RESUMEN
Animal models of osteoarthritis (OA) have played a key role in understanding the etiology of OA and in the development of new therapeutic strategies. Although pigs have an advantage as an animal disease model due to their similarity to humans, there are few studies on the induction of OA in minipigs. Therefore, this study aimed to characterize disease progression of OA in total medial meniscectomy (TMM)-operated skeletally mature minipigs, up to day 180 postoperatively. There were no significant alterations in vital signs or hematological indices throughout the observation period. However, clinical manifestations of OA in the medial femoral condyles of TMM-operated minipigs were progressive, depending on postoperative duration, with respect to osteophytes formation and roughened surfaces on radiological observation, cartilage erosion under macroscopic examination, and severe cartilage defects including fibrillation, vertical fissures, and cartilage denuding on histopathological observation, with the highest score indicating late-stage OA on day 180 and without indicating apparent variation between subjects. In particular, the lateral femoral condyles were also degenerated, possibly due to localization of weight-bearing from both menisci to the lateral meniscus. Therefore, TMM in minipigs is suitable for reproducible induction of degenerative changes in the femorotibial joints that closely resemble late-stage OA, and is suitable for use in further research.
RESUMEN
Animal models of osteoarthritis (OA) have played a key role in understanding the etiology of OA and in the development of new therapeutic strategies. Although pigs have an advantage as an animal disease model due to their similarity to humans, there are few studies on the induction of OA in minipigs. Therefore, this study aimed to characterize disease progression of OA in total medial meniscectomy (TMM)-operated skeletally mature minipigs, up to day 180 postoperatively. There were no significant alterations in vital signs or hematological indices throughout the observation period. However, clinical manifestations of OA in the medial femoral condyles of TMM-operated minipigs were progressive, depending on postoperative duration, with respect to osteophytes formation and roughened surfaces on radiological observation, cartilage erosion under macroscopic examination, and severe cartilage defects including fibrillation, vertical fissures, and cartilage denuding on histopathological observation, with the highest score indicating late-stage OA on day 180 and without indicating apparent variation between subjects. In particular, the lateral femoral condyles were also degenerated, possibly due to localization of weight-bearing from both menisci to the lateral meniscus. Therefore, TMM in minipigs is suitable for reproducible induction of degenerative changes in the femorotibial joints that closely resemble late-stage OA, and is suitable for use in further research.
Asunto(s)
Humanos , Cartílago , Modelos Animales de Enfermedad , Progresión de la Enfermedad , Articulaciones , Meniscos Tibiales , Modelos Animales , Osteoartritis , Osteofito , Porcinos , Porcinos Enanos , Signos Vitales , Soporte de PesoRESUMEN
Application of magnetic resonance imaging (MRI) for assessment of pulmonary disease has been limited, due to susceptibility to cardiac pulsation, respiratory motion, and inhomogeneity of the magnetic field of the lung. With technical advances of MRI and unmet clinical needs for more accurate diagnosis and assessment of the disease, however, the use of MRI for evaluation of the lung has broadened. Herein, we present a case of pneumonic-type lung adenocarcinoma in a patient with history of anaphylactic shock to iodinated contrast medium, in which MRI played a critical role for targeted lung biopsy and cancer staging. Through this paper, we would like to report potential value of MRI in assessment of lung cancer.
Asunto(s)
Humanos , Adenocarcinoma , Adenocarcinoma Mucinoso , Anafilaxia , Biopsia , Diagnóstico , Enfermedades Pulmonares , Neoplasias Pulmonares , Pulmón , Campos Magnéticos , Imagen por Resonancia Magnética , Necrosis , Estadificación de Neoplasias , NeumoníaRESUMEN
We present a case of retained placenta accreta treated by high-intensity focused ultrasound (HIFU) ablation followed by hysteroscopic resection. The patient was diagnosed as submucosal myoma based on ultrasonography in local clinic. Pathologic examination of several pieces of tumor mass from the hysteroscopic procedure revealed necrotic chorionic villi with calcification. HIFU was performed using an ultrasound-guided HIFU tumor therapeutic system. The ultrasound machine had been used for real-time monitoring of the HIFU procedure. After HIFU treatment, no additional vaginal bleeding or complications were observed. A hysteroscopic resection was performed to remove ablated placental tissue 7 days later. No abnormal vaginal bleeding or discharge was seen after the procedure. The patient was stable postoperatively. We proposed HIFU and applied additional hysteroscopic resection for a safe and effective method for treating retained placenta accreta to prevent complications from the remaining placental tissue and to improve fertility options.
Asunto(s)
Humanos , Vellosidades Coriónicas , Fertilidad , Ultrasonido Enfocado de Alta Intensidad de Ablación , Métodos , Mioma , Retención de la Placenta , Ultrasonografía , Hemorragia UterinaRESUMEN
We present a case of retained placenta accreta treated by high-intensity focused ultrasound (HIFU) ablation followed by hysteroscopic resection. The patient was diagnosed as submucosal myoma based on ultrasonography in local clinic. Pathologic examination of several pieces of tumor mass from the hysteroscopic procedure revealed necrotic chorionic villi with calcification. HIFU was performed using an ultrasound-guided HIFU tumor therapeutic system. The ultrasound machine had been used for real-time monitoring of the HIFU procedure. After HIFU treatment, no additional vaginal bleeding or complications were observed. A hysteroscopic resection was performed to remove ablated placental tissue 7 days later. No abnormal vaginal bleeding or discharge was seen after the procedure. The patient was stable postoperatively. We proposed HIFU and applied additional hysteroscopic resection for a safe and effective method for treating retained placenta accreta to prevent complications from the remaining placental tissue and to improve fertility options.
Asunto(s)
Humanos , Vellosidades Coriónicas , Fertilidad , Ultrasonido Enfocado de Alta Intensidad de Ablación , Métodos , Mioma , Retención de la Placenta , Ultrasonografía , Hemorragia UterinaRESUMEN
PURPOSE: Our previous studies have shown that oncostatin M (OSM) promotes trophoblast invasion activity through increased enzyme activity of matrix metalloproteinase (MMP)-2 and -9. We further investigated OSM-induced intracellular signaling mechanisms associated with these events in the immortalized human trophoblast cell line HTR8/SVneo. MATERIALS AND METHODS: We investigated the effects of OSM on RNA and protein expression of MMP-2 and -9 in the first-trimester extravillous trophoblast cell line (HTR8/SVneo) via Western blot. The selective signal transducer and activator of transcription (STAT)3 inhibitor, stattic, STAT3 siRNA, and extracellular signal-regulated kinase (ERK) siRNA were used to investigate STAT3 and ERK activation by OSM. The effects of STAT3 and ERK inhibitors on OSM-induced enzymatic activities of MMP-2 and -9 and invasion activity were further determined via Western blot and gelatin zymography. RESULTS: OSM-induced MMP-2 and -9 protein expression was significantly suppressed by STAT3 inhibition with stattic and STAT3 siRNA silencing, whereas the ERK1/2 inhibitor (U0126) and ERK silencing significantly suppressed OSM-induced MMP-2 protein expression. OSM-induced MMP-2 and MMP-9 enzymatic activities were significantly decreased by stattic pretreatment. The increased invasion activity induced by OSM was significantly suppressed by STAT3 and ERK1/2 inhibition, though to a greater extent by STAT3 inhibition. CONCLUSION: Both STAT3 and ERK signaling pathways are involved in OSM-induced invasion activity of HTR8/SVneo cells. Activation of STAT3 appears to be critical for the OSM-mediated increase in invasiveness of HTR8/SVneo cells.
Asunto(s)
Humanos , Western Blotting , Movimiento Celular/efectos de los fármacos , Proliferación Celular/efectos de los fármacos , Quinasas MAP Reguladas por Señal Extracelular/metabolismo , Metaloproteinasa 2 de la Matriz/genética , Metaloproteinasa 9 de la Matriz/genética , Oncostatina M/genética , Fosforilación/efectos de los fármacos , ARN Mensajero/metabolismo , ARN Interferente Pequeño , Factor de Transcripción STAT3/metabolismo , Transducción de Señal/efectos de los fármacosRESUMEN
Biliary plastic stent induced life-threatening hemobilia is very rare. In this case, hemobilia seriously worsened following removal of a biliary stent, which had been placed for treatment of a postoperative bile leak in a patient who had undergone lateral liver segmentectomy for abdominal trauma. Following placement of the biliary stent, the bile leak improved, but hemobilia and cholangitis developed five days later. To manage the stent malfunction, we removed the biliary stent. However, life-threatening hemobilia developed immediately after removal. Endoscopic hemostasis was impossible; therefore, emergency angiographic embolization and stent graft were performed successfully. In such cases, angiographic embolization and stent-graft placement are effective diagnostic and therapeutic alternatives. When a patient develops hemobilia or cholangitis after biliary stent placement, endoscopists should pay special attention to remove the stent, which might exacerbate hemobilia.
Asunto(s)
Humanos , Angiografía , Bilis , Prótesis Vascular , Colangitis , Urgencias Médicas , Hemobilia , Hemostasis Endoscópica , Hígado , Mastectomía Segmentaria , Plásticos , StentsRESUMEN
Heterotopic pregnancy is an unusual condition that intrauterine pregnancy is accompanied by a coexisting ectopic pregnancy. The incidence of heterotopic pregnancies has increased in recent years because of rising incidence of pelvic inflammatory disease, pelvic surgery, expanding use of assisted reproductive technology. We report a rare case with heterotopic pregnancy following ovulation induction and intrauterine insemination that was diagnosed after rupture of the ectopic pregnancy. After surgical removal of the ruptured left tubal pregnancy, she carried the intrauterine pregnancy to term without any complications.
Asunto(s)
Femenino , Embarazo , Incidencia , Inseminación , Ovulación , Inducción de la Ovulación , Enfermedad Inflamatoria Pélvica , Embarazo Ectópico , Embarazo Heterotópico , Embarazo Tubario , Técnicas Reproductivas Asistidas , RoturaRESUMEN
Heterotopic pregnancy is an unusual condition that intrauterine pregnancy is accompanied by a coexisting ectopic pregnancy. The incidence of heterotopic pregnancies has increased in recent years because of rising incidence of pelvic inflammatory disease, pelvic surgery, expanding use of assisted reproductive technology. We report a rare case with heterotopic pregnancy following ovulation induction and intrauterine insemination that was diagnosed after rupture of the ectopic pregnancy. After surgical removal of the ruptured left tubal pregnancy, she carried the intrauterine pregnancy to term without any complications.
Asunto(s)
Femenino , Embarazo , Incidencia , Inseminación , Ovulación , Inducción de la Ovulación , Enfermedad Inflamatoria Pélvica , Embarazo Ectópico , Embarazo Heterotópico , Embarazo Tubario , Técnicas Reproductivas Asistidas , RoturaRESUMEN
OBJECTIVE: To evaluate the safety and feasibility of single-port access laparoscopically assisted vaginal hysterectomy (SPA-LAVH) using conventional laparoscopic instruments compared to multi-port access laparoscopically assisted vaginal hysterectomy (MPA-LAVH). METHODS: We reviewed the medical records of 220 patients with uterine leiomyoma or adenomyosis who underwent 110 SPA-LAVH and 110 MPA-LAVH in Incheon St. Mary's Hospital between April 2007 and November 2009. We performed SPA-LAVH with conventional rigid straight laparoscopic instruments in all cases. We also performed a new vaginal cuff closure method, Kim's Vaginal Vault Suspension Method, named after the operator (Kim, YW) in both SPA-LAVH and MPA-LAVH. RESULTS: There was no significant difference in patients' age, operating time, uterine weight, hemoglobin change, frequency of blood transfusion, and incidence of postoperative fever between the two groups. The patients' mean age was 46.1+/-7.0 years (SPA-LAVH) and 45.5+/-6.3 years (MPA-LAVH). The mean operating time was 87.2+/-21.0 minutes (SPA-LAVH) and 83.3+/-20.3 minutes (MPA-LAVH). The mean uterine weight was 261.4+/-139.7 g (SPA-LAVH) and 257.8+/-132.9 g (MPA-LAVH). The mean hemoglobin change was 1.1+/-0.7 g/dL (SPA-LAVH) and 1.2+/-0.6 g/dL (MPA-LAVH). Neither bowel injury nor urinary tract injury occurred during the operation in the two groups. One of the SPA-LAVH and one of the MPA-LAVH cases were converted to abdominal total hysterectomy. The mean hospital stay time was shorter with SPA-LAVH (2.6+/-0.6 days [SPA-LAVH] and 3.3+/-0.7 days [MPA-LAVH], P<0.05). CONCLUSION: SPA-LAVH using conventional rigid straight laparoscopic instruments can be offered as a safe and feasible alternative to MPA-LAVH.
Asunto(s)
Femenino , Humanos , Adenomiosis , Transfusión Sanguínea , Fiebre , Hemoglobinas , Histerectomía , Histerectomía Vaginal , Incidencia , Leiomioma , Tiempo de Internación , Registros Médicos , Sistema UrinarioRESUMEN
OBJECTIVE: Human cervical cancer is caused by the high-risk types of human papillomavirus (HPV) such as HPV16, which possess the E6 and E7 oncogenes, whose expressions are a prerequisite for cancer development. We performed this study to compare the efficacy of antitumor activity by HPV siRNA which silences only E6 or both E6/E7. METHODS: We transfected siRNA 377 (HPV16 E6 siRNA), siRNA 3 (HPV16 E6 siRNA), and siRNA 198 (HPV16 E7 siRNA) into SiHa cell line (siRNA 377 silences only E6, and siRNA 3 and siRNA 198 silence both E6 and E7). We experimented cell counts and morphologic changes 24 and 48 hours after transfection and expressions of HPV16 E6/E7 mRNA by RT-PCR. RESULTS: siRNA 377, siRNA 3, and siRNA 198 suppressed the cell growth. siRNA 3 and siRNA 198 were more potent than siRNA 377 in cell growth suppression. siRNA 377 knocked down the expression of E6 mRNA, and both siRNA 3 and siRNA 198 knocked down the expression of E6/E7 mRNA. CONCLUSION: Our results suggest that simultaneous suppression of E6 and E7 was more potent than E6-specific suppression in cancer cell growth.
Asunto(s)
Humanos , Recuento de Células , Línea Celular , Oncogenes , ARN Mensajero , ARN Interferente Pequeño , Transfección , Neoplasias del Cuello UterinoRESUMEN
Basal cell carcinoma (BCC) is the most common human malignant neoplasm, accounting for 75% of all non-melanoma skin cancer. The incidence of BCC is strongly correlated with sun exposure as well as older age. Therefore, the vast majority of BCCs is observed in elderly patients on the sun-exposed skin of the head and neck with a frequency of more than 80%. BCC is very rare on sun-protected skin such as the perianal and genital regions and other etiologic factors must be considered in these cases. Although the pathogenesis of vulvar BCC is unclear, early diagnosis is very important. Because BCC in these areas sometimes seems innocuous, it is recommended that a biopsy of all suspect lesions be performed. We report a woman with BCC of the vulva treated with wide local resection and reviews the literatures on this subject.
Asunto(s)
Anciano , Femenino , Humanos , Contabilidad , Biopsia , Carcinoma Basocelular , Diagnóstico Precoz , Cabeza , Incidencia , Cuello , Piel , Neoplasias Cutáneas , Sistema Solar , VulvaRESUMEN
Lymphoepithelioma-like carcinoma (LELC) of the uterine cervix, also called lymphoepithelioma or medullary carcinoma, is a very rare variant of squamous cell carcinoma. Histologically, the tumor is characterized by groups and nests of poorly differentiated tumor cells with abundant cytoplasm and ill-defined cell borders, surrounded by an intense chronic inflammatory infiltrate. Epstein-Barr virus (EBV) may be involved in the development of LELC but the exact role remains unclear. The relationship between human papillomavirus (HPV) and LELC of the uterine cervix has also not been reported. The prognosis of LELC of the uterine cervix seems to be better than that of cervical squamous cell carcinoma. We report a case of LELC of the uterine cervix with a brief review.
Asunto(s)
Femenino , Humanos , Carcinoma Medular , Carcinoma de Células Escamosas , Cuello del Útero , Citoplasma , Herpesvirus Humano 4 , PronósticoRESUMEN
Lymphoepithelioma-like carcinoma (LELC) of the uterine cervix, also called lymphoepithelioma or medullary carcinoma, is a very rare variant of squamous cell carcinoma. Histologically, the tumor is characterized by groups and nests of poorly differentiated tumor cells with abundant cytoplasm and ill-defined cell borders, surrounded by an intense chronic inflammatory infiltrate. Epstein-Barr virus (EBV) may be involved in the development of LELC but the exact role remains unclear. The relationship between human papillomavirus (HPV) and LELC of the uterine cervix has also not been reported. The prognosis of LELC of the uterine cervix seems to be better than that of cervical squamous cell carcinoma. We report a case of LELC of the uterine cervix with a brief review.
Asunto(s)
Femenino , Humanos , Carcinoma Medular , Carcinoma de Células Escamosas , Cuello del Útero , Citoplasma , Herpesvirus Humano 4 , PronósticoRESUMEN
Primary malignant lymphoma of the uterine cervix is very rare. Lymphomas account for 3.5% of all malignant tumors in the females. Approximately, 25% of all malignant lymphomas arise from extranodal sites, most frequently from gastrointestinal tract and skin. Although the incidence of systemic non-Hodgkin's lymphoma (NHL) and extranodal NHL has increased in recent decades, only 1 to 1.5% arises from female genital tract. Primary pelvic sites include ovary, which is the most common site, uterine corpus, cervix, vagina, and vulva. Primary cervical lymphomas account for 0.12~0.6% of all extranodal lymphomas. However, there is still no consensus on the management of cervical lymphomas due to low incidence of the disease and limited experience in the literature. We experienced two cases of primary malignant lymphoma of the uterine cervix. A 41-year-old woman, Ann Arbor stage IE, was treated with laparoscopically assisted vaginal hysterectomy and both salpingo-oophorectomy and 4 cycles chemotherapy. A second case was a 73-year-old postmenopausal woman, Ann Arbor stage III, received five courses chemotherapy without any surgery. In this article, two cases of uterine cervical lymphoma are presented with a review of the available literature.
Asunto(s)
Adulto , Anciano , Femenino , Humanos , Cuello del Útero , Consenso , Tracto Gastrointestinal , Histerectomía Vaginal , Incidencia , Linfoma , Linfoma no Hodgkin , Ovario , Piel , Vagina , VulvaRESUMEN
Aggressive angiomyxoma is an uncommon soft-tissue neoplasm which affects the pelvis and genital organs of the young female predominantly. This tumor has a high tendency of local recurrence, but it usually does not develop metastasis. Although surgical excision with wide tumor-free margins may be necessary to obtain a complete cure, some of patients experience local recurrences. Many of the tumors are estrogen receptor (ER) and progesterone receptor (PR) positive and medical therapy with gonadotropin-releasing hormone (GnRH) agonists showed to be effective in a few cases. We present a case of 29-years-old women who has aggressive angiomyxoma which was misdiagnosed as bartholin duct cyst. She was treated by wide local excision with postoperative adjuvant GnRH agonist therapy for 3 months. She is now free of disease during 9 months of follow up. We have described this case with the brief of literature.
Asunto(s)
Femenino , Humanos , Estrógenos , Estudios de Seguimiento , Genitales , Hormona Liberadora de Gonadotropina , Mixoma , Metástasis de la Neoplasia , Pelvis , Receptores de Progesterona , Recurrencia , VulvaRESUMEN
The mature cystic teratoma of the ovary (ovarian dermoid cyst) is the most common ovarian neoplasm in young women and comprises approximately 10~25% of all ovarian tumors. There are many complications such as torsion, rupture, infection, suppuration, and rarely malignancy change. Teratoma derives from the three embryonic cell lines and may contain skin, sebaceous tissue, hair, cartilage and bone, neuroglial tissue, gastrointestinal and respiratory tissue, teeth, and muscle. Even though the presence of dental tissue within dermoid cysts has been reported in the literature, the cysts containing jaw bone and teeth are extremely rare. We report a case of ruptured ovarian dermoid cyst containing jaw bones and eight well-formed teeth with a brief review of literature.
Asunto(s)
Femenino , Humanos , Cartílago , Línea Celular , Quiste Dermoide , Cabello , Maxilares , Músculos , Neoplasias Ováricas , Ovario , Rotura , Piel , Supuración , Teratoma , DienteRESUMEN
Advanced age is known to be a risk factor for early mortality after heart transplantation and is considered to be a relative contraindication. However, recent studies have shown that there are no significant differences in early and midterm survival rates between older and younger recipients. With rising life expectancy and improvements in medical support, the demand for heart transplantation in elderly patients continues to grow. We present a successful case of heart transplantation in a 78-year-old patient.
Asunto(s)
Anciano , Humanos , Amiloidosis , Corazón , Trasplante de Corazón , Esperanza de Vida , Factores de Riesgo , Tasa de SupervivenciaRESUMEN
OBJECTIVE: Ultrasonography was used to determine not only the size but also the shape and site of gestational sac (GS) in early pregnancy. This study was performed to evaluate the role of transvaginal ultrasonography to predict placenta previa in early pregnancy, and analyze the correlation of the GS location with pregnancy outcomes. METHODS: From 1995 to 2007, medical records of pregnant women who had diagnosed placenta previa at Kangnam St. Mary's Hospital and Our Lady of Mercy Hospital were reviewed retrospectively. 71 patients with placenta previa had transvaginal ultrasonographic evidences within 7 weeks of gestation. As a control group, randomized sampling among pregnant women without placenta previa was performed, and 102 patients were selected and reviewed. Data was analyzed with SPSS version 11.0 statistically. RESULTS: 23.9% of GS (n=17) were found in lower 1/3 of the uterine cavity, 31.0% (n=22) were in middle 1/3, while 45.1% (n=32) were in upper 1/3. The distribution of GS in placenta previa patients leans to the lower in uterine cavity compared to normal pregnancies significantly (P=0.000). The relationship between the location of GS and differential diagnosis of placental previa was not statistically significant. CONCLUSION: Our results show that there would be higher risk for placenta previa, preterm labor, and early delivery when ultrasonographic finding of GS within 7 weeks of gestation reveals lower implantation in uterine cavity.
Asunto(s)
Femenino , Humanos , Embarazo , Diagnóstico Diferencial , Saco Gestacional , Registros Médicos , Trabajo de Parto Prematuro , Placenta , Placenta Previa , Resultado del Embarazo , Mujeres Embarazadas , Estudios RetrospectivosRESUMEN
OBJECTIVE:To assess the pregnancy outcomes complicated by maternal heart diseases. METHODS:From 1995 to 2006, medical records of pregnant women who had received full antenatal care at Kangnam St. Marys Hospital and Our Lady of Mercy Hospital with maternal heart diseases were reviewed. RESULTS:Forty one deliveries from 39 women were enrolled for analysis. 11 (26.7%) cases of the heart diseases were of rheumatic origin, 22 (53.7%) cases had arrhythmic disease, 3 (7.3%) cases had congenital heart disease, and the remaining 5 (12.3%) cases were consisted of miscellaneous diseases such as ischemic heart disease and congestive heart failure. There were 4 (9.8%) cases of pulmonary edema which had occurred as maternal complication during pregnancy. One case was a twin pregnancy. All of them were in New York Heart Association (NYHA) functional classes I, II before, during, and after delivery. Mean gestational age at birth and birth weight were 38.6 weeks and 3,157 g respectively. Neonatal congenital heart disease was shown in only one case with tetralogy of Falot and the other fetal anomaly was multicystic dysplastic kidney. CONCLUSION:Our results indicate that successful pregnancy outcome in patients with maternal heart disease would be possible in NYHA functional classes of I and II without any increased risk of complications.