Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 21
Filtrar
1.
Nano Lett ; 16(9): 5514-20, 2016 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-27575057

RESUMO

Au-Pd nanocrystals are an intriguing system to study the integrated functions of localized surface plasmon resonance (LSPR) and heterogeneous catalysis. Gold is both durable and can harness incident light energy to enhance the catalytic activity of another metal, such as Pd, via the SPR effect in bimetallic nanocrystals. Despite the superior catalytic performance of icosahedral (IH) nanocrystals compared to alternate morphologies, the controlled synthesis of alloy and core-shell IH is still greatly challenged by the disparate reduction rates of metal precursors and lack of continuous epigrowth on multiply twinned boundaries of such surfaces. Herein, we demonstrate a one-step strategy for the controlled growth of monodisperse Au-Pd alloy and core-shell IH with terraced shells by turning an ionic switch between [Br(-)]/[Cl(-)] in the coreduction process. The core-shell IH nanocrystals contain AuPd alloy cores and ultrathin Pd shells (<2 nm). They not only display more than double the activity of the commercial Pd catalysts in ethanol electrooxidation attributed to monatomic step terraces but also show SPR-enhanced conversion of 4-nitrophenol. This strategy holds promise toward the development of alternate bimetallic IH nanocrystals for electrochemical and plasmon-enhanced catalysis.

2.
Fertil Steril ; 91(1): 293.e9-11, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17412334

RESUMO

OBJECTIVE: To show that hysteroscopy is a feasible and safe method of evaluation in females with limited vaginal access. DESIGN: Retrospective review of two patients who received hysteroscopy for evaluation of uterus didelphys with hemivagina and a cervical polyp. SETTING: Private hospital. PATIENT(S): Two patients with either a vagina septum or cervical polyp. INTERVENTION(S): Hysteroscopy for visualization and resection. MAIN OUTCOME MEASURE(S): Resection of a vagina septum and cervical polyp. RESULT(S): No more cyclic dysmenorrhea in the patient with uterus didelphys and cessation of abnormal bleeding in the patient with a cervical polyp. Our results suggest that hysteroscopy can provide precise visualization of vagina and cervical lesions if the approach is difficult with decreased access, and allows concurrent treatment of pathologic conditions accordingly. CONCLUSION(S): Hysteroscopy is favorable in the diagnosis and treatment of vaginal and cervical lesions in women with limited vaginal access because of age or a narrower vagina. In the Eastern culture, it is very important for females to maintain their state of virginity signified by an uninjured hymen ring. This problem is solved, as hysteroscopy allows the evaluation of malformations of the female genital tract.


Assuntos
Cistos/cirurgia , Histeroscopia/métodos , Pólipos/cirurgia , Vagina/anormalidades , Vagina/patologia , Adulto , Criança , Dismenorreia/etiologia , Feminino , Humanos , Hímen/anatomia & histologia , Hímen/patologia , Imageamento por Ressonância Magnética , Estudos Retrospectivos , Doenças Uterinas/cirurgia , Doenças Vaginais/cirurgia
3.
Urol Int ; 80(1): 62-7, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18204236

RESUMO

INTRODUCTION: The aim of this prospective study was to evaluate the changes in the vascularization of the lower urinary tract following laparoscopic hysterectomy (LH). METHODS: Seventy women undergoing LH not under the indication of a uterine myoma were included. All subjects underwent urinalysis, pelvic examination, and introital color Doppler ultrasonography and completed a urinary questionnaire before and 6 months after LH. One-hour pad tests and urodynamic studies were performed in clinically incontinent women pre- and postoperatively. RESULTS: Evaluation of the Doppler velocimetric parameters of bladder neck and periurethral vessels before and after LH, including number of vessels, pulsatility index, systolic peak, and minimum diastole, revealed no statistically significant differences (p > 0.05). In addition, the prevalence of stress urinary incontinence (SUI) decreased significantly from 37.1% (n = 26) preoperatively to 17.1% (n = 12) postoperatively (p < 0.01). A total of 19 patients reported no further SUI following LH. Their urinary leakages on the pad tests had all <10 g before surgery. When we analyzed the data of the women reporting no further SUI (n = 19) and de novo SUI (n = 5) following LH, the changes in the pulsatility index also showed no significant difference from the pre-LH values (p > 0.05). CONCLUSIONS: The results of our study suggest that LH has little impact on the blood flow of bladder neck and urethra. Although some women experienced relief of the symptoms of mild or de novo SUI after LH, this being unrelated to changes in the vascularization of the lower urinary tract.


Assuntos
Histerectomia Vaginal/efeitos adversos , Laparoscopia/efeitos adversos , Incontinência Urinária por Estresse/etiologia , Sistema Urinário/irrigação sanguínea , Adulto , Idoso , Feminino , Humanos , Histerectomia Vaginal/métodos , Laparoscopia/métodos , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Tempo , Resultado do Tratamento , Incontinência Urinária por Estresse/diagnóstico , Urodinâmica , Urologia/métodos
4.
Fertil Steril ; 89(5 Suppl): 1522-9, 2008 May.
Artigo em Inglês | MEDLINE | ID: mdl-17889855

RESUMO

OBJECTIVE: To elucidate the role of RU486 in regulating the function of granulosa luteal cells and its possible involvement in ovarian dysfunction. DESIGN: An in vitro study. SETTING: University hospital. PATIENT(S): Our subjects were women under the age of 40 who were unable to get pregnant as a result of male-factor infertility. INTERVENTION(S): HCG and RU486 were added to cultured granulosa luteal cells; after incubation for 12 hours, the harvested cells were subjected to total mRNA and protein measurements. MAIN OUTCOME MEASURE(S): Reverse transcriptase-polymerase chain reaction, immunoblot assay, immunocytochemistry, and enzyme immunoassay were performed. RESULT(S): RU486 attenuates hCG-induced cyclooxygenase-2 (COX-2) mRNA and protein expression and extracellular signal-regulated kinase (ERK) 1/2 phosphorylation and decreases the hCG-induced prostaglandin E2 (PGE2) production in a dose-dependent manner. RU486 treatment had no significant effect on COX-1 mRNA expression. CONCLUSION(S): Treatments using gonadotropins are able to induce ERK1/2 phosphorylation resulting in increased COX-2 protein expression and prostaglandin synthesis. RU486 attenuates the activation of ERK1/2, decreases the expression of COX-2, and affects PGE2 production by inhibiting hCG-induced COX-2 expression.


Assuntos
Gonadotropina Coriônica/farmacologia , Ciclo-Oxigenase 2/metabolismo , Dinoprostona/metabolismo , Células Lúteas/efeitos dos fármacos , Mifepristona/farmacologia , Proteína Quinase 1 Ativada por Mitógeno/metabolismo , Proteína Quinase 3 Ativada por Mitógeno/metabolismo , Adulto , Células Cultivadas , Ciclo-Oxigenase 2/genética , Regulação para Baixo/efeitos dos fármacos , Interações Medicamentosas , Inibidores Enzimáticos/farmacologia , Feminino , Flavonoides/farmacologia , Antagonistas de Hormônios/farmacologia , Humanos , Proteínas Quinases JNK Ativadas por Mitógeno/metabolismo , Células Lúteas/metabolismo , Fosforilação/efeitos dos fármacos , RNA Mensageiro/metabolismo , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo
5.
Aust N Z J Obstet Gynaecol ; 47(4): 345-6, 2007 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-17627694

RESUMO

BACKGROUND: Three to five per cent acetic acid is commonly used in the field of gynaecology for colposcopic examinations of the cervix. It gives an 'acetowhite' effect that may assist clinicians in identifying neoplastic areas. CASE: A perimenopausal woman was treated with acetic acid for abnormal Pap smear report (cervical intraepithelial neoplasia 1). During application, the patient complained of burning sensation of vagina and vulva. The vagina was saline-irrigated after realising that the acetic acid had not been diluted. Following this incident, the patient was seen weekly and treated with conjugated vaginal oestrogen cream. The patient recovered and the vagina mucosa healed within two weeks. CONCLUSION: Acetic acid is corrosive and may cause vagina bleeding. Oestrogen cream can be used in an attempt to minimise the adverse reaction and speed the healing process.


Assuntos
Ácido Acético/efeitos adversos , Queimaduras Químicas/tratamento farmacológico , Congêneres do Estradiol/administração & dosagem , Indicadores e Reagentes/efeitos adversos , Erros de Medicação , Ácido Acético/administração & dosagem , Administração Tópica , Feminino , Humanos , Indicadores e Reagentes/administração & dosagem , Pessoa de Meia-Idade , Mucosa/lesões , Vagina , Cremes, Espumas e Géis Vaginais
6.
Kaohsiung J Med Sci ; 23(3): 138-41, 2007 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-17389178

RESUMO

Malignant lymphoma involving the genital tract is rare, and primary lymphoma of the uterus is even rarer. Immunohistochemically, most of the reported cases have been diffuse large cell lymphomas with a B-cell nature. Herein, we report an unusual case of uterine T-cell lymphoma in a 68-year-old woman. She suffered from fever, vaginal bleeding, and a huge mass in the lower abdomen. The initial clinical and histologic studies failed to indicate a cell type. We provide the clinical details of the case and discuss the diagnostic pitfalls.


Assuntos
Linfoma de Células T/patologia , Neoplasias Uterinas/patologia , Idoso , Feminino , Humanos , Linfoma de Células T/diagnóstico , Neoplasias Uterinas/diagnóstico , Útero/patologia
7.
Menopause ; 13(5): 737-43, 2006.
Artigo em Inglês | MEDLINE | ID: mdl-16946685

RESUMO

OBJECTIVE: To compare the effects of oral and vaginal estrogen therapy (ET) on the vaginal blood flow and sexual function in postmenopausal women with previous hysterectomy. DESIGN: Fifty-seven women were randomized to receive either oral (0.625 mg of conjugated equine estrogens per tablet; n = 27) or topical (0.625 mg conjugated equine estrogens per 1 g vaginal cream; n = 30) estrogen administered once daily. All women underwent estradiol measurements, urinalysis, pelvic examination, introital color Doppler ultrasonographies, and personal interviews for sexual symptoms using a validated questionnaire before and 3 months after ET. RESULTS: A higher serum level of estradiol was noted in the oral group compared with the topical group after 3 months of ET. There were significant increases in the number of vaginal vessels and the minimum diastole (P < 0.01), and marked decreases of pulsatility index values (P < 0.01) in both groups after ET. Regarding the systolic peak, we found a significant decrease only in the topical group (P < 0.05). Although the post-ET prevalence of anorgasmia decreased significantly in both groups (P < 0.05), changes in other domains, including the rates of low libido and coital frequency, were not statistically significant (P > 0.05). In the topical group, ET improved sexual function on the vaginal dryness and dyspareunia domains in a statistically significant manner (P < 0.05), but this was not the case in the oral group (P > 0.05). However, the efficacy of oral ET for vaginal dryness and dyspareunia reached 80% and 70.6%, respectively. The corresponding figures of the topical ET were 79.2% and 75%. CONCLUSIONS: The results of our study suggest that ET alone in hysterectomized postmenopausal women increases the vaginal blood flow and improves some domains of sexual function, but it may not have an impact on diminished sexual desire or activity. Compared with systemic therapy, topical vaginal preparations are found to correlate with better symptom relief despite the lower serum level of estradiol.


Assuntos
Terapia de Reposição de Estrogênios/métodos , Estrogênios Conjugados (USP)/administração & dosagem , Pós-Menopausa , Comportamento Sexual/efeitos dos fármacos , Vagina/irrigação sanguínea , Administração Oral , Administração Tópica , Estrogênios Conjugados (USP)/farmacologia , Feminino , Humanos , Histerectomia , Pessoa de Meia-Idade , Fluxo Pulsátil/efeitos dos fármacos , Fluxo Sanguíneo Regional/efeitos dos fármacos , Análise de Regressão , Ultrassonografia Doppler , Vagina/diagnóstico por imagem , Vagina/efeitos dos fármacos
8.
Fertil Steril ; 85(1): 155-60, 2006 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16412747

RESUMO

OBJECTIVE: To compare the effects of oral and vaginal estrogen therapy (ET) on the lower urinary tract in postmenopausal women with prior hysterectomy. DESIGN: Randomized, prospective study. SETTING: Tertiary teaching hospital. PATIENT(S): Fifty-seven hysterectomized, postmenopausal women. INTERVENTION(S): Patients were randomized to receive either oral (0.625 mg of conjugated equine E per tablet; n = 27) or topical (0.625 mg conjugated equine E per 1 g vaginal cream; n = 30) E, administered once daily. MAIN OUTCOME MEASURE(S): All subjects had E2 measurements, urinalysis, pelvic examination, introital color Doppler ultrasonographies, and personal interviews with the Bristol Female Lower Urinary Tract Symptoms Questionnaires before and 3 months after ET. RESULT(S): A higher serum level of E2 was noted in the oral group compared with the topical group after ET. The post-ET pulsatility index of periurethral vessels and bladder neck revealed statistically significant decreases in both groups. The incidences of urinary frequency and nocturia were significantly decreased after 3 months of ET in both groups. Changes in the incidence of other symptoms, including stress incontinence and urge incontinence, were not statistically significant. However, subjective improvement of stress incontinence was found in 72.7% of the oral group and 60% of the topical group. CONCLUSION(S): The results suggest that ET alone, by an oral or vaginal route, could increase the blood flow around the bladder neck and mid-urethra and relieve the symptoms of overactive bladder and stress incontinence in postmenopausal women with prior hysterectomy. In addition, vaginal preparations are as effective as systemic therapy at the lower serum level of E2.


Assuntos
Terapia de Reposição de Estrogênios , Estrogênios/administração & dosagem , Uretra/efeitos dos fármacos , Bexiga Urinária/efeitos dos fármacos , Incontinência Urinária por Estresse/tratamento farmacológico , Administração Intravaginal , Administração Oral , Administração Tópica , Velocidade do Fluxo Sanguíneo , Feminino , Humanos , Histerectomia , Pessoa de Meia-Idade , Pós-Menopausa , Estudos Prospectivos , Ultrassonografia Doppler em Cores , Uretra/irrigação sanguínea , Bexiga Urinária/irrigação sanguínea , Incontinência Urinária por Estresse/diagnóstico por imagem , Transtornos Urinários/diagnóstico por imagem , Transtornos Urinários/tratamento farmacológico
9.
Fertil Steril ; 84(4): 1037-9, 2005 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16213869

RESUMO

Conjugated equine estrogen alone or combined with medroxyprogesterone acetate lowered homocysteine levels in postmenopausal women. Regardless of the dosage of progestin used, there was no impact on homocysteine metabolism after 3 years of therapy.


Assuntos
Estrogênios Conjugados (USP)/administração & dosagem , Homocisteína/sangue , Acetato de Medroxiprogesterona/administração & dosagem , Pós-Menopausa/sangue , Pós-Menopausa/efeitos dos fármacos , Administração Oral , Análise de Variância , Quimioterapia Combinada , Feminino , Humanos , Pessoa de Meia-Idade
10.
J Minim Invasive Gynecol ; 12(2): 137-43, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-15904617

RESUMO

STUDY OBJECTIVE: To compare vesicourethral function following laparoscopic hysterectomy (LH) with and without vaginal cuff suspension. DESIGN: Prospective study (Canadian Task Force classification I). SETTING: Tertiary teaching hospital. PATIENTS: Sixty-eight women scheduled for LH randomly assigned to either LH without vaginal cuff suspension (LH group; n = 36) or LH with suspension (LHS group; n = 32). INTERVENTION: All subjects received urinalysis, pelvic examination, Q-tip test, introital ultrasonography, and a urinary questionnaire before and 6 months after surgery. MEASUREMENTS AND MAIN RESULTS: The prevalence of stress urinary incontinence (SUI) decreased significantly from 46.9% (n = 15) preoperatively to 18.8% (n = 6) postoperatively in the LHS group (p = .022), but this was not so in the LH group. Similarly, the mean straining urethral angle and the number of women exhibiting bladder neck (BN) hypermobility significantly decreased after surgery in only the LHS group (p <.05; p <.01, respectively). During straining, the postoperative position of the BN localized more dorsally (p <.01), and its ventral mobility decreased significantly (p <.01) in the LH group. In the LHS group, significant postoperative reduction was found in both ventral and caudal movements of the BN during stress (p <.01), causing a more cranial and dorsal position of the BN (p <.01). CONCLUSION: Laparoscopic hysterectomy with cuff suspension strengthens the traction effect on the endopelvic fascia, reducing both BN mobility during stress and the chance of SUI. However, simply performing a cuff suspension is not adequate for the treatment of severe SUI.


Assuntos
Doenças dos Genitais Femininos/cirurgia , Histerectomia/métodos , Laparoscopia/métodos , Telas Cirúrgicas , Incontinência Urinária por Estresse/prevenção & controle , Prolapso Uterino/prevenção & controle , Adulto , Feminino , Seguimentos , Doenças dos Genitais Femininos/diagnóstico , Humanos , Histerectomia/efeitos adversos , Laparoscopia/efeitos adversos , Pessoa de Meia-Idade , Probabilidade , Valores de Referência , Medição de Risco , Resultado do Tratamento , Uretra/cirurgia , Urodinâmica , Prolapso Uterino/cirurgia
11.
Artigo em Inglês | MEDLINE | ID: mdl-15580422

RESUMO

This study evaluated the clinical and urodynamic findings before and after tension-free bladder neck sling (TBS) procedure with Prolene tape. We enrolled 32 women who underwent TBS for genuine stress incontinence without intrinsic sphincter deficiency or severe uterovaginal prolapse. All subjects received 1-h pad test, Q-tip test, multichannel urodynamic testing, introital ultrasonography, and the Bristol Female Lower Urinary Tract Symptoms Questionnaires before and 1 year after surgery. Of the 32 subjects 27 were cured of stress incontinence, two improved, and three failed. The incidence of irritative symptoms and incomplete bladder emptying were significantly lower after surgery. The mean urethral straining angle showed a significant decrease from 73.8 degrees preoperatively to 30.1 degrees postoperatively. At rest the postsurgical position of the bladder neck (BN) was localized more cranially. During straining both ventral and caudal mobility of the BN decreased significantly following TBS, causing a more cranial and dorsal position of the BN. Urodynamic parameters including functional urethral length, maximal urethral closure pressure, and pressure transmission ratio showed significant increases after surgery. TBS could decrease the hypermobility of the BN and restore the BN support to prevent urinary leakage during straining, instead of urethral obstruction. The subjective and objective cure rate of stress incontinence is 84%, similar to those results reported after retropubic urethropexy and tension-free vaginal tape procedure. It is also worth emphasizing that no postoperative urinary retention occurred, although the limited number of cases makes it hard to confirm the significance of findings over the retention rate of tension-free vaginal tape.


Assuntos
Incontinência Urinária por Estresse/cirurgia , Vagina/cirurgia , Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Próteses e Implantes , Estudos Retrospectivos , Telas Cirúrgicas , Inquéritos e Questionários , Taiwan/epidemiologia , Fatores de Tempo , Incontinência Urinária por Estresse/epidemiologia , Incontinência Urinária por Estresse/fisiopatologia , Urodinâmica , Procedimentos Cirúrgicos Urológicos
12.
Obstet Gynecol ; 104(6): 1270-4, 2004 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-15572488

RESUMO

OBJECTIVE: To report our experience on lateral excision of tape in women with iatrogenic urethral obstruction after the tension-free vaginal tape (TVT) procedure. METHODS: Seven women had iatrogenic urethral obstruction based on their clinical and urodynamic findings. All underwent lateral excision of the tape using the vaginal approach. Lower urinary tract symptoms, postvoid residual volume and urodynamic data were evaluated before and after excision. RESULTS: Before excision, all subjects had either irritative symptoms or increased postvoid residual volume (more than 100 mL), and 6 (85.7%) voided with strain. The mean time from initial surgery to tape excision was 28 days (range 4 to 108), with an average follow-up of 32 months (range 24-39). After the excision, voiding dysfunction was resolved in 6 of 7 patients. The remaining patient had significant improvement with only occasional symptoms of irritation. Two (28.6%) women reported recurrent stress incontinence and 1 (14.3%) required surgical treatment. The intervals for the 2 recurrent patients from TVT to excision were 4 days. The intervals for the 5 continent women were 15 to 108 days. CONCLUSION: Urethral obstruction after TVT is a relatively uncommon condition. It can be effectively treated with transvaginal lateral excision of the tape. Recurrent stress incontinence seems to be less likely to occur when the takedown procedure occurs beyond 14 days after the initial TVT operation.


Assuntos
Próteses e Implantes/efeitos adversos , Obstrução Uretral/terapia , Incontinência Urinária por Estresse/terapia , Feminino , Humanos , Recidiva , Obstrução Uretral/etiologia , Obstrução Uretral/fisiopatologia , Urodinâmica
13.
J Reprod Med ; 49(1): 33-7, 2004 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-14976793

RESUMO

OBJECTIVE: To compare the clinical and urodynamic characteristics of continent and incontinent women with severe uterovaginal prolapse. STUDY DESIGN: Fifty-eight consecutive women with stage III or IV pelvic organ prolapse between June 1998 and December 2001 were enrolled. Each woman had a urinalysis, pelvic examination and urodynamic study and answered a urinary questionnaire. They were divided into clinically continent (n = 20) and incontinent (n = 38) groups. The clinical symptoms and urodynamic results in the 2 groups were compared statistically with the chi 2 test, Fisher's exact test and Mann-Whitney U test. RESULTS: Incontinent women with severe genital prolapse were more likely to report urinary frequency, urgency and nocturia than were continent women (P < .05). However, the incidence of voiding hesitancy was significantly higher for members of the continent group as compared to the incontinent group (P = .002). With respect to urodynamic variables, including detrusor pressure at peak flow, maximal urethral closure pressure and pressure transmission ratio, significantly higher values occurred in the continent group as compared with the incontinent group; they were 38 (range, 12-66) vs. 24 cm H2O (range, 10-49) (P < .01), 84 (range, 39-117) vs. 63 cm H2O (range, 45-84) (P = .033) and 102% (range, 66-135) vs. 66% (range, 14-98) (P = .019), respectively. All other parameters and the incidence of bladder outlet obstruction and detrusor instability did not differ significantly between the 2 groups (P > .05). CONCLUSION: The results of this study suggest that severe uterovaginal prolapse could produce obstructive symptoms and prevent or reduce urinary leakage, but whether urethral kinking or external urethral compression causes the obstruction remains unclear. More studies on different types of isolated pelvic organ prolapse are needed to elucidate the mechanism, and specific strategies can be developed to aid urogynecologists in their goal of restoring normal anatomy.


Assuntos
Incontinência Urinária/fisiopatologia , Prolapso Uterino/fisiopatologia , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Incontinência Urinária/etiologia , Micção/fisiologia , Urodinâmica/fisiologia , Prolapso Uterino/complicações
14.
Maturitas ; 46(4): 295-9, 2003 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-14625126

RESUMO

OBJECTIVE: To evaluate the change of endometrial histology and the expression of cyclooxygenase-2 (Cox-2) in the endometrium after continuous combined hormone replacement therapy (HRT). METHODS: Forty-five postmenopausal women were recruited. All participants received 0.625 mg conjugated equine estrogen (CEE) and 2.5 mg medroxyprogesterone (MPA) daily for 2 years. Endometrial biopsy was performed twice, before medication (baseline) and after 2 years of HRT, respectively. Immunohistochemistry was used to detect the presence of Cox-2 expression. RESULTS: More atrophic and weak secretory features of endometrium were noted after the 2-year HRT. Endometrial hyperplasia and carcinoma were not found and immunohistochemistry results revealed that Cox-2 was not expressed in the endometrium. CONCLUSION: Cox-2, known to play an important role in the tumorigenesis of cancer, was not stained in endometrium tissue after hormonal induction and more endometrium atrophy was noted after the 2-year HRT. From the results, it is noted that continuous combined HRT may be a relatively safe and appropriate regimen for long-term use in postmenopausal women.


Assuntos
Endométrio/enzimologia , Terapia de Reposição de Estrogênios , Isoenzimas/metabolismo , Prostaglandina-Endoperóxido Sintases/metabolismo , Ciclo-Oxigenase 2 , Esquema de Medicação , Endométrio/efeitos dos fármacos , Estrogênios Conjugados (USP)/administração & dosagem , Feminino , Humanos , Imuno-Histoquímica , Medroxiprogesterona/administração & dosagem , Proteínas de Membrana , Pessoa de Meia-Idade
15.
Fertil Steril ; 80(1): 218-20, 2003 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12849829

RESUMO

OBJECTIVE: To report a case of combined intrauterine and interstitial twin pregnancies after bilateral salpingectomy and IVF with replacement of three embryos. DESIGN: Case report. SETTING: University hospital. PATIENT(S): A 31-year-old woman known to have bilateral salpingectomy for ectopic pregnancies who underwent IVF. INTERVENTION(S): Laparotomy. MAIN OUTCOME MEASURE(S): Postoperation intrauterine monozygotic twins survival and birth. RESULT(S): After removing the interstitial monozygotic twin pregnancy, the patient had an uneventful postoperative course and delivered two healthy girls by cesarean section at 38 weeks' gestation. CONCLUSION(S): Heterotopic pregnancy can still occur in women treated by IVF after bilateral salpingectomy. The early sonography follow-up of IVF pregnancy would be of value because of the reported higher incidence of pathological pregnancies and especially monozygotic twinning.


Assuntos
Transferência Embrionária/efeitos adversos , Fertilização in vitro/efeitos adversos , Gravidez Ectópica/etiologia , Gravidez Múltipla , Adulto , Feminino , Humanos , Recém-Nascido , Gravidez , Resultado da Gravidez , Quadrigêmeos , Gêmeos Monozigóticos , Ultrassonografia Pré-Natal
16.
Gynecol Obstet Invest ; 55(2): 105-9, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-12771457

RESUMO

The objective of this study was to compare the results of a modified laparoscopically assisted vaginal hysterectomy (LAVH) procedure, using light-endorsed transvaginal section by two puncture trocars, with those of total abdominal hysterectomy (TAH) in a prospective, randomized, short-term study. A new, modified LAVH technique using Endo GIA stapler and two puncture trocars was established. For the laparoscopic phase, each adnexum was dissected, and the vesicouterine junction was identified clearly with the laparoscopic light from the vaginal side. Vaginal-phase surgery was performed as usual. Two hundred patients scheduled for abdominal hysterectomy were randomized to either LAVH (n = 100) or TAH (n = 100). Duration of hospitalization, time of surgery, dose of analgesics, and rates of complications were significantly lower in the LAVH group (p < 0.001). The average operating time was 77 +/- 30 min for LAVH and 102 +/- 18 min for TAH. The duration of hospitalization was 3.2 +/- 0.7 days for LAVH and 5.5 +/- 1.3 days for TAH. There were three complications in the LAVH group and 15 in the TAH group. Postoperative meperidine requirements (1.2 vs. 3.7 ampoules, 1 ampoule = 50 mg) were significantly fewer in the LAVH group. Regarding the training time, the mean operating time in the first 20 cases was 98 min, and in the last 20 cases it was 70.9 min. As compared with TAH and other modified LAVH procedures reported previously, the present technique is easy to learn and timesaving with fewer complications.


Assuntos
Histerectomia Vaginal/métodos , Histerectomia/métodos , Laparoscopia , Adulto , Endometriose/cirurgia , Feminino , Humanos , Complicações Intraoperatórias , Leiomioma/cirurgia , Tempo de Internação , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Prospectivos , Fatores de Tempo , Neoplasias Uterinas/cirurgia
17.
Aust N Z J Obstet Gynaecol ; 43(1): 65-9, 2003 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-12755352

RESUMO

OBJECTIVE: To assess the effect of laparoscopic hysterectomy (LH) on the mobility and position of bladder neck (BN) and urinary symptoms. DESIGN: We assessed the BN and urinary symptoms of 151 patients by introital ultrasonography and questionnaires before and after LH. SAMPLE: One hundred and fifty-one women who underwent LH from June 1999 to June 2001. RESULTS: A significant decrease was noted in the number of women exhibiting one or more urinary symptoms from 81 (53.6%) preoperatively to 58 (38.4%) postoperatively (P < 0.01). The incidence of urinary frequency, mild stress incontinence and nocturia decreased significantly after laparoscopic hysterectomy (P < 0.01). Changes in other urinary symptoms following hysterectomy showed no statistical significance (P > 0.05). During straining, the postoperative position of the BN localised more dorsally (P < 0.01) and the ventral mobility of the BN decreased significantly following surgery (P < 0.05). There was no significant difference in the location of the BN with respect to the pubis at rest and during straining, in the cephalocaudal direction, before and after hysterectomy (P > 0.05). CONCLUSION: Some patients experienced a substantial improvement of preoperative urinary symptoms following LH, partly as a result of a decrease in the hypermobility of BN.


Assuntos
Histerectomia/métodos , Laparoscopia , Complicações Pós-Operatórias/epidemiologia , Incontinência Urinária por Estresse/epidemiologia , Transtornos Urinários/epidemiologia , Feminino , Humanos , Incidência , Pessoa de Meia-Idade , Estudos Prospectivos , Bexiga Urinária/fisiopatologia
18.
Gynecol Obstet Invest ; 53(4): 214-9, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12186986

RESUMO

We compare the surgical results of 60 women undergoing laparoscopically assisted vaginal hysterectomy (LAVH) and 41 having total laparoscopic hysterectomy (TLH) under the indications of uterine fibroids or adenomyosis. With similar specimen weight, TLH required longer surgery duration (140.4 vs. 115.1 min; p < 0.05) than LAVH. Among women with uteri weighing 0.05) although the TLH group had a significantly higher rate of previous abdominal surgery (57.7 vs. 20%; p < 0.05). There were no significant differences between the two groups with respect to the mean cost, length of hospital stay and rate of various complications (p > 0.05). As for sexual symptoms, dyspareunia decreased significantly post-operatively in the LAVH group (p < 0.05), but not in the TLH group. A significant reduction in the frequency of orgasms after surgery was detected in both groups (p < 0.05). In conclusion, LAVH has advantages over TLH with reduced operating time. Although it is a technical challenge, TLH can be effectively performed within reasonable time limits in selected cases. The effects on sexual function, following either LAVH or TLH, are found to be similar.


Assuntos
Histerectomia/métodos , Histeroscopia/métodos , Doenças Uterinas/cirurgia , Adulto , Estudos de Coortes , Feminino , Seguimentos , Humanos , Histerectomia/efeitos adversos , Histerectomia Vaginal/efeitos adversos , Histerectomia Vaginal/métodos , Histeroscopia/efeitos adversos , Tempo de Internação , Pessoa de Meia-Idade , Dor Pós-Operatória/diagnóstico , Complicações Pós-Operatórias , Probabilidade , Estudos Prospectivos , Estatísticas não Paramétricas , Resultado do Tratamento , Doenças Uterinas/diagnóstico
19.
J Assist Reprod Genet ; 19(4): 169-76, 2002 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-12036084

RESUMO

PURPOSE: This study was to examine the serum leptin levels in the prediction of pregnancy outcomes in women receiving ovarian hyperstimulation. Effect of leptin on the steroidogenesis was evaluated for granulosa cell (GC) culture in vitro. METHOD: Serum levels of leptin and estradiol were measured on Day 2, the time of hCG administration and oocyte retrieval in 50 women undergoing long-course GnRH agonist ovarian hyperstimulation. The production of estrogen and progesterone in granulosa cell culture were detected after administration of leptin at the absence or presence of FSH 1 mIU. RESULTS: Leptin levels at the time of hCG injection were significantly lower in the pregnant women than in those without pregnancy. Estradiol concentrations were not correlated with leptin levels during the time of hCG injection and oocyte retrieval. High leptin concentration suppressed both basal estradiol and progesterone productions in GC. Leptin in high doses suppressed estradiol production, but did not alter progesterone production of GC in the presence of FSH. CONCLUSIONS: Serum leptin levels may be predictive of IVF pregnancy outcome with the effect on intraovarian progesterone/estradiol ratio during the follicular phase. Significantly low serum leptin levels were noted in the pregnant women than in the nonpregnant women.


Assuntos
Fertilização in vitro , Células da Granulosa/efeitos dos fármacos , Leptina/farmacologia , Esteroides/biossíntese , Adulto , Feminino , Hormônio Foliculoestimulante/biossíntese , Hormônio Foliculoestimulante/sangue , Células da Granulosa/metabolismo , Humanos , Leptina/sangue , Oócitos/efeitos dos fármacos , Gravidez , Resultado da Gravidez , Estudos Prospectivos
20.
Kaohsiung J Med Sci ; 18(12): 593-7, 2002 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-12670034

RESUMO

In order to investigate the effects of urogenital prolapse on lower urinary tract function, we studied 61 women with stage III to IV pelvic organ prolapse (prolapse group) and 40 volunteers without prolapse (control group). Each woman underwent urinalysis, urinary questionnaire, pelvic examination, and urodynamic study. The incidence of urinary symptoms, including urinary frequency and urgency, stress/urge incontinence, incomplete emptying, difficult voiding and nocturia, were significantly higher in the prolapse group compared to the control group (p < 0.05). Urodynamic parameters, including residual urine, total bladder capacity, and bladder volume at strong desire to void, were not significantly different between the two groups (p > 0.05). Maximal flow rate, bladder compliance at urgency, functional urethral length, and maximal urethral closure pressure, however, were significantly higher in the control group compared to the prolapse group (p < 0.05). In addition, there was a higher incidence of poor pressure transmission ratio in the prolapse group (p < 0.01). The results indicated that severe urogenital prolapse could produce abnormal clinical and urodynamic results.


Assuntos
Transtornos Urinários/etiologia , Urodinâmica , Prolapso Uterino/fisiopatologia , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Prolapso Uterino/complicações
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...