• The Journal of Korean Obstetrics and Gynecology
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• v.36 no.3
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• pp.196-210
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• 2023

Objectives: The purpose of this study is to review the research trends of infertile women with uterine myoma in Korean medicine and to recognize the efficacy of Korean medicine intervention. Methods: A search was conducted on November 18, 2022, using six databases, including Research Information Sharing Service (RISS), Oriental Medicine Advanced Searching Integrated System (OASIS), Cochrane Library Central, Pubmed, China National Knowledge Infrastructure (CNKI) and WangFang Med Online. We analyzed the studies using Korean medicine on women with uterine myoma preparing for pregnancy or complaining infertility. Results: Total 4 studies were selected and all of which were case reports. Among 6 cases, Korean medicine treatment including herbal medicine, acupuncture, electroacupuncture, moxibustion was used alone. Ikgibohyeol-tang-gami-bang, Gyejibokryeong-hwan, Saenghwa-tang-gami-bang were prescribed in 2 cases each. Angelicae Gigantis Radix and CV4 were most frequently used herb and acupoint. All subjects were successful in becoming pregnant. Conclusion: This review shows that Korean medicine treatment can be effective in infertile women with uterine myoma. However, the number of included studies is small, so the level of evidence needs to be raised through more clinical studies in the future.

• Clinical and Experimental Reproductive Medicine
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• v.18 no.2
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• pp.189-196
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• 1991

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

• Tuberculosis and Respiratory Diseases
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• v.76 no.3
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• pp.131-135
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• 2014

Low-grade endometrial stromal sarcoma (ESS) is an uncommon gynecologic malignancy of mesodermal origin. Pulmonary metastasis of low-grade ESS can occur years and decades after the treatment of the primary disease. Low-grade ESS is frequently mistaken as benign uterine neoplasm like uterine leiomyoma, which can potentially lead to a misdiagnosis. We present a case of a 42-year-old woman with low-grade ESS, that initially presented as an incidental lung mass with multiple pulmonary nodules, seven years after an uterine myomectomy. A $6.9{\times}5.8cm-sized$ intrapelvic mass suspected of uterine origin was discovered while searching for potential extrathoracic primary origin. A pelviscopy and simultaneous thoracoscopic lung biopsy were conducted for pathologic diagnosis. Finally, the diagnosis was confirmed as low-grade ESS with lung metastasis based on the histopathologic examination with immunohistochemical stain, which was showed positive for CD10 and hormone receptor markers (estrogen and progesterone receptors) in both pelvic and lung specimens.

• Tuberculosis and Respiratory Diseases
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• v.61 no.3
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• pp.273-278
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• 2006

Endobronchial leiomyoma is a rare tumor that accounts for less than 2% of pulmonary benign tumors. A 32 year-old woman was admitted with fever, cough and sputum for a month. She had suffered from intermittent cough over three years. The chest X-ray and chest CT(computed tomography) showed a nodular lesion obstructing the proximal portion of the left lower lobar bronchus and atelectasis of the left lower lobe. Flexible Bronchoscopy detected a mass obstructing the distal portion of the left main bronchus and endobronchial biopsy showed benign smooth muscle cells. There was no abnormal finding in the uterine examination. Therefore this case was diagnosed as primary endobronchial leiomyoma. The lobectomy was performed due to intractable pneumonia and secondary parenchymal destruction. Postoperative course was uneventful and she was discharged in good health.

• The Korean Journal of Cytopathology
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• v.2 no.1
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• pp.56-61
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• 1991

Curschmann's spirals morphologically similar to those seen in sputum were found in cervico-vaginal smears of six patients ranged from 28 to 40 years of age, during 18 months from January. 1985 to June 1986. The prevalence was 1 in 2147 smears in that period. All of them had gynecologic disorders without systemic effect such as chronic cervictis in three, leiomyoma in one, pelvic inflammatory disorder in one, and primary infertility in one. The Curshmann's spirals in the smear showed varying degrees of maturation from wavy incipient ones to highly celled mature ones, admixed with thick mucinous back-ground, suggesting of their production in the uterine cervix itself. Also the recent history of undergone cryocautery, electrocautery or parturition suggest its production in the endocervical gland due to mechanical obstruction and/or change in biochemical composition of mucus.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.3
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• pp.1123-1127
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• 2015

Uterine leiomyomas (ULM), are benign tumors of the smooth muscle cells of the myometrium. They represent a common health problem and are estimated to be present in 30-70% of clinically reproductive women. Abnormal angiogenesis and vascular-related growth factors have been suggested to be associated with ULM growth. The angiotensin-I converting enzyme (ACE) is related with several tumors. The aim of this study was to identify possible correlation between ULM and the ACE I/D polymorphism, to evaluate whether the ACE I/D polymorphism could be a marker for early diagnosis and prognosis. ACE I/D was amplified with specific primer sets recognizing genomic DNA from ULM (n=72) and control (n=83) volunteers and amplicons were separated on agarose gels. The observed genotype frequencies were in agreement with Hardy-Weinberg equilibrium ($x^2=2.162$, p=0.339). There was no association between allele frequencies and study groups ($x^2=0.623$; p=0.430 for ACE I allele, $x^2=0.995$; p=0.339 for ACE D allele). In addition, there were no significant differences between ACE I/D polymorphism genotype frequencies and ULM range in size and number ($X^2=1.760;$ p=0.415 for fibroid size, $X^2=0.342;$ p=0.843 for fibroid number). We conclude that the ACE gene I/D polymorphism is not related with the size or number of ULM fibroids in Turkish women. Thus it cannot be regarded as an early diagnostic parameter nor as a risk estimate for ULM predisposition.

• Clinical and Experimental Reproductive Medicine
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• v.30 no.1
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• pp.23-29
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• 2003

목 적: 본 연구의 목적은 내인성 성호르몬이 자궁근종의 성장에 미치는 영향을 알아보고자 연구를 시행하였다. 연구대상 및 방법: 폐경전 자궁근종 환자 27명과 같은 연령대의 정상여성 25명을 대상으로 하였다. 모든 대상군의 여성에서 24시간 소변을 모아서 소변내 estrogen, androgen의 대사체들을 GC-MS를 이용하여 측정하였으며 두 군에서의 차이를 비교분석 하였다. 결 과: 소변내 $17{\beta}$-estradiol, 5-androstene-$3{\beta}$, $16{\beta}$, $17{\beta}$-triol, 11-keto-ethiocholanolone, $11{\beta}$-hydroxy-androsterone, THS, THA, THE, a-cortolone, a-cortol 및 $\beta$-cortol가 환자군에서 의의있게 증가하였으며 $17{\beta}$estradiol/estrone 및 $11{\beta}$-hydroxy-ethiocholanolone/$11{\beta}$-hydroxy-androsterone도 환자군에서 의의있게 증가하였다. 결 론: 자궁근종의 성장은 요중 estrogen과 androgen의 농도와 밀접한 관련이 있으며 이는 환자의 스테로이드 호르몬 대사 감소에 기인한 것으로 사료된다.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.5
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• pp.207-220
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• 2021

This study aimed to evaluate the impact of education and counselling by nurses on anxiety, uncertainty, and pain in patients with benign uterine tumors. Electronic databases, including PubMed, OVID, CINAHL, Google Scholar, and Korean databases and were searched during January 2020. A total of 401 studies were identified of which 13 were suitable for meta-analysis. Cochrane's risk of bias tool and the R version 3.5.2 (Meta-analysis with R) program were used for analysis. The authors performed a meta-analysis of the 13 trials that met eligibility criteria. The findings in this study indicate that the effect size of nursing education for anxiety was Hedges' g=-0.89 (95% CI:-1.39 to -0.47), as indicated by a "large effect size" and the effect size of pain was Hedges' g=-0.49 (95% CI:-0.95 to -0.02) as indicated by a "moderate effect size". The effect size of uncertainty was Hedges' g=-1.38 (95% CI:-3.98 to 1.23), and it was not statistically significant. In the meta-subgroup analyses by approach intervention type, cognitive-behavioral programs, demonstration intervention, and relaxation therapy had a significant effect. The risk of publication bias was low. It may therefore be concluded that pre-operative education by nurses for patients with benign uterine tumors would affect their levels of anxiety, uncertainty, and pain.

• Development and Reproduction
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• v.11 no.3
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• pp.205-217
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• 2007

As an initial step toward better understanding of the molecular mechanism of estrogen-dependent growth in myoma, an optimal primary cell culture condition has been developed and examined by this study. Myoma and myometrium were cultured by two different methods. Culture stability and $E_2$-responsiveness in stable culture were studied. The culture of digested tissue pieces(Method 2) was found to be a stable culture method for the myoma and myometrium showing a favorable response to estrogen. mRNA expression of PR, IGF-1 and IGF-1 receptor genes was enhanced by $E_2$. The gene responses to $E_2$ were higher in myoma compared with myometrium. Moreover, these responses were more expressive in tissues than in the surrounding cells in primary culture of normal myometrium and myoma, implying a vital role of cell communication through the extracellular matrix in maintaining the estrogen-responsiveness. The development of an improved cell culture system for myoma provides an in vitro tool to further investigate the basis of the tumor formation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.5
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• pp.221-228
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• 2021

Recently, there has been an increased awareness on the use of High-Intensity Focused Ultrasound (HIFU) as a non-surgical treatment option for leiomyomas. This study aimed to assess gynecologists' perception of HIFU therapy for uterine leiomyomas in Korea. We analyzed questionnaires from 162 Korean gynecologists who provided data on 1) demographics, 2) pattern of practice with respect to leiomyomas, and 3) opinion regarding HIFU therapy for leiomyomas. Of the 162 gynecologists, 2.8 % regarded HIFU as a first-line treatment for leiomyomas. HIFU was only available at the workplace of 19 % of respondents; of these, 58 % had requested the use of HIFU. When asked about their perception of HIFU for treating leiomyomas, only 19 % of the respondents thought that it was effective. The commonest perceived complication was a delay in the adequate treatment of sarcoma (59 %), followed by bowel injury (52 %). The respondents considered HIFU to be suitable in the following circumstances: age between 40 and 49 years, those patients who no longer desired pregnancy, medium-sized (5-6 cm) leiomyomas, and up to 2 leiomyomas. The Korean gynecologists' perception of HIFU as a treatment for leiomyomas is still not favorable. Gynecologists working at hospitals where HIFU is available tended to have a higher positive perception of this treatment. In addition to research involving a large number of gynecologists from multiple countries, a study on the long-term outcomes of HIFU is needed.