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The case report : More than 20 submucosal myomas of the uterus removed by hysteroscopic resection
( Minsoon Song ),( Yewon Jung ),( Danbit Park ),( Kihwan Lee ),( Youngbok Ko ),( Jungbo Yang ) 대한산부인과학회 2018 대한산부인과학회 학술대회 Vol.104 No.-
Submucosal myoma arise just under the lining of the uterine cavity. The survey shows that the incidence rate of submucosal myoma of the uterus is about 20~40%, and the disease frequently occurs in women aged 30~50 years. Submucosal myoma is the most common cause of vaginal bleeding of all types of myomas. Even no more than 2-3 centimeters in diameter of submucosal myoma can produce very heavy and prolonged menses. In their submucosal localization, myomas can be treated exclusively using surgical procedures, and they may be accessible by operative hysteroscopy-the standard surgical approach. Almost patients have less than 2 myomas, but, there have not been reported many submucosal myomas as like this case. A 27 year-old woman was referred for evaluation of aggravated menorrhagia and dysmenorrhea. The length of the period was 8days and she needed more than 4 large pads from 3rd to 5th day. So, the Hb was 8.5. And the NRS (numeric rating scale) was 7 at the periods. The first time when she came to hospital, the ultrasonographic evaluation revealed 3 submucosal myomas (less than 3cm sized). The MRI(magnetic resonance imaging) confirmed the presence of multiple submucosal myomas. After injection of GnRH agonist for two times, she got myomectomy by hysteroscopic resection. From the operation, we could see over 20 myomas up to 3cm. Biopsy confirmed submucosal cellular leiomyoma. After the operation, the amount of vaginal bleeding is decreased, and menstrual pain score is also improved.
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강예은,Yi Hyon-Seung,Yeo Min-Kyung,Kim Jung Tae,Park Danbit,Jung Yewon,Kim Ok Soon,이성은,Kim Ji Min,Joung Kyong Hye,Lee Ju Hee,Ku Bon Jeong,Lee Mina,Kim Hyun Jin 대한의학회 2022 Journal of Korean medical science Vol.37 No.48
Background: Gestational diabetes mellitus (GDM) is the most common metabolic complication of pregnancy. To define the altered pathway in GDM placenta, we investigated the transcriptomic profiles from human placenta between GDM and controls. Methods: Clinical parameters and postpartum complications were reviewed in all participants. Differentially expressed canonical pathways were analyzed between the GDM and control groups based on transcriptomic analysis. CD4+ T, CD8+ T, and senescent T cell subsets were determined by flow cytometry based on staining for specific intracellular cytokines. Results: Gene ontology analysis revealed that the placenta of GDM revealed upregulation of diverse mitochondria or DNA replication related pathways and downregulation of T-cell immunity related pathways. The maternal placenta of the GDM group had a higher proportion of CD4+ T and CD8+ T cells than the control group. Interestingly, senescent CD4+ T cells tended to increase and CD8+ T cells were significantly increased in GDM compared to controls, along with increased programmed cell death-1 (CD274+ ) expression. Programmed death-ligand 1 expression in syncytotrophoblasts was also significantly increased in patients with GDM. Conclusion: This study demonstrated increased proinflammatory T cells, senescent T cells and immune-check point molecules in GDM placentas, suggesting that changes in senescent T cells and immune-escape signaling might be related to the pathophysiology of GDM.
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