ISSN:0378-7346    

DOI:10.1159/000291989

出版商:S. Karger AG    

年代:1915

数据来源: Karger

摘要:

The purpose of this study is to evaluate the diagnostic capability of transvaginal ultrasound in detecting diffuse adenomyosis. One hundred and seventy-five women, mean age 45.8 years (range 37–62), were studied by TV ultrasound before hysterectomy for benign uterine pathology. The sonographer diagnosed adenomyosis in 19 patients, whereas the pathologist diagnosed adenomyosis in 15 women making ex novo diagnoses in 2 cases. The sensitivity of TV ultrasound was 86.6%, the specificity 96.2%, the positive predictive value 68.4%, and the negative predictive value 98%. In conclusion, this study showed that TV ultrasound is an important and advanced tool in the diagnosis of diffuse adenomyosis.

ISSN:0378-7346    

DOI:10.1159/000291887

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

To understand the role of specific fats on carcinogenesis, we have studied the effects of lipids derived from the ascites fluids of ovarian cancer patients on oncogenic components, associated with the regulation of proliferation. The treatment of tumor cells with patient-derived fats produced increased cell proliferation, as indicated by an increase in the number of S-phase cells. A similar enhancement in cell proliferation was not observed in normal fibroblasts, following lipid treatment. The effects of patient-derived lipids on the expression ofc-jun, c-fos, and c-erbB2 gene products were examined. The cellular expression of the proto-oncogene product, c-fos, was increased in all three ovarian tumor cell lines, following lipid treatment. Expression of c-jun gene product was not detected in SKOV-3 or OVCAR-3 and was not induced by fat treatment. UL-1 cells did not express detectable levels of c-jun prior to fat treatment and treatment with patient-derived fat induced significant levels of c-jun product. All three ovarian tumor cell lines expressed the c-erbB2 gene product and it was generally enhanced by treatment with patient-derived lipids. When specific fatty acids were tested, 14:0, 16:1, and 18:1 were principally responsible for the observed enhancement of c-erbB2 levels, while the fatty acids, 18:0 and 20:4, produced the greatest increase in c-fos expression. Many alterations caused by fats are consistent with the loss of normal growth regulation and may account for the epidemiologic link between certain fats and the risk for ovarian cancer.

ISSN:0378-7346    

DOI:10.1159/000291888

出版商:S. Karger AG    

年代:1996

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000291990

出版商:S. Karger AG    

年代:1915

数据来源: Karger

摘要:

Background: In the general population, uterine sarcoma (US) is an uncommon tumor, which accounts for approximately 1–3% of all uterine neoplasms. Its biological behavior is characterized by hematogenous metastases and local recurrent growth including the pelvis and peritoneal cavity. In the management of US, surgery is the primary form of treatment. Up to now the role of adjuvant radiotherapy has not been clearly established. Patients and Methods: We report about 54 patients with US treated from 1954 to 1994 by surgical resection alone (22) or a combination of surgery and irradiation (32) and evaluate the influence of histology, stage and different treatment options on survival. Results and Conclusions: Our data indicate an increased disease-free survival for patients treated with adjuvant radiotherapy, especially if poor prognostic factors are present (advanced tumor stage, histopathological grade II or III of leiomyosarcoma and mixed mesodermal sarcoma). Postoperative irradiation using doses between 50 and 60 Gy is recommended, in selected cases brachytherapy should be added. Prospective multicentric trials including a statistically evaluable number of patients are necessary to further clarify the role of multimodality treatment programs for US.

ISSN:0378-7346    

DOI:10.1159/000291889

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

The mucin-like carcinoma-associated antigen (MCA) enzyme immunoassay was tested in 962 healthy controls. MCA levels were compared with CA 125 in 70 patients with benign and 76 with malignant ovarian tumors. In addition MCA was compared with CA 15.3 in 58 patients with breast cancer and with CEA in 50 patients with colon carcinoma. In healthy controls the 95th percentile cutoff of 19.2 U/ml appeared to be higher than generally used. With the common cutoff value of 14 U/ml, a 38% sensitivity and 100% specificity was reached in malignant versus benign ovarian tumors. In colorectal cancer only 4% of patients had elevated MCA serum levels (CEA: 50%). In breast cancer patients the MCA assay performed better than CA 15.3 although only 17.2% showed elevated levels (CA 15.3:7.4%). Thus MCA seems to be of limited value in the diagnosis and follow-up of adenocarcinomas of breast, ovary or colon.

ISSN:0378-7346    

DOI:10.1159/000291890

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

Pulmonary hypertension carries a grave prognosis during gestation with maternal mortality rates as high as 30–50%, even in patients with a good pre-pregnancy functional status. A case of a successfully managed pregnant woman with severe pulmonary hypertension, due to a surgically repaired atrial septal defect, is reported. She was admitted at 29 weeks of gestation with severe dyspnea at rest, orthopnea, tachypnea, cyanosis and edema of the extremities (functional class IV). On oxygen, her arterial blood had a pH of 7.25, an oxygen partial pressure of 60 mm Hg and a carbon dioxide partial pressure of 60 mm Hg. A continuous and gradual improvement of her condition was noticed with prompt therapy including bed rest, 02 administration by face mask, digitalis, corticosteroids and diuretics. The stabilization of her condition (functional class II), allowed an uneventful cesarian section at 31 weeks of gestation, under epidural anesthesia, giving birth to a premature neonate, weighing 1,600 g. The patient died 1 year later from severe cardiopulmonary insufficiency due to the gradual progression of her severe pulmonary disease. In conclusion, prevention or interruption of pregnancy should be recommended strongly for women with pulmonary hypertension. However, if a woman, despite medical advice, chooses to continue her pregnancy, she can benefit from a prompt and well-balanced management, even in the presence of severe impairment of her functional status.

ISSN:0378-7346    

DOI:10.1159/000291891

出版商:S. Karger AG    

年代:1996

数据来源: Karger

摘要:

We experienced a case of congenital afibrinogenemia and successfully performed cesarean section with administration of fibrinogen. The patient was administered fibrinogen every week to sustain a fibrinogen level above 60 mg/ dl according to our previously reported first case. Pregnancy course was uneventful, and fetal growth was normal, but unfortunately placental abruption occurred after the spontaneous onset of labor at 37 weeks gestation. The fibrinogen level before labor was 96 mg/dl, but decreased to 33 mg/dl when placental abruption was diagnosed. During and after the operation, it was increased to 147 and 199 mg/dl, respectively, through infusion of 10 g of fibrinogen, and massive bleeding was stopped. Two grams of fibrinogen were infused daily after cesarean section, and postpartum hemorrhage was normal. It is obvious that fibrinogen is an extremely important factor in maintaining pregnancy, and we conclude that fibrinogen level must be at least 60 mg/dl during pregnancy, 120 mg/dl during surgery and 150 mg/dl during labor, if possible as high as 200 mg/dl, under the continuous infusion of fibrinogen to prevent placental abruption.

ISSN:0378-7346    

DOI:10.1159/000291892

出版商:S. Karger AG    

年代:1996

数据来源: Karger

ISSN:0378-7346    

DOI:10.1159/000291991

出版商:S. Karger AG    

年代:1915

数据来源: Karger

摘要:

This is the case of a male newborn with holoprosencephaly, marked hypotelorism, and a rudimentary nasal structure, the proboscis. The head CT scan showed a single monoventricle and two ocular globes fused at the midline. Chromosome studies showed a normal karyotype. The importance of ultrasonography in the prenatal diagnosis of this malformation is presented.

ISSN:0378-7346    

DOI:10.1159/000291893

出版商:S. Karger AG    

年代:1996

数据来源: Karger