Its cyclic structural changes mirror changes in metabolic functions, and both are regulated by ovarian estradiol and progesterone. Because of this interplay of structure, function, and ovarian hormonal stimuli, the endometrium is considered one of the most sensitive indicators of the hypothalamic-pituitary-ovarian hormonal axis. As a result, morphologic evaluation of the endometrium is used in diagnostic evaluation of infertile patients to determine whether ovulation is occurring Fig. Schematic representation of steroid hormone-morphologic interactions during the endometrial cycle. Estradiol promotes endometrial proliferation, whereas after ovulation, progesterone converts estradiol-primed endometrium into secretory tissue. Postovulatory estradiol amplifies the progesterone effect, and after withdrawal of both estradiol and progesterone, the endometrial mucosa breaks down and regenerates within the period of menstruation. These steroid receptors are specific proteins concentrated exclusively in the nuclei of both endometrial epithelial and stromal cells, as well as the endothelial cells of stromal capillaries. They have high affinity to bind estradiol and progesterone, respectively. This chapter contains a review of the technical procedures for handling endometrial tissues and a discussion of the morphologic aspects of the endometrium, focusing on the interpretation and understanding of the physiomorphology of the endometrial cycle.
Indocyanine Green Angiography
Literature or art that is meant to be sexually arousing. Erotophobia Fear of the erotic. Escort Someone who takes someone somewhere.
The staging of human endometrium following the Noyes criteria (Noyes et al., ) is a subjective system that has been scrutinized in recent years because of its inaccuracies in properly dating.
Nature versus nurture Certain characteristics may be innate in humans; these characteristics may be modified by the physical and social environment in which people interact. The sexual drive affects the development of personal identity and social activities. Freud believed sexual drives are instinctive. He was a firm supporter of the nature argument; he said there are a large number of instincts but they are reduced into two broad groups: Eros the life instinct , which comprises the self-preserving and erotic instincts, and Thanatos the death instinct , which comprises instincts invoking aggression, self-destruction, and cruelty.
His instinct theory said humans are driven from birth by the desire to acquire and enhance bodily pleasures, thus supporting the nature debate. Freud redefined the term sexuality to make it cover any form of pleasure that can be derived from the human body. His developmentalist perspective was governed by inner forces, especially biological drives and maturation, and his view that humans are biologically inclined to seek sexual gratification demonstrates the nature side of the debate.
Later, behaviorists would apply this notion in support of the idea that the environment is where one develops one’s sexual drives. A number of them, including neo-analytic theories, sociobiological theories, social learning theory , social role theory , and script theory , agree in predicting that men should be more approving of casual sex sex happening outside a stable, committed relationship such as marriage and should also be more promiscuous have a higher number of sexual partners than women.
These theories are mostly consistent with observed differences in males’ and females’ attitudes toward casual sex before marriage in the United States; other aspects of human sexuality, such as sexual satisfaction, incidence of oral sex , and attitudes toward homosexuality and masturbation , show little to no observed difference between males and females.
Transvaginal ultrasonography and female infertility
Thus, estradiol produces breast development , and is responsible for changes in the body shape , affecting bones, joints, and fat deposition. It enhances growth of the myometrium. Estradiol appears necessary to maintain oocytes in the ovary. During the menstrual cycle , estradiol produced by the growing follicles triggers, via a positive feedback system, the hypothalamic-pituitary events that lead to the luteinizing hormone surge, inducing ovulation.
In the luteal phase, estradiol, in conjunction with progesterone , prepares the endometrium for implantation. During pregnancy , estradiol increases due to placental production.
Endometrial dating and determination of the window of implantation in healthy fertile women Key Words: Endometrium, window of implantation, dating, pinopodes, integrins, LIF, IL-1r-R tI, MAG, MUC-1, progesterone receptors The classic work of Noyes et al. (1, 2) on.
Sie werden durch die hormonale Regulierung des Eisprungs Ovulation gesteuert. Diese findet auf drei Ebenen statt: Hypothalamus – Hypophyse – Eierstock. Man unterscheidet zwei Haupthormone, die auf das Endometrium einwirken: Die Zeit vor dem Eisprung nennt man Proliferationsphase , die 14 darauf folgenden Tage bezeichnet man als Sekretionsphase. So wird die Schleimhaut auf die Implantation vorbereitet.
Bei Primaten setzt sich das Endometrium aus einer oberen Funktionalis und einer unteren Zellschicht Basalis zusammen. Bleibt eine Implantation aus, wird die Funktionalis des Endometriums bei Primaten abgesondert und ausgeschieden: Es kommt zur Regelblutung Menstruation. Daher wird die Funktionalis in Vorbereitung auf die Menstruation auch Dezidua lat.
Kommt es dagegen zur Einnistung einer befruchteten Eizelle und damit zu einer Schwangerschaft, erfolgen weitreichende hormonell gesteuerte Modifikationen des Endometriums, das nunmehr Dezidua graviditatis genannt wird. Sie bildet zusammen mit dem Chorion die Plazenta aus.
First trimester ultrasound is performed in the first months of a pregnancy. Pregnancy ultrasounds are performed mainly using transabdominal ultrasound. For many women, especially after 8 weeks gestation, sufficient information about the baby may be obtained with transabdominal ultrasound only. However, in the early pregnancy, the developing embryo is very small at 6 weeks gestation, the baby is only mm long and a transvaginal ultrasound may be required to get a better image of the baby.
Start studying Disorders of the Uterus/Endometrium and Myometrium. Learn vocabulary, terms, and more with flashcards, games, and other study tools.
My medical students Especially if you’re looking for information on a disease with a name that you know, here are a couple of great places for you to go right now and use Medline, which will allow you to find every relevant current scientific publication. You owe it to yourself to learn to use this invaluable internet resource. Not only will you find some information immediately, but you’ll have references to journal articles that you can obtain by interlibrary loan, plus the names of the world’s foremost experts and their institutions.
Take your questions here first. Medline lists other sites that may work well for you Alternative complementary medicine has made real progress since my generally-unfavorable review. If you are interested in complementary medicine, then I would urge you to visit my new Alternative Medicine page. If you are looking for something on complementary medicine, please go first to the American Association of Naturopathic Physicians. And for your enjoyment I cannot examine every claim that my correspondents share with me.
Sometimes the independent thinkers prove to be correct, and paradigms shift as a result. You also know that extraordinary claims require extraordinary evidence. When a discovery proves to square with the observable world, scientists make reputations by confirming it, and corporations are soon making profits from it. When a decades-old claim by a “persecuted genius” finds no acceptance from mainstream science, it probably failed some basic experimental tests designed to eliminate self-deception.
If you ask me about something like this, I will simply invite you to do some tests yourself, perhaps as a high-school science project.
hCG Levels After a Miscarriage or a Medical Abortion
La diminuzione del pH favorisce la proliferazione dei batteri gram-negativi Due possibili quadri di patologia orale possono essere identificati nella donna in gravidanza: In particolare Prevotella intermedia ha un notevole incremento nelle donne in gravidanza Diversi studi hanno dimostrato le funzioni immunosoppressive degli ormoni durante la gravidanza.
To date endometrium, should see surface endometrium, but date based on most advanced area Must biopsy uterine corpus above the level of the isthmus; must also biopsy functionalis as basalis layer does not respond to progesterone.
Prediction of post-operative thrombosis in the internal jugular vein Prediction of wound complications in ventral hernia repair Sarcoidosis Spinal dural arteriovenous fistula Vogt-Koyanagi-Harada disease. Aetna considers indocyanine green angiography-assisted internal limiting membrane peeling in macular hole surgery experimental and investigational because the safety and effectiveness of this approach has not been established. Aetna considers intra-operative indocyanine green angiography during microsurgical subinguinal varicocelectomy experimental and investigational because the effectiveness of this approach has not been established.
Aetna considers the Spy Elite System near-infrared angiography with indocyanine green experimental and investigational for breast reconstruction surgery, evaluation of anastomotic perfusion in colorectal surgery and mapping of sentinel lymph node in cutaneous melanoma, and all other indications because the safety and effectiveness of this approach has not been established.
Aetna considers indocyanine green fluorescence angiography experimental and investigational for intraoperative evaluation of residual parathyroid glands function and prediction of post-operative hypocalcemia risk after total thyroidectomybecause the effectiveness of this approach has not been established. Aetna considers the use of indocyanine green for sentinel lymph node mapping of other cancers e.
Background Fluorescein angiography allows visualization of blood flow in retinal and choroidal tissues, permitting diagnostic support in many ocular diseases. In particular, fluorescein angiography has become a very important tool in the diagnosis and treatment of chorio-retinal diseases. However, limitations of fluorescein angiography in imaging the choroidal circulation and associated pathologies prompted the use of alternative dyes to improve choroidal angiography. Indocyanine green angiography is a diagnostic study where indocyanine green, a fluorescent dye, is injected intravenously, and observations of the retina are made at intervals as increasing intensity of retinal and choroidal circulation is displayed.
Indocyanine green angiography is used for the imaging of retinal and choroidal vasculatures. It is effective when used as an adjunct to fluorescein angiography in the diagnosis and treatment of ill-defined choroidal neovascularization i. It is generally used in evaluating retinal neovascularization, serous detachment of retinal pigment epithelium, hemorrhagic detachment of retinal pigment epithelium, and retinal hemorrhage.
Lion’s Pride Alumni Association
Calculating the results of various prenatal tests , for example, in the triple test. Birth classification into for example preterm, term or postterm. Classification of infant deaths and stillbirths Postnatally after birth to estimate various risk factors Timeline of pregnancy by gestational age.
In dating the endometrium it is important to remember that there is a delay of 2–3 days between ovulation and appearance o f diagnostic postovulatory histologic changes. This is caused by progressively rising progesterone levels and time necessary for the endometrium to respond.
Adapted from Witkin et al. Unsuspected Chlamydia trachomatis infection and in vitro fertilization outcome. Am J Obstet Gynecol Nongonococcal-nonchlamydial salpingitis may also arise de novo as a primary infection. There is less fever, vaginal discharge, and liver tenderness than with gonococcal PID. Despite these differences, the clinical presentation does not adequately distinguish between the two, and reliance on culture is necessary.
Except for the presence of N. As shown in Table 1 , the cervix and vagina of healthy women contain an abundance of aerobic and anaerobic microorganisms. There may be a critical number of organisms needed to overwhelm local host defense mechanisms in the cervix, allowing an infection to ascend to the upper genital tract. There is probably a continuum from bacterial vaginosis to endometritis and salpingitis, because women with bacterial vaginosis are significantly more likely to be diagnosed with PID.
Previous gonorrhea, use of an IUD, frequent douching, and uterine instrumentation predispose to the development of nongonococcal PID.
Transvaginal ultrasound is performed using a special transducer which is slightly thicker than a tampon. It is covered with a disposable latex sheath and lubricating gel, then gently placed into the vagina. The probe sits in the vagina throughout the examination which usually takes between minutes. Most patients find the examination much more tolerable when compared to a cervical PAP smear. During the scan the sonographer may need to gently press on the abdomen to move bowel out of the way and bring the ovaries and other pelvic structures into view.
+ Filters Instead of filtering your photos to look all the same, A Color Story filters aim to enhance the color you’ve chosen in your composition.
Accessed January 24th, Diagrams Phases Proliferative phase: Early proliferative endometrium Mid proliferative days 8 – Mid proliferative endometrium and Ki67 staining Late proliferative days 11 – Day 10 – 12 endometrium shows glands that are more tortuous and crowded; intraglandular nuclear pseudo- stratification and mitotic activity are more prominent see inset and the stroma is edematous and mitotically active Ovulation: Traditionally assumed to be 14 days, but may vary Progesterone secretion inhibits endometrial proliferative activity and induces secretory activity Note: The glands exhibit a regular tortuosity and are clearly oriented from the base to the surface of the endometrium; subnuclear glycogen vacuoles are clearly visible The glands of this day 17 endometrium contain prominent subnuclear glyco- gen vacuoles underlying a single row of nuclei in the endometrial glands Images hosted on other servers: Day 17 endometrium, with reduced Ki67 staining Day These regularly tortuous glands in this day 20 endometrium contain secretions that are largely intracellular apical, and partially intraluminal Day In this day 23 – 24 endometrium, the glands are beginning to show regressive changes; spiral arterioles are present and are most prominent in the lower left portion of the illustration; they are beginning to be surrounded by cuffs of predecidua; predecidual stromal change is not yet apparent in the superficial compacta Day The glands of this day 25 endo- metrium are markedly regressed, and the superficial compacta has a diffusely predecidualized stroma This high power photomicrograph of a day 25 endometrium shows a spiral arteriole cut in multiple profiles and surrounded by predecidual stroma; note the admixture in the stroma of large decidualized cells and smaller endometrial granulocytes Day
Pelvic / Gynaecologic Ultrasound
A pelvic or gynaecologic ultrasound is an ultrasound of the female pelvis. Most pelvic ultrasounds are performed using both the transabdominal and transvaginal approaches. Transabdominal ultrasound involves scanning through your lower abdomen. Transabdominal ultrasound usually provides an overview of the pelvis rather than detailed images. The transabdominal assessment is particularly helpful for the examination of large pelvic masses extending into the abdomen, which are not always well viewed with transvaginal ultrasound.
A small amount of ultrasound gel is put on the skin of the lower abdomen, with the ultrasound probe then scanning through this gel.
1. Am J Obstet Gynecol. May;(2) Dating the endometrial biopsy. Noyes RW, Hertig AT, Rock J. PMID: [PubMed – indexed for MEDLINE].
Urinary clearance is reduced by anencephalia lack of ACTH , therapeutic administration of corticosteroids to pregnant negative feedback , adrenal cortical hypoplasia, lack of placental sulfatase Y-linked trait , reduced placental tissue gestosis, delayed delivery , maternal liver diseases imparing conjugation, impaired enterohepatic circulation, severe renal diseases Across the animal kingdom, birth rate falls steadily with increasing food requirements. Energy use is closely linked to size, so bigger animals have fewer offspring.
This seemed not to hold for humans. A female gorilla weighs in at about kg, and can expect to have between 3 and 6 offspring. But human birth rates fit the pattern perfectly if you look at total energy consumption. Considering food, transport, heating, entertainment and so on, the average North American runs at 11, W: North Americans’ energy consumption is equivalent to the metabolism of a 30, kilogram primate.
And they have a birth rate to match. In darwinian terms, it doesn’t make sense that greater resources aren’t used to make babies.
44 Natural Home Remedies For Heavy Menstrual Bleeding Clots
The DHB says a national programme designed to improve prescribing during the first post-graduate year is also being developed. The programme will involve a compulsory assessment of prescribing competency. For example, a year-old Illinois man with episodes of low cost phentermine Care Chemist spokesperson and Orewa pharmacist Antony Wentworth says paracetamol is listed by the National Poisons Centre as the most common substance in the poisoning of children under five, accounting for abut 65 per cent of its calls.
The endometrial biopsy has been used to assess endometrial histology for the last 60 to 70 years. While sampling the endometrium is used extensively in the setting of abnormal bleeding as a diagnostic tool for endometrial cancer or hyperplasia, its primary role in the evaluation of the infertile couple was assessment of the luteal phase.
The American Society of Reproductive Medicine has formulated diagnostic criteria for minimal to severe endometriosis to aid in standardized description of the types and locations of implants and associated scar tissue. Pelvic pain may occur in women with minimal to severe disease; however, pain cannot be used to predict the amount or location of endometriosis implants.
Severe pain may be present with minimal endometriosis and minimal or no pain may coexist with severe endometriosis. Only large implants on the ovaries that develop into endometriomas can be visualized reliably with ultrasonography. Fertility potential is impaired when endometriosis distorts the oviducts and ovaries. However, the mechanisms by which endometriosis might lead to infertility are unclear. Minimal endometriosis does not involve either oviducts or ovaries.