Objective: Pelvic floor muscles (PFMs) form the base of the abdomino-pelvic cavity and also the PFMs function is important for urinary continence. PFMs training (PFMT) is considered to be the first method for PFM dysfunction. This study demonstrated correct PFMs contraction among commonly used different contraction methods for PFMT. Design: Cross-sectional study. Methods: In this study, nineteen middle-aged (40-70 years) women participated. To evaluate PFM function, ultrasonography was used to measure the distance of the bladder base movement. The distance of the PFM movements were calculated at rest and during the other contractions. The following four different contraction methods were performed randomly: (1) PFM contraction, (2) abdominal drawing-in maneuver (ADIM), (3) anal contraction, and (4) hip adductor muscle contraction. The participants held the contraction for 3 seconds for a total of 3 times with a 30 seconds rest period between each trial. The mean of three measurements in each position were obtained and compared with that in the resting position. Results: The bladder base movement values were significantly greater when comparing PFM with ADIM and hip adductor contractions (p<0.05). The bladder base movement values were significantly greater when comparing ADIM and anal contractions with hip adductor contractions (p<0.05). Conclusions: The results of this study suggest that performing PFM contractions is the best method among the common methods for PFMT. Performing PFM contractions was more effective than the other contraction methods.
Park, Soo-Min;Kim, Young-Nam;Woo, Young-Jong;Choi, Ho-Sun;Lee, Ji-Shin;Heo, Suk-Hee;Kim, Chan-Jong
Clinical and Experimental Pediatrics
/
v.54
no.5
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pp.224-227
/
2011
A sclerosing stromal tumor of the ovary is an extremely rare benign tumor; it usually is found during the second and third decades of life. Patients present with pelvic pain or a palpable abdominal mass. Hormonal effects such as masculinization are uncommon. Here, an 11-year old premenarchal girl presented with deepening of the voice. In addition, clitoromegaly and hirsutism with a male suprapubic hair pattern were observed. The laboratory findings showed that the testosterone level was elevated to 3.67 ng/ml, andostenedione to above 10 ng/ml, dehydroepiandrosterone-sulfate to 346 ${\mu}g$/dl and 17-hydroxy progesterone (17-OHP) to 11.28 ng/ml. The chromosome evaluation revealed a 46,XX female karyotype. An adrenocorticotropic hormone stimulation test was performed. The 17-OHP to cortisol ratio in 30 minutes was 0.045, which suggested a heterozygote for the 21-hydroxylase deficiency. However, the CYP21A2 gene encoding steroid 21-hydroxylase showed normal. The pelvic ultrasound showed a heterogeneous mass consisting of predominantly solid tissue in the pelvic cavity. The pelvic magnetic resonance imaging revealed an $8.9{\times}6.2{\times}6.6$ cm mass of the left ovary. A left oophrectomy was performed and microscopic examination confirmed a sclerosing stromal tumor. Immunohistochemical studies showed that the tumor was positive for smooth muscle actin and vimentin, but negative for S-100 protein and cytokeratin. Following surgery, the hormone levels returned to the normal range and the hirsutism resolved.
Anatomical features of the renal papilla and pelvis and ultrastructures of the epithelium covering these areas in four species of mammals were studied by means of light, scanning and transmission electron microscopy. In terms of the morphology of mammalian kidney types distinguished by Sperber(1944), Pfeiffer(1968) and Schmidt-Nielsen(1977), the kidneys of animal species used in this experiment were; 1) the mouse kidney with the fornix between a long conical papilla and the funnel-shaped pelvis, 2) the guinea pig kidney with the peripelvic column and pelvic pouch between a short conical papilla and the funnel-shaped pelvis, 3) the dog kidney with the peripelvic column and pelvic pouch between the crest-shaped papilla and the funnel-shaped pelvis, and 4) the cattle kidney which is divided into multiple renculi with minor and major calyces and pelvis. The renal papilla was lined with the simple or pseudostratified columnar epithelium which covered the inner zone of the renal medulla. The epithelial cells with numerous short microvilli on the surface contained a few organelles. In the mouse, the fornix was lined with one to two cell-layered cuboidal epithelium which covered the outer zone of the renal medulla and a part of the cortex. The epithelial cells of the fornix with numerous short microvilli or microridges on the surface had well-developed organelles. In the guinea pig, the peripelvic column was lined with the simple cuboidal or low columnar epithelium which covered the outer zone of the renal medulla. The epithelial cells with numerous short microvilli on the surface contained well-developed organelles. The pelvic pouch was lined with the pseudostratified columnar epithelium which was composed of four kinds of cells; the secretory cell with small electron-dense granules (310 nm), the secretory cell with large granules (720 nm) showing various electron densities, the mitochondria-rich cell with a single cilium, and the basal cell. Pelves of the mouse and guinea pig, peripelvic column, pelvic pouch and pelvis of the dog, and minor and major calyces and pelvis of the cattle were lined with the transitional epithelium. The fusiform vesicles in the superficial cells of the epithelium were highly developed in the dog, relatively well developed in the mouse and guinea pig, and poorly developed in the cattle. From the above findings, it is suggested that the transport of solutes and water of the urine in the pelvic cavity can take place through the epithelia covering the renal papilla and fornix of the mouse, papilla and peripelvic column of the guinea pig, and papillae of the dog and the cattle. And specialized cell types in the epithelium of the guinea pig pelvic pouch, two kinds of secretory cells and mitochondria-rich cell with a single cilium, could have peculiar functions in the renal pelvis, respectively.
An 11-year-old spayed female maltese was presented for abdominal distention, dysuria and dyschezia. Panting and heart murmur was found and abdominal palpation was difficult due to increased abdominal pressure. A soft tissue mass, $6{\times}3cm$ in size, was identified radiographically in pelvic canal, displacing the descending colon to the medioventral direction and the urinary bladder cranially. On ultrasonography, the mass consisted of homogeneous hypoechoic parenchyma containing the focal hyperechoic region ($1.6{\times}1.5cm$). The mass had distinct margin and no connection with adjacent organs. It was considered as a mass originating from the retroperitoneal cavity. Additional diagnostic procedures were not advanced because of the owner's request, and only a surgical excision of the mass was performed to alleviate the dysuria and dyschezia. Histopathologic examination and immunohistochemistry determined the mass as a soft tissue sarcoma and excluded hemangiosarcoma and osteosarcoma, both are the most common types of the retroperitoneal tumors. This report described non-vascular soft tissue sarcoma originating from the retroperitoneal cavity in a maltese dog.
Objectives : The purpose of this study is to understand truncus area conception to be explained in the pyobon and geungyul (Root-Stem and Origin-End relationships; PG) of meridian theory as to do the macro organic spatial conception in bio-mechanic system for human body. Methods : The extremity areas and truncus area to be explained in PG theories were classified spatially, and the reason was discussed that human body was classified as the extremities and truncus areas for the people of old times. It was considered the structural characteristics, exercise species and movement characteristics of truncus area in human body also. Results : The truncus area were made of cranium, vertebrae, sternum, ribs, clavicle, scapula, sacrum and the hipbone. It was the hollow structure and classified as cranial cavity, pleural cavity(thoracic cavity) and pelvic cavity. These cavities had mutually organic relationships, and because of cavity structures in the truncus and full structures in extremities would act in different direction about gravity with each other for movements. So it would be estimated that the old peoples had to need to separate the truncus and the extremities. Conclusions : In this study, the truncus area and the extremity areas in the PG of meridian theory could be recognized as the spatial conception of bio-mechanic system in human body. Although this study was the theoretical study not to be proven, it will be used to understand for the meridian theory as basic reference for spatial conception and bio-mechanic system.
Adenomyosis is a common gynecological disorder characterized by the presence of endometrial glands and stroma deep within the myometrium associated with myometrial hypertrophy and hyperplasia. Focal uterine infarction after IVF-ET in a patient with adenomyosis following biochemical pregnancy has not been previously reported, although it occurs after uterine artery embolization in order to control symptoms caused by fibroids or adenomyosis. We report a case of a nulliparous woman who had uterine adenomyosis presenting with fever, pelvic pain and biochemical abortion after undergoing an IVF-ET procedure and the detection of a slightly elevated serum hCG. Focal uterine infarction was suspected after a pelvic magnetic resonance imaging demonstrated preserved myometrium between the endometrial cavity and inner margin of the necrotic myometrium. This case demonstrates that focal uterine infarction should be considered in the differential diagnosis of acute abdominal pain, vaginal bleeding and infectious signs in women experiencing biochemical abortion after an IVF-ET procedure.
Primary peritoneal psammocarcinoma is a rare type of serous carcinoma that is characterized by the massive formation of psammoma bodies and the invasion of adjacent organs. A 55-year-old female who previously underwent a hysterectomy presented to the emergency room with severe abdominal pain. Contrast-enhanced CT revealed an intra-abdominal calcific mass. Initially, it was thought to be a heterotopic ossification due to the previous pelvic surgery with intact ovaries. However, this was diagnosed as a primary peritoneal psammocarcinoma. Primary peritoneal psammocarcinoma is a very rare disease entity that should be considered a differential diagnosis in patients with normal ovaries, massive ossification in the pelvic cavity, and calcific peritoneal nodules.
Background: In patients with endometrial carcinoma, preoperative evaluation of exact staging has important prognostic and therapeutic implications. The incidence of pelvic and aortic lymph node involvement in endometrial carcinoma depends on grade of tumor differentiation and depth of myometrial invasion. Material and method: To evaluate whether MRI provides a preoperative assessment for staging of endometrial carcinoma, MRI was undertaken in 28 patients, a few weeks before operation. Myometrial invasion was devided in three categories, and involvement of cervix, adnexa, and pelvic cavity were classified. Results: The results of MR imaging were compared with these of pathology. The preoperative MRI staging of endometrial carcinoma was correct in 22 out of 28 patients. In the evaluation of myometrial invasion, the MR imaging underestimated in 4 cases and overestimated in 1 case. Conclusion: In patients with endometrial carcinoma, MR imaging is very useful in the assessment of the depth of myometrial invasion, stromal invasion of cevix, lymphatic & pelvic metastases and extent of the lesion.
Hysterosalpingograms (H.S.G.) have been done for several decades to determine causative factors in female infertility. However, the H.S.G. only reverals uterine cavity and tubal patency or inpatency. The author prefers to find more details in regard to the status and condition of the female reproductive organs and their surrounding tissue as they pertain to infertility. H.S.G. in combination with laparoscopic examination reveals the following results. Preparation and method of performance of H.S.G. during laparoscopy in a healthy reproductive age women are as follows. When laparoscopy is not contraindicated, NPO is ordered with routine bowel preparation. Analgesics administered by injection prior to procedure are valium 10mgs and pethidine 50-100mgs. The radiographic procedure is the same as for any HSG technique. During laparoscopy a solution of 3 to 10 ccs. of 60% hypaque sodium is used. Fluroscopic scout films are obtained A-P and oblique views as well as a delayed check film. 1. Age distribution of primary and secondary infertility in this studies involving tubal factors was as follows: 20-29 age group showed 46% incidence and in the 30-39 age group, 50% incidence. Duration of infertility in this study group was the following: 1-2 years showed 26.7%, 3-5 years 53.8%, and 6-9 years 13.3%. 2. Indications of laparoscopic examination were as follows: Secondary infertility in 35% of the cases, obscure tubal occlusion on previous H.S.G. in 25%, unknown origin in 11.7%, and the remaining cases included pelvic pain, small masses, dysmenorrhea, and uterine anomaly. The laparoscopic examination showed clearly the reproductive organs and the surrounding tissues in the pelvic cavity. The abnormal tubal findings there revealed were tuberculous salpingitis and hydrosalpinx in 10% each, endometriosis and peritubabl adhesions in 6.7% each, biconuate uterus in 3.3%. The remaining 58.3% of the cases showed normal findings. Laparoscopic observation for possible myoma nodules, streak ovary, and peritubal adhesions was also done at this time. 3. Comparative tubal findings in combined H.S.G. and laparoscopic examination revealed the following. Bilateral tubal occlusion was present in 14% (7cases) on laparoscopic examination but on H.S.G. 38% (19 cases) were noted. However, tubal occlusion and peritubal adhesions were found in 26% (13 cases) upon laparoscopy and only 8% (4 cases) on H.S.G. examination alone. Normal pelvic findings were present in 60% (27 cases).
Kim, Chong-sup;Huh, Chan-kwen;Lee, Jong-hwan;Lee, Jong-han
Korean Journal of Veterinary Research
/
v.36
no.2
/
pp.289-296
/
1996
A case of schistosomus reflexes in Korean native female calf was observed macroscopically and radiographically. The results were summarized as follows. 1. The abdominal visceral organs were exposed. 2. The vertebral column bent laterally to the left, and the sacrum approached to the cranium by reflected caudal lumber vertebrae, presenting S-shaped lateral twisting of the vertebrae. 3. The right ribs reflected laterally and dorso-cranially from the 7th rib to 13th rib. The left ribs bent caudally from 8th rib to 13th rib. 4. The length of rudimentary 6th right rib was one half of normal size and the 7th right rib was one third. 5. The sternum was bifid split from the fourth sternebra through the xyphoid cartilage. 6. The diaphragm was intact and thoracic cavity was reduced in size. The lung and heart severely deformed in shape and size. 7. The liver markedly deformed in shape and thickness. 8. The pelvic cavity was reduced in size by compression laterally to the left. 9. The uterus horn, ovary, urinary bladder, and urethra were severely deformed in the shape and position.
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