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Journal of Minimally Invasive Gynecology Aug 2023To demonstrate the laparoscopic excision of a retroperitoneal adnexal cyst and describe the advanced surgical techniques and anatomic considerations in a patient with...
STUDY OBJECTIVE
To demonstrate the laparoscopic excision of a retroperitoneal adnexal cyst and describe the advanced surgical techniques and anatomic considerations in a patient with previous abdominopelvic surgery.
DESIGN
Stepwise demonstration of advanced laparoscopic techniques with narrated video footage.
SETTING
Adnexal masses after hysterectomy are a common reason for repeat abdominal surgery. Up to 9% of patients may require future adnexal surgery if ovarian preservation was chosen at the time of hysterectomy. Indications for surgery can include persistent adnexal masses, masses with concern for malignancy, chronic pelvic pain, and risk-reducing surgery. This patient is a 53-year-old postmenopausal female with a history of a total abdominal hysterectomy and left salpingectomy who underwent excision of an 8 cm retroperitoneal left adnexal cyst (Still 1).
INTERVENTIONS
Excision of a retroperitoneal adnexal cyst can be performed through a laparoscopic approach with several key strategies: CONCLUSION: Knowledge of retroperitoneal anatomy is crucial in the surgical management of retroperitoneal adnexal masses because dissection can be technically challenging and anatomy may be distorted due to pelvic adhesive disease. Use of advanced laparoscopic techniques and understanding surgical planes are important for safe dissection. High and early ligation of the infundibulopelvic ligament at the pelvic brim and a complete ureterolysis with parametrial excision are often necessary to remove all ovarian tissue to prevent an ovarian remnant.
Topics: Humans; Female; Middle Aged; Hysterectomy; Ovariectomy; Ovary; Adnexal Diseases; Laparoscopy; Cysts
PubMed: 37245674
DOI: 10.1016/j.jmig.2023.05.011 -
Frontiers in Endocrinology 2022Osteoporosis is a common metabolic bone disease with a rapidly increasing prevalence, characterized by massive bone loss because of excessive osteoclast formation....
Osteoporosis is a common metabolic bone disease with a rapidly increasing prevalence, characterized by massive bone loss because of excessive osteoclast formation. Gallic acid (GA), a phenolic acid isolated from , has anti-inflammatory and anti-oxidant effects, but its effect on osteoclast formation has not been confirmed. In our study, we demonstrated that GA significantly inhibited RANKL-induced osteoclast formation and function of osteoclast in bone marrow monocytes (BMMs) and RAW264.7 cells in a dose-dependent manner without cytotoxicity. For molecular mechanisms, GA repressed osteoclastogenesis by blocking Akt, ERK, and JNK pathways, and suppressed osteoclastogenesis-related marker expression, including nuclear factor of the activated T-cell cytoplasmic 1 (NFATc1), c-Fos, and cathepsin K (CTSK). In addition, we further assessed the effect of GA in an ovariectomized mouse model, which indicated that GA has a notable effect on preventing bone loss. In conclusion, GA exerts notable effects in inhibiting osteoclastogenesis and preventing ovariectomy-induced bone loss, suggesting that GA is a potential agent in osteoporosis treatment.
Topics: Mice; Animals; Female; Humans; Osteogenesis; Gallic Acid; NFATC Transcription Factors; Osteoporosis; Ovariectomy
PubMed: 36601012
DOI: 10.3389/fendo.2022.963237 -
Tierarztliche Praxis. Ausgabe G,... Dec 2022A 13.25-year-old Tyrol Grey cow was presented to the Clinic for Ruminants at the Justus Liebig University in Giessen with the request to have the animal castrated after...
A 13.25-year-old Tyrol Grey cow was presented to the Clinic for Ruminants at the Justus Liebig University in Giessen with the request to have the animal castrated after having experienced dystocia. The cow had already given birth to 10 live calves by this time and was kept on pasture in a herd of cows and one bull. As the owner did not intend to continue breeding the cow, but still wanted to keep the animal, he brought the cow to the clinic. The animal was presented 6 weeks after calving with a calf at foot. The calf was in good general health, displayed good developmental and nutritional status and did not show any clinical abnormalities. The general, as well as the gynecological examination of the cow, were unremarkable. During the transrectal examination, the uterus could be gathered in the hand. The uterus was flaccid, not filled with fluid, and the uterine wall showed no abnormalities. The ovaries measured 3×2x2 cm on the left and 3.5 × 2.5 × 2 cm on the right. The left ovary showed no functional structures and only a few follicles were palpated on the right side. Vaginoscopy did not reveal any abnormal findings. Due to the physiological puerperium, the cow was castrated by means of laparoscopic ovariectomy. The animal was left standing, and the surgery was performed from the left flank. In the days after the surgical procedure, the cow was in good general health, showed no pain at all during transrectal palpation of the amputation sites and was reintegrated into the herd two days post-surgery. The case presented here is intended to demonstrate the technique of endoscopy-assisted ovariectomy. It also intends to argue that castrating cows is an effective means of keeping cows in the herd, even if they are no longer bred. This seems to be of increasing interest, especially for beef cattle farmers and hobby farmers.
Topics: Pregnancy; Female; Cattle; Animals; Male; Reproduction; Dystocia; Cattle Diseases; Ovariectomy; Laparoscopy
PubMed: 36516825
DOI: 10.1055/a-1952-3216 -
Journal of Equine Veterinary Science Jan 2020Mules are hybrids bred from the mating of a jack donkey and a horse mare, known for their strength and resistance and still used to work in agriculture. Although they...
Mules are hybrids bred from the mating of a jack donkey and a horse mare, known for their strength and resistance and still used to work in agriculture. Although they have been for long considered sterile, evidence of estrus cycle has been demonstrated together with abnormal behavior related to ovarian activity. In this study, a bilateral standing laparoscopic ovariectomy technique using the LigaSure technology was applied in 10 mare mules for treating unwanted behavioral patterns. The technique was effectively performed on these animals avoiding the risk of general anesthesia, and the use of the LigaSure technology allowed good hemostasis and reduced surgical time. Owners declared to be satisfied with the resolution of the behavior.
Topics: Animals; Equidae; Estrus; Female; Horses; Laparoscopy; Ovariectomy; Standing Position
PubMed: 31864467
DOI: 10.1016/j.jevs.2019.102857 -
Veterinary Surgery : VS Jul 2021To assess outcomes and behavior changes associated with bilateral laparoscopic ovariectomies.
OBJECTIVE
To assess outcomes and behavior changes associated with bilateral laparoscopic ovariectomies.
STUDY DESIGN
Retrospective study.
SAMPLE POPULATION
Fifty-one equids.
METHODS
Medical records were evaluated from equid bilateral laparoscopic ovariectomies from January 2012 to October 2018 with a potential of 6 months follow-up. Follow-up information obtained by telephone interviews included behavior before and after surgery. Likelihood ratio chi-square tests and odds ratios (OR) with 95% CI were calculated where applicable, with statistical significance at p < .05.
RESULTS
Bilateral ovariectomy was performed in 51 cases, with elective (no pathologic ovaries) ovariectomies performed in 41/51 cases. Occasional estrus-like behavior was observed postoperatively in 14/51 (27%) mares, but the behavior was mild and manageable in all cases. There was no age effect on outcome in all bilateral (p = .56) or elective only (p = .36) cases. In 37/41 (90%) elective cases, improvement was observed in the reason for presentation. Some response to altrenogest administration for behavior modification was observed preoperatively in 12/18 (67%) elective cases. Response to altrenogest was not associated with (p = .31) or able to predict a beneficial response to surgery (OR = 5.5; 95% CI = 0.38-78.57; p = .21).
CONCLUSION
Response to altrenogest in elective cases may not predict behavioral outcome with ovariectomy. Occasional estrus-like behavior in mares postoperatively was not problematic for any owners. Bilateral ovariectomy is a viable treatment option for owners seeking to alleviate undesirable behavior in mares.
CLINICAL SIGNIFICANCE
This study should aid veterinarians and horse owners in case selection for bilateral ovariectomy.
Topics: Animals; Behavior, Animal; Female; Horses; Laparoscopy; Ovarian Diseases; Ovariectomy; Postoperative Period; Progestins; Retrospective Studies; Treatment Outcome; Trenbolone Acetate
PubMed: 33931888
DOI: 10.1111/vsu.13651 -
JCI Insight Nov 2023NF-κB is a transcription factor that is activated with aging. It plays a key role in the development of osteoporosis by promoting osteoclast differentiation and...
NF-κB is a transcription factor that is activated with aging. It plays a key role in the development of osteoporosis by promoting osteoclast differentiation and inhibiting osteoblast differentiation. In this study, we developed a small anti-NF-κB peptide called 6A-8R from a nuclear acidic protein (also known as macromolecular translocation inhibitor II, Zn2+-binding protein, or parathymosin) that inhibits transcriptional activity of NF-κB without altering its nuclear translocation and binding to DNA. Intraperitoneal injection of 6A-8R attenuated ovariectomy-induced osteoporosis in mice by inhibiting osteoclast differentiation, promoting osteoblast differentiation, and inhibiting sclerostin production by osteocytes in vivo with no apparent side effects. Conversely, in vitro, 6A-8R inhibited osteoclast differentiation by inhibiting NF-κB transcriptional activity, promoted osteoblast differentiation by promoting Smad1 phosphorylation, and inhibited sclerostin expression in osteocytes by inhibiting myocyte enhancer factors 2C and 2D. These findings suggest that 6A-8R has the potential to be an antiosteoporotic therapeutic agent with uncoupling properties.
Topics: Female; Mice; Animals; Humans; NF-kappa B; Osteoclasts; Nuclear Proteins; Osteoporosis; Peptides; Ovariectomy
PubMed: 37991021
DOI: 10.1172/jci.insight.171962 -
STAR Protocols Mar 2024Ovariectomy, involving the surgical removal of ovaries, and estradiol replacement facilitate the understanding of sexual dimorphism-related physiological changes,...
Ovariectomy, involving the surgical removal of ovaries, and estradiol replacement facilitate the understanding of sexual dimorphism-related physiological changes, encompassing reproductive biology, metabolism, and hormone-related diseases. In this study, we present a protocol for conducting ovariectomy and estradiol replacement in mice. We describe steps for performing sham and ovariectomy operations, outline preoperative preparations, and provide details on postoperative care, including analgesia administration and the removal of surgical clips. Additionally, we elaborate on the procedures for performing vehicle and estradiol injections. For complete details on the use and execution of this protocol, please refer to Luengo-Mateos et al..
Topics: Female; Humans; Mice; Animals; Estradiol; Ovariectomy; Ovary
PubMed: 38416648
DOI: 10.1016/j.xpro.2024.102910 -
Hypertension (Dallas, Tex. : 1979) May 2024Arterial stiffness is a cardiovascular risk factor and dramatically increases as women transition through menopause. The current study assessed whether a mouse model of...
BACKGROUND
Arterial stiffness is a cardiovascular risk factor and dramatically increases as women transition through menopause. The current study assessed whether a mouse model of menopause increases arterial stiffness in a similar manner to aging and whether activation of the G-protein-coupled estrogen receptor could reverse stiffness.
METHODS
Female C57Bl/6J mice were ovariectomized at 10 weeks of age or aged to 52 weeks, and some mice were treated with G-protein-coupled estrogen receptor agonists.
RESULTS
Ovariectomy and aging increased pulse wave velocity to a similar extent independent of changes in blood pressure. Aging increased carotid wall thickness, while ovariectomy increased material stiffness without altering vascular geometry. RNA-sequencing analysis revealed that ovariectomy downregulated smooth muscle contractile genes. The enantiomerically pure G-protein-coupled estrogen receptor agonist, LNS8801, reversed stiffness in ovariectomy mice to a greater degree than the racemic agonist G-1. In summary, ovariectomy and aging induced arterial stiffening via potentially different mechanisms. Aging was associated with inward remodeling, while ovariectomy-induced material stiffness independent of geometry and a loss of the contractile phenotype.
CONCLUSIONS
This study enhances our understanding of the impact of estrogen loss on vascular health in a murine model and warrants further studies to examine the ability of LNS8801 to improve vascular health in menopausal women.
Topics: Animals; Female; Mice; Aging; Carotid Arteries; Estrogens; GTP-Binding Proteins; Ovariectomy; Pulse Wave Analysis; Receptors, Estrogen; Receptors, G-Protein-Coupled; Vascular Stiffness
PubMed: 38445498
DOI: 10.1161/HYPERTENSIONAHA.123.22024 -
Molecular and Cellular Biochemistry Dec 2020Bilateral ovariectomy is the best characterized and the most reported animal model of human menopause. Ovariectomized rodents develop insulin resistance (IR) and... (Review)
Review
Bilateral ovariectomy is the best characterized and the most reported animal model of human menopause. Ovariectomized rodents develop insulin resistance (IR) and visceral obesity, the main risk factors in the pathophysiology of metabolic syndrome (MS). These alterations are a consequence of hypoestrogenic status, which produces an augment of visceral fat, high testosterone levels (hyperandrogenism), as well as inflammation, oxidative stress, and metabolic complications, such as dyslipidemia, hepatic steatosis, and endothelial dysfunction, among others. Clinical trials have reported that menopause per se increases the severity and incidence of MS, and causes the highest mortality due to cardiovascular disease in women. Despite all the evidence, there are no reports that clarify the influence of estrogenic deficiency as a cause of MS. In this review, we provide evidence that ovariectomized rodents can be used as a menopausal metabolic syndrome model for evaluating and discovering new, safe, and effective therapeutic approaches in the treatment of cardiometabolic complications associated to MS during menopause.
Topics: Animals; Cardiovascular Diseases; Disease Models, Animal; Female; Humans; Insulin Resistance; Intra-Abdominal Fat; Menopause; Metabolic Syndrome; Ovariectomy; Ovary; Rodentia
PubMed: 32852713
DOI: 10.1007/s11010-020-03879-4 -
Biological Trace Element Research Feb 2022Osteoporosis is a growing public health issue for an aging society. Previous studies have found both beneficial and detrimental effects of obesity on bone health. The...
Osteoporosis is a growing public health issue for an aging society. Previous studies have found both beneficial and detrimental effects of obesity on bone health. The purpose of this study was to investigate the impact of estrogen deficiency and physical activity on bone and blood concentrations of macrominerals (Ca, P, and Mg) and microminerals (Zn, Se, Cu, and Fe) in a high-fat diet-induced obesity rat model. Forty-eight female Wistar rats were divided into six groups: sham-operated and ovariectomized rats that received a standard diet (SD), high-fat diet (HFD), or HFD accompanied by physical exercise. The effect of ovariectomy on bone minerals varied with diet. Ovariectomy significantly decreased femoral Ca and Mg in sedentary rats receiving a SD; femoral Se, Cu, Zn, and Fe in sedentary rats on HFD; and plasma Fe in both sedentary rats on SD and exercising rats on HFD. The interaction of ovariectomy and diet had the strongest impact on Mg and Se concentrations in femur. In ovariectomized rats, HFD showed to have a protective effect on bone mineralization (femoral Ca and Mg), and a negative one on antioxidant microminerals (femoral Se, Cu, and Zn). Physical activity reduced the decline of Se, Cu, Zn, and Fe in the femur of ovariectomized rats on HFD. In the current state of knowledge, it is difficult to suggest if decreased femoral levels of antioxidant microminerals may contribute to the pathophysiology of osteoporosis in obese individuals or just reflect the mineral status in the body.
Topics: Animals; Bone Density; Diet, High-Fat; Female; Humans; Minerals; Obesity; Ovariectomy; Rats; Rats, Wistar
PubMed: 33656659
DOI: 10.1007/s12011-021-02655-9