Immunoautoradiographic determination of beta-1 gamma globulin in the blood serum of patients with trophoblastic tumors]

The authors determined beta1-G-globulin (beta1GG) in the sera of patients with different malignant tumours and of normal donors by means of the immunodiffusion method (ID) and immunoautoradiography (IAR). In the ID-negative sera beta1GG was revealed by means of IAR in 7 out of 8 patients with chorionepithelioma of the uterus and in 1 out of 7 patients with teratomblastoma of the testis before the treatment. After the treatment the beta1GG was determined in 7 out of 21 patients with chorionepithelioma of the uterus. At the early stage of trophoblastic tumours of the uterus beta1GG could be found in 77.7% of cases by means of IAR and in 16.8% of cases by means of the ID method.     

EMA/CO化疗方案治疗恶性滋养细胞肿瘤的临床疗效观察

目的:恶性滋养细胞肿瘤(Malignant trophoblastic tumor)是胚胎滋养细胞发生病变而产生的恶性肿瘤,严重威胁女性患者的身体健康及生活质量。本研究对EMA/CO(etoposide,methotrexate,actinomycin D,cyclophosphamide and vincristine)化疗方案治疗恶性滋养细胞肿瘤的临床效果及毒副反应情况进行探讨,旨在为该病的临床治疗积累经验。方法:选取我院2010年8月-2012年12月收治的恶性滋养细胞肿瘤患者58例,随机分为研究组和对照组,每组各29例。对照组采用5-Fu+KSM方案进行治疗,研究组采用EMA/CO方案治疗。观察并比较两组患者的治疗总有效率及毒副反应的发生情况。结果:对照组治疗总有效率为75.9%,研究组治疗总有效率为79.3%,两组患者的临床疗效无显著差异(P0.05)。研究组白细胞减少、呕吐及口腔溃疡程度均比对照组轻,差异具有统计学意义(P0.05)。结论:应用EMA/CO化疗方案治疗恶性滋养细胞肿瘤具有积极的作用,不但可以获得较好的近期疗效,且毒副反应较轻,值得临床应用推广。     

Diverticulum of the urinary bladder in a woman

In the two cases of congenital absence of the vagina reported herein, the embryologic point of arrest of development of the mullerian ducts was identical. Both patients had a rudimentary uterus, and one had a fibroid tumor on the rudimentary uterus. As a part of operation to construct a vagina in such cases, exploratory pelvic laparotomy appears to be a desirable step in order to determine the status of the internal genital organs. The use of a split thickness skin graft sewn around a vaginal mold and inserted into the dissected vaginal space results in more rapid healing, less scar tissue and a vagina that is soft, pliable and normal in appearance, even to the extent of having rugal folds.     

经利用网片的前盆底重建术治疗重度盆腔器官脱垂的临床疗效

目的:探讨经利用网片的前盆底重建术治疗重度盆腔器官脱垂的临床效果。方法:选取2013年1月-2015年3月我院妇科收治的以前中盆腔联合缺陷为主的盆底障碍性疾病患者39例(POP-Q分度III-IV度)。实施经阴道Avaulta前盆腔重建术,24例切除子宫,9例保留子宫,其中6例因中盆腔重度脱垂联合行阴道残端骶棘韧带固定术,2例合并尿失禁同时行经尿道无张力悬吊术。术后随访12-25月,根据盆腔脏器脱垂评分(POP-Q)测量及PFIQ-7评分进行客观评价及主观感受评价进行中短期的临床效果分析。结果:39例患者手术过程顺利,术后无严重并发症,POP-Q评分均较术前显著降低,客观疗效理想。术后阴道前壁及子宫、阴道穹窿脱垂等症状显著改善;到目前为止无一例复发。结论:经阴道前盆腔重建术治疗前盆腔重度盆腔脱垂为主以及合并尿失禁等复杂情况的并发症少,治愈率高,复发率低,临床效果好。     

Risk Evaluation of Selective Renal Arterial Embolization in the Treatment of Delayed Hemorrhage from Renal Artery Pseudoaneurysm After Partial Nephrectomy

Renal-artery pseudoaneurysm (RAP) is a well-described complication of partial nephrectomy. We aimed to evaluate the occurrence rate of delayed hemorrhage from RAP after partial nephrectomy, and to investigate the efficacy and safety of selective renal arterial embolization. Between January 2000 and December 2010, 426 partial nephrectomies were performed at our institution for treatment of small renal mass (SRMs). A retrospective review of these cases revealed that 14 patients developed a postoperative RAP (3.29 % incidence). We compared the clinical characteristics between the 14 patients with delayed renal hemorrhage and other 412 patients. RAP was diagnosed by renal angiography in 12 patients with delayed renal hemorrhage. Of the 12 patients, 10 patients were successfully treated with selective renal arterial embolization after presenting with symptoms postoperatively, 1 patient was treated with open surgery, and 1 patient was treated with nephrectomy. The other two patients showed no abnormalities in renal angiography, and the symptoms relieved by transfusion and hemostasis treatment. We found that tumor type, tumor size, tumor location, and surgical approach were significantly different between the 14 patients and other 412 patients. RAP showed a low incidence. The risk factors of RAP included renal cell carcinoma, tumor with large size, and tumor location. Most patients with delayed renal hemorrhage from RAP were successfully cured by selective renal arterial embolization. Therefore, selective renal arterial embolization can be used as the preferential therapy for RAP.     

The clinical evaluation of the simultaneous measurements of human chorionic gonadotropin (hCG) and its alpha-subunit in sera of patients with trophoblastic diseases

The concentrations of human chorionic gonadotropin (hCG) and its free immunoreactive alpha-subunit (hCG-alpha) in the sera of patients with trophoblastic diseases were measured by hCG and hCG-alpha radioimmunoassay (RIA), respectively. In the sera of 12 women with hydatidiform mole large amounts of hCG and considerably high level of hCG-alpha were detected in all cases. After the evacuation of mole the serum level of these glycoproteins decreased, the leve of hCG-alpha declined more rapidly than hcg. in the sera of patients with destructive mole the concentration of hCG-alpha was usually lower than that of hCG. After hysterectomy and chemotherapy the levels of hCG-alpha declined practically paralleling that of hCG. However, when hCG had decreased to undetectable level, hCG-alpha could no longer be detected in all cases. Although in the serum of patient with choriocarcinoma involving the uterus and lungs the concentration of hCG-alpha was almost as high as that of hCG, the secretory pattern of hCG and hCG-alpha might not be closely related. The changes in the serum level of free hCG-alpha as well as that of hCG parelled the clinical course of the patients examined in this study. The present results suggest that measurements of the serum free hCG-alpha may be a useful parameter to follow the clinical course and to evaluate the efficacy of treatments of trophoblastic diseases.     

The use of digital subtraction angiography in diseases of the arteries of the pelvis and lower limbs

The diagnostic potentialities of digital subtraction angiography (DSA) in diseases of the pelvic arteries and lower limbs were studied. Intravenous (iv) and intraarterial (ia) DSA were performed in 613 patients, among them were patients with obliterating atherosclerosis and endarteritis, thromboembolism, aneurysms and arteriovenous fistulas. Iv DSA provided good information for the solution of therapeutic and tactical problems in pelvic, femoral and popliteal arterial lesions but in 16% of the cases it gave no opportunity to assess the status of the crural arteries. Ia DSA was shown to be no inferior to routine arteriography in the visualization of the lower limb arteries. This method is economical, well tolerated by patients, permits the intensification of examination of patients with acute and chronic arterial pathology. It can be employed under outpatient conditions and in the early postoperative period.     

子宫动脉栓塞术治疗子宫肌瘤的临床应用价值

目的：研究子宫动脉栓塞术（UAE）治疗子宫肌瘤的安全性和临床应用价值,材料和方法：25例经临床,B超证实的子宫肌瘤患者,平均年龄43．5岁,主要临床表现为月经量增多21例,贫血16例,有压迫症状4例,选择性双侧子宫动脉插管造影,用聚己烯已醇海绵（PVA）颗粒栓塞该动脉。结果：UAE后第3,6个月随访,所有患者月经量均恢复正常,15例贫血,4例压迫症状者均缓解,第3,6个月B超复查子宫肌瘤体积分别缩小47．37％和51．31％,与UAE产比较有显著差异（P＜0．01）,缺血性盆腔疼痛（92％）是最常见的副反应,UAE后卵巢体积均无显著缩小（P＞0．05）,结论：介入性双侧子宫动脉栓塞术治疗子宫肌瘤是一种微创,安全的手术,可保留子宫及其功能,其近期疗效显著,子宫动脉栓塞治疗子宫肌瘤具有重要的临床应用价值。     

妇科肿瘤患者术后盆腔感染情况调查、 病原菌分布及其危险因素分析

目的调查妇科肿瘤患者术后盆腔感染的情况以及病原菌分布,并探讨术后发生盆腔感染的危险因素。方法回顾性分析自2013年1月到2017年1月在东南大学附属中大医院接受妇科肿瘤手术治疗的384例患者的临床资料。统计妇科肿瘤术后盆腔感染的发生率及病原菌的分布情况。将发生盆腔感染的患者分为感染组,未发生盆腔感染的患者分为未感染组,对比两组的临床资料,并通过多因素Logistic回归分析,归纳妇科肿瘤患者术后发生盆腔感染的危险因素。结果术后发生盆腔感染41例,感染率为10.68%,培养出病原菌54株,其中革兰阳性菌14株,占25.93%,革兰阴性菌35株,占64.81%,真菌5株,占9.26%。感染组患者年龄60岁的比例、手术持续时间2h的比例、合并慢性基础疾病的比例、开放手术的比例、术前化疗的比例、术后留置引流管的比例和术后卧床时间7d的比例均显著高于未感染组(均P0.05);多因素Logistic回归分析结果显示,年龄大、手术持续时间长、合并慢性基础疾病、开放手术、术前化疗、术后留置引流管、术后卧床时间长均是妇科肿瘤患者术后盆腔感染的危险因素(均P0.05)。结论妇科肿瘤患者术后较容易并发盆腔感染,病原菌主要为革兰阴性菌。多种因素可增加术后盆腔感染的风险,临床应加强防控措施,降低妇科肿瘤患者术后盆腔感染的发生率。     

Clinical genealogy and genetic-mathematical study of families of probands with uterine cancer in the Chernovitsy Region

Complex clinic-genealogical and genetic-mathematical investigation of 482 patients with uterus cancer from Chernovtsy region was carried out. It was proved that primary in the population is multifactoral origin of uterus cancer. Percentage of genetic component in general susceptibility to disease was 11.40 9.40. Recurrent risk of the malignant tumor in progeny has been estimated. Results of the investigation are the base for development and execution of uterus cancer precaution and segregated with it oncopathology in proband relatives.     

Palliative treatment of hepatocellular carcinoma with percutaneous ethanol injection using tumor's feeding artery occlusion under the ultrasonic color Doppler guidance

We evaluate the efficacy of PEIT in patients with HCC using duplex color Doppler US. The study included 27 HCC patients admitted to the University Hospital Centre Zagreb, between 1993 and 1997. PEIT was performed for ablation of tumor supplying vessels in HCCs of < 5 cm in diameter, and as a palliative measure for tumor feeding vessel obliteration in larger tumors. The efficacy of PEIT was evaluated with duplex color Doppler US, and controlled by dynamic CT scan (16 patients) or selective angiography of hepatic artery (11 patients). All patients had well vascularized tumors before PEIT, and after therapy 25 of them showed absent or minimal tumor vascularization. Recanalization of the tumor feeding vessel was detected with Doppler US within 9 months after therapy. Study results suggested that duplex color Doppler US should be the method of choice in the evaluation of PEIT as well as in the follow-up of HCC patients after PEIT.     

Maintenance of the corpus luteum after uterine transfer of trophoblastic vesicles to cyclic cows and ewes

One or two trophoblastic vesicles (0.4-2 mm diam.) from cow (Day 14) or ewe (Day 11-13) embryos without their disc were transferred, after culture for 24 h, into recipients. Each vesicle was transferred into the uterine horn ipsilateral to the CL by the cervical route in heifers and surgically in ewes on Day 12 of the oestrous cycle. In cows, daily measurements of plasma progesterone concentrations and checks for return to oestrus showed that the CL was maintained in 8 out of 12 recipients. These 8 cows had 25- to 37-day cycles while 4 recipient heifers returned to oestrus normally. Three recipients with an extended cycle were slaughtered. The dissected uterus showed that trophoblastic vesicles had developed in the uterine horns. In ewes, the serum progesterone curve, determined in each recipient, showed that the CL was maintained in 7 out of 12 recipients. These 7 ewes had 20- to 54-day cycles and the other 5 ewes had a normal cycle of 15-19 days comparable to that of 17.0 +/- 0.5 days for the 6 control ewes. Whenever the CL was maintained, high blood progesterone levels were followed by rapid luteolysis. In cattle and sheep, therefore, a trophoblastic vesicle transferred into the uterus can develop in vivo, secreting the embryonic signals when there is no embryonic disc control and transforming the cyclic CL into a CL of pregnancy in about 60% of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)     

In vitro development of day-2 equine embryos co-cultured with oviductal explants or trophoblastic vesicles

This study compared the in vitro development of Day-2 equine embryos co-cultured with either trophoblastic vesicles or oviductal explants. Embryos were collected surgically from the oviducts of pony mares 2 d after ovulation and assessed for stage of development. Culture medium was Ham's F12 and Dulbecco's Modified Eagle's Medium (50:50 v/v) in a humidified atmosphere of 5% CO(2) in air at 38.5 degrees C with either trophoblastic vesicles or oviductal explants. The quality score of embryos was assessed daily. After 4 d in culture, embryos were stained (Hoechst 33342) and evaluated with epifluorescence to determine the number of nuclei present. Six of seven embryos co-cultured with oviductal exmplants developed to the morula/blastocyst stage, while four of seven embryos co-cultured with trophoblastic vesicles developed to the morula stage. More (P = 0.1) embryos co-cultured with oviductal explants reached the blastocyst stage than embryos co-cultured with trophoblastic vesicles (3 7 vs 0 7 , respectively). The number of cells was higher (P = 0.1) for embryos co-cultured with oviductal explants than for embryos co-cultured with trophoblastic vesicles (162.6 +/- 32 vs 87.3 +/- 28, respectively). The number of cells for embryos co-cultured with either oviductal explants or trophoblastic vesicles appeared to be lower than for embryos matured in vivo that were recovered from the uterus at Day 6 (378, 399, >1000). The co-culture of early equine embryos in a completely defined medium with either trophoblastic vesicles or oviductal explants can support development to at least the morula stage. The co-culture of embryos with oviductal explants resulted in superior development of four-to eight-cell embryos, as indicated by the proportion that reached the blastocyst stage and by the number of cells.     

The Choice of Corticosteroid Preparations: Medical Ward Round,Vancouver General Hospital,December 20, 1962

Hysterosalpingography was performed on 175 patients who had gynecological symptoms but negative pelvic findings, in order to test a new method of introducing the contrast medium into the uterus and tubes and to record the incidence of pathology revealed. In 132 patients, an attempt was made to secure a No. 14 Foley catheter in the uterus for introducing the contrast medium. This method was successful in 124 patients and can be recommended as being simple, less painful and more efficient than older methods. Of 156 patients with the complaints of infertility (68), dysmenorrhea (31), pelvic pain (29) or menstrual disorder (28), hysterosalpingography revealed significant abnormality in 58; most of these (47) had chronic salpingitis. One flare-up of pelvic inflammation occurred but no other complications were observed. It was concluded that hysterosalpingography is now sufficiently safe and reliable to merit wider utilization in gynecological diagnosis.     

Development and characterization of a synthetic promoter for selective expression in proliferating endothelial cells

BACKGROUND: Systemic administration of non-viral gene therapy provides better access to tumors than local administration. Development of a promoter that restricts expression of cytotoxic proteins to the tumor vasculature will increase the safety of the system by minimizing expression in the non-dividing endothelial cells of the vasculature of non-target tissues. METHODS: Cell cycle promoters were tested for selective expression in dividing cells vs. non-dividing cells in vitro and promoter strength was compared to the cytomegalovirus (CMV) promoter. Successful promoter candidates were tested in vivo using two proliferating endothelium mouse models. Ovarectomized mice were injected with estradiol prior to lipoplex administration and expression levels were measured in the lungs and uterus 4 days after administration. The second model was a subcutaneous tumor model and expression levels were measured in the lungs and tumors. For both animal models, expression levels from the proliferating endothelium promoter were compared to that obtained from a CMV promoter. RESULTS: The results showed that the Cdc6 promoter yielded higher expression in proliferating vs. non-proliferating cells. Secondly, promoter strength could be selectively increased in endothelial cells by the addition of a multimerized endothelin enhancer (ET) to the Cdc6 promoter. Thirdly, comparison of expression levels in the lungs vs. uterus in the ovarectomized mouse model and lungs vs. tumor in the mouse tumor model showed expression was much higher in the uterus and the tumor than in the lungs for the ET/Cdc6 promoter, and expression levels were comparable to that of the CMV promoter in the hypervascularized tissues. CONCLUSIONS: These results demonstrate that the combination of the endothelin enhancer with the Cdc6 promoter yields selective expression in proliferating endothelium and can be used to express cytotoxic proteins to treat vascularized tumors.     

The dose-response relationship in the use of hexabrix in angiography]

The authors present the results of a clinical trial of Hexabrix, a new radiopaque low osmolar agent, to be used in visceral catheterization translumbar angiography. Hexabrix was shown to reduce the frequency of side-effects by 40% as compared to triiodinated agents. The new agent causes no marked reactions in intraarterial administration even at a dose over 2 ml/kg. Hexabrix is an agent of choice to be used for patients at risk of angiographic investigation (allergy, advanced age, a severe general condition).     

Factors affecting the survival of whole and half-embryos transferred in cattle

We estimated that embryonic loss in cattle was about 30% after direct blastocyst transfer. This loss occurred mostly before and during implantation and was augmented by handling the embryo during deep-freezing or culture $\text{in vitro}$. Pregnancy rate increased with the number of embryos transferred. The establishment of a “dialogue” between the embryo and uterus thus depended on the number and quality of the embryonic cells transferred. The trophoblastic cells gave the signal maintaining the corpus luteum of the recipient cow, but the survival of the transferred embryo depended on the good viability of the cells of the embryonic disc.To limit early embryonic loss, the embryonic signal could be amplified by transferring a trophoblastic vesicle $\text{in utero}$ at the same time as the embryo.     

New insights for pelvic radiation disease treatment: Multipotent stromal cell is a promise mainstay treatment for the restoration of abdominopelvic severe chronic damages induced by radiotherapy

Radiotherapy may induce irreversible damage on healthy tissues surrounding the tumor. It has been reported that the majority of patients receiving pelvic radiation therapy show early or late tissue reactions of graded severity as radiotherapy affects not only the targeted tumor cells but also the surrounding healthy tissues. The late adverse effects of pelvic radiotherapy concern 5% to 10% of them, which could be life threatening. However, a clear medical consensus concerning the clinical management of such healthy tissue sequelae does not exist. Although no pharmacologic interventions have yet been proven to efficiently mitigate radiotherapy severe side effects, few preclinical researches show the potential of combined and sequential pharmacological treatments to prevent the onset of tissue damage. Our group has demonstrated in preclinical animal models that systemic mesenchymal stromal cell (MSC) injection is a promising approach for the medical management of gastrointestinal disorder after irradiation. We have shown that MSCs migrate to damaged tissues and restore gut functions after irradiation. We carefully studied side effects of stem cell injection for further application in patients. We have shown that clinical status of four patients suffering from severe pelvic side effects resulting from an over-dosage was improved following MSC injection in a compationnal situation.     

Quantitative immunoenzyme technic in the evaluation of specificity of the beta 1-g-globulin test in trophoblastic tumors]

The method of guantitative immunoenzymatic determination of beta 1-G-globulin (TSG) in the blood serum has been developed. The sensitivity of the method is 6 ng/ml TSG. It has been shown that elevated levels (12-100 ng/ml and higher) are usually observed in trophoblastic tumours of the uterus. The TSG ectopic synthesis is found to proceed in some tumours of the gastrointestinal tract and testicular teratoblastomas.     

Aromatase inhibition by R 83 842, the dextro isomer of R 76 713, in JEG-3 choriocarcinoma grown in ovariectomized nude mice

The effects of repeated (5 days) dosing with the non-steroidal aromatase inhibitor R 83 842 (the dextro isomer of R 76 713) on tumor aromatase and uterus weight in ovariectomized nude mice bearing JEG-3 tumors were examined. In animals bearing an androstenedione implant the presence of a JEG-3 tumor significantly increased uterus weight, proving that tumor aromatase indeed converted androgens to estrogens. Oral administration of R 76 713 (10 mg/kg) for 5 days reduced the increase in uterus weight by 84% in tumor bearing mice revealing true in vivo aromatase inhibition by R 76 713.

Experiments performed in the absence of exogenously added androgens gave similar results. Uterus weights in tumor bearing mice were significantly higher than in control mice. Oral administration of R 83 842 (5 mg/kg) for 5 days reduced uterus weight in the tumor bearing animals. Ex vivo aromatase measurements performed in JEG-3 tumors from these animals showed an aromatase inhibition of 93.9% in treated mice as compared to untreated mice. Five days oral treatment with R 83 842 dose-dependently lowered both aromatase activity and uterus weight. Doses of 5 and 0.5 mg/kg inhibited tumor aromatase by 94.1 and 74.7%, respectively, and reduced uterus weight. After a dose of 0.05 mg/kg aromatase activity and uterus weight were similar to those in the control group.