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INTRODUCTION: Eighty-five per cent of uterine inversions are puerperal. Non-puerperal uterine inversion is usually caused by tumours that exert a traction force on the fundus of the uterus. This causes the uterus to be partially or completely inverted. It is commonly related to benign tumours like submucosal leiomyomas. Nevertheless, malignancies are an infrequent association. CASE PRESENTATION: We report a case of a 35-year-old female patient, medically and surgically free, gravida0 para0, complaining of menometrorrhagia associated with pelvic pain for 2 years. A suprapubic ultrasound scan showed an enlarged, globular uterus with a heterogeneous, undefined mass of 49 mm in size. MRI scan showed the appearance of a U-shaped uterine cavity and a thickened inverted uterine fundus with an endometrial infiltrating mass of 25 mm. Intraoperative exploration showed uterine inversion involving the ovaries; the fallopian tubes and the round ligaments and a necrotic intracavitary mass. The malignancy of the tumor was confirmed through anatomopathological examination as Adenosarcoma. CONCLUSIONS: Uterine inversion is rare outside the puerperal period, and malignant etiology must not be overlooked. Therefore, comprehensive care with meticulous etiological investigation is crucial.
Assuntos
Adenossarcoma , Leiomioma , Anormalidades Urogenitais , Inversão Uterina , Neoplasias Uterinas , Útero/anormalidades , Feminino , Humanos , Adulto , Inversão Uterina/diagnóstico , Inversão Uterina/etiologia , Inversão Uterina/cirurgia , Neoplasias Uterinas/complicações , Neoplasias Uterinas/diagnóstico , Neoplasias Uterinas/cirurgia , Adenossarcoma/complicações , Adenossarcoma/diagnóstico , Adenossarcoma/cirurgia , Leiomioma/cirurgiaRESUMO
INTRODUCTION: Gallbladder Duplication is an uncommon anomaly of the biliary system that rarely seen during the routine ultrasound examination. It is a challenge that can be encountered by surgeons and associated with an increased risk of complications after cholecystectomy. CASE PRESENTATION: We report the case of a 58-year-old woman, presented to the emergency department with persistent right upper quadrant pain. Ultrasound exam detected Gallbladder Duplication with lithiasic cholecystitis in both of them. Besides, a Computed Tomography and a Magnetic Resonance Imaging confirmed the diagnosis showing a hepatic abscess by contiguity. The Patient was operated and, three days later, she was discharged home without incident. DISCUSSION: Gallbladder duplication is an anatomic biliary variant, which can associate with biliary ducts malformation. It can complicate the diagnosis and the surgical management of symptomatic Cholelithiasis or Cholecystitis. So, defining the exact anatomy of the biliary tree before surgery is crucial. Currently, the imaging technique, widely used for evaluating of the biliary tree, is the Magnetic Resonance Cholangiography. Laparoscopic cholecystectomy is the treatment of choice. CONCLUSIONS: Duplication of the gallbladder that could now be detected preoperatively by imaging should always be in a surgeon's mind, since it has been associated with anatomical biliary and vessels variations.
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Coating techniques are key factors in determining coated film properties. In the present study, nanocomposite coatings of poly(vinyl alcohol) and a nanoclay, montmorillonite, were deposited layer-by-layer using roll (doctor blade, DB) and dip coating techniques, in an effort to compare the impact of these techniques on the crosslinking efficiency and oxygen barrier of the coated films. The barrier properties at different relative humidities were tested, and the extent of nanoclay intercalation as well as the films' morphology was investigated. Barrier was further improved by crosslinking the coating with glyoxal and glutaraldehyde. Both techniques gave similar results but with a higher impact of relative humidity in roll coated films. Better results were achieved by tailoring the composition of those coatings to favor a higher density of hydrogen bonding in the coating.
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Layer by layer (LbL) film deposition is an efficient technique used to produce thin coatings with high gas barrier properties. In this study, multilayer composite coatings with hydrogen bonding inter-layer interactions were deposited by LbL on a PET substrate, with an alternate deposition of a nanoclay layer and different intercalating polymers layers, namely chitosan (CS), polyethylene oxide (PEO), polyvinylpyrrolidone (PVP) and polyvinyl alcohol (PVA). The investigated coatings had two different structures, quadlayers and bilayers which are different in the number of layers in the repetitive unit (four and two respectively). The alignment of nanoclay platelets and the extent of their intercalation were studied using Fourier transform infrared (FTIR) spectroscopy and X-ray diffraction (XRD). The results showed that the dispersion level and the orientation of nanoclay particles depend considerably on the molecular structure of intercalating polymers and their interactions with nanoclay. An oxygen permeability model, specific to high filler loading composites, was then developed by considering only the aspect ratio and the volume fraction of the nanoparticles.
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[This corrects the article DOI: 10.1039/C8RA09522A.].