumores en la edad pediátrica y su identificación oportuna por parte de los profesionales de la salud

The paraovarian cyst develops in the broad ligament, between the fallopian tube and the ovary. They are rounded structures with a smooth wall, filled with serous fluid, which are located in the mesosalpinx, the broad ligament or on the uterine tube itself. They have an approximate incidence of 1 in 1,500,0002 and are common in the third and fourth decades of life; they rarely occur in childhood. Generally, they are benign and have a slow and progressive growth, they are usually asymptomatic, so the diagnosis is usually incidental. In cases of large volume cysts, the symptoms are pelvic pain or abdominal mass. They are usually diagnosed clinically and confirmed by ultrasonographic images. The importance of this case is the infrequency of these tumors in the pediatric age and their timely identification by health professionals

Clinical, sonographic and anatomopathological aspects of ovarian teratoma in a heifer / Aspectos clínicos, ultrassonográficos e anatomopatológicos do teratoma ovariano em uma novilha

Teratomas rarely occur in domestic species, especially in cattle. These tumors originate in fetal life and are characterized by rapid growth, which justifies their frequent detection in young animals. This study reported a case of ovarian teratoma in a heifer. On physical examination, the main signs identified were apathy, abdominal distention and tension, empty rumen, and mushy diarrhea. During rectal palpation, a mass was identified in the pelvic region, which was suggestive of cysts on ultrasound examination. The animal underwent laparotomy, followed by euthanasia due to a poor prognosis. At necropsy, a 54 x 43 x 52 cm (length x width x thickness) tumor was observed in the right ovary with multiple cystic areas, in addition to masses associated with multiple adhesions of the intestinal loops and peritonitis. On histopathology, muscle, cartilage, bone, nervous and epithelial tissue, glands, hair with follicles, were identified in the affected ovary. There was mixed inflammation and foci of necrosis observed with a complete absence of ovarian architecture in both the ovaries. Infiltrations were identified in the lymph nodes and mesenteric vessels. Glandular ducts were seen from the serosa to the intestinal mucosa. A locally infiltrative and expansile ovarian teratoma was diagnosed accordingly. It is considered that this kind of tumor can induce abdominal distension and absence of estrus in previously healthy, non-pregnant heifers.

Os teratomas são tumores raros nas espécies domésticas, sobretudo em bovinos. Esses tumores são caracterizados por crescimento rápido e origem durante a vida fetal, o que justifica seu diagnóstico frequente em animais jovens. O presente trabalho relata um caso de teratoma ovariano em uma novilha. No exame físico, os principais sinais identificados foram apatia, distensão e tensão abdominal, rúmen vazio e diarreia pastosa. Durante a palpação retal, uma massa foi identificada na região pélvica. Ao exame ultrassonográfico, a massa era sugestiva de cistos. O animal foi submetido a laparotomia, seguido de eutanásia devido ao mau prognóstico. Na necropsia foi observado um tumor de 54 x 43 x 52 cm (comprimento x largura x espessura) no ovário direito com múltiplas áreas císticas, além de massas associadas à múltiplas aderências das alças intestinais e peritonite. Na histopatologia foram identificados no ovário acometido a presença de tecidos muscular, cartilaginoso, ósseo, nervoso e epitelial, com glândulas, pelos e folículos. Havia inflamação mista e focos de necrose com ausência completa de arquitetura ovariana em ambos os ovários. Infiltrações foram identificadas em linfonodos e vasos mesentéricos. Ductos glandulares foram vistos desde a serosa até mucosa intestinal. Diagnosticou-se um teratoma ovariano localmente infiltrativo e expansivo. Considera-se que este tumor pode induzir distensão abdominal e ausência de estro em novilhas previamente sadias e não gestantes.

Primary ovarian leiomyosarcoma in a 72-year-old nulligravid and the 2022 provisional diagnostic criteria for primary ovarian leiomyosarcoma / Philippine Journal of Obstetrics and Gynecology

@#Primary ovarian leiomyosarcoma (POLMS) is an exceedingly rare neoplasm accounting for only 0.1% of all ovarian malignancies and most commonly occurring in postmenopausal women. Prognosis is poor with only a 20% 5-year survival rate. Surgery remains to be its mainstay treatment. Discussed here is a 72-year-old nulligravid with hypogastric pain. Transrectal ultrasound showed a right ovarian new growth, probably malignant on International Ovarian Tumor Analysis (IOTA) simple rules, with a 79.2% risk of malignancy by IOTA ADNEX and an unremarkable uterus. Other workups were normal. She underwent primary cytoreductive surgery. Histopathologic diagnosis was ovarian leiomyosarcoma with positive immunohistochemical staining for desmin, S-100 protein, smooth muscle actin, and epithelial membrane antigen. She refused adjuvant chemotherapy postoperatively. The latest published literature on POLMS was also reviewed to develop the provisional criteria for its prompt diagnosis, thereby decreasing the heterogeneity of the diagnostic approach as well as supporting future researches on manifestations, clinical courses, and therapeutic plans.

Avaliação da aplicabilidade de polímeros sintéticos na vitrificação de tecido ovariano bovino / Evaluation of the applicability of synthetic polymers in the vitrification of bovine ovarian tissue

A preservação da fertilidade em pacientes com câncer objetiva assegurar a saúde reprodutiva. A criopreservação de tecido ovariano é a única técnica disponível para meninas pré-púberes e para casos em que o tratamento não pode ser adiado. A técnica de vitrificação está associada a uma melhor preservação de fragmentos do córtex ovariano quando comparada ao congelamento lento. Estudos preliminares demonstraram que a combinação de polímeros sintéticos na vitrificação preservou melhor o tecido e os folículos secundários no córtex de ovários de macacos, por serem miméticos às proteínas naturais responsáveis pela proteção conferida a alguns organismos durante o inverno. A técnica de vitrificação associada a polímeros sintéticos é uma alternativa promissora, mas ainda não está disponível um protocolo padrão que demonstre resultados consistentes. Assim, este trabalho teve como objetivo avaliar a aplicabilidade de polímeros sintéticos na criopreservação por vitrificação de tecido ovariano bovino. Ovários bovinos foram obtidos a partir de animais abatidos para consumo em um abatedouro local. O córtex foi extraído e cortado em fragmentos. Os fragmentos foram divididos em três grupos (controle fresco, vitrificação com (CP) e sem (SP) adição de polímeros sintéticos). Os fragmentos de tecido de todos os grupos antes e após aquecimento foram fixados em paraformaldeído a 4%, corados com hematoxilina e eosina para avaliação de morfologia, contagem e observação do estágio folicular. Parte dos fragmentos tiveram seus folículos secundários isolados mecanicamente e cultivados em matriz de alginato até atingirem o estágio antral. Durante o cultivo, para análise de viabilidade, foram avaliados a sobrevida, crescimento e formação de antro folicular. Para avaliação da funcionalidade folicular, o meio de cultivo foi coletado para posterior dosagem de esteróides ovarianos. Então, os três grupos foram comparados estatisticamente. Os tecidos ovarianos vitrificados apresentaram uma morfologia com sinais de injúria, com espaços vazios e menos densos, além de exibirem uma menor porcentagem de folículos normais quando comparados ao tecido fresco (Fresco x CP p<0,0001; Fresco x SP p=0,0004). Contudo, não foi observada diferença entre os grupos vitrificados com e sem polímeros (CP x SP p = 0,7173). Os folículos que passaram pela vitrificação apresentaram uma sobrevida similar entre si e menor que o controle fresco (χ²(2) = 19,87; p< 0,0001). Todos os grupos avaliados foram semelhantes na taxa de formação de antro (χ²(1) = 0,6569; p< 0,4176). Em todos os grupos houve crescimento folicular durante o cultivo. No entanto, os folículos frescos e com adição de polímeros aumentaram de diâmetro durante todo o cultivo, ao passo que os folículos sem adição de polímeros cresceram apenas na primeira semana. No fim do cultivo, os folículos que passaram pelo processo de vitrificação produzem menos hormônios que os frescos (p < 0,05), mas sem diferença entre SP e CP. A partir desses resultados, é possível concluir que a combinação do uso de polímeros sintéticos na vitrificação de tecido ovariano é uma técnica promissora, que poderá proteger o desenvolvimento folicular, mas são necessários mais estudos que possam aperfeiçoar esse protocolo.

The preservation of fertility in cancer patients aims to ensure reproductive health. Ovarian tissue cryopreservation is the only technique available for prepubescent girls and for cases where treatment cannot be delayed. The vitrification technique is associated with better preservation of ovarian cortex fragments when compared to slow freezing. Preliminary studies in the cortex of monkeys' ovaries have shown that the combination of synthetic polymers in vitrification is better to preserve the tissue and secondary follicles, as they are mimetic to the natural proteins responsible for the protection during the winter in some organisms. The vitrification technique associated with synthetic polymers is a promising alternative, but a standard protocol that demonstrates consistent results is not yet available. Thus, this work aimed to evaluate the applicability of synthetic polymers in cryopreservation by vitrification of bovine ovarian tissue. Bovine ovaries were obtained at a local abattoir. The cortex was extracted and cut into fragments. The fragments were divided into three groups (fresh control, vitrification with (CP) and without (SP) addition of synthetic polymers). Tissue fragments from all groups before and after heating were fixed in 4% paraformaldehyde, stained with hematoxylin and eosin for morphology assessment, counting and observation of the follicular stage. Part of the fragments had their secondary follicles mechanically isolated and cultivated in alginate matrix until they reached the antral stage. During cultivation, for viability analysis, survival, growth and follicular antrum formation were evaluated. To evaluate the follicular functionality, the culture medium was collected for later measurement of ovarian steroids. The vitrified ovarian tissues presented a morphology with signs of injury, with empty and less dense spaces, in addition to showing a lower percentage of normal follicles when compared to fresh tissue (Fresh control x CP p< 0.0001). All groups evaluated were similar in the rate of antrum formation (χ²(1) = 0.6569; p< 0.4176). In all groups there was follicular growth during cultivation. However, fresh and polymer-added follicles increased in diameter throughout the cultivation, whereas follicles without polymer additions grew only in the first week. At the end of cultivation, the follicles that underwent the vitrification process produced less hormones than the fresh ones (p < 0.05), but there was no difference between SP and CP. From these results, it is possible to conclude that the combination of the use of synthetic polymers in the vitrification of ovarian tissue is a promising technique, which may protect follicular development, but further studies are needed to improve this protocol.

Los términos corpus rubrum, corpus luteum y corpus albicans en terminologia anatomica del ovario / The terms rubrum, luteum and albicans in terminologia anatomica of the ovary

RESUMEN: El objetivo del presente artículo fue revisar la etimología de los términos Corpus rubrum, Corpus luteum y Corpus albicans, identificar si la forma de nombrarlos en las diferentes nóminas y terminologías internacionales están acorde a las sugerencias de la FIPAT y, analizar y reflexionar respecto de la pertinencia de estos términos en la Terminologia Anatomica. Se buscó en primer lugar el significado de las raíces latinas de los términos: Corpus rubrum, Corpus luteum y Corpus albicans, en el Diccionario de la Real Academia de la Lengua, última actualización; en el Diccionario Términos Médicos de la Real Academia Nacional de Medicina en España y en el Diccionario Vox, Español Latín. Indagamos en la historia para conocer desde cuando se utilizan estos términos, así como la revisión de las diferentes nomenclaturas, nóminas y terminologías anatómicas, histológicas y embriológicas, desde 1955 hasta la fecha. La búsqueda reportó que estos adjetivos latinos deberían traducirse al español de la siguiente manera: rubrum como rojo; luteum como amarillo y albicans como albicante que significa blanquear, por lo que la traducción correcta debiera ser: Cuerpo rojo, Cuerpo amarillo y Cuerpo albicante o blanco del ovario, estructuras transitorias y funcionales. Los términos Corpus rubrum, Corpus luteum y Corpus albicans que identifican estructuras del ovario en Terminologia Anatomica y Terminologia Histologica deberían ser revisados, puesto que son estructuras transitorias y su nombre sólo indica el color que adquieren en el momento funcional y es referente a los cambios que presenta la misma estructura.

SUMMARY: The aim of this article was to review the etymology of the terms Corpus rubrum, Corpus luteum and Corpus albicans, to identify if the way of naming them in the different lists and international terminologies are in accordance with the FIPAT suggestions and to analyze and reflect on the relevance of these terms in the Terminologia Anatomica. Firstly, the meaning of the Latin roots of the terms: Corpus rubrum, Corpus luteum and Corpus albicans were searched in the dictionaries: of the Royal Academy of Language, latest update; of the Medical Terms of the Royal National Academy of Medicine in Spain; in the Vox dictionary, Spanish Latin. Then we investigate the history to know since when these terms are used, as well as the review of the different anatomical, histological and embryological lists and terminologies from 1955 to date. The search reported that these Latin adjectives should be translated as follows: rubrum as red; luteum as yellow and albicans as albicante which means to whiten, therefore, the correct translation should be: Red body, Yellow body and Albicans or white body of the ovary, they are also transitory and functional structures. The terms Corpus rubrum, Corpus luteum and Corpus albicans that identify ovarian structures in the Terminologia Anatomica and Terminologia Histologica should be reviewed since they are transitory structures and their name only indicates the color they acquire at the functional moment and refers to the changes that the same structure presents.