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Sample records for giant abdominal leiomyoma

  1. Hypovolemic shock due to giant uterus leiomyoma detachment.

    PubMed

    Galani, P; Kapetanakis, S; Papadopoulos, C; Dimitrakopoulou, G; Kosma, L; Lafoyianni, S; Dimitrakova, E; Papathanasiou, J; Fiska, A

    2010-01-01

    Uterine leiomyoma (UL) is the most common benign gynecologic tumor of the reproductive age females. It is symptomatic only in 25% of the patients causing dysmenorrhea, menorrhagia or anemia. In some patients it occurs just as a palpable abdominal mass. In this study, we report a 50-year-old woman with a giant mass, attached to the uterus, which was detached and therefore led to shock due to major hemorrhage. Surgical removal of both the mass and the uterus confirmed the diagnosis of a pedunculated uterine leiomyoma.

  2. Minimally invasive surgery for giant esophageal leiomyoma: a case report & review of the literatures

    PubMed Central

    Chen, Xiaosang; Xi, Yong; Wang, Hao

    2017-01-01

    Despite the rapid development of minimally invasive surgery, the treatment of esophageal lesions remains controversial. Giant esophageal leiomyoma could be removed once diagnosed, but its operative method is not quite the same as esophageal leiomyoma of small size. We report a case of giant esophageal leiomyoma and review published cases of giant leiomyomas in the past 10 years. A 29-year-old man was admitted to the clinic for the complaints of 2-month history of dysphagia and discomfort. Radiologic and endoscopic findings suggested esophageal lesion in the muscular layer. The VATS enucleation was performed to relieve the patient’s symptoms. The patient started oral intake on the 1st postoperative day, with following solid meal. The postoperative course was uneventful, and the patient was discharged on the 8th postoperative day. PMID:28203434

  3. Fetal arthrogryposis secondary to a giant maternal uterine leiomyoma.

    PubMed

    Vila-Vives, José María; Hidalgo-Mora, Juan José; Soler, Inmaculada; Rubio, Juan; Quiroga, Ramiro; Perales, Alfredo

    2012-01-01

    Arthrogryposis multiplex congenital is a rare condition defined as contractures in multiple joints at birth due to disorders starting in fetal life. Its etiology is associated with many different conditions and in many instances remains unknown. The final common pathway to all of them is decreased fetal movement (fetal akinesia) due to an abnormal intrauterine environment. Causes of decreased fetal movements may be neuropathic abnormalities, abnormalities of connective tissue or muscle, intrauterine vascular compromise, maternal diseases, and space limitations within the uterus. When the cause of arthrogryposis is space limitations in uterus, the most common etiology is oligohydramnios. The same can result from intrauterine tumours as fibroids, although to our knowledge there are only two papers reporting cases of fetal deformities related to uterine leiomyomas. We describe a well-documented exceptional case of arthrogryposis associated with the presence of a large uterine fibroid. It could illustrate the importance of a careful and appropriate assessment of uterine fibroids before and in the course of a pregnancy considering that they can cause both serious maternal and fetal complications.

  4. Giant Perineal Leiomyoma: A Case Report and Review of the Literature

    PubMed Central

    Picon, Antonio I.

    2014-01-01

    We report the case of a 40-year-old woman who presented with a large perineal mass with no rectal or vaginal involvement. Imaging could not rule out malignancy. She underwent wide surgical excision. Histological analysis revealed a large atypical leiomyoma, measuring 24 × 12 × 8 cm. Followup after two years showed no recurrence and she has been asymptomatic since surgery. This is the largest perineal leiomyoma reported so far. PMID:24991446

  5. [Anesthetic management of an infant with giant abdominal neuroblastoma].

    PubMed

    Gómez-Ríos, Manuel Ángel; Nuño, Federico Curt; Barreto-Calvo, Purísima

    Neuroblastoma is the most common, non-central nervous system tumor of childhood. It has the potential to synthesize catecholamines. However, the presences of hypertension are uncommon. We report the perioperative management of a 15-month-old infant with giant abdominal neuroblastoma who presented severe hypertension. The pathophysiological alterations of neuroblastoma are reviewed and perioperative management presented.

  6. Anesthetic management of an infant with giant abdominal neuroblastoma.

    PubMed

    Gómez-Ríos, Manuel Ángel; Nuño, Federico Curt; Barreto-Calvo, Purísima

    Neuroblastoma is the most common, non-central nervous system tumor of childhood. It has the potential to synthesize catecholamines. However, the presences of hypertension are uncommon. We report the perioperative management of a 15-month-old infant with giant abdominal neuroblastoma who presented severe hypertension. The pathophysiological alterations of neuroblastoma are reviewed and perioperative management presented.

  7. Spontaneous Rupture of a Leiomyoma Causing Life-Threatening Intra-Abdominal Hemorrhage

    PubMed Central

    Powell, Kristin

    2017-01-01

    Background. Uterine fibroids are common benign tumors in women. Clinical manifestations are well known. Acute complications necessitating emergent surgical intervention are rare. Case. We report a case of a 53-year-old woman with a history of uterine fibroids presenting with acute-onset severe abdominal pain. Imaging indicated massive free fluid and a large partially solid uterine mass. Vitals were consistent with hypovolemic shock. Examination revealed a surgical abdomen. She underwent an emergent laparotomy and total hysterectomy. Surgery revealed 4.5 L of hemoperitoneum and a 15 cm degenerated uterine fibroid with active bleeding. Pathology was consistent with intraoperative findings. She required transfusion of numerous blood products perioperatively. Her postoperative course was uncomplicated. Conclusion. It is rare for a uterine fibroid to spontaneously rupture. However, prompt recognition of this severe complication is critical for expeditious, life-saving surgical management. PMID:28127487

  8. Intestinal leiomyoma

    MedlinePlus

    Leiomyoma - intestine ... McLaughlin P, Maher MM. The duodenum and small intestine. In: Adam A, Dixon AK, Gillard JH, Schaefer- ... Roline CE, Reardon RF. Disorders of the small intestine. In: Marx JA, Hockberger RS, Walls RM, et ...

  9. Epithelioid cotyledonoid leiomyoma of uterus.

    PubMed

    Chawla, Indu; Bhardwaj, Minakshi; Sareen, Neetu; Khattar, Nikhil

    2014-01-10

    A 42-year-old para 2 women underwent laparotomy with a preoperative diagnosis of leiomyoma uterus and ovarian endometrioma. At laparotomy, uterus was 12-week size and bilateral tubes and ovaries were normal. There was a large friable reddish-brown mass dissecting the leaves of broad ligament with extension into pelvic cavity and retroperitoneal spaces. Total abdominal hysterectomy with bilateral salpingo-oophorectomy with resection of tumour was performed as there was concern about the possibility of malignancy. Histopathological examination revealed a cotyledonoid leiomyoma epithelioid variant. These tumours, though benign, raise the possibility of malignancy at the time of surgery due to their bizarre and sarcoma-like appearance. It is important for the pathologist and gynaecologist to be aware of this rare variant of leiomyoma to avoid an overtreatment.

  10. A Case of Giant Uterine Lipoleiomyoma Simulating Malignancy.

    PubMed

    Karaman, Erbil; Çim, Numan; Bulut, Gülay; Elçi, Gülhan; Andıç, Esra; Tekin, Mustafa; Kolusarı, Ali

    2015-01-01

    Introduction. Uterine leiomyoma is the most common benign pathology in women and lipoleiomyoma is an extremely rare and specific type of leiomyoma. Here, we report an unusual case of giant pedunculated subserous lipoleiomyoma misdiagnosed preoperatively as leiomyosarcoma. Case. A 45-year-old woman admitted to our gynecology outpatient clinic for complaints of abdominal distention, tiredness, and pelvic pain for the last 6 months. Sonography and abdominal magnetic resonance imaging (MRI) showed a giant semisolid mass that filled whole abdominal cavity from pelvis to subdiaphragmatic area. A primary diagnosis of uterine sarcoma or ovarian malignancy was made. On operation, total abdominal hysterectomy with a pedunculated mass of size 30 × 23 × 12 cm and weighing 5.4 kg and bilateral salpingo-oophorectomy were performed. The histopathology revealed a lipoleiomyoma with extensive cystic and fatty degeneration without any malignancy. Discussion. The diagnosis of leiomyoma is done usually with pelvic ultrasound but sometimes it is difficult to reach a correct diagnosis especially in cases of giant and pedunculated lipoleiomyoma that included fatty tissue which may mimick malignancy. Conclusion. Subserous pedunculated giant lipoleiomyoma should be kept in mind in the differential diagnosis of leiomyosarcoma or ovarian malignancy.

  11. Mesothelioma as a rapidly developing Giant Abdominal Cyst.

    PubMed

    Vyas, Dinesh; Pihl, Kerent; Kavuturu, Srinivas; Vyas, Arpita

    2012-12-20

    The benign cystic mesothelioma of the peritoneum is a rare lesion and is known for local recurrence. This is first case report of a rapidly developing massive abdominal tumor with histological finding of benign cystic mesothelioma (BCM). We describe a BCM arising in the retroperitoneal tis[sue on the right side, lifting ascending colon and cecum to the left side of abdomen. Patient was an active 58-year-old man who noticed a rapid abdominal swelling within a two month time period with a weight gain of 40 pounds. Patient had no risk factors including occupational (asbestos, cadmium), family history, social (alcohol, smoking) or history of trauma. We will discuss the clinical, radiologic, intra-operative, immunohistochemical, pathologic findings, and imaging six months after surgery. Patient has no recurrence and no weight gain on follow up visits and imaging.

  12. Tuberculosis endometritis presenting as a leiomyoma.

    PubMed

    Shirazi, Mahboobeh; Shahbazi, Fatemeh; Pirzadeh, Leila; Mohammadi, Seyed Rahim; Ghaffari, Parisa; Eftekhar, Tahereh

    2015-01-01

    Genitourinary tuberculosis is a common extrapulmonary manifestation of tuberculosis. Taking into consideration that genitourinary tuberculosis may be associated with a diversity of presentations, its diagnoses may be difficult. A young woman with an initial presumptive diagnosis of a uterine leiomyoma presented with abdominal pain and a pelvic mass that after further investigations, she was diagnosed with genital tuberculosis.

  13. Tuberculosis Endometritis Presenting as A Leiomyoma

    PubMed Central

    Shirazi, Mahboobeh; Shahbazi, Fatemeh; Pirzadeh, Leila; Mohammadi, Seyed Rahim; Ghaffari, Parisa; Eftekhar, Tahereh

    2015-01-01

    Genitourinary tuberculosis is a common extrapulmonary manifestation of tuberculosis. Taking into consideration that genitourinary tuberculosis may be associated with a diversity of presentations, its diagnoses may be difficult. A young woman with an initial presumptive diagnosis of a uterine leiomyoma presented with abdominal pain and a pelvic mass that after further investigations, she was diagnosed with genital tuberculosis. PMID:25780530

  14. Benign Pulmonary Metastasizing Leiomyoma of the Uterus

    PubMed Central

    Iscan, Reyyan; Köse, Gültekin; Kaban, Isik

    2016-01-01

    Benign Metastasizing Leiomyoma (BML) is a rare disease which represents with multiple leiomyomatous lesions in many tissues and organs especially in lungs. These patients have been operated for leiomyoma of the uterus. Here we report a case of a 41-year-old woman who was evaluated in a thoracic surgery hospital for dyspnea and bilateral nodules in chest roentgenogram. She had no history of neoplasm, only myomectomy history of uterine leiomyoma 10 years ago. Biopsy and histopathological examination were consistent with pulmonary leiomyoma. The patient was reffered to our clinic and we performed a total abdominal hysterectomy for her multiple uterine leiomyomas. The final diagnosis was ‘benign pulmonary metastasizing leiomyoma’. After this diagnosis, surgical castration was performed but two years later, repeat imaging showed progression in pulmonary lesions and progesterone therapy was administered to the patient. Patient has continued on this hormonal therapy to date and during the 5-years follow-up, the persisting lesions in both lungs regressed. PMID:27790528

  15. Rare Epithelioid Leiomyoma of the Vagina Exhibiting a Pelvic Mass

    PubMed Central

    Nagasaka, Mayuko; Takahashi, Mariko; Kobayashi, Masashi

    2017-01-01

    Epithelioid leiomyoma of the vagina is extremely rare. Smooth muscle tumors of the vagina usually present with a submucosal growth pattern or a pedunculated growth pattern from the anterior vaginal wall into the vaginal cavity. Here we report a case of a 43-year-old woman with a solid epithelioid leiomyoma and a palpable mass in the pouch of Douglas. Transvaginal biopsy and angiography showed the epithelioid leiomyoma feeding from the vaginal artery behind the posterior vagina. An abdominal wide excision of the tumor with a partial vaginectomy was performed. Our use of ultrasound-guided needle biopsy and angiography was useful for preoperative diagnosis of a vaginal epithelioid leiomyoma exhibiting a pelvic mass. PMID:28348906

  16. [Stagewise treatment of a giant false paraanastomotic aneurysm of the abdominal aorta].

    PubMed

    Ignatyev, I M; Volodyukhin, M Yu; Zanochkin, A V; Rafikov, A Yu; Khairullin, R N

    2016-01-01

    The article deals with a case report concerning successful stagewise treatment of a patient presenting with a giant false abdominal aortic paraanastomotic aneurysm having developed 2 months after an operation of linear prosthetic repair for a juxtarenal aneurysm with reimplantation of the left renal artery. The secondary operation was carried out 3 months after aortic reconstruction. The first stage consisted in performing endovascular prosthetic repair of the abdominal aortic paraanastomotic pseudoaneurysm by means of a bifurcated stent graft Endurant II (Medtronic), with the second stage being laparotomy with the removal of the retroperitoneal haematoma. The postoperative period turned out uneventful. The patient was discharged from hospital on the 8th day after the second operation. The patient was examined 2 months later, presenting no complaints and returning to his previous work. According to the findings of the check-up duplex scanning, the graft was patient, with no evidence of a paraanastomotic aneurysm. This is followed by discussion of the problems regarding the use of surgical and endovascular technologies in treatment of paraanastomotic aortic aneurysms.

  17. Gasless laparoscopic surgery plus abdominal wall lifting for giant hiatal hernia-our single-center experience.

    PubMed

    Yu, Jiang-Hong; Wu, Ji-Xiang; Yu, Lei; Li, Jian-Ye

    2016-12-01

    Giant hiatal hernia (GHH) comprises 5% of hiatal hernia and is associated with significant complications. The traditional operative procedure, no matter transthoracic or transabdomen repair of giant hiatal hernia, is characteristic of more invasion and more complications. Although laparoscopic repair as a minimally invasive surgery is accepted, a part of patients can not tolerate pneumoperitoneum because of combination with cardiopulmonary diseases or severe posterior mediastinal and neck emphesema during operation. The aim of this article was to analyze our experience in gasless laparoscopic repair with abdominal wall lifting to treat the giant hiatal hernia. We performed a retrospective review of patients undergoing gasless laparoscopic repair of GHH with abdominal wall lifting from 2012 to 2015 at our institution. The GHH was defined as greater than one-third of the stomach in the chest. Gasless laparoscopic repair of GHH with abdominal wall lifting was attempted in 27 patients. Mean age was 67 years. The results showed that there were no conversions to open surgery and no intraoperative deaths. The mean duration of operation was 100 min (range: 90-130 min). One-side pleura was injured in 4 cases (14.8%). The mean postoperative length of stay was 4 days (range: 3-7 days). Median follow- up was 26 months (range: 6-38 months). Transient dysphagia for solid food occurred in three patients (11.1%), and this symptom disappeared within three months. There was one patient with recurrent hiatal hernia who was reoperated on. Two patients still complained of heartburn three months after surgery. Neither reoperation nor endoscopic treatment due to signs of postoperative esophageal stenosis was required in any patient. Totally, satisfactory outcome was reported in 88.9% patients. It was concluded that the gasless laparoscopic approach with abdominal wall lifting to the repair of GHH is feasible, safe, and effective for the patients who cannot tolerate the pneumoperitoneum.

  18. Leiomyoma in the Retzius space

    PubMed Central

    2017-01-01

    Parauterine location of leiomyomas is observed to be an extremely rare clinical condition. However, when benign or malignant primary tumours are detected in that area, they are often found in the Retzius space. There have been only six cases of leiomyomas in the Retzius space reported in the literature so far. The paper presents one such leiomyoma case located in the Retzius space. This extremely rare location of the tumour justifies its presentation. The medical records of the patient treated in the outpatient’s obstetrics and gynaecology (ob-gyn) clinic, her case history, and hospital records, supplemented by information obtained from the patient’s daughter, were analysed. The patient, a 50-year-old woman with type 2 diabetes, was referred to hospital for diagnosed secondary anaemia due to heavy menstruation for four months, which was associated with intramural leiomyoma in the anterior wall of the uterine body. Clinical examination found a large leiomyoma located in the anterior wall of the uterus. Laparotomy was performed: apart from and a leiomyoma in the uterine body it found a tumour, 140 × 100 mm in size, in the Retzius space. Total resection of the tumour was performed. Since the leiomyoma was located in the uterine wall, hysterectomy with bilateral excision of adnexa was also performed. The patient was discharged home in generally good condition on the sixth day following the operation. Concomitant occurrence of leiomyoma atypically located in the Retzius space and leiomyoma in the uterine body made perioperative diagnosis very difficult. PMID:28250727

  19. Atypical leiomyoma: An unusual variant of cutaneous pilar leiomyoma.

    PubMed

    Nocito, Mabel Jimena; Lustia, María Marcela; Luna, Paula Carolina; Cañadas, Nadia Guadalupe; Castellanos Posse, María Laura; Marchesi, Carolina; Carabajal, Graciela; Mazzini, Miguel Angel

    2009-03-15

    Cutaneous atypical leiomyoma is an unusual benign tumor arising from arrector pili muscle that shares histological features with uterine atypical or symplastic leiomyoma: atypical cellularity with pleomorphic nuclei but minimal or no mitosis. Six other cases have been reported so far and, in spite of its name and of being a smooth muscle proliferation, no recurrences nor metastasis have been reported.

  20. Should Prophylactic Anticoagulation Be Considered with Large Uterine Leiomyoma? A Case Series and Literature Review

    PubMed Central

    Paredes Saenz, Carmen; Raju, Rubin; Cuthpert, Sierra; Kanzy, Abed; Abhari, Sina; Hebert III, John; Rocha, Frederico G.

    2016-01-01

    Introduction. Uterine leiomyomas, also called uterine fibroids or myomas, are the most common pelvic tumors in women. They are very rarely the cause of acute complications. However, when complications occur they cause significant morbidity and mortality. Thromboembolic disease has been described as a rare complication of uterine leiomyomas. DVT is a serious illness, sometimes causing death due to acute PE. Cases. We report a case series of 3 patients with thromboembolic disease associated with uterine leiomyoma at Hurley Medical Center, Flint, Michigan, during 2015 and conduct a literature review on the topic. A literature search was conducted using Medline, PubMed, and PMC databases from 1966 to 2015. Conclusion. The uterine leiomyoma is a very rare cause of PE and only few cases have been reported. DVT secondary to uterine leiomyoma should be considered in a female presenting with abdominal mass and pelvic pressure, if there is no clear common cause for her symptoms. Thromboembolic disease secondary to large uterine leiomyoma should be treated with acute stabilization and then hysterectomy. Prophylactic anticoagulation would be beneficial for lowering the risk of VTE in patients with large uterine leiomyoma. PMID:27885348

  1. Male genital leiomyomas showing androgen receptor expression.

    PubMed

    Suárez-Peñaranda, José Manuel; Vieites, Begoña; Evgenyeva, Elena; Vázquez-Veiga, Hugo; Forteza, Jeronimo

    2007-12-01

    Genital leiomyoma in men include those superficial leiomyomas arising in the scrotum and the areola. They are unusual neoplasms: few cases have been reported in the literature and they usually escape clinical diagnosis. Three cases of male genital leiomyomas are reported: two in the scrotum and one in the areola. They were all conservatively excised and the behaviour was completely benign in all cases. Histopathological examination showed the typical findings of superficial leiomyomas, with some minor differences between cases arising in the scrotum and those from the areola. Immunohistochemical findings not only confirmed the smooth muscle nature of all cases but also showed unequivocal immunostaining for androgen receptors in the leiomyomas from the scrotum. Immunostaining for androgen receptors in scrotal leiomyomas is, as far as we are aware, a previously unknown characteristic of male genital leiomyomas. This finding supports the role of steroid hormones in the growth of genital leiomyomas, similar to leiomyomas found in other locations.

  2. Thoraco-abdominal wall reconstruction after surgical debulking of a giant retroperitoneal liposarcoma: a case report.

    PubMed

    Colebunders, B; Colpaert, S D M; Mertens, M; Willemsen, P

    2011-01-01

    A case of a patient with a recurrent dedifferentiated retroperitoneal liposarcoma with extensive invasion of the thoraco-abdominal wall including the skin, requiring reconstructive surgery after debulking of the tumor is reported.

  3. Giant Cutaneous Leiomyosarcoma Originating From the Abdominal Wall: A Case Report

    PubMed Central

    Eken, Huseyin; Karagul, Servet; Topgül, Koray; Yoruker, Savaş; Ozen, Necati; Gun, Seda; Balci, Mecdi Gurhan; Somuncu, Erkan; Cimen, Orhan; Soyturk, Mehmet; Karavas, Erdal

    2016-01-01

    Patient: Male, 44 Final Diagnosis: Cutaneous Leiomyosarcoma Symptoms: Abdominal mass Medication: — Clinical Procedure: Surgery Specialty: Surgery Objective: Rare disease Background: Leiomyosarcoma, a rare type of tumor, accounts for 5–10% of all soft tissue tumors. Case Report: A 44-year-old male patient was admitted to the emergency service of our medical faculty with the complaints of fatigue and abdominal mass. Conclusions: The pathology result was leiomyosarcoma. Leiomyosarcoma of the skin is rare and our case is the largest such lesion reported in the literature. PMID:26787636

  4. A Giant Superior Mesenteric Artery Aneurysm Mimicking an Abdominal Aortic Aneurysm

    PubMed Central

    Hogendoorn, Wouter; Schlösser, Felix J.V.; Sumpio, Bauer E.

    2013-01-01

    Superior mesenteric artery aneurysms are a rare clinical finding but can present with a wide range of symptoms. They are associated with a high risk of rupture, as well as high morbidity and mortality. We present a case of a 38-year-old female who presented with acute abdominal pain and a pulsatile palpable mass in the right epigastric region without other signs or symptoms. PMID:26798672

  5. [Non-standard method of reconstruction of the abdominal aorta for a giant aneurysm].

    PubMed

    Gaibov, A D; Baratov, A K; Sadriev, O N; Gaibova, Z V; Sharipov, Z R

    2016-01-01

    Abdominal aortic aneurysms are encountered predominantly in elderly patients suffering from severe concomitant diseases. Therefore, the rate of various complications associated with resection of aortic aneurysm amounts to 30%, with lethality in separate cohorts of patients reaching 43.7%. According the authors' opinion, in the development of intra- and postoperative complications of special importance is the duration of aortic clamping accompanied by severe haemodynamic alterations in coronary, cerebral and renal vessels. These changes are key moments in the development of fatal outcomes. In order to reduce the duration of aortic clamp the authors suggested a non-standard surgical technique of prosthetic repair of the abdominal aorta. Presented herein is a clinical case report illustrating this technique. The patient operated on according to this technique was discharged in a satisfactory condition with no serious postoperative complications. The proposed non-standard surgical technique makes it possible to reduce the duration of aortic cross-clamping in resection of an aneurysm by 10-12 minutes.

  6. Prostatic Leiomyoma: A Case Report

    PubMed Central

    Mellas, Soufiane; Bouchikhi, Ahmed Amine; Tazi, Mohammed-Fadl; Khallouk, Abdelhak; Elammari, Jalal-Eddin; El Fassi, Mohammed-Jamal; Farih, Moulay Hassan

    2012-01-01

    Prostatic enlargement due to benign adenomatous hyperplasia is very common in elderly males. However, benign mesenchymal tumors especially true leiomyoma of the prostate are rare. We describe a 68-year-old male presenting a urinary obstruction lasting more than two years. The patient was referred for an acute urinary retention. The clinical examination was normal. The perrectal examination revealed an enlarged prostate without abnormalities. An endoscopic resection was performed. The histopathological examination revealed a benign smooth muscle tumor with absence of glandular hyperplasia; the result was confirmed by immunohistochemistry. Accordingly, the diagnosis of true leiomyoma of the prostate was made. PMID:23198266

  7. Prostatic leiomyoma: a case report.

    PubMed

    Mellas, Soufiane; Bouchikhi, Ahmed Amine; Tazi, Mohammed-Fadl; Khallouk, Abdelhak; Elammari, Jalal-Eddin; El Fassi, Mohammed-Jamal; Farih, Moulay Hassan

    2012-01-01

    Prostatic enlargement due to benign adenomatous hyperplasia is very common in elderly males. However, benign mesenchymal tumors especially true leiomyoma of the prostate are rare. We describe a 68-year-old male presenting a urinary obstruction lasting more than two years. The patient was referred for an acute urinary retention. The clinical examination was normal. The perrectal examination revealed an enlarged prostate without abnormalities. An endoscopic resection was performed. The histopathological examination revealed a benign smooth muscle tumor with absence of glandular hyperplasia; the result was confirmed by immunohistochemistry. Accordingly, the diagnosis of true leiomyoma of the prostate was made.

  8. Atypical (symplastic) leiomyoma of the uterus--a case report.

    PubMed

    Siti-Aishah, M A; Noriah, O; Malini, M N; Zainul-Rashid, M R; Das, S

    2011-01-01

    A 30-year-old, nulliparous woman presented with a history of subfertility. On examination she was found to have uterine fibroid of 28 weeks size of gravid uterus and subsequently laporatomy myomectomy was performed. Multilobulated masses, with diameters ranging from 22 mm to 160 mm were found. Cut sections of the lobulated masses showed whitish whorled cut surface. One of the multilobulated masses had a cystic cavity, measuring 60x50x35 mm(3). Light microscopic findings of the mass with the cystic cavity showed a well-circumscribed cellular tumour composed of cells exhibiting moderate nuclear atypia which were enlarged, nuclei with prominent chromatin clumping and were distributed in areas. Some tumour cells showed large nuclear pseudoinclusions, multinucleated or multilobated tumour giant cells, smudging and few enlarged nucleoli. Mitotic activity was 4 MFs per 10 HPFs. Occasional cells with intracytoplasmic inclusions resembling rhabdoid - like features were seen. There were no atypical mitoses or tumour necroses were noted. Diagnosis of atypical leiomyoma or symplastic leiomyoma was made. Atypical or symplastic leiomyomas are rare in the region of Malaysia and the present case discusses its incidence in younger age, its morphological features along with diagnosis and clinical outcome.

  9. Active Transport of Potassium by the Giant Neuron of the Aplysia Abdominal Ganglion

    PubMed Central

    Russell, J. M.; Brown, A. M.

    1972-01-01

    We measured the internal potassium activity, aiK, and membrane potential, Em, simultaneously in 111 R2 giant neurons of Aplysia californica. aiK was 165.3 ± 3.4 mM, Em was -47.8 ± 0.9 mv, and EK calculated using the Nernst equation was -76.9 ± 0.05 mv. Such values were maintained for as long as 6 hr of continuous recording in untreated cells, aiK fell exponentially after the following treatments: cooling to 0.5°–4°C, ouabain, zero external potassium, 2,4-dinitrophenol, and cyanide. The effects of cooling and zero potassium were reversible. Potassium permeability was calculated from net potassium flux using the constant field equation and ranged from 2.6 to 18.5 x 10-8 cm/sec. We conclude that potassium is actively transported into this neuron against a 30–40 mv electrochemical gradient. PMID:4644326

  10. Active Transport of Chloride by the Giant Neuron of the Aplysia Abdominal Ganglion

    PubMed Central

    Russell, J. M.; Brown, A. M.

    1972-01-01

    Internal chloride activity, aiCl, and membrane potential, Em, were measured simultaneously in 120 R2 giant neurons of Aplysia californica. aiCl was 37.0 ± 0.8 mM, Em was -49.3 ± 0.4 mv, and ECl calculated using the Nernst equation was -56.2 ± 0.5 mv. Such values were maintained for as long as 6 hr of continuous recording in untreated neurons. Cooling to 1°–4°C caused aiCl to increase at such a rate that 30–80 min after cooling began, ECl equalled Em. The two then remained equal for as long as 6 hr. Rewarming to 20°C caused aiCl to decline, and ECl became more negative than Em once again. Exposure to 100 mM K+-artificial seawater caused a rapid increase of aiCl. Upon return to control seawater, aiCl declined despite an unfavorable electrochemical gradient and returned to its control values. Therefore, we conclude that chloride is actively transported out of this neuron. The effects of ouabain and 2,4-dinitrophenol were consistent with a partial inhibitory effect. Chloride permeability calculated from net chloride flux using the constant field equation ranged from 4.0 to 36 x 10-8 cm/sec. PMID:4644325

  11. Giant abdominal osteosarcoma causing intestinal obstruction treated with resection and adjuvant chemotherapy

    PubMed Central

    Diamantis, Alexandros; Christodoulidis, Grigorios; Vasdeki, Dionysia; Karasavvidou, Foteini; Margonis, Evangelos; Tepetes, Konstantinos

    2017-01-01

    Extraskeletal osteosarcoma (ESOS) is an uncommon tumor that accounts for 1% of all soft tissue sarcomas and 4% of all osteosarcomas. Its presentation may be atypical, while pain has been described as the most common symptom. Radiological findings include a large mass in the soft-tissues with massive calcifications, but no attachment to the adjacent bone or periosteum. We present the case of a 73-year-old gentle man who presented with a palpable, tender abdominal mass and symptoms of bowel obstruction. Computer tomography images revealed a large space-occupying heterogeneous, hyper dense soft tissue mass involving the small intestine. Explorative laparotomy revealed a large mass in the upper mesenteric root of the small intestine, measuring 22 cm × 12 cm × 10 cm in close proximity with the cecum, which was the cause of the bowel obstruction. Pathology confirmed the diagnosis of an ESOS. ESOS is an uncommon malignant soft tissue tumor with poor prognosis and a 5-year survival rate of less than 37%. Regional recurrence and distant metastasis to lungs, regional lymph nodes and liver can occur within the first three years of diagnosis in a high rate (45% and 65% respectively). Wide surgical resection of the mass followed by adjuvant chemotherapy or radiotherapy has been the treatment of choice. PMID:28289512

  12. Two cases of male nipple leiomyoma: idiopathic leiomyoma and gynecomastia-associated leiomyoma.

    PubMed

    Nakamura, Satoshi; Hashimoto, Yoshio; Takeda, Keiko; Nishi, Kaoru; Ishida-Yamamoto, Akemi; Mizumoto, Toshihiro; Iizuka, Hajime

    2012-05-01

    We describe 2 cases of male nipple leiomyoma. A 70-year-old man had a painful subcutaneous tumor on his left nipple of 6 months duration. Histopathology disclosed dermal spindle cells with oval-shaped nuclei forming interlacing bundles with irregular pattern. Glandular elements were absent. The spindle cells were positive to α-smooth muscle actin, desmin, and vimentin. Estrogen receptor (ER) and progesterone receptor (PrR) were negative. We diagnosed this case as male leiomyoma of the nipple. Another patient was a 61-year-old man with gynecomastia induced by spironolactone of 6 months duration. He also had a painful nodule on his left nipple and histopathology disclosed spindle-shaped tumor cells as in the previous patient. The tumor was accompanied by glandular elements in the deep dermis and subcutaneous tissue, which showed apocrine secretion and were positive for α-smooth muscle actin, ER, and PrR. These glandular elements were interpreted as mammary gland. But ER and PrR stain did not show positive results for leiomyoma in the upper dermis. To the best of our knowledge, this is the first report of male idiopathic and gynecomastia-induced leiomyoma with ER and PrR staining.

  13. Cecal Leiomyoma: Can We Attempt Endoscopic Resection?

    PubMed Central

    Badipatla, Kanthi Rekha; Kamireddy, Chandana; Niazi, Masooma; Nayudu, Suresh Kumar

    2016-01-01

    Gastrointestinal leiomyomas are smooth muscle tumors arising from the muscularis mucosae, muscularis propriae and possibly from smooth muscle of the vessel wall. Management depends on the size, location and the clinical scenario. Endoscopic snare cauterization with or without saline lift has been described in literature for tumors involving the left colon. To the best of our knowledge, endoscopic resection of right colon leiomyoma was never attempted in the past. We present a case of cecal leiomyoma which was resected endoscopically. PMID:28058080

  14. Aromatase and leiomyoma of the uterus.

    PubMed

    Shozu, Makio; Murakami, Kouich; Inoue, Masaki

    2004-02-01

    In leiomyoma of the uterus, both aromatase and 17beta-hydroxysteroid dehydrogenase (17beta-HSD) type I are overexpressed compared with myometrium. This suggests that leiomyoma cells convert circulating androstenedione into estrone (via aromatase), then into the active form of estrogen, estradiol (via 17beta-HSD type I). In vitro experiments and several clinical findings support the notion that in situ estrogen plays a role in leiomyoma growth under hypoestrogenemic conditions, such as natural menopause and therapy with gonadotropin-releasing hormone (GnRH) agonists. GnRH agonists abolish estrogen production both in situ in leiomyoma and in the ovary, leading to quick and profound regression of the leiomyoma. Aromatase inhibitors also inhibit estrogen synthesis in both leiomyoma and the ovary and may be used therapeutically. Certain doses of competitive aromatase inhibitors would completely inhibit estrogen production in leiomyoma, whereas ovarian production of estrogen would continue at reduced levels. This may lead to advantageous therapeutic conditions in which leiomyoma regresses without adverse symptoms related to estrogen depletion because levels of ovarian estrogen would be insufficient to support leiomyoma growth but sufficient to prevent symptoms associated with deficiency. This article discusses the potential uses of aromatase inhibitors.

  15. Malignant Transformation of Pulmonary Benign Metastasizing Leiomyoma

    PubMed Central

    Song, Kyung Sub; Keum, Dong Yoon; Hwang, Il Seon

    2017-01-01

    Pulmonary benign metastasizing leiomyoma (PBML) is defined as metastasis of a leiomyoma to lung tissue. It was first reported in 1937. P BML is known as a benign disease, but can undergo malignant transformation. Only 1 case of the malignant transformation of PBML to leiomyosarcoma has been reported previously. In this report, we present a case of malignant transformation of PBML. PMID:28180107

  16. Latissimus dorsi free flap reconstruction of major abdominal defect in treatment of giant Marjolin’s ulcer: a short report focused on preoperative imaging

    PubMed Central

    Thomassen, Anders; Jensen, Jesper Poul Naested; Soerensen, Jens Ahm

    2014-01-01

    We present a case of a 56-year-old man with a giant carcinoma in the abdominal wall. Based on positron emission tomography/computed tomography (PET/CT) scan there were FDG-avid lymph nodes in the ipsilateral axillary and groin, suspicious for metastases. At contrast-enhanced CT the parietal peritoneum seemed free of tumor invasion, which was essential to radical surgery planning. The tumor was completely removed with clear margins of resection and no metastasis in the resected lymph nodes. The PET/CT scan was repeated after 4 months, showing no signs of recurrence. PMID:24778800

  17. Nanomedicine for Uterine Leiomyoma Therapy

    PubMed Central

    Ali, Hazem; Kilic, Gokhan; Vincent, Kathleen; Motamedi, Massoud; Rytting, Erik

    2013-01-01

    Aims The purpose of this work was to engineer polymeric nanoparticles to encapsulate and deliver 2-methoxyestradiol, a potential antitumor drug for treatment of uterine leiomyoma (fibroids), the most common hormone-dependent pathology affecting women of reproductive age. Materials & Methods Encapsulation efficiency and drug release from the nanoparticles were monitored by HPLC. Cell morphology and in vitro cytotoxicity experiments were carried out in a human leiomyoma cell line (huLM). Results The nanoparticles displayed high encapsulation efficiency (>86%), which was verified by differential scanning calorimetry and X-ray diffraction. Excellent long-term stability of the nanoparticles and gradual drug release without burst were also observed. Cellular uptake of fluorescent nanoparticles was confirmed by confocal imaging. The drug-loaded poly(lactic acid) and poly(lactic-co-glycolic acid) nanoparticles induced cytotoxicity in huLM cells to a significantly greater extent than the free drug at 0.35 μM. Conclusion This novel approach represents a potential fertility-preserving alternative to hysterectomy. PMID:23343157

  18. Large primary leiomyoma causing progressive cervical deformity

    PubMed Central

    Al-Habib, Amro; Elgamal, Essam A.; Aldhahri, Saleh; Alokaili, Riyadh; AlShamrani, Rami; Abobotain, Abdulaziz; AlRaddadi, Khulood; Alkhalidi, Hisham

    2016-01-01

    Leiomyomas are benign smooth tumors that rarely affect the neck area. Complete surgical resection is the treatment of choice. Here, we describe a 13-year-old girl with a large leiomyoma of the neck, which increased in size after incomplete resection. The tumor caused progressive cervical kyphotic deformity, difficulty breathing and severe malnourishment. The tumor was resected successfully in a second surgery, and the patient is stable after 3 years of follow-up. Histopathologically, the tumor was consistent with leiomyoma and showed strong reactivity to specific smooth muscle markers, such as desmin and caldesmon. This is the second reported case demonstrating massive growth of a leiomyoma, with emphasis on complete resection from the beginning. PMID:27887011

  19. Leiomyoma and leiomyoma cellulare of the fallopian tube: review of the literature and case reports

    PubMed Central

    2016-01-01

    Introduction Leiomyoma of the fallopian tube is extremely rare, and its version – leiomyoma cellulare (LC) of the fallopian tube is absolutely unique. Aim of the study was to review literature reports on leiomyomas of the fallopian tubes, and to present cases of leiomyoma and LC of the fallopian tubes in the patients operated on in our ward. Material and methods There were fewer than 100 cases of leiomyomas of the fallopian tubes discussed in the literature up to 1993. Case 1. Leiomyoma of the left fallopian tube was detected postoperatively in a 68-year-old patient, G.K., on histopathological examination after laparoscopic total hysterectomy with bilateral adnexa. Case 2. A 56-year-old patient, K.T., with LC of the fallopian tube was qualified for laparoscopy. At operation, the procedure was converted to microlaparotomy due to the tumor size. The adnexa on the right side with the tumor of the fallopian tube were excised, and the left fallopian tube was excised, too. Histopathological microscopy found leiomyoma cellulare partim epithelioides. Results In the presented cases, the extent of operation was connected with the clinical picture, and in the case of LC of the right fallopian tube, with intraoperative histopathological findings. In both cases the postoperative course was uneventful. Conclusions Diagnosis of leiomyoma and LC of the fallopian tube, like in the other organs of the female genital tract, is possible only due to results of histopathological microscopy. PMID:27980525

  20. Vascular Leiomyoma and Geniculate Ganglion

    PubMed Central

    Magliulo, Giuseppe; Iannella, Giannicola; Valente, Michele; Greco, Antonio; Appiani, Mario Ciniglio

    2013-01-01

    Objectives Discussion of a rare case of angioleiomyoma involving the geniculate ganglion and the intratemporal facial nerve segment and its surgical treatment. Design Case report. Setting Presence of an expansive lesion englobing the geniculate ganglion without any lesion to the cerebellopontine angle. Participants A 45-year-old man with a grade III facial paralysis according to the House-Brackmann scale of evaluation. Main Outcomes Measure Surgical pathology, radiologic appearance, histological features, and postoperative facial function. Results Removal of the entire lesion was achieved, preserving the anatomic integrity of the nerve; no nerve graft was necessary. Postoperative histology and immunohistochemical studies revealed features indicative of solid vascular leiomyoma. Conclusion Angioleiomyoma should be considered in the differential diagnosis of geniculate ganglion lesions. Optimal postoperative facial function is possible only by preserving the anatomical and functional integrity of the facial nerve. PMID:23943721

  1. Vascular leiomyoma and geniculate ganglion.

    PubMed

    Magliulo, Giuseppe; Iannella, Giannicola; Valente, Michele; Greco, Antonio; Ciniglio Appiani, Mario

    2013-06-01

    Objectives Discussion of a rare case of angioleiomyoma involving the geniculate ganglion and the intratemporal facial nerve segment and its surgical treatment. Design Case report. Setting Presence of an expansive lesion englobing the geniculate ganglion without any lesion to the cerebellopontine angle. Participants A 45-year-old man with a grade III facial paralysis according to the House-Brackmann scale of evaluation. Main Outcomes Measure Surgical pathology, radiologic appearance, histological features, and postoperative facial function. Results Removal of the entire lesion was achieved, preserving the anatomic integrity of the nerve; no nerve graft was necessary. Postoperative histology and immunohistochemical studies revealed features indicative of solid vascular leiomyoma. Conclusion Angioleiomyoma should be considered in the differential diagnosis of geniculate ganglion lesions. Optimal postoperative facial function is possible only by preserving the anatomical and functional integrity of the facial nerve.

  2. Leiomyoma of the fetal membranes: report of a case.

    PubMed

    Misselevich, I; Abramovici, D; Reiter, A; Boss, J H

    1989-04-01

    A leiomyoma of the fetal membranes was incidentally discovered on examination of a spontaneously expulsed placenta following an uneventful pregnancy and delivery of a healthy neonate. Perusal of the literature uncovered only a single report of a placental leiomyoma.

  3. Primary ovarian leiomyoma in a postmenopausal woman: A case report

    PubMed Central

    Sanverdi, Ilhan; Vural, Fisun; Temizkan, Osman; Temel, Orhan; Ayvaci, Habibe; Gunes, Pembegul

    2016-01-01

    Leiomyomas are benign neoplasms that can develop wherever smooth muscle is present. Primary leiomyomas of the ovary originate from smooth muscle cells of ovarian tissue and are rare, solitary tumors. Approximately 70 cases have been reported. They usually present in premenopausal women. The present case is a report of left ovarian leiomyoma in a postmenopausal woman.

  4. Zosteriform cutaneous leiomyoma: a rare cutaneous neoplasm.

    PubMed

    Arfan-ul-Bari

    2013-08-01

    Cutaneous leiomyomas are firm, round to oval, skin-coloured to brownish papules and nodules that may present as a solitary, few discrete or multiple clustered lesions. Different uncommon patterns of multiple leiomyoma distribution have been noted as bilateral, symmetrical, linear, zosteriform, or dermatomal-like arrangement. One such rare presentation was seen in a 23-year-old patient who presented with zosteriform skin coloured, occasionally painful cutaneous lesions over left shoulder region. Histopathology confirmed the diagnosis of cutaneous leiomyoma. He was symptomatically managed with non-steroidal anti-inflammatory agents and topical capcicum cream. Case is reported here due to rare occurrence of this benign cutaneous neoplasm in an atypical pattern and on uncommon site.

  5. Strong Association Between Endometriosis and Symptomatic Leiomyomas

    PubMed Central

    Nezhat, Camran; Li, Anjie; Abed, Sozdar; Balassiano, Erika; Soliemannjad, Rose; Nezhat, Ceana H.; Nezhat, Farr

    2016-01-01

    Background and Objectives: The relationship between leiomyoma and endometriosis is poorly understood. Both contribute to considerable pain and may cause subfertility or infertility in women. We conducted this retrospective study to assess the rate of coexistence of endometriosis in women with symptomatic leiomyoma. The primary outcome measured was the coexistence of histology-proven endometriosis in women with symptomatic leiomyoma. Methods: This is a retrospective review of a data-based collection of medical records of 244 patients treated at a tertiary medical center, who were evaluated for symptomatic leiomyoma from March 2011 through December 2015. Of those, 208 patients underwent laparoscopic or laparoscopic-assisted myomectomy or hysterectomy. All patients provided consent for possible concomitant diagnosis and treatment of endometriosis. The remaining 36 patients underwent medical therapy and were excluded from the study. All patients who had myomectomy or supracervical hysterectomy underwent minilaparotomy for extracorporeal morcellation and specimen removal beginning in April 2012. Results: Of the 208 patients with the presenting chief concern of symptomatic leiomyoma and who underwent surgical therapy, 181 had concomitant diagnoses of leiomyoma and endometriosis, whereas 27 had leiomyoma. Of the 27 patients, 9 also had adenomyosis. Patients with only fibroid tumors were, on average, 4.0 years older than those with endometriosis and fibroids (mean age, 44 vs 40 ± SD). Patients with both pathologies were also more likely to present with pelvic pain and nulliparity than those with fibroid tumors alone. Conclusions: In our patient population, 87.1% of patients with a chief concern of symptomatic fibroids also had a diagnosis of histology-proven endometriosis, which affirms the need for concomitant diagnosis and intraoperative treatment of both conditions. Overlooking the coexistence of endometriosis in women with symptomatic leiomyoma may lead to suboptimal

  6. Uterine Fibroid (Leiomyoma) with Acute Urinary Retention: A Case Series.

    PubMed

    Singh, Sweta; Jena, Saubhagya Kumar; Naik, Monalisha; Ray, Lipsa; Behera, Satyanarayan

    2016-04-01

    Uterine leiomyomas are an extremely rare cause of acute urinary retention in women. The delay in diagnosing uterine leiomyomas presenting with acute urinary retention further complicates the management. The rarity of the condition makes it difficult to plan either prospective or retrospective trials. Hence, most of the evidence comes from case reports or series. We report a case series of acute urinary retention in women with uterine leiomyomas and discuss the pathophysiology, diagnosis and management options.

  7. Uterine Fibroid (Leiomyoma) with Acute Urinary Retention: A Case Series

    PubMed Central

    Jena, Saubhagya Kumar; Naik, Monalisha; Ray, Lipsa; Behera, Satyanarayan

    2016-01-01

    Uterine leiomyomas are an extremely rare cause of acute urinary retention in women. The delay in diagnosing uterine leiomyomas presenting with acute urinary retention further complicates the management. The rarity of the condition makes it difficult to plan either prospective or retrospective trials. Hence, most of the evidence comes from case reports or series. We report a case series of acute urinary retention in women with uterine leiomyomas and discuss the pathophysiology, diagnosis and management options. PMID:27190903

  8. Bladder leiomyoma: Presentation, evaluation and treatment

    PubMed Central

    Khater, Nazih; Sakr, Ghazi

    2012-01-01

    Background Bladder leiomyomas are benign mesenchymal neoplasms and very rare urinary tumours that represent <0.5% of all bladder tumours, with only 250 cases reported worldwide to date. The importance of recognising their characteristic features, leading to their correct treatment, is fundamental. Therefore, we reviewed reports of leiomyomas of the urinary bladder, their causes, clinical presentations, imaging methods and surgical management, updated to 2012. Methods We retrospectively reviewed articles published in the USA, Europe and Asia, from 1953 to date, using PubMed, Medscape, Medline and the several major journals. We report areas of controversies and well-established guidelines. Results We reviewed 36 articles that confirmed, with a high level of evidence-based medicine, that the male to female ratio is equal, the cause of bladder leiomyomas remains unknown, and their most common presentation is obstructive uropathy; endovesical tumours are the most common. Their radiological diagnosis can be made by ultrasonography, computed tomography or magnetic resonance imaging. Complete surgical resection is a very effective treatment, associated with almost no recurrence. Conclusion In symptomatic patients a complete surgical resection can give a very good outcome, with almost no recurrence. PMID:26579246

  9. Magnetic Resonance Elastography of Uterine Leiomyomas: A Feasibility Study

    PubMed Central

    Stewart, Elizabeth A.; Taran, F. Andrei; Chen, Jun; Gostout, Bobbie S.; Woodrum, David A.; Felmlee, Joel P.; Ehman, Richard L.

    2010-01-01

    Objective To determine the feasibility of performing in vivo magnetic resonance elastography (MRE) for uterine leiomyoma. Design Pilot study Setting Academic Medical Center Patients Six subjects planning surgical excision of uterine leiomyomas. Intervention MRE prior to planned surgery Main Outcome Measures Achieving an appropriate phase signal to noise ratio (PSNR) in the leiomyoma to allow assessment of leiomyoma elasticity in kilo pascals (kPa). Results MRE was successful in all subjects for uteri ranging from 100 to over 1000 grams. Subjects had body mass indices (BMIs) ranging from 23.0 to 38.0 kg/m2. Appropriate PSNR ranging from 5.45 to 42.28 were achieved for leiomyomas in all subjects. Mean elasticity of uterine leiomyomas ranged from 3.95 to 6.68 kPa. Conclusion(s) MRE is a feasible technique for studying the in vivo mechanical properties of uterine leiomyomas and demonstrates significant heterogeneity in elasticity between lesions. Further work is necessary to optimize the technique and understand the clinical utility of this technique for women with uterine leiomyomas. PMID:20633880

  10. Rare Case of Leiomyoma and Adenomyosis in Mayer-Rokitansky-Kuster-Hauser Syndrome

    PubMed Central

    Norhaslinda, A. R.; Reza, J. N. Shah

    2016-01-01

    We report a case of adenomyosis which developed from a hypoplastic uterus and leiomyoma in a patient with MRKH syndrome. A 45-year-old Malay female with primary amenorrhoea and primary infertility presented with abdominal mass and abdominal pain. She is phenotypically female, has well developed secondary sexual characteristics, and has normal female external genitalia with shallow vagina dimple. Transabdominal ultrasonography showed a homogenous adnexal mass of 10 × 8 cm, uterus sized 5 × 4 cm, and normal kidneys. A complex mass of right adnexa was demonstrated by CT scan. Exploratory laparotomy showed torsion of right adnexal mass and rudimentary uterus with fibroid but no endometrial tissue and blind end with absent cervix. The normal right ovary and tube were not visualized. The left fallopian tube and ovary were normal. It is also complicated by vaginal agenesis. Removal of right adnexal mass and rudimentary uterus was done with preservation of left ovary. The histologic diagnosis was uterine adenomyosis and leiomyoma arising from the right adnexa, possibly from the broad ligament. PMID:27843659

  11. Immunohistochemical and morphological features of a small bowel leiomyoma in a black crested macaque (Macaca nigra)

    PubMed Central

    2012-01-01

    Background Spontaneous gastrointestinal neoplasms in non-human primates are commonly seen in aged individuals. Due to genetic similarities between human and non-human primates, scientists have shown increasing interest in terms of comparative oncology studies. Case presentation The present study is related to a case of an intestinal leiomyoma in a black crested macaque (Macaca nigra), kept on captivity by Matecaña Zoo, Pereira City, Colombia. The animal had abdominal distension, anorexia, vomiting, diarrhea and behavioral changes. Clinical examination showed an increased volume in the upper right abdominal quadrant caused by a neoplastic mass. The patient died during the surgical procedure. Necropsy revealed several small nodules in the peritoneum with adhesion to different portions of the small and large intestines, liver, stomach and diaphragm. Tissue samples were collected, routinely processed and stained by H&E. Microscopic examination revealed a mesenchymal tumor limited to tunica muscularis, resembling normal smooth muscle cells. Neoplastic cells were positive for alpha-smooth muscle actin and vimentin, and negative for cytokeratin AE1/AE3 by immunohistochemistry. Those morphological and immunohistochemical findings allowed to diagnose the intestinal leiomyoma referred above. Conclusion Neoplastic diseases in primates have multifaceted causes. Their manifestations are understudied, leading to a greater difficulty in detection and measurement of the real impact provides by this disease. PMID:22747606

  12. Comparison of Leiomyoma of Modern Medicine and Traditional Persian Medicine.

    PubMed

    Tansaz, Mojgan; Tajadini, Haleh

    2016-04-01

    Leiomyoma is the most common benign tumor of the pelvic that is associated with reproductive problems such as infertility, frequent abortions, and undesirable prenatal outcomes. High prevalence of leiomyoma and its relation with important gynecological complications, especially during reproductive ages, on the one hand, and high medical expenses and significant complications of common treatments, on the other, made us search traditional Persian medicine texts for a similar disease. In traditional Persian medicine, a condition has been introduced similar to leiomyoma (Oram-e-rahem). In this article, by collecting materials from traditional medicine texts on leiomyoma, we aim to provide theories for further studies on this topic, as there is an obvious difference between traditional Persian medicine and modern medicine with regard to leiomyoma. When modern medicine has not found a suitable response to treatment, reviewing of traditional Persian medicine for finding better treatment strategies is wise.

  13. Integrin β1 regulates leiomyoma cytoskeletal integrity and growth

    PubMed Central

    Malik, Minnie; Segars, James; Catherino, William H.

    2014-01-01

    Uterine leiomyomas are characterized by an excessive extracellular matrix, increased mechanical stress, and increased active RhoA. Previously, we observed that mechanical signaling was attenuated in leiomyoma, but the mechanisms responsible remain unclear. Integrins, especially integrin β1, are transmembrane adhesion receptors that couple extracellular matrix stresses to the intracellular cytoskeleton to influence cell proliferation and differentiation. Here we characterized integrin and laminin to signaling in leiomyoma cells. We observed a 2.25 ± 0.32 fold increased expression of integrin β1 in leiomyoma cells, compared to myometrial cells. Antibody-mediated inhibition of integrin β1 led to significant growth inhibition in leiomyoma cells and a loss of cytoskeletal integrity. Specifically, polymerization of actin filaments and formation of focal adhesions were reduced by inhibition of integrin p1. Inhibition of integrin β1 in leiomyoma cells led to 0.81 ± 0.02 fold decrease in active RhoA, and resembled levels found in serum-starved cells. Likewise, inhibition of integrin β1 was accompanied by a decrease in phospho-ERK. Compared to myometrial cells, leiomyoma cells demonstrated increased expression of integrin α6 subunit to laminin receptor (1.91 ± 0.11 fold), and increased expression of laminin 5α (1.52±0.02), laminin 5β (3.06±0.92), and laminin 5γ (1.66 ± 0.06). Of note, leiomyoma cells grown on laminin matrix appear to realign themselves. Taken together, the findings reveal that the attenuated mechanical signaling in leiomyoma cells is accompanied by an increased expression and a dependence on integrin β1 signaling in leiomyoma cells, compared to myometrial cells. PMID:23023061

  14. The management of uterine leiomyomas.

    PubMed

    Vilos, George A; Allaire, Catherine; Laberge, Philippe-Yves; Leyland, Nicholas; Vilos, Angelos G; Murji, Ally; Chen, Innie

    2015-02-01

    Objectifs : La présente directive clinique a pour objectif d’aider les cliniciens à mieux comprendre la pathophysiologie, la prévalence et l’importance clinique des myomes, et de leur faire part des meilleures données probantes disponibles quant aux modalités de traitement. Options : Dans le cadre de la rédaction de la présente directive clinique, nous avons tenu compte des aspects suivants de la pratique clinique : évaluation, traitements médicaux, traitements conservateurs par myolyse, occlusion sélective de l’artère utérine et solutions de rechange chirurgicales (dont la myomectomie et l’hystérectomie). Le rapport risques-avantages doit faire l’objet d’une analyse personnalisée dans le cadre des discussions menées entre la patiente et son fournisseur de soins. Issues : La mise en œuvre de la présente directive clinique devrait optimiser le processus décisionnel pour les patientes et les fournisseurs de soins en ce qui a trait à la tenue d’autres explorations ou à la façon d’assurer la prise en charge des léiomyomes utérins, en ayant tenu compte du processus pathogénique (et des options disponibles en matière de traitement) et en ayant passé en revue les risques et les avantages anticipés. Résultats : La littérature publiée a été récupérée par l’intermédiaire de recherches menées dans PubMed, CINAHL et Cochrane Systematic Reviews en février 2013 au moyen d’un vocabulaire contrôlé (p. ex. « uterine fibroids », « myoma », « leiomyoma », « myomectomy », « myolysis », « heavy menstrual bleeding » et « menorrhagia ») et de mots clés (p. ex. « myoma », « leiomyoma », « fibroid », « myomectomy », « uterine artery embolization », « hysterectomy », « heavy menstrual bleeding », « menorrhagia ») appropriés. Des recherches ont également été menées dans les listes de références des articles identifiés en vue d’en tirer d

  15. Benign metastasizing leiomyoma of the lung: PET findings.

    PubMed

    di Scioscio, Valerio; Feraco, Paola; Miglio, Laura; Toni, Francesco; Malvi, Deborah; Pacilli, Angela M G; Fasano, Luca; Fabbri, Mario; Zompatori, Maurizio

    2009-02-01

    We report the case of pulmonary benign metastasizing leiomyoma in an asymptomatic 64-year-old woman who underwent hysterectomy for a uterine leiomyoma 26 years earlier. Routine chest radiograph revealed bilateral diffuse nodular opacities within the pulmonary lobes. Thoracic computed tomography (CT) scan showed peripheral lung nodules that do not display contrast enhancement. Positron emission tomography (PET)-CT with 18F-fluorodeoxyglucose (18F-FDG PET-CT) demonstrated no significant metabolic activity of the nodules. The lesions were diagnosed as benign metastasizing leiomyoma by histopathologic examination. To our best knowledge, this is the first case studied combining CT and FDG PET-CT technique.

  16. Lipoleiomyoma of the uterus and primary ovarian leiomyoma in a postmenopausal woman: two rare entities in the same individual.

    PubMed

    Kelekci, Sefa; Eris, Serenat; Demirel, Emine; Aydogmus, Serpil; Ekinci, Nese

    2015-01-01

    Uterine lipoleiomyomas are rare benign tumours that are composed of various mixtures of smooth muscle and mature fat tissue. Leiomyomas, which arise primarily in the ovary, are extremely rare tumours that account for 0.5-1% of all benign ovarian tumours. To the best of our knowledge, we present the first case of an ovarian leiomyoma coexisting with a uterine lipoleiomyoma in the postmenopausal period. A 59-year-old, gravida 4, para 3, postmenopausal woman exhibited pelvic discomfort and increased frequency of micturition. A pelvic examination revealed a solid, tender mass on the left side that could not be clearly separated from the uterus. She underwent a laparotomy with an initial diagnosis of a left ovarian mass. She had previously undergone a total abdominal hysterectomy and bilateral salpingo-oophorectomy. A histopathological examination revealed a uterine lipoleiomyoma, composed of variable amounts of smooth muscle cells and mature adipocytes and a right ovarian leiomyoma composed of interlacing bundles and fascicles of spindle cells. The coexistence of these two rare entities in the same individual may represent a common pathway as a stimulating agent. This case may help to clarify the pathogenesis of these lesions.

  17. Identification of uterine leiomyoma-specific marker genes based on DNA methylation and their clinical application

    PubMed Central

    Sato, Shun; Maekawa, Ryo; Yamagata, Yoshiaki; Tamura, Isao; Lee, Lifa; Okada, Maki; Jozaki, Kosuke; Asada, Hiromi; Tamura, Hiroshi; Sugino, Norihiro

    2016-01-01

    Differential diagnosis of uterine leiomyomas and leiomyosarcomas is needed to determine whether the uterus can be retained. Therefore, biomarkers for uterine leiomyomas, and reliable and objective diagnostic methods have been desired besides the pathological diagnosis. In the present study, we identified 12 genes specific to uterine leiomyomas based on DNA methylation. Using these marker genes specific to uterine leiomyomas, we established a hierarchical clustering system based on the DNA methylation level of the marker genes, which could completely differentiate between uterine leiomyomas and normal myometrium. Furthermore, our hierarchical clustering system completely discriminated uterine cancers and differentiated between uterine leiomyosarcomas and leiomyomas with more than 70% accuracy. In conclusion, this study identified DNA methylation-based marker genes specific to uterine leiomyomas, and our hierarchical clustering system using these marker genes was useful for differential diagnosis of uterine leiomyomas and leiomyosarcomas. PMID:27498619

  18. Uterine angioleiomyoma: A rare variant of uterine leiomyoma--A case report and literature review.

    PubMed

    Diwaker, Preeti; Pradhan, Dinesh; Garg, Garima; Bisaria, Dipti; Gogoi, Kamakhya; Mohanty, Sambit K

    2015-01-01

    Uterine angioleiomyoma (AL) is an extremely rare variant of leiomyoma and only 15 cases have been reported till date. Herein we present a case of AL of the uterus in a 39-year-old multiparous female with polymenorrhagia and pain abdomen. A pelvic ultrasonogram showed a large heterogeneously hypoechoic intramural nodule in the posterior myometrium. The patient underwent a total abdominal hysterectomy. Histological examination of the nodule revealed a moderately cellular spindle cell tumor composed of interlacing fascicles of spindle to plump cells swirling around the thick walled vessels. No hypercellularity, pleomorphism, mitotic figures, or necrosis was identified. The spindle to plump cells showed strong and diffuse immunoreactivity for smooth muscle actin, desmin and progesterone receptor, focal and weak positivity for CD10 and estrogen receptor and were negative for CD34 and HMB-45. The Ki-67 labeling index was low (1%). A diagnosis of AL was offered. The patient is on follow up for over 10 months and is asymptomatic.

  19. Deep soft-tissue leiomyoma of the forearm mimicking a primary bone tumor of the ulna

    PubMed Central

    Ramachandran, Rajoo; Rangaswami, Rajeswaran; Raja, Dorai Kumar; Shanmugasundaram, Gouthaman

    2015-01-01

    Leiomyomas of the soft tissues are rare in general, and extremely uncommon in the forearm. In general, leiomyomas are benign soft-tissue tumors that occur where smooth muscles are present. We present a case of soft-tissue leiomyoma of the forearm eroding the midshaft of the ulna, with emphasis on radiological diagnosis and histopathological correlation. PMID:27186256

  20. Locally relapsed and metastatic uterine leiomyoma: A case report

    PubMed Central

    Londero, Ambrogio P; Perego, Patrizia; Mangioni, Costantino; Lellé, Ralph J; Londero, Franco; Marchesoni, Diego

    2008-01-01

    Introduction Benign metastasising leiomyoma refers to a type of lesion characterised by leiomyomatous alterations without any indication of malignancy. It presents as either a singular nodule or multiple nodules of proliferating smooth muscle cells and is generally found in the lungs of women who have undergone a hysterectomy. The purpose of this case report is to contribute to the knowledge of this rare disease by presenting evidence and experience of a patient case. In particular, this report seeks to investigate the therapeutic approaches in order to understand whether a standard of care can be prescribed and whether the use of prophylaxis therapy with progesterone as a follow-up to surgery serves as a reasonable treatment in certain cases diagnosed as benign metastasising leiomyoma. Case presentation We present the case of a 52-year-old Caucasian woman who developed a pelvic relapse and a pulmonary localisation of benign metastasising leiomyoma following a hysterectomy for myomatous uterus. Conclusion Our literature review revealed a single case of the use of chemoprophylaxis as treatment of a benign metastasising leiomyoma. The role of chemoprophylaxis in preventing future recurrences remains unclear. The use of progesterone as an adjuvant therapy for benign metastasising leiomyoma could simply be palliative, with associated psychological benefits, or it could be of therapeutic significance. PMID:18811931

  1. Vascular leiomyoma of the lung arising from pulmonary artery.

    PubMed

    Terada, Tadashi

    2013-01-01

    Leiomyoma of the lung is extremely rare. The entity is not described in WHO blue book. Less than 100 cases of leiomyoma of the lung have been reported in the literature. However, vascular leiomyoma has not been reported in the literature, to the author's best knowledge. Herein reported is the first case of vascular leiomyoma of the lung arising from smooth muscles of the pulmonary artery. A 62-year-old woman (non-smoker) was found to have a small tumor in the upper lobe in the right lung in routine check. Imaging modalities including CT demonstrated no metastatic lesions. Although clinical cytology and biopsy revealed no malignant cell, right upper lobectomy was performed under the clinical diagnosis of lung carcinoma. Grossly, a white tumor of 1 x 0.8 cm was recognized in the lung. Microscopically, the tumor was connected to the pulmonary arteries. The tumor was composed of mature smooth muscles. Small pulmonary arteries are embedded in the tumor. No lymphatics were seen. Immunohistochemically, the tumor cells were poisitive for alpha-smooth muscle actin, vimentin and Ki-67 (labeling 2%). However, they were negative for cytokeratin (CK) AE1/3, CK CAM5.2, desmin, S100 protein, p53, CD34, KIT, HMB45, estrogen receptor, progesterone receptor, and myoglobin. A pathological diagnosis of primary vascular leiomyoma arising from the smooth muscle of pulmonary artery was made. The patient is now free from tumor, and is now alive 10 year after the operation.

  2. Progesterone Receptor Action in Leiomyoma and Endometrial Cancer

    PubMed Central

    Kim, J. Julie; Sefton, Elizabeth C.; Bulun, Serdar E.

    2013-01-01

    Progesterone is a key hormone in the regulation of uterine function. In the normal physiological context, progesterone is primarily involved in remodeling of the endometrium and maintaining a quiescent myometrium. When pathologies of the uterus develop, specifically, endometrial cancer and uterine leiomyoma, response to progesterone is usually altered. Progesterone acts through mainly two isoforms of the progesterone receptor (PR), PRA and PRB which have been reported to exhibit different transcriptional activities. Studies examining the expression and function of the PRs in the normal endometrium and myometrium as well as in endometrial cancer and uterine leiomyoma are summarized here. The clinical use of progestins and the transcriptional activity of the PR on genes specific to endometrial cancer and leiomyoma are described. An increased understanding of the differential expression of PRs and response to progesterone in these two diseases is critical in order to develop more efficient and targeted therapies. PMID:20374701

  3. Benign metastasizing leiomyoma presenting as cavitating lung nodules.

    PubMed

    Loukeri, Angeliki A; Pantazopoulos, Ioannis N; Tringidou, Rodoula; Giampoudakis, Pantelis; Valaskatzi, Argyro; Loukeri, Pinelopi A; Kampolis, Christos F

    2014-07-01

    Benign metastasizing leiomyoma (BML) was initially used to describe single or multiple pulmonary nodules composed of proliferating smooth muscle cells (lacking cellular atypia) in premenopausal females 3 months to 20 y after hysterectomy for uterine leiomyoma. The lung is the most commonly involved site, thus including many malignant and benign entities in the differential diagnosis. The present case refers to a 47-y-old premenopausal woman with a history of subtotal hysterectomy for a uterine leiomyoma presenting with bilateral cavitating pulmonary nodules. A number of nodules were resected by video-assisted thoracoscopic surgery. The histological findings in correlation with the immunohistochemical results were consistent with the diagnosis of BML. A bilateral salpingo-oophorectomy was performed, combined with complete removal of the remaining cervix. One year later, the subject remains asymptomatic, and the pulmonary nodules are stable with regard to number, size, location, and morphology.

  4. Synthesis of catechol estrogens by human uterus and leiomyoma

    SciTech Connect

    Reddy, V.V.; Hanjani, P.; Rajan, R.

    1981-02-01

    Homogenates of human endometrial, myometrial and leiomyoma tissues were incubated with (2,4,6,7-/sub 3/H)-estradiol and tritiated catechol estrogens were isolated and identified. Though 2- and 4-hydroxylations were about the same in endometrium, 4-hydroxylation was two to four fold higher than 2-hydroxylation in myometrium and leiomyoma. However, endometrium showed greater capacity to form both 2- and 4-hydroxyestrogens than the other two tissues. Both 2- and 4-hydroxylations were significantly less than in myometrium. In view of the reports indicating that inhibitors of catechol 0-methyl transferase (COMT) might act as antineoplastic agents due to their interference with t-RNA methylases and since catechol estrogens inhibit COMT, the present results suggest that endogenous synthesis of catechol estrogens may play an important role in the pathophysiology of uterine leiomyoma.

  5. Determination of the pheromone-producing region that has epoxidation activity in the abdominal tip of the Japanese giant looper, Ascotis selenaria cretacea (Lepidoptera: Geometridae).

    PubMed

    Fujii, Takeshi; Suzuki, Masataka G; Kawai, Takeshi; Tsuneizumi, Kazuhide; Ohnishi, Atsushi; Kurihara, Masaaki; Matsumoto, Shogo; Ando, Tetsu

    2007-04-01

    The epoxydienyl sex pheromone of Ascotis selenaria cretacea can be detected only within a rod-like abdominal tip (RAT) of the female. To clarify which part of the RAT is the sex pheromone-producing region, the RAT was morphologically divided into three sections, defined positionally from the abdomen as sections A, B, and C. GC-MS measurements clearly showed that the sex pheromone compound levels in section B were four times greater than those of the other sections. Microscopic dissection analysis revealed that section B consists of four tissues: rectum, oviduct, musculature, and intersegmental membrane. GC-MS analysis of the individual tissues revealed that approximately 90% of the sex pheromone in section B is localized in the intersegmental membrane. A cell layer was found in the intersegmental membrane after staining with propidium iodide. Furthermore, incubation of tissues dissected from section B with a deuterated trienyl pheromone precursor revealed that the labeled epoxy pheromonal component was detected exclusively in the intersegmental membrane. We have determined that the sex pheromone-producing region of A. s. cretacea is on the terminal side of the intersegmental membrane located between the 8th and 9th abdominal segments.

  6. Abdominal ultrasound

    MedlinePlus

    ... Kidney - blood and urine flow Abdominal ultrasound References Chen L. Abdominal ultrasound imaging. In: Sahani DV, Samir ... the Health on the Net Foundation (www.hon.ch). The information provided herein should not be used ...

  7. Abdominal tap

    MedlinePlus

    ... tap; Cirrhosis - abdominal tap; Malignant ascites - abdominal tap Images Digestive system Peritoneal sample References Garcia-Tiso G. ... urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows ...

  8. Abdominal Pain

    MedlinePlus

    ... call your doctor. In Spanish— Dolor abdominal en niños menores de 12 años What is recurrent abdominal ... Functional abdominal pain (FAP) typically affects kids ages 4-12, and is quite common, affecting up to ...

  9. The OPPIuM technique: office hysteroscopic technique for the preparation of partially intramural leiomyomas.

    PubMed

    Cicinelli, Ettore; Mitsopoulos, Vasileios; Fascilla, Fabiana D; Sioutis, Dimos; Bettocchi, Stefano

    2016-06-01

    Uterine fibroids, also known as leiomyomas, represent the most common benign tumors of the female genital tract. Submucosal leiomyomas are classified into three grades: G0, GI, GII according to the degree of their intramural proportion. A recently developed technique enables the preparation of G1 and G2 leiomyomas for their subsequent successful resection in a second step. The OPPIuM (office preparation of partially intramural leiomyomas) technique aims to downgrade type I and II leiomyomas, in order to facilitate a subsequent easier and safer resectoscopy. Hysteroscopic resection of large GI or GII submucosal fibroids is a complex procedure. OPPIuM technique has been invented and seems to achieve the downgrading of these types of leiomyomas in approximately 93% of cases, without any significant surgical complications or the need of hormonal agents' administration. In this way, the safer and quicker subsequent complete myomectomy is facilitated.

  10. Round Ligament Leiomyoma Presenting as an Incarcerated Inguinal Hernia: Case Report and Review of the Literature

    PubMed Central

    Mandel, Marc

    2016-01-01

    Leiomyomas are common benign gynecologic tumors occurring in up to 30% of women. Round ligament leiomyomas however are very rare and, if symptomatic, can present as an inguinal hernia. We report the case of a 47-year-old woman who presented with an irreducible inguinal mass consistent with an incarcerated hernia. Intraoperatively, the mass was found to be a round ligament leiomyoma, a diagnosis that was confirmed by histopathology following excision of the mass. Although rare, round ligament leiomyomas should be part of the differential diagnosis of an inguinal hernia in females. PMID:27144048

  11. Uterine leiomyomas: effects on architectural, cellular, and molecular determinants of endometrial receptivity.

    PubMed

    Makker, Annu; Goel, Madhu Mati

    2013-06-01

    Impaired endometrial receptivity is an important contributing factor to implantation failure. Uterine leiomyomas are widely prevalent steroid hormone-dependent benign tumors that act as a restraint to conception and successful outcome of pregnancies. Reports are available, which suggest that leiomyomas have negative influence on endometrial receptivity to blastocyst implantation. The aim of the present review is to provide a comprehensive picture of the current knowledge of the effect of uterine leiomyomas on the architectural, cellular, and molecular determinants of endometrial receptivity. Understanding the potential role of these factors will provide insight into the underlying mechanisms of leiomyoma-associated infertility and provide new areas for basic and translational research.

  12. Molecular and cytogenetic analysis of chromosome 7 in uterine leiomyoma

    SciTech Connect

    Ishwad, C.; Ferrell, R.E.; Davare, J.

    1994-09-01

    Uterine leiomyomas are benign tumors which arise clonally from smooth muscle cells of the myometrium. Cytogenetic studies of uterine leiomyomas revealed that about 50% have chromosome abnormalities and that deletion 7q is a common finding. This observation suggest the possible location of a growth suppressor gene within the 7q21-q22 region. Molecular genetic analysis of cytogenetically normal tumors has frequently revealed somatic loss of specific tumor suppressor genes detected by loss of heterozygosity in the critical region (RB1 in retinoblastoma and WT1 in Wilms tumor). To test the hypothesis that chromosome region 7q21-q22 contains a growth suppressor gene involved in the development of leiomyomas, we tested 67 leiomyomas for allelic loss of 7q markers spanning the cytogenetically defined critical region. Nineteen tumors with cytogenetically defined 7q deletion and 48 tumors without cytogenetically visible 7q deletion were examined for allelic loss of loci D7S487, D7S440, D7S492, D7S518, D7S471, D7S466 and D7S530. Loss of heterozygosity for one or more of these loci was observed in 14/19 (73.7%) of tumors with deletion 7q and no evidence of allelic loss was observed in tumors without cytogenetic deletion. The tumors with deletion 7q but no loss of 7q21-q22 markers were tumors which were mosaics with only a minority of cells showing chromosome 7q deletion. The critical region of loss is defined by markers D7S518 and D7S471, each showing loss in 56% of informative cases. These markers define a 10cM region of 7q21.2-q22 consistent with the cytogenetically defined smallest region of overlap. These markers exclude loss of the MET oncogene locus and WNT1, the murine mammary tumor virus integration site, from the critical region. These results define a region that is consistently lost in leiomyomas with abnormalities in chromosome 7q and may define the location of a gene involved in the development of a subset of leiomyomas.

  13. Recovery after abdominal wall reconstruction.

    PubMed

    Jensen, Kristian Kiim

    2017-03-01

    Incisional hernia is a common long-term complication to abdominal surgery, occurring in more than 20% of all patients. Some of these hernias become giant and affect patients in several ways. This patient group often experiences pain, decreased perceived body image, and loss of physical function, which results in a need for surgical repair of the giant hernia, known as abdominal wall reconstruction. In the current thesis, patients with a giant hernia were examined to achieve a better understanding of their physical and psychological function before and after abdominal wall reconstruction. Study I was a systematic review of the existing standardized methods for assessing quality of life after incisional hernia repair. After a systematic search in the electronic databases Embase and PubMed, a total of 26 studies using standardized measures for assessment of quality of life after incisional hernia repair were found. The most commonly used questionnaire was the generic Short-Form 36, which assesses overall health-related quality of life, addressing both physical and mental health. The second-most common questionnaire was the Carolinas Comfort Scale, which is a disease specific questionnaire addressing pain, movement limitation and mesh sensation in relation to a current or previous hernia. In total, eight different questionnaires were used at varying time points in the 26 studies. In conclusion, standardization of timing and method of quality of life assessment after incisional hernia repair was lacking. Study II was a case-control study of the effects of an enhanced recovery after surgery pathway for patients undergoing abdominal wall reconstruction for a giant hernia. Sixteen consecutive patients were included prospectively after the implementation of a new enhanced recovery after surgery pathway at the Digestive Disease Center, Bispebjerg Hospital, and compared to a control group of 16 patients included retrospectively in the period immediately prior to the

  14. [Abdominal paracentesis].

    PubMed

    Glauser, Frédéric; Barras, Anne-Catherine; Pache, Isabelle; Monti, Matteo

    2008-10-29

    Abdominal paracentesis is frequently performed in the clinical setting. Every newly developed ascites need to be investigated by abdominal paracentesis. Any clinical or biological deterioration in patients with chronic ascites also requires a new paracentesis. Therapeutically abdominal paracentesis is performed for refractory or symptomatic ascites. As other invasive procedures, it is critical to master its indications, contra-indications and complications. The aim of this article is to review the basics of abdominal paracentesis in order to help physicians to carry out this technical skill.

  15. Benign metastasizing leiomyomas in the lungs: a case study

    PubMed Central

    Bruliński, Krzysztof

    2016-01-01

    Benign metastasizing leiomyoma (BML) is a rare disease that occurs in middle-aged women with a history of uterine myomas. The most common location of BML is the lungs. We report the case of a 44-year-old obese woman (BMI 45.5) who underwent surgery to remove uterine leiomyomata and then continued to take a drug containing the hormone estradiol for a period of 15 years. Computed tomography chest examinations revealed multiple size nodules of varying size in both lungs. Videothoracoscopy and right thoracotomy was performed, and a few nodules were enucleated from each lobe of the right lung. Postoperative histopathological examination revealed benign metastasizing leiomyoma staining positive for estrogen and progesterone receptors (ER+, PR+). Because of the hormonally dependent cell proliferation, the previously used hormonal drug was discontinued. Treatment with a gonadotropin-releasing hormone analog was included, yielding radiological stabilization of the lung lesions. PMID:27212984

  16. Posterior Wall Gastric Leiomyoma: Endoscopic Tattooing Facilitates Laparoscopic Resection

    PubMed Central

    Mehta, Dhiren; Zelen, Johnathan; Fogler, Richard

    1998-01-01

    Objective: To demonstrate the application of tattooing for the intraoperative localization of posterior wall gastric leiomyoma during laparoscopic resection. The preoperative injection of Indian ink in the tumor-bearing area of the posterior gastric wall eliminates the need to perform anterior wall gastrostomy or intraoperative upper endoscopic tumor localization. Methods: A patient with posterior wall gastric leiomyoma was marked with Indian ink during preoperative upper endoscopy. The dye was visualized intraoperatively facilitating wedge resection of the tumor-bearing area with the Endo GIA. Results: The patient had an uneventful surgery and recovery. Complete excision of the tumor was accomplished. Conclusion: The preoperative endoscopic marking of gastric lesions, facilitates the intraoperative localization and resection of these lesions. PMID:9876718

  17. [Orbital leiomyoma. Case report and review of the literature].

    PubMed

    González-Martínez, Emilio; Robla Costales, Javier; Fernández Fernández, Javier; Viñuela Lobo, Jesús; Santamarta, David; Lomas García, Jesús; Iglesias, Elena; Ribas Ariño, Teresa; García-Cosamalón, José

    2014-01-01

    Leiomyoma are slowly growing lesions arising from smooth muscle. Orbital location has been reported in 25 cases. Histological findings and no recurrence after total resection support their benign behaviour. We report an intraconal orbital haemangioleiomyoma in a 55-year-old female treated by total resection through fronto-orbital craniotomy, with no recurrence after 15 months of follow-up. Radiological and pathological features are discussed, emphasising the prognostic role of the surgery.

  18. Intraosseous Leiomyoma of the Tibia. A Case Report

    PubMed Central

    Abdelaal, Ahmed Hamed Kassem; Yamamoto, Norio; Hayashi, Katsuhiro; Takeuchii, Akihiko; Tsuchiyai, Hiroyuki

    2016-01-01

    Introduction: Leiomyoma is benign smooth-muscle tumor most commonly arising in the uterus, the gastrointestinal tract, and the skin. Leiomyomata are infrequently seen in the extremities and rarely seen in the bone. It is usually presented by a gradually increasing pain with nonspecific radiological findings, and could be a differential diagnosis for wide range of bone tumors. Case presentation: We report a case of a 73-year-old Japanese female patient with a painful intraosseous leiomyoma involving the proximal tibia. The patient had undergone tumor excision with wide margin, immediate weight bearing was allowed, pain had been relieved and the patient was satisfied with no recurrence, malignant change, distant metastases or functional impairment. We reviewed all published cases of intraosseous leiomyomata in English literature. Conclusion: Diagnosis of Intraosseous leiomyoma of the extremities is difficult due to extreme rarity of the tumor and absence of pathognomonic radiological sign in X-ray, CAT, or even MRI. While the exact diagnosis is only achieved by histopathological examination and with immunohistochemistry stains, which can differentiate it from malignancy, especially from the much less rare leiomyosarcoma. Orthopedic oncologists have to include this rare benign tumor in the differential diagnosis of any intraosseous lesion with gradually worsening and long-standing pain, despite of benign imaging characters. Different histological patterns of leiomyoma do exist, however there is no difference in prognosis or treatment options. Treatment standard includes wide excision with autologous bone graft whenever possible. Internal fixation may be necessary if the bone defect is large or there is thinning out of the cortex that may lead to pathological fracture. PMID:27703944

  19. Conjunctival Leiomyoma; a Rare Tumor of the Ocular Surface

    PubMed Central

    Afghani, Tayyab; Khan, Furqan Ahmed; Mansoor, Hassan

    2016-01-01

    Purpose: To report a case of conjuctival leiomyoma. Case Report: An 18-year-old female patient presented with a conjunctival growth in the left eye for a 2-year-period with no change in size. She merely presented for cosmetic reasons. Visual acuity was 20/20 in each eye. The lesion had prominent vessels and was not adherent to the sclera. The growth resembled a benign lesion of the conjunctiva. The tough and vascular tissue was excised and sent for histopathology. The defect was covered by an end to end conjunctival suturing. Histopathology showed the lesion to be conjunctival leiomyoma. Trichome was used to highlight the spindle shaped cells and immuno-histochemistry using anti-smooth muscle actin antibody and Vimentin was applied to confirm the diagnosis. Conclusion: This case adds to the total number of cases of conjuctival leiomyoma reported in the literature to date. An ophthalmologist needs to think beyond a common mass when encountering a conjunctival growth extending onto the cornea. PMID:27994813

  20. Leiomyosarcoma: a rare malignant transformation of a uterine leiomyoma.

    PubMed

    Di Luigi, G; D'Alfonso, A; Patacchiola, F; Di Stefano, L; Palermo, P; Carta, G

    2015-01-01

    The malignant transformation of a uterine leiomyoma is still debated and, if it occurs, it is very rare. The case of a patient affected by one small leiomyoma is described. Diagnosis was made postoperatively on histopathological examination. The case reported here is meant to underline the need to keep all uterine myomas in check since the transition into leiomyosarcomas (LMSs) may occur with an evolution over a time period which has not been established so far. Specific receptors for luteinizing hormone/human chorionic gonadotropin (LH/hCG) have also been identified in the myometrium of several animal species, including humans. Conventional LMSs express estrogen receptors (ER), progesterone receptors (PR), and androgen receptors (AR) in 30-40% of cases. In comparison with other more common uterine malignancies, uterine LMSs bear some resemblance to type 2 endometrial carcinomas and high-grade serous carcinomas of ovary/fallopian tube origin, based on their genetic instability, frequent p53 abnormalities, aggressive behavior, and resistance to chemotherapy. It could be useful to understand with further researches if hormonal stimulation could be a contributing factor of uterine leiomyoma transformation into LMS. Until today the oncogenic mechanisms underlying the development of uterine LMSs remain elusive.

  1. Multiple cavitating pulmonary nodules: rare manifestation of benign metastatic leiomyoma

    PubMed Central

    Choi, Youn-I; Lee, Seok Jeong; Shim, Sung Shine; Lee, Jin Hwa; Kim, Yoo Kyung; Sung, Soon Hee

    2017-01-01

    Benign metastasizing leiomyoma (BML) is a rare disease of pathologically benign, but the tumor metastasizes to other organs. The most common organ involved in BML is lung. Pulmonary involvement usually manifested as multiple nodules on chest X-ray, however we experienced an interesting case of a 52-year-old premenopausal woman who presented with multiple bilateral lung cavitations and nodules on a chest X-ray without any respiratory symptoms. Chest computed-tomography identified multiple cavitary lesions of 5–12 mm in diameter and well-defined nodules of 5–10 mm in diameter in both lung fields. Transthoracic needle biopsy was performed and the resected lesion consisted of benign spindle cells was positive for estrogen receptor (ER) and progesterone receptor (PR) and was diffuse positive for actin and desmin by immunohistochemical (IHC) staining, suggesting leiomyoma. The final diagnosis was benign pulmonary metastasizing leiomyoma (BPML) and the patient underwent subcutaneous injection of a gonadotrophin releasing hormone (GnRH) agonist for 12 months, follow-up low-dose chest computed tomography (CT) scan at 15 months revealed decreased cavitations and nodular lesions. We should take into consideration the possibility of BPML when we encounter multiple cystic or cavitary lesions on chest X-ray, although the common form of BPML is nodulary lesions on imaging studies. PMID:28203428

  2. Pulmonary benign metastasizing leiomyoma: a case report and literature review

    PubMed Central

    Chen, Shi; Liu, Rui-Ming

    2014-01-01

    Benign metastasizing leiomyoma (BML) is a rare condition that occurs in all age groups and that is particularly prevalent among women of late childbearing age. All patients have a history of uterine leiomyoma and/or myomectomy, often associated with distant metastases from the uterus, which commonly occurs in the lung. We report the case of a 32-year-old young woman suffering from chest stuffiness, labored respiration and weakness after a myomectomy performed one month earlier. The chest CT showed a diffuse miliary shadow in both sides of her lungs, but serum tumor markers such as CA125, CA199, carcinoembryonic antigen (CEA), neuron specific enolase (NSE), and CYFRA21-1 were normal. The patient underwent a lung biopsy by thoracoscopic surgery after four weeks of anti-TB treatment; there were no significant changes in the chest CT. H&E staining showed that the tumor cells had characteristics of smooth muscle cell differentiation. Immunohistochemical staining showed a low tumor cell proliferation index, which indicated that the likelihood of a malignancy was not high. There was no expression of CD10, indicating a diagnosis of pulmonary benign metastasizing leiomyoma (PBML). Smooth muscle actin (SMA) and desmin as specific markers of smooth muscle and the estrogen receptor (ER) and progesterone receptor (PR) were all strongly positive, which is characteristic of PBML. The patient was given the anti-estrogen tamoxifen for 3 months. With no radiological evidence of disease development and further distant metastasis, the patient will continue to be followed. PMID:24977035

  3. Giant cell arteritis

    PubMed Central

    Calvo-Romero, J

    2003-01-01

    Giant cell arteritis (GCA), temporal arteritis or Horton's arteritis, is a systemic vasculitis which involves large and medium sized vessels, especially the extracranial branches of the carotid arteries, in persons usually older than 50 years. Permanent visual loss, ischaemic strokes, and thoracic and abdominal aortic aneurysms are feared complications of GCA. The treatment consists of high dose steroids. Mortality, with a correct treatment, in patients with GCA seems to be similar that of controls. PMID:13679546

  4. Familial massive leiomyoma with esophageal leiomyomatosis: an unusual presentation in a father and his 2 daughters.

    PubMed

    Lee, Lawrence S; Nance, Michael; Kaiser, Larry R; Kucharczuk, John C

    2005-05-01

    Esophageal leiomyomatosis and leiomyoma are benign neoplastic lesions composed of proliferating smooth muscle cells. Although rare, these 2 conditions may occur simultaneously in an individual patient. Symptomatic patients often require surgical management. We describe the first reported cases of family members presenting with esophageal leiomyomatosis and concomitant massive esophageal leiomyoma.

  5. A large uterine leiomyoma leading to non-puerperal uterine inversion: A case report

    PubMed Central

    Teimoori, Batool; Esmailzadeh, Arezoo

    2017-01-01

    Background: Although leiomyomas are the most common gynecologic disorders, non-puerperal uterine inversion due to leiomyoma is considered as a rare clinical problem. This condition can occur as a complication of a large sub-mucous leiomyoma that leads to dilate cervix and protrude into vagina. The patient may have several symptoms such as heavy vaginal bleeding, pelvic pain and intermittent acute urinary retention. Case: We presented a 32-year-old nulliparous woman with 17 years of unexplained infertility and diagnosis of a large vaginal prolapsed non-pedunculated leiomyoma. Conclusion: Haultain’s procedure was used to reposition uterine inversion and remove leiomyoma through a posterior incision, using laparotomy. PMID:28280801

  6. Association between Oesophageal Diverticula and Leiomyomas: A Report of Two Cases

    PubMed Central

    Chowdhry, Muhammad; Lorenzi, Bruno; Kadirkamanathan, Sritharan; Charalabopoulos, Alexandros

    2016-01-01

    We report two rare cases of female patients presenting with oesophageal leiomyoma associated with oesophageal diverticulum, both of whom were surgically managed. Oesophageal leiomyoma and oesophageal diverticulum are uncommon as separate entities and rare as combined disease presentation. Clinicians need to be aware of the rare combination of the two entities and need to be able to exclude the presence of a tumour (benign or malignant) within a diverticulum and so plan the optimum treatment. Herein, we present two cases of oesophageal leiomyoma within oesophageal diverticulum and we try to elucidate the association between the two. To date, there is no consensus whether a diverticulum is secondary to a leiomyoma or, on the contrary, a leiomyoma arises within a diverticulum. PMID:27885346

  7. [Benign Metastasizing Leiomyoma of the Lung;Report of a Case].

    PubMed

    Sawada, Takahiro; Yamamoto, Satoshi; Sugihara, Hajime; Iwasaki, Akinori

    2017-02-01

    A 71-year-old woman, in whom computed tomography revealed a solitary mass shadow at the base of the left lung, underwent resection of the mass. Histopathological examination showed estrogen receptor-positive leiomyoma cells growing in cords and mixed with glandular structures composed of alveolar cells. These findings led to a diagnosis of benign metastatic leiomyoma. Benign metastatic leiomyoma is a rare disease in which histologically benign uterine leiomyoma cells metastasize to different sites of the body. However, in this patient, the presence of uterine myoma was not confirmed in the past or at present. She had a history of cervical conization, which suggests that a small amount of the leiomyoma component contained in cervical tissue may have been forced into blood vessels during surgical manipulation, causing lung metastasis.

  8. The Effects of Guizhi Fuling Capsule Drug Serum on Uterine Leiomyoma Cells and Its Mechanism

    PubMed Central

    Shen, Qi; Ye, Weijing; Hu, Xiaoli; Zhao, Chuchu; Zhou, Lulu

    2016-01-01

    Aims. To observe the effects of Guizhi Fuling Capsule (GZFLC) drug serum on uterine leiomyoma cells and explore its mechanism. Main Methods. Sixty Sprague Dawley rats were randomly divided into two groups (normal saline lavage group and GZFLC lavage group), then, respectively, blank serum and GZFLC drug serum were collected, and finally human uterine leiomyoma cells were treated. Human leiomyoma tissues were collected from 20 patients who underwent uterine leiomyomas operations, and leiomyoma cells were primary cultured. The leiomyoma cells were treated by GZFLC drug serum in different concentrations (10%, 20%, and 30%) and variable treatment time (12 h, 24 h, 36 h, 48 h, and 72 h). Cell proliferation was observed using CCK8 assay. Flow cytometry and Annexin V/PI were used to assay the effects of GZFLC drug serum on cell apoptosis. Western blot analysis was used to assay the effects of GZFLC drug serum on TSC2, FOXO, and 14-3-3γ expression in uterine leiomyoma cells. Key Findings. In the concentrations of 10%~30%, GZFLC drug serum could inhibit proliferation of leiomyoma cells in dose-dependent manner; at the time of 36 h, cell inhibition rate was at the peak; GZFLC drug serum could induce apoptosis of leiomyoma also in a dose-dependent manner, and apoptosis rate quickly achieved maximum at 12 h time points, and then second apoptosis peak appeared at 36 h. Compared to nontreatment group, TSC2, FOXO, and 14-3-3γ expressions in drug serum group were significantly changed after 12 h treatment. Significance. GZFLC drug serum can efficiently inhibit the proliferation and induce apoptosis of leiomyoma cells, which is related to the 14-3-3γ pathway. PMID:27895695

  9. G-protein-coupled estrogen receptor-30 gene polymorphisms are associated with uterine leiomyoma risk

    PubMed Central

    Kasap, Burcu; Turhan, Nilgün Öztürk; Edgünlü, Tuba; Duran, Müzeyyen; Akbaba, Eren; Öner, Gökalp

    2016-01-01

    The G-protein-coupled estrogen receptor, GPER-1) is a member of the G-protein-coupled receptor 1 family and is expressed significantly in uterine leiomyomas. To understand the relationship between GPR30 single nucleotide polymorphisms and the risk of leiomyoma, we measured the follicle-stimulating hormone (FSH) and estradiol (E2) levels of 78 perimenopausal healthy women and 111 perimenopausal women with leiomyomas. The participants’ leiomyoma number and volume were recorded. DNA was extracted from whole blood with a GeneJET Genomic DNA Purification Kit. An amplification-refractory mutation system polymerase chain reaction approach was used for genotyping of the GPR30 gene (rs3808350, rs3808351, and rs11544331). The differences in genotype and allele frequencies between the leiomyoma and control groups were calculated using the chi-square (χ2) and Fischer’s exact test. The median FSH level was higher in controls (63 vs. 10 IU/L, p=0.000), whereas the median E2 level was higher in the leiomyoma group (84 vs. 9.1 pg/mL, p=0.000). The G allele of rs3808351 and the GG genotype of both the rs3808350 and rs3808351 polymorphisms and the GGC haplotype increased the risk of developing leiomyoma. There was no significant difference in genotype frequencies or leiomyoma volume. However, the GG genotype of the GPR30 rs3808351 polymorphism and G allele of the GPR30 rs3808351 polymorphism were associated with the risk of having a single leiomyoma. Our results suggest that the presence of the GG genotype of the GPR30 rs3808351 polymorphism and the G allele of the GPR30 rs3808351 polymorphism affect the characteristics and development of leiomyomas in the Turkish population. PMID:26773178

  10. A giant pancreatic pseudocyst treated by cystogastrostomy

    PubMed Central

    Wang, Grace C; Misra, Subhasis

    2015-01-01

    We report a case of a giant pancreatic pseudocyst in a 65-year-old man presenting with abdominal pain, loss of appetite and abdominal distension. CT scans demonstrated a giant pancreatic pseudocyst measuring 25.7 cm×15.3 cm×10.9 cm anteroposteriorly, with significant compression of surrounding organs. An open cystogastrostomy was performed through a midline incision, and 3 L of fluid was drained from the giant pseudocyst. Recovery has been uneventful. PMID:25804943

  11. Abdominal pain

    MedlinePlus

    Stomach pain; Pain - abdomen; Belly ache; Abdominal cramps; Bellyache; Stomachache ... Almost everyone has pain in the abdomen at some point. Most of the time, it is not serious. How bad your pain is ...

  12. [Abdominal pain].

    PubMed

    Gschossmann, J M; Holtmann, G; Netzer, P; Essig, M; Balsiger, B M; Scheurer, U

    2005-10-01

    Abdominal pain can result from a variety of different intra- and extra-abdominal disorders. Given the wide variety of etiological triggers for this pain, the primary task during the first stage of the diagnostic work-up is to determine as soon as possible the underlying cause and the degree of emergency. The aim of this evaluation is to adapt the therapeutic measures which are necessary for a causal treatment to the individual situation. Contrary to somatic causes of abdominal pain, the availability of such a causal therapy for functional bowel disorders is still very limited. Given this dilemma, the therapeutic focus of abdominal pain associated with these functional syndromes has to be placed on symptom-oriented treatment.

  13. A comparison of abdominal and vaginal hysterectomies in Benghazi, Libya.

    PubMed

    Agnaeber, K; Bodalal, Z

    2013-08-01

    We performed a comparative study between abdominal and vaginal hysterectomies using clinical data from Al-Jamhouria hospital (one of the largest maternity hospitals in Eastern Libya). Various parameters were taken into consideration: the rates of each type (and their subtypes); average age of patients; indications; causes; postoperative complications; and duration of stay in the hospital afterwards. Conclusions and recommendations were drawn from the results of this study. In light of the aforementioned parameters, it was found that: (1) abdominal hysterectomies were more common than vaginal hysterectomies (p < 0.001); (2) patients admitted for abdominal hysterectomies are younger than those admitted for vaginal hysterectomies (p < 0.001); (3) the most common indication for an abdominal hysterectomy was menstrual disturbances, while for vaginal hysterectomies it was vaginal prolapse; (4) the histopathological cause for abdominal and vaginal hysterectomies were observed and the most common were found to be leiomyomas and atrophic endometrium; (5) there was no significant difference between the two routes in terms of postoperative complications; (6) patients who were admitted for abdominal hysterectomies spent a longer amount of time in the hospital (p < 0.01). It was concluded that efforts should be made to further pursue vaginal and laparoscopic hysterectomies as a viable option to the more conventional abdominal route.

  14. Superficial leiomyomas of the gastrointestinal tract with interstitial cells of Cajal

    PubMed Central

    Janevska, Vesna; Qerimi, Adelina; Basheska, Neli; Stojkova, Elena; Janevski, Vlado; Jovanovic, Rubens; Zhivadinovik, Julija; Spasevska, Liljana

    2015-01-01

    Objective: Some authors suggest common origin of gastrointestinal stromal tumors from stem cells, which may show diverse differentiation. There are reports in which cells morphologically identical to the interstitial cells of Cajal are found in deep leiomyomas. The aim of this study was to demonstrate CD117 positive cells in superficial gastrointestinal (GI) leiomyomas and to find other cells that would suggest diverse differentiation in histologically typical leiomyoma. Materials and methods: We analyzed 8 cases of superficial leiomyomas and one deep leiomyoma, received in our institutions as endoscopically or surgically obtained material. The tumor sections were immunohistochemicaly stained with CD117, CD34, NF, S100, αSMA, desmin, caldesmon and mast cell antigen. Results: All leiomyomas showed diffuse positivity for αSMA, caldesmon and desmin. All of them had CD117 and CD34 positive cells morphologically identical to the interstitial cells of Cajal between smooth muscle fibers, 5 had S-100 and NF positive cells and 2 showed positivity for GFAP. The cells were found in different quantity; they were usually diffusely scattered through the tumors without predilection site, forming small groups in some areas. Conclusion: CD177, CD34, S-100 and NF positive cells are present in superficial leiomyomas and they may suggest common origin of GI stromal tumors. PMID:26884872

  15. Intraosseous leiomyoma of the calcaneum: An unusual bone tumor of foot and review of literature.

    PubMed

    Salunke, Abhijeet Ashok; Vala, Pathik Chandrakant; Singh, Harpreet; Parwani, Rohan; Gandhi, Sanjay; Shah, Diva

    2016-01-01

    Leiomyoma is a benign tumor of smooth muscle origin and commonly diagnosed in the uterus, gastrointestinal tract, skin, and mucous membranes. To the best of our knowledge, the only reported intraosseous leiomyomas in extremities occurred in the proximal aspect and distal aspect of the femur, in the tibia, and in the ulna. We are not aware of any previous reports of intraosseous leiomyomas in the foot. The radiograph of the intraosseous leiomyoma shows unilocular or multilocular lytic lesion with sclerotic rim. Due to lack of definitive radiological features on magnetic resonance imaging and computed tomography diagnosis of this rare tumor is established with histopathological study and immuno-histochemistry markers. Smooth muscle spindle cells and positive immunohistochemistry markers for muscle cells is hall mark for the diagnosis. The treatment of intraosseous leiomyoma is surgical intervention by excision with wide margin and curettage followed by filling the cavity. The diagnosis of this tumor is challenging due to its extraordinarily rare incidence. Intraosseous leiomyoma should be included in the differential diagnosis of intraosseous lesion with benign radiographic feature. We report of the first published case of primary intraosseous leiomyoma of calcaneum in a 22-year-old male patient.

  16. Abdominal Sepsis.

    PubMed

    De Waele, Jan J

    2016-08-01

    Abdominal infections are an important challenge for the intensive care physician. In an era of increasing antimicrobial resistance, selecting the appropriate regimen is important and, with new drugs coming to the market, correct use is important more than ever before and abdominal infections are an excellent target for antimicrobial stewardship programs. Biomarkers may be helpful, but their exact role in managing abdominal infections remains incompletely understood. Source control also remains an ongoing conundrum, and evidence is increasing that its importance supersedes the impact of antibiotic therapy. New strategies such as open abdomen management may offer added benefit in severely ill patients, but more data are needed to identify its exact role. The role of fungi and the need for antifungal coverage, on the other hand, have been investigated extensively in recent years, but at this point, it remains unclear who requires empirical as well as directed therapy.

  17. Signaling Pathways in Leiomyoma: Understanding Pathobiology and Implications for Therapy

    PubMed Central

    Borahay, Mostafa A; Al-Hendy, Ayman; Kilic, Gokhan S; Boehning, Darren

    2015-01-01

    Uterine leiomyomas are the most common tumors of the female genital tract, affecting 50% to 70% of females by the age of 50. Despite their prevalence and enormous medical and economic impact, no effective medical treatment is currently available. This is, in part, due to the poor understanding of their underlying pathobiology. Although they are thought to start as a clonal proliferation of a single myometrial smooth muscle cell, these early cytogenetic alterations are considered insufficient for tumor development and additional complex signaling pathway alterations are crucial. These include steroids, growth factors, transforming growth factor-beta (TGF-β)/Smad; wingless-type (Wnt)/β-catenin, retinoic acid, vitamin D, and peroxisome proliferator-activated receptor γ (PPARγ). An important finding is that several of these pathways converge in a summative way. For example, mitogen-activated protein kinase (MAPK) and Akt pathways seem to act as signal integrators, incorporating input from several signaling pathways, including growth factors, estrogen and vitamin D. This underlines the multifactorial origin and complex nature of these tumors. In this review, we aim to dissect these pathways and discuss their interconnections, aberrations and role in leiomyoma pathobiology. We also aim to identify potential targets for development of novel therapeutics. PMID:25879625

  18. Abdominal Adhesions

    MedlinePlus

    ... Adhesions 1 Ward BC, Panitch A. Abdominal adhesions: current and novel therapies. Journal of Surgical Research. 2011;165(1):91–111. Seek Help for ... and how to participate, visit the NIH Clinical Research Trials and You website ... Foundation for Functional Gastrointestinal Disorders 700 West Virginia ...

  19. [Atypical leiomyoma in a patient with cutaneous leiomyomatosis and mutation of the enzyme fumarate hydratase].

    PubMed

    Calderón-Komáromy, Angélica; Arias-Palomo, Dolores; Tardío, Juan C; Freites-Martínez, Azael; Borbujo, Jesús

    2016-03-01

    We report the case of a 56 year-old male with an atypical leiomyoma in the context of a cutaneous leiomyomatosis and a family history of uterine leiomyomatosis. The genetic study revealed a mutation in the gene for the enzyme fumarate hydratase, but he has not had any renal malignancy so far. Atypical leiomyoma is a rare tumor that usually presents as a single lesion and is exceptional in patients with cutaneous leiomyomatosis. The relation between fumarate hydratase enzyme mutations with multiple leiomyomas, uterine leiomyomatosis and an increased risk of developing kidney cancer is widely known. However, the role of these mutations in the development of atypical leiomyomas is still impossible to clarify given the few cases reported in the literature.

  20. Incidental benign metastasizing leiomyoma in a patient with bone sarcoma: a case report.

    PubMed

    Del Real-Romo, Zanndor Jacob; Montero-Cantú, Carlos; Villegas-Cabello, Oscar; Díaz-Elizondo, José Antonio; Reyes-Salas, Danae; Palomo-Hoil, Rene; Peralta-Castillo, Guillermo; Martínez-Sánchez, David; Flores-Villalba, Eduardo

    2014-01-01

    Background. The benign metastasizing leiomyoma is an exceptionally rare entity; it presents with ectopic leiomyoma nodules with a benign pattern. Symptoms vary according to the anatomic location. The diagnosis is histopathological, usually in patients with history of hysterectomy. Case Presentation. A 36-year-old female with 2-month history of left knee pain was diagnosed with bone fibrosarcoma. A CT scan showed pulmonary nodules. The patient started neoadjuvant chemotherapy. Conservative surgery of pelvic limb was achieved. A new CT scan reported pulmonary nodules that remained in relation to the previous CT. A nodule resection by thoracotomy and TOB (transoperative biopsy) was performed. The final pathology report described benign proliferative lesions consistent with benign metastatic leiomyoma. Conclusions. Benign metastatic leiomyoma is a rare condition presenting with uterine and extrauterine nodules most commonly in the lung. The diagnosis is histopathological. The surgical procedure must be reserved for selected patients.

  1. [Leiomyoma of the urethra - cause of an obstruction misdiagnosed as hereditary urethral stricture in a young man].

    PubMed

    Seseke, S; Schweyer, S; Reissig, K; Seseke, F

    2008-03-01

    Leiomyomas are benign neoplasms arising from smooth muscle cells. We describe the case of a 17-year-old boy admitted with progressive severe obstructive voiding symptoms. Retrograde urethrography showed a bulbous urethral stricture which was resected with primary urethral anastomosis. Histopathological examination confirmed the very rare case of a leiomyoma of the urethra. In patients with urethral stricture, leiomyoma should be included in the diagnostic considerations.

  2. Increased Urinary Phthalate Levels in Women with Uterine Leiomyoma: A Case-Control Study

    PubMed Central

    Kim, Young Ah; Kho, Younglim; Chun, Kyoung Chul; Koh, Jae Whoan; Park, Jeong Woo; Bunderson-Schelvan, Melisa; Cho, Yoon Hee

    2016-01-01

    We assessed the urinary concentration of 16 phthalate metabolites in 57 women with and without uterine leiomyoma (n = 30 and 27; respectively) to determine the association between phthalate exposure and uterine leiomyoma. To evaluate exposure to di-(2-ethylhexyl) phthalate (DEHP); we calculated the molar sum of DEHP metabolites; ∑3-DEHP (combining mono-(2-ethylhexyl) phthalate (MEHP); mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP); and mono-(2-ethyl-5-oxohexyl) phthalate); ∑4-DEHP (∑3-DEHP plus mono-(2-ethyl-5-carboxypentyl) phthalate); and ∑5-DEHP (∑4-DEHP plus mono (2-(carboxylmethyl)hexyl) phthalate (2cx-MMHP)). The log transformed urinary levels of MEHP; MEHHP; 2cx-MMHP; ∑3-DEHP; ∑4-DEHP; and ∑5-DEHP in the leiomyoma group were significantly higher than those of controls. When we adjusted for age; waist circumference; and parity using multiple logistic regression analyses; we found log ∑3-DEHP (OR = 10.82; 95% CI = 1.25; 93.46) and ∑4-DEHP (OR = 8.78; 95% CI = 1.03; 75.29) were significantly associated with uterine leiomyoma. Our findings suggest an association between phthalate exposure and uterine leiomyoma. However; larger studies are needed to investigate potential interactions between phthalate exposure and uterine leiomyoma. PMID:27983712

  3. Feasibility study on energy prediction of microwave ablation upon uterine adenomyosis and leiomyomas by MRI

    PubMed Central

    Xia, M; Zhi-yu, H; Jian-ming, C; Hong-yu, Z; Rui-fang, X; Yu, Y; Yan-li, H; Bao-wei, D

    2014-01-01

    Objective: To evaluate the feasibility of energy prediction of percutaneous microwave ablation (PMWA) upon uterine leiomyomas and adenomyosis by MRI. Methods: 63 patients (49 patients with 49 uterine leiomyomas and 14 patients with adenomyosis) who underwent ultrasound-guided PMWA treatment were studied during the period from June 2011 to December 2012. Before PMWA, contrast-enhanced MRI (ceMRI) was performed for all of the patients. Based on the signal intensity (SI) of T2 weighted MRI, uterine leiomyomas were classified as hypointense, isointense and hyperintense. During ablation, the output energy of the microwave was set at 50 W, and T11a microwave antennas were used. ceMRI was performed within 7 days after PMWA treatment. Non-perfused volume and energy required per unit volume were analysed statistically. Results: When unit volume of lesions was ablated, uterine adenomyosis needed more energy than did uterine leiomyomas, and hyperintense uterine leiomyomas needed more energy than did hypointense pattern. Conclusions: MRI SI of uterine leiomyomas and uterine adenomyosis can be used to predict PMWA energy. Advances in knowledge: The conclusions indicate that MRI SI can be used to perform pre-treatment planning, which will make the treatment more precise. PMID:24947033

  4. Roles of microRNA-21 and PDCD-4 in the pathogenesis of human uterine leiomyomas

    PubMed Central

    Fitzgerald, J. Browning; Chennathukuzhi, Vargheese; Koohestani, Faezeh; Nowak, Romana A.; Christenson, Lane K.

    2012-01-01

    Objective To determine if programmed cell death 4 (PDCD-4) is altered in autologous leiomyoma and myometrial tissues and microRNA-21's (miR-21) role in PDCD-4 expression, apoptosis and translation. Design Laboratory research. Setting Academic medical center. Patient(s) Myometrial and leiomyoma tissues from patients with symptomatic leiomyomata. Interventions(s) Tissue analysis and miR-21 knockdown in cultured immortalized myometrial (UtM) and leiomyoma (UtLM) cells. Main Outcome Measure(s) MiR-21 and PDCD-4 mRNA and protein expression. Result(s) Leiomyoma tissues robustly expressed the full-length 51kDA isoform of PDCD-4, while normal myometrial tissue had negligible expression Consistent with autologous tissues, UtLM cells expressed elevated miR-21 and a similar pattern of PDCD-4 compared to UtM cells. Knockdown of miR-21 increased PDCD-4 levels in UtM cells and UtLM cells, indicating that it can regulate PDCD-4 expression. Loss of miR-21 also increased cleavage of caspase-3 (apoptosis marker) and increased phosphorylation of elongation factor -2 (marker of reduced translation) in both cell lines. Conclusions Elevated leiomyoma miR-21 levels are predicted to decrease PDCD-4 levels, thus leiomyomas differ from other tumors where loss of PDCD-4 is associated with tumor progression. Our studies indicate regulation of PDCD-4 expression is not a primary miR-21 function in leiomyomas, but instead miR-21 is able to impact cellular apoptosis and translation, through unknown targets, in a manner consistent with its involvement in the pathophysiology of uterine fibroids. PMID:22728051

  5. Progestins Activate the AKT Pathway in Leiomyoma Cells and Promote Survival

    PubMed Central

    Hoekstra, Anna V.; Sefton, Elizabeth C.; Berry, Emily; Lu, Zhenxiao; Hardt, Jennifer; Marsh, Erica; Yin, Ping; Clardy, Jon; Chakravarti, Debabrata; Bulun, Serdar; Kim, J. Julie

    2009-01-01

    Context: Progesterone has been associated with promoting growth of uterine leiomyomas. The mechanisms involved remain unclear. Objective: In this study we investigated the activation of the AKT pathway and its downstream effectors, glycogen synthase kinase-3b and Forkhead box O (FOXO)-1 by progesterone as a mechanism of proliferation and survival of leiomyoma cells. Inhibitors of the AKT pathway were used to demonstrate the role of phosphatidylinositol 3-kinase, AKT, and FOXO1 in contributing to cell proliferation and apoptosis. Results: Treatment of leiomyoma cells with R5020 over a period of 72 h resulted in higher cell numbers compared with untreated cells. When cells were treated with 100 nm R5020 for 1 and 24 h, the levels of phospho(Ser 473)-AKT increased. This increase was inhibited when cells were cotreated with RU486. Treatment of leiomyoma cells with a phosphatidylinositol 3-kinase inhibitor, LY294 dramatically decreased levels of phospho(Ser 473)-AKT, despite R5020 treatment. In addition to increased phospho(Ser 473)-AKT levels, R5020 treatment resulted in an increase in phospho(Ser 256)-FOXO1 and phosphoglycogen synthase kinase-3b. Inhibition of AKT using API-59 decreased proliferation and cell viability even in the presence of R5020. Higher concentrations of API-59-induced apoptosis of leiomyoma cells, even in the presence of R5020. Psammaplysene A increased nuclear FOXO1 levels and did not affect cell proliferation but induced apoptosis of leiomyoma cells. Conclusions: The progestin, R5020, can rapidly activate the AKT pathway. Inhibition of the AKT pathway inhibits cell proliferation and promotes apoptosis of leiomyoma cells. PMID:19240153

  6. Research of dose-effect relationship parameters of percutaneous microwave ablation for uterine leiomyomas - a quantitative study

    PubMed Central

    Xia, Ma; Jing, Zhang; Zhi-yu, Han; Yu, Yang; Yan-li, Hao; Chang-tao, Xu; Rui-fang, Xu; Bing-song, Zhang; Bao-wei, Dong

    2014-01-01

    Eighty eight patients with 91 uterine leiomyomas who underwent ultrasound-guided percutaneous microwave ablation (PMWA) treatment were prospectively included in the study in order to study the dose-effect relationship parameters (DERP) of PMWA for uterine leiomyomas and its relationship with T2-weighted MR imaging (T2WI). Based on the signal intensity of T2WI, uterine leiomyomas were classified as hypointense, isointense, and hyperintense. During ablation, leiomyomas were treated with quantitative microwave ablation (QMWA) energy of 50 w × 300 s or 60 w × 300 s. After QMWA, contrast-enhanced ultrasound (CEUS) was performed to evaluate DERP. No matter under 50 w × 300 s or 60 w × 300 s, quantitative microwave ablation volume (QMAV) of hyperintense leiomyoma was smaller than that of hypointense and isointense leiomyoma (P<0.016). For hypointense and isointense leiomyoma, QMAV of 60 w × 300 s was larger than that of 50 w × 300 s (P<0.05). DERPs obtained by T2WI can be used to guide the treatment of uterine leiomyoma by PMWA. PMID:25267154

  7. The Impact of Uterine Leiomyomas: A National Survey of Affected Women

    PubMed Central

    Borah, Bijan J.; Nicholson, Wanda K.; Bradley, Linda; Stewart, Elizabeth A.

    2014-01-01

    Objectives To characterize the impact of uterine leiomyomas (fibroids) in a racially diverse sample of women in the United States. Study Design A total of 968 women (573 White, 268 African-American, 127 other races) aged 29–59 with self-reported symptomatic uterine leiomyomas participated in a national survey. We assessed diagnosis, information seeking, attitudes about fertility, impact on work, and treatment preferences. Frequencies and percentages were summarized. Chi-square test was used to compare age groups. Results Women waited an average of 3.6 years before seeking treatment for leiomyomas, and 41% saw two or more healthcare providers for diagnosis. Almost a third of employed respondents (28%) reported missing work due to leiomyoma symptoms, and 24% felt that their symptoms prevented them from reaching their career potential. Women expressed desire for treatments that do not involve invasive surgery (79%), preserve the uterus (51%), and preserve fertility (43% of women under 40). Conclusions Uterine leiomyomas cause significant morbidity. When considering treatment, women are most concerned about surgical options, especially women under 40 who want to preserve fertility. PMID:23891629

  8. Predictive Value of Magnetic Resonance Imaging in Differentiating Between Leiomyoma and Adenomyosis

    PubMed Central

    Moghadam, Rosa; Lathi, Ruth B.; Shahmohamady, Babac; Saberi, Naghmeh S.; Nezhat, Ceana H.; Nezhat, Farr

    2006-01-01

    Objective: We evaluated the role of MRI as a preoperative diagnostic tool for leiomyoma and adenomyosis. Method: This is a retrospective chart review at a university-based hospital. The study included 1517 women who underwent hysterectomy or myomectomy over a 5-year period, and 153 women with a preoperative pelvic MRI were included. Comparisons were made between the results of the MRI and postoperative pathology reports. Results: The MRI and pathology report were the same for 136 of 144 women with leiomyoma and 12 of 31 women with adenomyosis. The MRI had 94% sensitivity and 33% specificity for leiomyoma and 38% sensitivity and 91% specificity for adenomyosis. Positive and negative predictive values of MRI for leiomyoma were 95% and 27% with 90% accuracy. Positive and negative predictive values of MRI for adenomyosis were 52% and 85%, respectively, with 80% accuracy. Conclusion: MRI has a high sensitivity and a low specificity for diagnosing leiomyoma and a high specificity and a low sensitivity for diagnosing adenomyosis. Due to the high cost and technical variations, we suggest using MRI only as an adjunctive diagnostic tool when ultrasound is not conclusive and differentiation between the 2 pathologies ultimately affects patient management. PMID:16882423

  9. Abdominal tuberculosis.

    PubMed Central

    Kapoor, V. K.

    1998-01-01

    Tuberculosis has staged a global comeback and forms a dangerous combination with AIDS. The abdomen is one of the common sites of extrapulmonary involvement. Patients with abdominal tuberculosis have a wide range and spectrum of symptoms and signs; the disease is therefore a great mimic. Diagnosis, mainly radiological and supported by endoscopy, is difficult to make and laparotomy is required in a large number of patient. Management involves judicious combination of antitubercular therapy and surgery which may be required to treat complications such as intestinal obstruction and perforation. The disease, though potentially curable, carries a significant morbidity and mortality. Images Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Figure 7 Figure 8 Figure 9 Figure 10 Figure 11 Figure 12 Figure 13 PMID:9926119

  10. Gastric leiomyoma in a child with Gorlin-Goltz syndrome: First pediatric case.

    PubMed

    Virgone, Calogero; Decker, Emily; Mitton, Sally G; Mansour, Sahar; Giuliani, Stefano

    2016-04-01

    Gorlin-Goltz syndrome (GGS), also known as nevoid basal cell carcinoma syndrome (MIM 109 400), is a rare genetic condition with a prevalence between 1/56 000 and 1/256 000. Clinical presentation is usually characterized by multiple basal cell carcinomas, odontogenic jaw keratocysts, palmar or plantar pitting and skeletal anomalies. It is furthermore associated with the development of various tumors beside basal cell carcinoma, among which medulloblastoma is the most frequent. Increased incidence of other mesenchymal neoplasms, however, is also well known: recently the first adult case of gastric leiomyoma in GGS was reported, and the inclusion of "fibromas and leiomyomas of other organs" in the minor criteria for the diagnosis was suggested. We report the first case of a pediatric patient with GGS who also developed a gastric leiomyoma: the present case illustrates the need for this change to the diagnostic criteria to encompass the highly variable presentations and phenotype in GGS.

  11. Intranodal leiomyoma in a young child: report of a rare spindle cell lesion.

    PubMed

    Girhotra, Manish; Virk, Shehbaaz Singh; Verma, Sarika; Bansal, Kalpana; Gupta, Ruchika

    2014-01-01

    ABSTRACT Primary spindle cell lesions of lymph nodes, with the exception of Kaposi's sarcoma, are rare. Intranodal palisaded myofibroblastoma has been described as a spindle cell tumor with prominent amianthoid fibers, intralesional hemorrhage, and intracellular or extracellular inclusions. Another spindle cell lesion, intranodal leiomyoma, has been reported only occasionally. We report the case of a 6-year-old boy with a mass in the neck without other systemic complaints. Excision biopsy of the lymph node revealed a spindle cell tumor with lymph nodal tissue at the periphery. The tumor showed features of smooth muscle differentiation with focally high mitotic index. The classical features of myofibroblastoma were not present. A final pathologic diagnosis of intranodal leiomyoma was rendered. The child has been free of recurrence in the follow-up period. Intranodal leiomyoma is a rare primary spindle cell lesion of the lymph nodes and should be considered in the differential diagnosis of the same.

  12. Spontaneous leiomyomas of the gastroesophageal junction in a chimpanzee (Pan troglodytes).

    PubMed

    Gumber, Sanjeev; Stovall, Melissa I; Breding, Eileen; Crane, Maria M

    2014-06-01

    A 49-y-old, female chimpanzee presented with a history of cardiac failure. Postmortem examination revealed lesions consistent with congestive heart failure and 2 incidental, round, firm, pale-tan intramural nodules (diameter, 2 cm) in the stomach at the gastroesophageal junction (GEJ). Histologically, the GEJ nodules were diagnosed as benign spindle-cell tumors. Immunohistochemical evaluation revealed neoplastic cells diffusely labeled with α-smooth muscle actin and vimentin, multifocally labeled for desmin, and were negative for c-kit (CD117). Electron microscopy revealed intracytoplasmic bundles of myofilaments with dense bodies, basal lamina, and few pinocytic vesicles in the neoplastic cells. According to these findings, leiomyomas of the GEJ were diagnosed. Gastrointestinal stromal tumors have been documented to occur in chimpanzees, but there are no reports of GEJ leiomyomas. To our knowledge, this report is the first description of spontaneous leiomyomas of the GEJ in a chimpanzee.

  13. Etiology and pathogenesis of uterine leiomyomas: a review.

    PubMed Central

    Flake, Gordon P; Andersen, Janet; Dixon, Darlene

    2003-01-01

    Uterine leiomyomas, or fibroids, represent a major public health problem. It is believed that these tumors develop in the majority of American women and become symptomatic in one-third of these women. They are the most frequent indication for hysterectomy in the United States. Although the initiator or initiators of fibroids are unknown, several predisposing factors have been identified, including age (late reproductive years), African-American ethnicity, nulliparity, and obesity. Nonrandom cytogenetic abnormalities have been found in about 40% of tumors examined. Estrogen and progesterone are recognized as promoters of tumor growth, and the potential role of environmental estrogens has only recently been explored. Growth factors with mitogenic activity, such as transforming growth factor- (subscript)3(/subscript), basic fibroblast growth factor, epidermal growth factor, and insulin-like growth factor-I, are elevated in fibroids and may be the effectors of estrogen and progesterone promotion. These data offer clues to the etiology and pathogenesis of this common condition, which we have analyzed and summarized in this review. PMID:12826476

  14. A High Concentration of Genistein Induces Cell Death in Human Uterine Leiomyoma Cells by Autophagy

    PubMed Central

    Castro, Lysandra; Gao, Xioahua; Moore, Alicia B; Yu, Linda; Di, Xudong; Kissling, Grace E; Dixon, Darlene

    2016-01-01

    Genistein, an estrogenic, soy-derived isoflavone, may play a protective role against hormone-related cancers. We have reported that a high concentration of genistein inhibits cell proliferation and induces apoptosis in human uterine smooth muscle cells, but not in leiomyoma (fibroid) cells. To better understand the differential cell death responses of normal and tumor cells to a high concentration of genistein, we treated uterine smooth muscle cells and uterine leiomyoma cells with 50 μg/ml of genistein for 72 h and 168 h, and assessed for mediators of apoptosis, cytotoxicity and autophagy. We found that leiomyoma cells had increased protection from apoptosis by expressing an increased ratio of Bcl-2: bak at 72 h and 168 h; however, in smooth muscle cells, the Bcl-2: bak ratio was decreased at 72 h, but significantly rebounded by 168 h. The apoptosis extrinsic factors, Fas ligand and Fas receptor, were highly expressed in uterine smooth muscle cells following genistein treatment at both time points as evidenced by confocal microscopy. This was not seen in the uterine leiomyoma cells; however, cytotoxicity as indicated by elevated lactate dehydrogenase levels was significantly enhanced at 168 h. Increased immunoexpression of an autophagy/autophagosome marker was also observed in the leiomyoma cells, although minimally present in smooth muscle cells at 72 h. Ultrastructurally, there was evidence of autophagic vacuoles in the leiomyoma cells; whereas, the normal smooth muscle cells showed nuclear fragmentation indicative of apoptosis. In summary, our data show differential cell death pathways induced by genistein in tumor and normal uterine smooth muscle cells, and suggest novel cell death pathways that can be targeted for preventive and intervention strategies for inhibiting fibroid tumor cell growth in vivo. PMID:27512718

  15. Novel methylene blue staining technique for localizing small esophageal leiomyomas during thoracoscopic enucleation.

    PubMed

    Zhang, Z; Ai, B; Liao, Y; Liu, L; Liu, M

    2016-11-01

    The treatment of choice for leiomyoma, the most common benign esophageal tumor, is thoracoscopic enucleation. One of the most difficult aspects of thoracoscopic enucleation is the precise localization of small tumors (≤1.5 cm) and tumors without external protrusion. No simple, feasible solutions to this problem are available. We developed a novel methylene blue staining technique to localize small esophageal leiomyomas and evaluated the feasibility of our technique. Between January 2013 and July 2014, eight patients with small esophageal leiomyomas (≤1.5 cm) underwent thoracoscopic enucleation in Tongji Hospital. Preoperative endoscopic ultrasonography was performed in all patients. The leiomyomas were located in the middle (n = 5) and lower (n = 3) thirds of the esophagus. We preoperatively injected 0.5-1.0 mL methylene blue in the submucosa adjacent to the tumors under standard gastroscope guidance. The entire staining process took about 10 minutes. Staining was successful in all patients. The unstained tumor was exposed after the blue-stained mediastinal pleura, and overlying muscle were incised longitudinally. All procedures were successfully completed without conversion to open surgery. No abnormalities were detected in the esophageal mucosa. The median operating time was 60 minutes (range, 40-90 minutes). Postoperative histopathology confirmed leiomyoma in all patients. The median postoperative hospital stay was 6 days (range, 5-7 days). No major complications, such as esophageal leakage or esophageal diverticulum, occurred. Endoscopic methylene blue staining is safe and feasible for localizing small esophageal leiomyomas during thoracoscopic enucleation. This method will enable precise and easy enucleation.

  16. Leiomyoma-Derived TGF-β Impairs BMP-2 Mediated Endometrial Receptivity

    PubMed Central

    Doherty, Leo F; Taylor, Hugh S

    2015-01-01

    Objective To determine if TGF-β3 is a paracrine signal secreted by leiomyoma that inhibits BMP mediated endometrial receptivity and decidualization. Design Experimental Setting Laboratory Patients Women with symptomatic leiomyomas Interventions Endometrial stromal cells (ESC) and leiomyoma cells were isolated from surgical specimens. Leiomyoma-conditioned media (LCM) was applied to cultured ESC. TGF-β was blocked by two approaches: TGF-β pan-specific antibody or transfection with a mutant TGF-β receptor type II. Cells were then treated with rhBMP-2 to assess BMP responsiveness. Main Outcome Measures Expression of BMP receptor types 1A (BMPR1A), 1B (BMPR1B), 2 (BMPR2), as well as endometrial receptivity mediators HOXA10 and LIF. Results ELISA showed elevated TGF-β levels in LCM. LCM treatment of ESC reduced expression of BMPR1B and BMPR2 to approximately 60% of pretreatment levels. Pre-incubation of LCM with TGF-β neutralizing antibody or mutant TGF receptor, but not respective controls, prevented repression of BMP receptors. HOXA10 and LIF expression was repressed in rhBMP-2 treated, LCM exposed ESC. Pre-treatment of LCM with TGF-β antibody or transfection with mutant TGF receptor prevented HOXA10 and LIF repression. Conclusions Leiomyoma derived TGF-β was necessary and sufficient to alter endometrial BMP-2 responsiveness. Blockade of TGF-β prevents repression of BMP-2 receptors and restores BMP-2 stimulated expression of HOXA10 and LIF. Blockade of TGF signaling is a potential strategy to improve infertility and pregnancy loss associated with uterine leiomyoma. PMID:25596622

  17. A Rare Combination of Ovarian and Uterine Leiomyomas with Goblet Cell Carcinoid of the Appendix

    PubMed Central

    Al-Shaikh, Abdulrahman F.; Darwish, Abdulla; Nagaraj, Veena; Alsada, Abeer

    2015-01-01

    We present a case of the rare combination of unilateral ovarian leiomyoma, uterine leiomyoma, and goblet cell carcinoid tumor of the appendix in a premenopausal woman who presented with right iliac pain. Immunohistochemistry study for desmin (muscle marker) and chromogranin and synaptophysin (neuroendocrine markers) confirmed immunophenotyping origin. Interestingly, both tumors showed positive reaction for estrogen receptor. To our knowledge, such a combination has not been reported previously in the literature. In this paper, the pathogenesis and differential diagnosis of both types of tumors are discussed. PMID:25685587

  18. Epidemiological and genetic clues for molecular mechanisms involved in uterine leiomyoma development and growth

    PubMed Central

    Commandeur, Arno E.; Styer, Aaron K.; Teixeira, Jose M.

    2015-01-01

    BACKGROUND Uterine leiomyomas (fibroids) are highly prevalent benign smooth muscle tumors of the uterus. In the USA, the lifetime risk for women developing uterine leiomyomas is estimated as up to 75%. Except for hysterectomy, most therapies or treatments often provide only partial or temporary relief and are not successful in every patient. There is a clear racial disparity in the disease; African-American women are estimated to be three times more likely to develop uterine leiomyomas and generally develop more severe symptoms. There is also familial clustering between first-degree relatives and twins, and multiple inherited syndromes in which fibroid development occurs. Leiomyomas have been described as clonal and hormonally regulated, but despite the healthcare burden imposed by the disease, the etiology of uterine leiomyomas remains largely unknown. The mechanisms involved in their growth are also essentially unknown, which has contributed to the slow progress in development of effective treatment options. METHODS A comprehensive PubMed search for and critical assessment of articles related to the epidemiological, biological and genetic clues for uterine leiomyoma development was performed. The individual functions of some of the best candidate genes are explained to provide more insight into their biological function and to interconnect and organize genes and pathways in one overarching figure that represents the current state of knowledge about uterine leiomyoma development and growth. RESULTS In this review, the widely recognized roles of estrogen and progesterone in uterine leiomyoma pathobiology on the basis of clinical and experimental data are presented. This is followed by fundamental aspects and concepts including the possible cellular origin of uterine fibroids. The central themes in the subsequent parts are cytogenetic aberrations in leiomyomas and the racial/ethnic disparities in uterine fibroid biology. Then, the attributes of various in vitro and

  19. Leiomyomas of the female urethra and bladder: a report of five cases and review of the literature.

    PubMed

    Bai, Sang Wook; Jung, Hyun Joo; Jeon, Myung Jae; Jung, Da Jung; Kim, Sei Kwang; Kim, Jae Wook

    2007-08-01

    Through the experience of five cases of leiomyoma developed in the female bladder and urethra with a review of the literature, we have made an effort to characterize the association of symptom with the size and location of the tumor and demonstrate an appropriate treatment. The study population was composed of patients who underwent surgery for bladder or urethral leiomyoma in our hospital from March 1990 to April 2005. Their medical records were reviewed retrospectively concerning the symptom, size and location of leiomyoma, the result of cystoscope and radiological examination, surgical method, pathologic report, complications, and recurrence. Four cases were diagnosed as urethral leiomyoma and one case as bladder leiomyoma. All patients with urethral leiomyoma were admitted for the chief complaint of a palpable tumor. When the tumor size was small, if it was located on the lateral side of the urethra, it was asymptomatic, but if located in the midline, it presented irritative or obstructive symptom. When it was big, if located on the lateral side, it presented irritative rather than obstructive symptom, and if located in the midline, it presented obstructive symptom. One case of bladder leiomyoma was discovered incidentally during ultrasonic exam. In all five cases, surgical removal was performed and complications or recurrence were not detected afterwards. Bladder and urethral leiomyomas are very rare and cause diverse manifestations from asymptomatic to irritative or obstructive symptom. It is presumed that the location and size of the tumor are associated with symptom. Unless it is the case with severe hemorrhage or obstructive acute renal failure, immediate surgery is not required. However, it is desirable to distinguish leiomyoma from malignant or other benign tumors by surgical biopsy or removal.

  20. PI3K/Akt/mTOR signaling & its regulator tumour suppressor genes PTEN & LKB1 in human uterine leiomyomas

    PubMed Central

    Makker, Annu; Goel, Madhu Mati; Mahdi, Abbas Ali; Bhatia, Vikram; Das, Vinita; Agarwal, Anjoo; Pandey, Amita

    2016-01-01

    Background & objectives: Despite their high occurrence and associated significant level of morbidity manifesting as spectrum of clinical symptoms, the pathogenesis of uterine leiomyomas (ULs) remains unclear. We investigated expression profile of tumour suppressor genes PTEN (phosphatase and tensin homolog deleted on chromosome ten) and LKB1 (liver kinase B1), and key signaling components of P13K (phosphatidylinositol 3-kinase)/Akt (protein kinase B)/mTOR (mammalian target of rapamycin) pathway in leiomyomas and adjacent normal myometrium in women of reproductive age, to explore the possibility of targeting this pathway for future therapeutic implications. Methods: Real time PCR (qPCR) was used to quantify relative gene expression levels of PTEN, Akt1, Akt2, mTOR, LKB1 and VEGFA (vascular endothelial growth factor A) in leiomyoma as compared to adjacent normal myometrium. Immunohistochemistry was subsequently performed to analyze expression of PTEN, phospho-Akt, phospho-mTOR, phospho-S6, LKB1 and VEGFA in leiomyoma and adjacent normal myometrium. Results: Significant upregulation of PTEN (2.52 fold; P=0.03) and LKB1 (3.93 fold; P=0.01), and downregulation of VEGFA (2.95 fold; P=0.01) genes were observed in leiomyoma as compared to normal myometrium. Transcript levels of Akt1, Akt2 and mTOR did not vary significantly between leiomyoma and myometrium. An increased immunoexpression of PTEN (P=0.015) and LKB1 (P<0.001) and decreased expression of VEGFA (P=0.01) was observed in leiomyoma as compared to myometrium. Immunostaining for activated (phosphorylated) Akt, mTOR and S6 was absent or low in majority of leiomyoma and myometrium. Interpretation & conclusions: Upregulation of PTEN and LKB1 in concert with negative or low levels of activated Akt, mTOR and S6 indicates that PI3K/Akt/mTOR pathway may not play a significant role in pathogenesis of leiomyoma. PMID:27748285

  1. Management of giant liver hemangiomas: an update.

    PubMed

    Hoekstra, Lisette T; Bieze, Matthanja; Erdogan, Deha; Roelofs, Joris J T H; Beuers, Ulrich H W; van Gulik, Thomas M

    2013-03-01

    Liver hemangiomas are the most common benign liver tumors and are usually incidental findings. Liver hemangiomas are readily demonstrated by abdominal ultrasonography, computed tomography or magnetic resonance imaging. Giant liver hemangiomas are defined by a diameter larger than 5 cm. In patients with a giant liver hemangioma, observation is justified in the absence of symptoms. Surgical resection is indicated in patients with abdominal (mechanical) complaints or complications, or when diagnosis remains inconclusive. Enucleation is the preferred surgical method, according to existing literature and our own experience. Spontaneous or traumatic rupture of a giant hepatic hemangioma is rare, however, the mortality rate is high (36-39%). An uncommon complication of a giant hemangioma is disseminated intravascular coagulation (Kasabach-Merritt syndrome); intervention is then required. Herein, the authors provide a literature update of the current evidence concerning the management of giant hepatic hemangiomas. In addition, the authors assessed treatment strategies and outcomes in a series of patients with giant liver hemangiomas managed in our department.

  2. Obstructive uropathy secondary to uterine leiomyoma in a chimpanzee (Pan troglodytes).

    PubMed

    Hanley, Patrick W; Barnhart, Kirstin F; Satterfield, William C; McArthur, Mark J; Buchl, Stephanie J; Baze, Wallace B

    2012-12-01

    Complications due to uterine leiomyomata in chimpanzees have rarely been documented. Here we describe a female chimpanzee that developed severe hydronephrosis in the right kidney due to leiomyoma. Because hysterectomy did not alleviate the hydronephrosis, nephrectomy was elected. After these procedures, the chimpanzee is doing well. Leiomyomata screening programs with treatment algorithms are a useful component of a comprehensive chimpanzee program.

  3. Severely calcified leiomyoma of broad ligament in a postmenopausal woman: Report of a rare case

    PubMed Central

    Pal, Subrata; Mondal, Sajeeb; Mondal, Palash Kr; Raychaudhuri, Gargi; Pradhan, Rajashree; Banerjee, Suparna

    2016-01-01

    Calcified broad ligament leiomyoma is a rare benign lesion in postmenopausal age group. It causes diagnostic confusion with solid calcified adnexal mass and large bladder calculi at the pelvic region. Clinical and radiological diagnoses were confirmed by histopathology of the hysterectomy specimen. We hereby present a case of heavily calcified broad ligament fibroid in a postmenopausal woman. PMID:27721644

  4. Giant Inguinal Herniae Managed by Primary Repair: A Case Series

    PubMed Central

    Anand, Madhur; Naku, Narang; Hajong, Debobratta; Singh, K Lenish

    2017-01-01

    Giant inguinal hernia are usually found in developing countries due to delay in seeking medical attention. The management of such hernias may sometimes require procedures to increase the intra-peritoneal capacity prior to the repair of the giant hernia. Otherwise patients may develop abdominal compartment syndrome leading to various unwanted complications. Primary repair of giant hernias are possible in some cases without having significant post-operative complications. In this present case series, we have managed a total of four patients of giant inguinal hernia by primary repair without much post-operative complications. PMID:28384934

  5. Uterine leiomyoma and its association with menstrual pattern and history of depo-medroxyprogesterone acetate injections

    PubMed Central

    Amanti, L; Sadeghi-Bazargani, H; Abdollahi, H; Ehdaeivand, F

    2011-01-01

    Background and aim: Despite the high prevalence of uterine leiomyoma, according to recent review studies there is uncertainty and a paucity of information regarding its predisposing or protective factors. The aim of this study was to assess the possible association between menstrual cycle pattern and occurrence of surgically treated myomas and also to check if depo-medroxyprogesterone acetate (DMPA) injection earlier in reproductive life can affect the later occurrence of myomas needing surgical treatment. Methods: In a case–control study in Ardabil, 85 women with definite diagnosis of surgically treated uterine leiomyoma and 154 community controls were enrolled. Possible predictors of myoma including menstrual cycle and menstrual bleeding patterns were assessed. Data were analyzed using SPSS software (SPSS, IBM, Somers, NY). Odds ratios were used as the main statistic in assessing the strength of observed associations. Results: Mean age of the participants was 41.8 ± 8.5 years. Length of menstrual cycle was associated with myoma and a higher likelihood of myoma was observed among those having shorter menstrual cycles (P < 0.05). Number of menstrual bleeding days was also associated with surgically treated myoma and longer bleeding periods increased the likelihood of myoma (P < 0.05). Only one of the eight women who had a history of depo-medroxyprogesterone acetate injections had developed surgically treated uterine leiomyoma and the others belonged to the control group without a history of surgical treatment for uterine leiomyoma. Conclusion: Menstrual cycle pattern is associated with developing leiomyomas requiring surgical treatment. DMPA, other than its role in myoma treatment, is also assumed to have a role in preventing myomas, but due to the small sample size in this study, larger scale prospective trials are needed in the future. PMID:21845062

  6. Abdominal Aortic Aneurysm (AAA)

    MedlinePlus

    ... Professions Site Index A-Z Abdominal Aortic Aneurysm (AAA) Abdominal aortic aneurysm (AAA) occurs when atherosclerosis or plaque buildup causes the ... weak and bulge outward like a balloon. An AAA develops slowly over time and has few noticeable ...

  7. Abdominal aortic aneurysm

    MedlinePlus

    ... this page: //medlineplus.gov/ency/article/000162.htm Abdominal aortic aneurysm To use the sharing features on this page, ... blood to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs when an area of the aorta becomes ...

  8. Ovarian steroid hormones modulate the expression of progesterone receptors and histone acetylation patterns in uterine leiomyoma cells.

    PubMed

    Sant'Anna, Gabriela Dos Santos; Brum, Ilma Simoni; Branchini, Gisele; Pizzolato, Lolita Schneider; Capp, Edison; Corleta, Helena von Eye

    2017-03-16

    Uterine leiomyomas are the most common benign smooth muscle cell tumors in women. Estrogen (E2), progesterone (P4) and environmental factors play important roles in the development of these tumors. New treatments, such as mifepristone, have been proposed. We evaluated the gene expression of total (PRT) and B (PRB) progesterone receptors, and the histone acetyltransferase (HAT) and deacetylase (HDAC) activity after treatment with E2, P4 and mifepristone (RU486) in primary cell cultures from uterine leiomyoma and normal myometrium. Compared to myometrium, uterine leiomyoma cells showed an increase in PRT mRNA expression when treated with E2, and increase in PRB mRNA expression when treated with E2 and P4. Treatment with mifepristone had no significant impact on mRNA expression in these cells. The HDAC activity was higher in uterine leiomyoma compared to myometrial cells after treatment with E2 and E2 + P4 + mifepristone. HAT activity was barely detectable. Our results suggest that ovarian steroid hormones modulate PR, and mifepristone was unable to decrease PRT and PRB mRNA. The higher activity of HDAC leiomyoma cells could be involved in transcriptional repression of genes implicated in normal myometrium cell function, contributing to the maintenance and growth of uterine leiomyoma.

  9. Rare Leiomyoma of the Tunica Dartos: A Case Report with Clinical Relevance for Malignant Transformation and HLRCC

    PubMed Central

    Bell, Robert C.; Austin, Evan T.; Arnold, Stacy J.; Walker, Jonathan R.; Larsen, Brandon T.

    2016-01-01

    Background. Genital leiomyomas fall under the broader category of cutaneous leiomyomas, which are rare smooth muscle neoplasms accounting for 5% of all leiomyomas. Genital leiomyomas arising from the dartos muscle are exceedingly rare with fewer than 30 cases reported in the literature. They are typically benign and adequately treated with simple surgical excision; however, previously reported cases of malignant transformation and a possible link to the hereditary leiomyomatosis and renal cell cancer (HLRCC) syndrome warrant closer follow-up. Case Presentation. We report a case of a 47-year-old male refugee from Rwanda found to have a mobile, pea-sized, mildly painful scrotal lesion near the left penoscrotal junction and 1.5 cm indeterminate vascular mass in the right kidney. Surgical excision of the scrotal nodule was performed and the diagnosis of a dartoic leiomyoma was rendered. The presence of moderate nuclear atypia, rare mitotic activity, and close surgical margins prompted a wide reexcision. We report the surgical approach, pathologic findings, and clinical follow-up related to this scrotal lesion. Conclusion. Scrotal leiomyomas demonstrate a high rate of recurrence and pose a risk for malignant transformation. They may also indicate an underlying autosomal dominant syndrome associated with increased risk for development of an aggressive form of renal cell carcinoma. When discovered, management should include surgical excision, screening for syndromic features, and routine follow-up. PMID:27529047

  10. Diagnostic value of progesterone receptor, p16, p53 and pHH3 expression in uterine atypical leiomyoma

    PubMed Central

    Liang, Yun; Zhang, Xiaofei; Chen, Xiaoduan; Lü, Weiguo

    2015-01-01

    The differential diagnosis between atypical leiomyoma and leiomyosarcoma may be hard based on morphological criterion at times. It would be helpful to find out biomarkers that can be used to distinguish them. The aim of the study was to investigate the diagnostic value of progesterone receptor (PR), p16, p53 and pHH3 expression in a series of uterine smooth muscle tumors. Immunohistochemical expression of PR, p16, p53 and pHH3 was investigated on 32 atypical leiomyomas, 15 leiomyosarcomas and 15 usual leomyomas. The difference in expression was compared between atypical leiomyoma and other groups. The expression of PR, p16, and pHH3 was found significantly different between atypical leiomyomas and leiomyosarcomas, but lack of significant difference between atypical leiomyomas and usual leiomyomas. There was no significant difference with regard to p53 distribution among these uterine smooth muscle tumors. High p16, pHH3 expression and low PR expression preferred the diagnosis of leiomyosarcoma. The panel of antibodies used in this study is a useful complementary analysis in the assessment of problematic uterine smooth muscle tumors. PMID:26261614

  11. [Results of surgical treatment of postoperative abdominal hernia].

    PubMed

    Belokonev, V I; Pushkin, S Iu

    2000-09-01

    There were examined 525 patients with postoperative abdominal hernia, in 47.3% of them big, vast and giant hernia was revealed. There were operated 436 patients using local tissues with duplicature formation--according to Mayo, Sapezhko, Napalkov and Yanov method.

  12. Cystic Endometriosis in a Huge Degenerated Subserous Leiomyoma Mimicking Bilateral Multicystic Endometriomas in an Infertile Woman with Diminished Ovarian Reserve: A Rare Endometriotic Implantation

    PubMed Central

    Colak, Sabri; Reis, Abdulkadir

    2016-01-01

    Uterine leiomyomas are the most common pelvic tumor in women. Leiomyoma can show atypical locations and degenerations and may not be easily differentiated from adnexal masses. Uterine leiomyoma can undergo cystic degeneration and is said to be found in 4% of all types of degenerations. The commonest type of degeneration is hyaline seen in 60% of patients. Usually uterine leiomyoma does not present as clinical and radiological diagnostic challenge. However, when leiomyoma undergoes massive cystic degeneration they may become clinical and radiological diagnostic dilemmas. The MRI showed a huge cystic mass protruding up to the pelvis not differentiated from bilateral endometriomas and accompanying subserous myomas. Surgery revealed that the mass is not bilateral endometriomas but a huge pedunculated leiomyoma with cystic degeneration and cystic endometriosis. Endometriosis is a troubling gynecologic condition occurring in 10% to 15% of women of reproductive age and is associated with fertility problems. As a peritoneal disease, the locations of endometriotic lesions are predominantly the ovaries (96.4%), followed by the soft tissue (2.8%), gastrointestinal tract (0.3%), and urinary tract (0.2%) and other rare locations. The presented case is multiple sized cystic endometriosis (endometriomas) located in a huge pedunculated subserous leiomyoma in an infertile woman having a history of laparoscopic bilateral endometrioma surgery. Conclusion. To our knowledge, this is the first reported case for endometriotic cysts (endometriomas) located in a huge cystic degenerated leiomyoma. PubMed search revealed no report concerning endometriotic implantation in the leiomyomas. PMID:27057369

  13. Reed's Syndrome: A Case of Multiple Cutaneous Leiomyomas Treated with Liquid Nitrogen Cryotherapy

    PubMed Central

    Basendwh, Mohammad A.; Fatani, Mohammad; Baltow, Badee

    2016-01-01

    Reed's syndrome is an autosomal dominant genetic disorder. Affected individuals are at increased risk of developing benign smooth muscle tumors in the skin and uterus. In this article, we report a case of a 52-year-old female who presented to our dermatology clinic complaining of painful skin lesions on her right arm, left forearm and trunk. The patient had a past medical history of uterine leiomyomatosis for which she underwent hysterectomy 17 years ago. The patient's family history revealed that her mother, 2 sisters and 2 maternal aunts also had uterine leiomyomas. The diagnosis of Reed's syndrome was confirmed by histopathologic examination of the patient's dermal lesion in conjunction with her surgical and family histories. Five years after the initial presentation, the patient underwent treatment with liquid nitrogen cryotherapy for the dermal leiomyomas. After the treatment, marked improvement was noticed with regard to the pain and size of the skin lesions. PMID:27064320

  14. Leiomyoma of uterus in a patient with ring chromosome 12: Case presentation and literature review

    SciTech Connect

    Hajianpour, M.J.; Habibian, R.; Hajianpour, A.K.

    1996-05-17

    We report on a 30-year-old woman with de novo ring chromosome 12 mosaicism, 46,XX,r(12)(p13.3q24.3)/46,XX. In addition to the clinical manifestations generally observed in {open_quotes}ring syndrome{close_quotes} cases such as growth retardation, short stature, microcephaly, and mental deficiency, she had a broad nasal bridge, micrognathia with overbite, underdeveloped breasts, mild dorsal scoliosis, clinodactyly of the fifth fingers with a single interdigital crease, symphalangism of thumbs, tapering fingers, mild cutaneous syndactyly between the second and third toes, multiple cafe-au-lait spots, sebaceous acne on the face and back, and mild dystrophic toenails. She developed a large, pedunculated uterine leiomyoma at age 28 years. To our knowledge, uterine leiomyoma in association with r(12) has not been reported previously. However, a gain of chromosome 12 and translocations involving 12q14-15 have been described. 12 refs., 5 figs., 2 tabs.

  15. Magnetic resonance-guided focused ultrasound surgery for leiomyoma-associated infertility

    PubMed Central

    Bouwsma, Esther V. A.; Gorny, Krzysztof R.; Hesley, Gina K.; Jensen, Jani R.; Peterson, Lisa G; Stewart, Elizabeth A.

    2017-01-01

    Objective To describe magnetic resonance-guided focused ultrasound surgery (FUS) as a treatment for a case of leiomyoma-associated infertility. Design Case report from a randomized clinical trial. Setting Academic medical center. Patient(s) A 37-year-old woman with known leiomyomas and a history of 18 months of home-inseminations from a known donor. Intervention(s) Magnetic resonance-guided FUS treatment of uterine fibroids, where the dominant fibroid distorted the uterine cavity. Main Outcome Measure(s) Pregnancy. Result(s) A viable intrauterine pregnancy, with a full-term vaginal delivery, was conceived after a single clomiphene citrate and intrauterine insemination cycle. Conclusion(s) The role of FUS for enhancement of fertility in women with nonhysteroscopically resectable uterine fibroids distorting the uterine cavity should be investigated further. PMID:21570071

  16. [Endoscopic submucosal dissection of a leiomyoma originating from the muscularis propria of upper esophagus].

    PubMed

    Kang, Myung Soo; Hong, Su Jin; Han, Jae Pil; Seo, Jung Yeon; Yoon, La Young; Choi, Moon Han; Kim, Hee Kyung

    2013-10-01

    The technique of endoscopic submucosal dissection is occasionally used for resection of myogenic tumors originating from muscularis mucosa or muscularis propria of stomach and esophagus. However, endoscopic treatments for esophageal myogenic tumors >2 cm have rarely been reported. Herein, we report a case of large leiomyoma originating from muscularis propria in the upper esophagus. A 59-year-old woman presented with dysphagia. Esophagoscopy and endoscopic ultrasonography revealed an esophageal subepithelial tumor which measured 25 × 20 mm in size, originated from muscularis propria, and was located at 20 cm from the central incisors. The tumor was successfully removed by endoscopic submucosal dissection and there were no complications after en bloc resection. Pathologic examination was compatible with leiomyoma.

  17. Role of Activin-A and Myostatin and Their Signaling Pathway in Human Myometrial and Leiomyoma Cell Function

    PubMed Central

    Islam, Md Soriful; Catherino, William H.; Protic, Olga; Janjusevic, Milijana; Gray, Peter Clarke; Giannubilo, Stefano Raffaele; Ciavattini, Andrea; Lamanna, Pasquale; Tranquilli, Andrea Luigi; Petraglia, Felice

    2014-01-01

    Context: Uterine leiomyomas are highly prevalent benign tumors of premenopausal women and the most common indication for hysterectomy. However, the exact etiology of this tumor is not fully understood. Objective: The objective of the study was to evaluate the role of activin-A and myostatin and their signaling pathways in human myometrial and leiomyoma cells. Design: This was a laboratory study. Setting: Myometrial and leiomyoma cells (primary and cell lines) were cultured in vitro. Patients: The study included premenopausal women who were admitted to the hospital for myomectomy or hysterectomy. Interventions: Primary myometrial and leiomyoma cells and/or cell lines were treated with activin-A (4 nM) and myostatin (4 nM) for different days of interval (to measure proliferation rate) or 30 minutes (to measure signaling molecules) or 48 hours to measure proliferating markers, extracellular matrix mRNA, and/or protein expression by real-time PCR, Western blot, and/or immunocytochemistry. Results: We found that activin-A and myostatin significantly reduce cell proliferation in primary myometrial cells but not in leiomyoma cells as measured by a CyQUANT cell proliferation assay kit. Reduced expression of proliferating cell nuclear antigen and Ki-67 were also observed in myometrial cells in response to activin-A and myostatin treatment. Activin-A also significantly increased mRNA expression of fibronectin, collagen1A1, and versican in primary leiomyoma cells. Finally, we found that activin-A and myostatin activate Smad-2/3 signaling but do not affect ERK or p38 signaling in both myometrial and leiomyoma cells. Conclusions: This study results suggest that activin-A and myostatin can exert antiproliferative and/or fibrotic effects on these cell types via Smad-2/3 signaling. PMID:24606069

  18. Leiomyoma treatment by uterine artery embolization using gelatin sponge prepared by the pumping method

    PubMed Central

    KOJIMA, TAKAHISA; TAKI, YASUNORI; FUJISAWA, HIDEFUMI; KOYAMA, KUMIKO

    2012-01-01

    Uterine leiomyoma, a benign tumor, may be treated with drugs, albeit surgical resection is more common. The present study aimed to evaluate the treatment of leiomyoma cases by uterine artery embolization (UAE) using a gelatin sponge prepared by the pumping method. The results of 700 leiomyoma cases treated by UAE in the outpatient department were evaluated. UAE was performed by injecting gelatin sponge prepared by the pumping method into the uterine artery. Among 700 cases, effective cases were 680 (97.2%), ineffective cases were 18 (2.8%) and impossible cases for UAE were 2 (0.2%). Retreatment was required in 23 cases (3.3%). Complication events designated by the Society of Interventional Radiology Clinical Practice Guidelines occurred in 31 cases (4.4%): 1 case showed permanent adverse sequelae, 4 cases required major therapy with a prolonged hospitalization (>48 h) and 10 patients required therapy with minor hospitalization (<48 h). The remaining 16 cases required nominal or no therapy. Follow-up of patients was performed for 599 cases for an average period of 1.2±0.9 years, ranging between 1 month and 6 years. Pregnancy after UAE was observed in 12 cases/15 cycles. Thus, the findings indicate that UAE using gelatin sponge prepared by the pumping method applied to outpatients is a safe and useful treatment procedure. PMID:23226725

  19. Histopathological and Digital Morphometrical Evaluation of Uterine Leiomyoma in Brazilian Women

    PubMed Central

    da Silva, Ana Paula Fernandes; Mello, Luciano de Albuquerque; dos Santos, Erlene Roberta Ribeiro; Paz, Silvania Tavares; Cavalcanti, Carmelita Lima Bezerra; de Melo-Junior, Mario Ribeiro

    2016-01-01

    The current study aims to evaluate histopathological and digital morphometrical aspects associated with uterine leiomyomas in one hundred and fifty (150) patients diagnosed with leiomyoma. Uterine tissues were subjected to the histopathological and digital morphometric analyses of the interstitial collagen distribution. The analysis of medical records indicates that most of the women diagnosed with uterine leiomyomas (68.7%) are between 37 and 48 years old. As for the anatomic location of the tumors, approximately 61.4% of the patients had intramural and subserosal lesions. In 50% of the studied cases, the patients developed uterine leiomyomatosis (with more than eight tumors). As for the morphometric study, the average size of the interstitial collagen distribution held approximately 28.53% of the capture area, whereas it was of 7.43% in the normal tissue adjacent to the tumor. Another important aspect observed in the current study was the high rate of young women subjected to total hysterectomy, a fact that resulted in early and definitive sterility. PMID:27293441

  20. Study of the relation between the incidence of uterine leiomyomas and the concentrations of PCB and DDT in Baltic gray seals.

    PubMed

    Bredhult, Carolina; Bäcklin, Britt-Marie; Bignert, Anders; Olovsson, Matts

    2008-02-01

    Exposure to environmental contaminants is believed to be associated with the previously described decrease in the reproduction rate of Baltic gray seals. In the present study the prevalence of uterine leiomyomas was investigated in 257 Baltic gray seal females examined during 1973-2007, in relation to the levels of polychlorinated biphenyls (PCBs) and dichlorodiphenyltrichloroethane (DDT) in Baltic biota, using an estimated exposure index. Additionally, the proliferative activity in leiomyomas, occurrence of corpora lutea, and blubber concentrations of PCB and DDT were investigated in a subset of females. Leiomyomas were only found in females 22-41 years old, at a prevalence of 65%. No differences in blubber concentrations of PCB or DDT were detected between the subset of leiomyoma-bearing females and reference females, but the estimated exposure index indicated that the PCB level in Baltic biota might be related to the leiomyoma prevalence in Baltic gray seal females.

  1. [Giant haemangioma of the liver: diagnosis and treatment].

    PubMed

    Hoekstra, Lisette T; Bieze, Matthanja; Erdogan, Deha; Roelofs, Joris J T H; Beuers, Ulrich H W; van Gulik, Thomas M

    2012-01-01

    A liver haemangioma is a benign, usually small tumour comprised of blood vessels, which is often discovered coincidentally; giant haemangiomas are defined as haemangiomas larger than 5 cm. The differential diagnosis includes other hypervascular tumours, such as hepatocellular adenoma, hepatocellular carcinoma, metastasis of a neuro-endocrine tumour or renal cell carcinoma.- The diagnosis is based on abdominal ultrasonography and can be confirmed by a CT or MR scan. A wait-and-see approach is justified in patients without symptoms or with minimal symptoms, even in the presence of a giant haemangioma. Surgical resection of a giant haemangioma is only necessary when the preoperative diagnosis is inconclusive, or when the haemangioma leads to mechanical symptoms or complications. Extirpation is the only effective form of treatment of the giant haemangioma; enucleation is preferred over partial liver resection. A known complication of a giant haemangioma is the occurrence of disseminated intravascular coagulation, the Kasabach-Merritt syndrome; intervention is then demanded.

  2. [Abdominal pregnancy, institutional experience].

    PubMed

    Bonfante Ramírez, E; Bolaños Ancona, R; Simón Pereyra, L; Juárez García, L; García-Benitez, C Q

    1998-07-01

    Abdominal pregnancy is a rare entity, which has been classified as primary or secondary by Studiford criteria. A retrospective study, between January 1989 and December 1994, realized at Instituto Nacional de Perinatología, found 35,080 pregnancies, from which 149 happened to be ectopic, and 6 of them were abdominal. All patients belonged to a low income society class, age between 24 and 35 years, and average of gestations in 2.6. Gestational age varied from 15 weeks to 32.2 weeks having only one delivery at term with satisfactory postnatal evolution. One patient had a recurrent abdominal pregnancy, with genital Tb as a conditional factor. Time of hospitalization varied from 4 to 5 days, and no further patient complications were reported. Fetal loss was estimated in 83.4%. Abdominal pregnancy is often the sequence of a tubarian ectopic pregnancy an when present, it has a very high maternal mortality reported in world literature, not found in this study. The stated frequency of abdominal pregnancy is from 1 of each 3372, up to 1 in every 10,200 deliveries, reporting in the study 1 abdominal pregnancy in 5846 deliveries. The study had two characteristic entities one, the recurrence and two, the delivery at term of one newborn. Abdominal pregnancy accounts for 4% of all ectopic pregnancies. Clinical findings in abdominal pregnancies are pain, transvaginal bleeding and amenorrea, being the cardinal signs of ectopic pregnancy.

  3. Giant Magnons Meet Giant Gravitons

    SciTech Connect

    Hofman, Diego M.

    2008-07-28

    We study the worldsheet reflection matrix of a string attached to a D-brane in AdS{sub 5}xS{sup 5}. The D-brane corresponds to a maximal giant graviton that wraps an S{sup 3} inside S{sup 5}. In the gauge theory, the open string is described by a spin chain with boundaries. We focus on open strings with a large SO(6) charge and define an asymptotic boundary reflection matrix. Using the symmetries of the problem, we review the computation of the boundary reflection matrix, up to a phase. We also discuss weak and strong coupling computations where we obtain the overall phase factor and test our exact results.

  4. [Inflammatory abdominal aortic aneurysm].

    PubMed

    Ziaja, K; Sedlak, L; Urbanek, T; Kostyra, J; Ludyga, T

    2000-01-01

    The reported incidence of inflammatory abdominal aortic aneurysm (IAAA) is from 2% to 14% of patients with abdominal aortic aneurysm and the etiology of this disease is still discussed--according to the literature several pathogenic theories have been proposed. From 1992 to 1997 32 patients with IAAA were operated on. The patients were mostly symptomatic--abdominal pain was present in 68.75% cases, back pain in 31.25%, fever in 12.5% and weight loss in 6.25% of the operated patients. In all the patients ultrasound examination was performed, in 4 patients CT and in 3 cases urography. All the patients were operated on and characteristic signs of inflammatory abdominal aortic aneurysm like: thickened aortic wall, perianeurysmal infiltration or retroperitoneal fibrosis with involvement of retroperitoneal structures were found. In all cases surgery was performed using transperitoneal approach; in three cases intraoperatively contiguous abdominal organs were injured, which was connected with their involvement into periaortic inflammation. In 4 cases clamping of the aorta was done at the level of the diaphragmatic hiatus. 3 patients (9.37%) died (one patient with ruptured abdominal aortic aneurysm). Authors present diagnostic procedures and the differences in the surgical tactic, emphasizing the necessity of the surgical therapy in patients with inflammatory abdominal aortic aneurysm.

  5. Uterine angioleiomyoma – a rare variant of uterine leiomyoma: review of literature and case reports

    PubMed Central

    2016-01-01

    Introduction Uterine angioleiomyoma (AL) is an extremely rare variant of uterine leiomyoma. It is composed of smooth muscle cells and thick-walled blood vessels. Angioleiomyoma usually occurs in middle-aged women, 40-60 years old. Aim of the study was to review of literature research reports on uterine AL. Discussion of nine case reports of uterine AL in the patients operated on in our ward. Material and methods The paper presents analysis of accessible research reports on uterine AL, and medical records of the patients operated on in our ward. Results Mean age of the patients with uterine AL was 47.11 ±5.21, body mass index (BMI) 25.88 ±3.95. All women had given birth (1-5 natural deliveries, 2.44 mean). Uterine AL occurred in 0.34% to 0.40% cases of leiomyomas. Angioleiomyoma were located intramurally and subserosally in six and three patients (respectively, 66.7% and 33.3%). Laparotomy was undertaken in seven cases (77.8%), transvaginal access in two cases (22.2%), and myomectomy in one case (11.1%). Blood transfusion was required in four cases (44.4%). Conclusions In the group of uterine leiomyomas, uterine ALs occurred in 0.34-0.40% of cases. Angioleiomyoma cases posed a greater risk of complications threatening the patient’s health and life. Preoperative differentiation of AL with ovarian tumour was more difficult due to frequent degenerative lesions in the course of uterine AL. PMID:27980528

  6. Recurrence factors and reproductive outcomes of laparoscopic myomectomy and minilaparotomic myomectomy for uterine leiomyomas

    PubMed Central

    Shin, Dong Gi; Yoo, Heon Jong; Lee, Yeon Ah; Kwon, In Sun

    2017-01-01

    Objective The aim of this study was to determine recurrence factors and reproductive outcomes of laparoscopic myomectomy (LM) and minilaparotomic myomectomy (MM) for treating uterine leiomyomas. Methods Between 2007 and 2013, 160 patients underwent myomectomy, including 122 who underwent LM and 38 who underwent MM. Patients were followed up for recurrence based on pelvic ultrasound exams. Only patients who were followed up for a minimum of two years were selected for this retrospective study. Pregnancy rate, delivery, and delivery methods were compared between the two groups to evaluate reproductive outcomes. Furthermore, mean age, body mass index, preoperative administration of gonadotropin-releasing hormone agonist (GnRHa), and characteristics of leiomyomas were investigated to determine recurrence factors. Results The mean body mass index in the MM group was significantly (P=0.048) higher than that in the LM group. The number and the largest diameter of removed leiomyoma were also significantly higher in the MM group (both P=0.001). Logistic regression after adjusting significantly different characteristics showed that the LM group had shorter (P=0.020) postoperative hospitalization days compared to the MM group. Other outcome variables including recurrence rate were not significantly different between the two groups. Reproductive outcomes such as pregnancy rate, delivery, and delivery methods were not significantly different between the two groups. Preoperative GnRHa therapy was the only significant (P=0.039) recurrence factor after myomectomy. Conclusion This study showed that LM and MM had similar recurrence rates and reproductive outcomes. The only recurrence factor of significance was preoperative administration of GnRHa. PMID:28344961

  7. Transforming giants.

    PubMed

    Kanter, Rosabeth Moss

    2008-01-01

    Large corporations have long been seen as lumbering, inflexible, bureaucratic--and clueless about global developments. But recently some multinationals seem to be transforming themselves: They're engaging employees, moving quickly, and introducing innovations that show true connection with the world. Harvard Business School's Kanter ventured with a research team inside a dozen global giants--including IBM, Procter & Gamble, Omron, CEMEX, Cisco, and Banco Real--to discover what has been driving the change. After conducting more than 350 interviews on five continents, she and her colleagues came away with a strong sense that we are witnessing the dawn of a new model of corporate power: The coordination of actions and decisions on the front lines now appears to stem from widely shared values and a sturdy platform of common processes and technology, not from top-down decrees. In particular, the values that engage the passions of far-flung workforces stress openness, inclusion, and making the world a better place. Through this shift in what might be called their guidance systems, the companies have become as creative and nimble as much smaller ones, even while taking on social and environmental challenges of a scale that only large enterprises could attempt. IBM, for instance, has created a nonprofit partnership, World Community Grid, through which any organization or individual can donate unused computing power to research projects and see what is being done with the donation in real time. IBM has gained an inspiring showcase for its new technology, helped business partners connect with the company in a positive way, and offered individuals all over the globe the chance to contribute to something big.

  8. Reconstruction of the abdominal wall by using a combination of the human acellular dermal matrix implant and an interpositional omentum flap after extensive tumor resection in patients with abdominal wall neoplasm: A preliminary result

    PubMed Central

    Gu, Yan; Tang, Rui; Gong, Ding-Quan; Qian, Yun-Liang

    2008-01-01

    AIM: To present our trial using a combination of the human acellular dermal matrix (HADM) implant and an interpositional omentum flap to repair giant abdominal wall defects after extensive tumor resection. METHODS: Between February and October of 2007, three patients with giant defects of the abdominal wall after extensive tumor resection underwent reconstruction with a combination of HADM and omentum flap. Postoperative morbidities and signs of herniation were monitored. RESULTS: The abdominal wall reconstruction was successful in these three patients, there was no severe morbidity and no signs of herniation in the follow-up period. CONCLUSION: The combination of HADM and omentum flap offers a new, safe and effective alternative to traditional forms in the repair of giant abdominal wall defects. Further analysis of the long-term outcome and more cases are needed to assess the reliability of this technique. PMID:18205267

  9. miR-139-5p regulates proliferation, apoptosis, and cell cycle of uterine leiomyoma cells by targeting TPD52

    PubMed Central

    Chen, Hong; Xu, Hong; Meng, Yu-gang; Zhang, Yun; Chen, Jun-ying; Wei, Xiao-ning

    2016-01-01

    Background Uterine leiomyoma is one of the most common benign tumors in women. It dramatically decreases the quality of life in the affected women. However, there is a lack of effective treatment paradigms. Micro-RNAs are small noncoding RNA molecules that are extensively expressed in organisms, and they are interrelated with the occurrence and development of the tumor. miR-139-5p was found to be downregulated in various cancers, but its function and mechanism in uterine leiomyoma remain unknown. The aim of this study was to investigate the role of miR-139-5p and its target gene in uterine leiomyoma. Methods By using a bioinformatic assay, it was found that TPD52 was a potential target gene of miR-139-5p. Then, expressions of miR-139-5p and TPD52 in uterine leiomyoma and adjacent myometrium tissues were evaluated by quantitative real-time polymerase chain reaction and Western blot. Proliferation, apoptosis, and cell cycle of uterine leiomyoma cells transfected by miR-139-5p mimics or TPD52 siRNA were determined. Results It was observed that the expression of miR-139-5p in uterine leiomyoma tissues was significantly lower (P<0.001) than that in the adjacent myometrium tissues. Overexpression of miR-139-5p inhibited the growth of uterine leiomyoma cells and induced apoptosis and G1 phase arrest. Dual-luciferase reporter assay and Western blot validated that TPD52 is the target gene of miR-139-5p. Furthermore, downregulation of TPD52 by siRNA in uterine leiomyoma cells inhibited cell proliferation and induced cell apoptosis and G1 phase arrest. Conclusion Data suggested that miR-139-5p inhibited the proliferation of uterine leiomyoma cells and induced cell apoptosis and G1 phase arrest by targeting TPD52. PMID:27785063

  10. Giant Cell Arteritis

    MedlinePlus

    Giant cell arteritis is a disorder that causes inflammation of your arteries, usually in the scalp, neck, and arms. ... arteries, which keeps blood from flowing well. Giant cell arteritis often occurs with another disorder called polymyalgia ...

  11. Abdominal Pain Syndrome

    MedlinePlus

    ... or cancer Infection of the tubes (salpingitis) Ectopic pregnancy Fibroid tumors of the uterus (womb) Malignant tumors of the uterus or cervix Endometriosis Adhesions (scars) Screening and Diagnosis How is the cause of abdominal pain determined? ...

  12. [The abdominal catastrophe].

    PubMed

    Seiler, Christian A

    2011-08-01

    Patients with an abdominal catastrophe are in urgent need of early, interdisciplinary medical help. The treatment plan should be based on medical priorities and clear leadership. First priority should be given to achieve optimal oxygenation of blood and stabilization of circulation during all treatment-phases. The sicker the patient, the less invasive the (surgical) treatment should to be, which means "damage control only". This short article describes 7 important, pragmatic rules that will help to increase the survival of a patient with an abdominal catastrophe. Preexisting morbidity and risk factors must be included in the overall risk-evaluation for every therapeutic intervention. The challenge in patients with an abdominal catastrophe is to carefully balance the therapeutic stress and the existing resistance of the individual patient. The best way to avoid abdominal disaster, however, is its prevention.

  13. Abdominal ultrasound (image)

    MedlinePlus

    Abdominal ultrasound is a scanning technique used to image the interior of the abdomen. Like the X-ray, MRI, ... it has its place as a diagnostic tool. Ultrasound scans use high frequency sound waves to produce ...

  14. Acute abdominal pain.

    PubMed

    Stone, R

    1998-01-01

    Abdominal pain is among the most frequent ailments reported in the office setting and can account for up to 40% of ailments in the ambulatory practice. Also, it is in the top three symptoms of patients presenting to emergency departments (ED) and accounts for 5-10% of all ED primary presenting ailments. There are several common sources for acute abdominal pain and many for subacute and chronic abdominal pain. This article explores the history-taking, initial evaluation, and examination of the patient presenting with acute abdominal pain. The goal of this article is to help differentiate one source of pain from another. Discussion of acute cholecystitis, pancreatitis, appendicitis, ectopic pregnancy, diverticulitis, gastritis, and gastroenteritis are undertaken. Additionally, there is discussion of common laboratory studies, diagnostic studies, and treatment of the patient with the above entities.

  15. Abdominal and Pelvic CT

    MedlinePlus Videos and Cool Tools

    ... as ulcerative colitis or Crohn's disease , pancreatitis or liver cirrhosis. cancers of the liver, kidneys, pancreas, ovaries and bladder as well as ... injuries to abdominal organs such as the spleen, liver, kidneys or other internal organs in cases of ...

  16. Abdominal wall surgery

    MedlinePlus

    ... the results of abdominoplasty. Many feel a new sense of self-confidence. Alternative Names Cosmetic surgery of the abdomen; Tummy tuck; Abdominoplasty Images Abdominoplasty - series Abdominal muscles References McGrath MH, Pomerantz J. Plastic surgery. In: Townsend ...

  17. Abdominal involvement in tuberculosis.

    PubMed

    Neyman, Edward G; Georgiades, Christos S; Fishman, Elliot K

    2002-10-01

    Rising incidence of disseminated and extrapulmonary tuberculosis (TB), especially in immunocompromised hosts and patients with multi-drug-resistant tuberculosis, has resulted in an increase of unusual clinical and radiographic presentations of TB. With CT being a common part of emergency room (ER) evaluation of abdominal pain, it is imperative that radiologists be able to recognize abdominal presentations of TB. We discuss and illustrate typical and less common CT manifestations of tuberculosis in the abdomen to help ER radiologists in this task.

  18. Inflammatory abdominal aortic aneurysm.

    PubMed

    Savarese, R P; Rosenfeld, J C; DeLaurentis, D A

    1986-05-01

    Between January 1976 and December 1982, 181 patients with abdominal aortic aneurysms were treated surgically, and in 13 patients the aneurysms were found to be inflammatory. Inflammatory aneurysms of the abdominal aorta (IAAA) share important characteristics with typical atherosclerotic abdominal aortic aneurysms. Diagnosis and surgical management of IAAA are distinctive which suggests that IAAA should be considered separately, as a varient of typical abdominal aortic aneurysms. IAAA occur predominantly in males. The presenting symptoms are often idiosyncratic and include severe abdominal or back pain, or both, and ureteral obstruction; the diagnosis of IAAA should be considered when these symptoms are present. Although grossly and microscopically, the perianeurysmal fibrosis resembles idiopathic retroperitoneal fibrosis, the two conditions can be differentiated. At the present time, ultrasonography and computed tomography appear to offer reliable means for diagnosing IAAA. The presence of IAAA, whether established preoperatively or discovered unexpectedly at operation, necessitate certain modifications in the surgical approach, in order to avoid injuring the duodenum and the venous structures. Most patients can be successfully treated by resection and graft replacement. Rupture of the aneurysm in IAAA appears to be less frequent than in typical atherosclerotic abdominal aortic aneurysm.

  19. Genes associated with the genesis of leiomyoma of the uterus in a commonly deleted chromosomal region at 7q22.

    PubMed

    Saito, Emi; Okamoto, Aikou; Saito, Misato; Shinozaki, Hideo; Takakura, Satoshi; Yanaihara, Nozomu; Ochiai, Kazunori; Tanaka, Tadao

    2005-03-01

    Uterine leiomyoma occurs in about 20-30% of women over the age of 30, and is the most frequent benign tumor in gynecology. Despite its benign status, leiomyoma of the uterus has been reported to involve chromosomal abnormalities on chromosome 7. To search for genes associated with the genesis and development of this disease, we examined microsatellite alterations on chromosome 7 in 41 uterine leiomyomas, and identified a commonly-deleted region. Allelic imbalance on chromosome 7 was detected with an incidence of 7% (3/41), with the D7S501 locus being the most frequently affected (13%). The commonly deleted region was between D7S2545 and D7S2420. We examined alterations in the expression of genes located within this region by RT-PCR. Only the LAMB1 (Laminin beta1) gene showed a variable expression. Of the 21 cases, 12 showed an increase, and 5 (24%) a decrease in the expression of LAMB1 in the leiomyomatous region. These results suggested that alteration of LAMB1 expression is associated with the genesis and development of uterine leiomyoma.

  20. Genome-wide acquired uniparental disomy as well as chromosomal gains and losses in an uterine epithelioid leiomyoma

    PubMed Central

    2014-01-01

    Background Epitheloid leiomyoma is a rare subtype of benign smooth muscle tumors. Results Herein, we present the results of classical cytogenetics, MED12 mutation analysis, and copy number variation array evaluation in one such case. Whereas cytogenetic did not show evidence for clonal chromosome abnormalities and no MED12 mutation in the “fibroid hot spot” region was detected, array hybridization revealed multiple abnormalities. Most noteworthy, almost all chromosomes showed copy-number neutral loss of heterozygosity. As examples of further abnormalities, trisomies of chromosomes 8, 12, 20, and X were noted. Discussion The data presented suggest a near-haploid karyotype of the tumor as the initial genetic alteration followed by secondary duplications of large parts of the genome. The absence of any clonal karyotypic alterations after performing classical cytogenetics is likely explained by a reduced ability of the tumor cells to proliferate in vitro. However, to the best of our knowledge this is the first report of an uterine leiomyoma showing extended uniparental disomy. It remains to be determined if this is a more common phenomenon in epithelioid leiomyomas or even subsets of “ordinary” leiomyomas. PMID:24593849

  1. CYP1A1 and CYP1B1 genetic polymorphisms and uterine leiomyoma risk in Chinese women

    PubMed Central

    Ye, Yi; Cheng, Xiao; Luo, Hai-Bo; Liu, Li; Li, Ying-Bi

    2008-01-01

    Purpose The aim of the study was to evaluate the association of CYP1A1 and CYP1B1 polymorphisms with uterine leiomyoma in Chinese women. Methods We investigated 100 women with clinically diagnosed uterine leiomyoma and 110 healthy normal subjects from Chinese women. The genetic distribution of two CYP1A1 polymorphisms at MspI, Ile462Val and four CYP1B1 polymorphisms at Arg48Gly, Ala119Ser, Leu432Val, Asp449Asp were analyzed by polymerase chain reaction–restriction fragment length polymorphism and DNA sequencing method. Results All the SNPs showed polymorphisms in Chinese women. The genotype A/G and the allele G on Ile462Val was significantly different between uterine leiomyoma patients and controls (P < 0.05). Conclusion These results suggest that the genotype of CYP1A1 Ile462Val was associated with the increased risk of uterine leiomyomas in Chinese women. PMID:18763031

  2. Giant impacts on giant planets

    NASA Astrophysics Data System (ADS)

    de Pater, Imke

    2013-10-01

    The 2009 impact and recent superbolides on Jupiter caught the world by surprise and cast doubt on impactor flux estimates for the outer solar system. Enhanced amateur planetary imaging techniques yield both high spatial resolution {enabling the 2009 impact debris field detection} and rapid frame rates {enabling the 2010/2012 impact flash detections and lightcurve measurements}.We propose a ToO program to image future impacts on Jupiter and Saturn. To remove the possibility of impact cloud non-detections, the program will be triggered only if an existing impact debris field is seen, an object on a collision course with Jupiter or Saturn is discovered, or an impact light curve is measured with an estimated total energy large enough to generate an impact cloud in a giant planet atmosphere {10^20 J}.HST provides the only way to image these events in the ultraviolet, providing information on aerosol altitudes and on smaller particles that are less visible to ground-based infrared observations. High-resolution imaging with proper timing {not achievable from the ground} is required to measure precisely both the velocity fields of impact sites and the optical spectrum of impact debris. HST observations of past impacts on Jupiter have also served both as cornerstones of science investigations at other wavelengths and as vehicles for effective public outreach.Large outer solar system impacts are governed by the same physics as in the terrestrial events that dominate the impact threat to humans. Studying the behavior of impactors of various sizes and compositions, as they enter the atmosphere at varying angles and speeds, will better quantify terrestrial impact hazards.

  3. Giant impacts on giant planets

    NASA Astrophysics Data System (ADS)

    de Pater, Imke

    2014-10-01

    The 2009 impact and recent superbolides on Jupiter caught the world by surprise and cast doubt on impactor flux estimates for the outer solar system. Enhanced amateur planetary imaging techniques yield both high spatial resolution (enabling the 2009 impact debris field detection) and rapid frame rates (enabling the 2010/2012 impact flash detections and lightcurve measurements).We propose a ToO program to image future impacts on Jupiter and Saturn. To remove the possibility of impact cloud non-detections, the program will be triggered only if an existing impact debris field is seen, an object on a collision course with Jupiter or Saturn is discovered, or an impact light curve is measured with an estimated total energy large enough to generate an impact cloud in a giant planet atmosphere (10^20 J).HST provides the only way to image these events in the ultraviolet, providing information on aerosol altitudes and on smaller particles that are less visible to ground-based infrared observations. High-resolution imaging with proper timing (not achievable from the ground) is required to measure precisely both the velocity fields of impact sites and the optical spectrum of impact debris. HST observations of past impacts on Jupiter have also served both as cornerstones of science investigations at other wavelengths and as vehicles for effective public outreach.Large outer solar system impacts are governed by the same physics as in the terrestrial events that dominate the impact threat to humans. Studying the behavior of impactors of various sizes and compositions, as they enter the atmosphere at varying angles and speeds, will better quantify terrestrial impact hazards.

  4. Giant impacts on giant planets

    NASA Astrophysics Data System (ADS)

    de Pater, Imke

    2012-10-01

    The 2009 impact on Jupiter caught the world by surprise and cast doubt on impactor flux estimates for the outer solar system. Enhanced amateur planetary imaging techniques yield both high spatial resolution {enabling the 2009 impact debris field detection} and rapid frame rates {enabling the 2010 impact flash detections and lightcurve measurements}.We propose a Target of Opportunity program to image future impacts on Jupiter and Saturn. To remove the possibility of impact cloud non-detections, the program will be triggered only if an existing impact debris field is seen, an object on a collision course with Jupiter or Saturn is discovered, or an impact light curve is measured with an estimated total energy large enough to generate an impact cloud in a giant planet atmosphere.HST provides the only way to image these events in the ultraviolet, providing information on aerosol altitudes and on smaller particles that are less visible to ground-based infrared observations. High-resolution imaging with proper timing {not achievable from the ground} is required to measure precisely both the velocity fields of impact sites and the optical spectrum of impact debris. HST observations of past impacts on Jupiter have also served both as cornerstones of science investigations at other wavelengths and as vehicles for effective public outreach.Large outer solar system impacts are governed by the same physics as in the terrestrial events that dominate the impact threat to humans. Studying the behavior of impactors of various sizes and compositions, as they enter the atmosphere at varying angles and speeds, will better quantify terrestrial impact hazards.

  5. Correlated Expression of HMGA2 and PLAG1 in Thyroid Tumors, Uterine Leiomyomas and Experimental Models

    PubMed Central

    Klemke, Markus; Müller, Marietta Henrike; Wosniok, Werner; Markowski, Dominique Nadine; Nimzyk, Rolf; Helmke, Burkhard Maria; Bullerdiek, Jörn

    2014-01-01

    In pleomorphic adenomas of the salivary glands (PASG) recurrent chromosomal rearrangements affecting either 8q12 or 12q14∼15 lead to an overexpression of the genes of the genuine transcription factor PLAG1 or the architectural transcription factor HMGA2, respectively. Both genes are also affected by recurrent chromosomal rearrangements in benign adipocytic tumors as e. g. lipomas and lipoblastomas. Herein, we observed a strong correlation between the expression of HMGA2 and PLAG1 in 14 benign and 23 malignant thyroid tumors. To address the question if PLAG1 can be activated by HMGA2, the expression of both genes was quantified in 32 uterine leiomyomas 17 of which exhibited an overexpression of HMGA2. All leiomyomas with HMGA2 overexpression also revealed an activation of PLAG1 in the absence of detectable chromosome 8 abnormalities affecting the PLAG1 locus. To further investigate if the overexpression of PLAG1 is inducible by HMGA2 alone, HMGA2 was transiently overexpressed in MCF-7 cells. An increased PLAG1 expression was observed 24 and 48 h after transfection. Likewise, stimulation of HMGA2 by FGF1 in adipose tissue-derived stem cells led to a simultaneous increase of PLAG1 mRNA. Altogether, these data suggest that HMGA2 is an upstream activator of PLAG1. Accordingly, this may explain the formation of tumors as similar as lipomas and lipoblastomas resulting from an activation of either of both genes by chromosomal rearrangements. PMID:24516594

  6. Gorlin syndrome with an ovarian leiomyoma associated with a PTCH1 second hit.

    PubMed

    Akizawa, Yoshika; Miyashita, Toshiyuki; Sasaki, Ryo; Nagata, Reiko; Aoki, Ryoko; Ishitani, Ken; Nagashima, Yoji; Matsui, Hideo; Saito, Kayoko

    2016-04-01

    We describe a Gorlin syndrome (GS) case with two different second hit mutations of PTCH1, one in a keratocystic odontogenic tumor (KCOT) and the other in an ovarian leiomyoma. GS is a rare genetic condition manifesting as multiple basal cell nevi associated with other features such as medulloblastomas, skeletal abnormalities, and ovarian fibromas. A 21-year-old Japanese woman with a history of two KCOTs was diagnosed with GS according to clinical criteria. A PTCH1 mutation, c.1427del T, was detected in peripheral blood. A novel PTCH1 mutation, c.264_265insAATA, had been found in the maxillary KCOT as a second hit mutation. More recently, the ovarian tumor was detected during a gynecological examination. Laparoscopic adnexectomy was performed, and the pathological diagnosis of the ovarian tumor was leiomyoma. Interestingly, another novel mutation, loss of heterozygosity spanning from 9q22.32 to 9q31.2, including PTCH1 and 89 other genes, was detected in this ovarian tumor, providing evidence of a second hit mutation. This is the first report describing a GS-associated ovarian tumor carrying a second hit in the PTCH1 region. We anticipate that accumulation of more cases will clarify the importance of second hit mutations in ovarian tumor formation in GS.

  7. Elevated blood active ghrelin and normal total ghrelin and obestatin concentrations in uterine leiomyoma.

    PubMed

    Markowska, A; Ziolkowska, A; Nowinka, K; Malendowicz, L K

    2009-01-01

    Ghrelin and obestatin originate from the same peptide precursor, preproghrelin. Both peptides are secreted in the blood. We investigated serum active and total ghrelin and obestatin concentrations in women with uterine myomatosis. Serum concentrations of active ghrelin in uterine leiomyoma were significantly higher compared to women in the control group (86 +/- 3 vs 56 +/- 9 pg/ml, respectively; p < 0.02). On the other hand, serum concentrations of total ghrelin and obestatin in uterine leiomyoma did not differ from those in the control group. In the control group the ratio of active to total ghrelin concentrations amounted to 0.62, while in women with uterine myoma it was 0.95, pointing to a prevalence of the active form of ghrelin in women with uterine myoma. Also the ratio of active ghrelin concentration to obestatin concentration was higher in the latter group while the ratio of total circulating ghrelin to obestatin concentrations was similar in the two groups. The data may suggest a role of active ghrelin in the development of a myoma. Moreover, the results indicate that increased blood ratios of active to total ghrelin and to obestatin concentrations are not specific for cachexia.

  8. Abdominal emergencies in pediatrics.

    PubMed

    Coca Robinot, D; Liébana de Rojas, C; Aguirre Pascual, E

    2016-05-01

    Abdominal symptoms are among the most common reasons for pediatric emergency department visits, and abdominal pain is the most frequently reported symptom. Thorough history taking and physical examination can often reach the correct diagnosis. Knowing the abdominal conditions that are most common in each age group can help radiologists narrow the differential diagnosis. When imaging tests are indicated, ultrasonography is usually the first-line technique, enabling the diagnosis or adding relevant information with the well-known advantages of this technique. Nowadays, plain-film X-ray studies are reserved for cases in which perforation, bowel obstruction, or foreign body ingestion is suspected. It is also important to remember that abdominal pain can also occur secondary to basal pneumonia. CT is reserved for specific indications and in individual cases, for example, in patients with high clinical suspicion of abdominal disease and inconclusive findings at ultrasonography. We review some of the most common conditions in pediatric emergencies, the different imaging tests indicated in each case, and the imaging signs in each condition.

  9. Giant primary angiosarcoma of the small intestine showing severe sepsis.

    PubMed

    Takahashi, Mizuna; Ohara, Masanori; Kimura, Noriko; Domen, Hiromitsu; Yamabuki, Takumi; Komuro, Kazuteru; Tsuchikawa, Takahiro; Hirano, Satoshi; Iwashiro, Nozomu

    2014-11-21

    Primary malignant tumors of the small intestine are rare, comprising less than 2% of all gastrointestinal tumors. An 85-year-old woman was admitted with fever of 40 °C and marked abdominal distension. Her medical history was unremarkable, but blood examination showed elevated inflammatory markers. Abdominal computed tomography showed a giant tumor with central necrosis, extending from the epigastrium to the pelvic cavity. Giant gastrointestinal stromal tumor of the small intestine communicating with the gastrointestinal tract or with superimposed infection was suspected. Because no improvement occurred in response to antibiotics, surgery was performed. Laparotomy revealed giant hemorrhagic tumor adherent to the small intestine and occupying the peritoneal cavity. The giant tumor was a solid tumor weighing 3490 g, measuring 24 cm × 17.5 cm × 18 cm and showing marked necrosis. Histologically, the tumor comprised spindle-shaped cells with anaplastic large nuclei. Immunohistochemical studies showed tumor cells positive for vimentin, CD31, and factor VIII-related antigen, but negative for c-kit and CD34. Angiosarcoma was diagnosed. Although no postoperative complications occurred, the patient experienced enlargement of multiple metastatic tumors in the abdominal cavity and died 42 d postoperatively. The prognosis of small intestinal angiosarcoma is very poor, even after volume-reducing palliative surgery.

  10. [Giant Meckel's diverticulum in an adult].

    PubMed

    Rivas, Tomas Contreras; Gallardo, Nasser Eluzen; Valenzuela, Sebastian King; Pezoa, María Elena Molina; Zúñiga, José Miguel; Muñoz, Carol Bustamante; Saralic, Biserka Spralja

    2014-10-07

    Meckel's diverticulum results from a partial persistence of the omphalomesenteric duct and is the most common congenital anomaly of the gastrointestinal tract, affecting about 2% of the general population. Its presentation as a giant Meckel's diverticulum (>5 cm) is rare and is associated with major complications. We report a case of a 53 year-old woman with constipation for at least ten years. A colonoscopy from eight years ago suggested megacolon. The patient consults in the last month for abdominal pain associated with anorexia. The computed tomography scan image suggested an ileal megadiverticulum. An exploratory laparotomy revealed a saccular dilatation of the distal ileum of 6 x 15.5 cm, located 20 cm away from the ileocecal valve. We resected the involved segment of distal ileum and performed a manual ileo-ascendo anastomosis. The biopsy showed a saccular dilatation of the wall, lined by small intestinal mucosa with areas of gastric metaplasia, supporting the diagnosis of giant Meckel's diverticulum.

  11. [Inflammatory abdominal aortic aneurysm].

    PubMed

    Mikami, Y; Kyogoku, M

    1994-08-01

    Inflammatory abdominal aortic aneurysm (IAAA) is a distinct clinicopathological entity, characterized by: (1) clinical presentation, such as back pain, weight loss, and increased ESR, (2) patchy and/or diffuse lymphoplasmacytic infiltration, and (3) marked periaortic fibrosis resulting in thickening of the aneurysmal wall and occasional retroperitoneal fibrosis. Its pathogenesis is unknown, but some authors support the theory that IAAA is a subtype of atherosclerotic abdominal aortic aneurysm because of close relationship between IAAA and atherosclerotic change. In this article, we describe clinical and histological features of IAAA on the basis of the literature and our review of 6 cases of IAAA, emphasizing the similarity and difference between IAAA and atherosclerotic abdominal aortic aneurysm. Our review supports that marked lamellar fibrosis completely replacing the media and adventitia, patchy lymphocytic infiltration (mostly B cells) and endarteritis obliterans are characteristic features of IAAA.

  12. [Abdominal actinomycosis with IUD].

    PubMed

    Kamprath, S; Merker, A; Kühne-Heid, R; Schneider, A

    1997-01-01

    We report a case of abdominal actinomycosis in a 54 year old woman using an intrauterine device for a period of 8 years. The most important finding was a tuboovarialabscess at the left pelvic side with involvement of the serosa of the jejunum, ileum, sigma, and omentum majus. Intraoperative exploration showed a solid retroperitoneal infiltration between the pelvic side wall and sigma. Another infiltration was found on the left side of the abdominal wall. The diagnosis was confirmed by histopathological examination and the patient was treated by a combination of Aminopenicillin and Metronidazol. After a period of three months we observed a complete regression of the clinical and the MRI findings.

  13. The Electric Giant Resonances

    NASA Astrophysics Data System (ADS)

    van der Woude, A.

    The following sections are included: * Introduction * Experimental Methods to Study Giant Resonances * Introduction * The Tools * Introduction * Tools for Isoscalar Scattering * INELASTIC α-SCATTERING * INELASTIC PROTON SCATTERING * Tools for Isovector Excitations * γ-ABSORPTION AND PARTICLE CAPTURE REACTIONS * CHARGE EXCHANGE REACTIONS - THE (π+, π0) REACTION * Tools For Isoscalar And Isovector Excitations * INELASTIC ELECTRON SCATTERING * GIANT RESONANCE EXCITATION BY FAST HEAVY IONS * From Multipole Cross Section To Multipole Strength * The Electric Isoscalar Resonances * The Isoscalar Giant Monopole Resonance * Systematics on the GMR * Compressibility and the Giant Monopole Resonance * Introduction * The Compressibility of nuclear matter from the GMR energies * Discussion * The Isoscalar Giant Quadrupole Resonance * General Trends In Medium-Heavy and Heavy Nuclei * The GQR In Light Nuclei * The Isoscalar 3- Strength, LEOR and HEOR * Isoscalar 4+ Strength * Miscellaneous; Isoscalar 1- and L > 4-Strength * The Electric Isovector Giant Resonances * The Isovector Giant Dipole Resonance: GDR * The Isovector Giant Monopole Resonances: IVGMR * The Isovector Quadrupole Resonance: IVGQR * The Effect of Ground State Deformation on the Shape of Giant Resonance: Microscopic Picture * Giant Resonances Built on Excited States * Introduction * Capture Reactions on Light Nuclei * Statistical decay of GDR γ Emission in Heavy Compound Systems * Introduction * Theoretical Predictions * Some Experimental Results * Summary and Outlook * Acknowledgements * General References * References

  14. Abdominal exploration - slideshow

    MedlinePlus

    ... anatomy URL of this page: //medlineplus.gov/ency/presentations/100049.htm Abdominal exploration - series—Normal anatomy To use the sharing features on this page, please enable JavaScript. Go to slide 1 out of 4 Go to slide 2 ...

  15. Incision for abdominal laparoscopy (image)

    MedlinePlus

    Abdominal laparoscopy is a useful aid in diagnosing disease or trauma in the abdominal cavity with less scarring than ... as liver and pancreatic resections may begin with laparoscopy to exclude the presence of additional tumors (metastatic ...

  16. Ulipristal Acetate in Myomectomy Optimization in an Infertile Patient with Giant Myomas

    PubMed Central

    Borrás, María Dolores; Rubio, Miriam; Abril, Nuria

    2016-01-01

    The use of ulipristal acetate (UPA) has been recently introduced in the treatment of uterine leiomyomas. This drug has proven useful to control menometrorrhagia and to reduce myoma size. In the case presented here, we show the benefits of UPA treatment in facilitating surgical removal of giant myomas in an infertile patient. In addition to myoma reduction and a better control of preoperative bleeding, the treatment with UPA reduced the duration and complexity of the surgery, as well as the area of uterine wall involved and the resulting scar. No side effects were observed and the patient became pregnant 6 months after the surgery and had a normal pregnancy and delivery. This case report shows the beneficial effects of UPA in the preoperative treatment of myomas which affect uterus function. PMID:27594886

  17. Polymorphism of the IL13 gene may be associated with Uterine leiomyomas in Slovenian women

    PubMed Central

    Krsteski, J; Jurgec, S; Pakiž, M; But, I

    2016-01-01

    Abstract Uterine leiomyomas (ULM) are a common cause of solid pelvic tumors in women. Their etiopathogenesis remains unclear. Interleukins (ILs) and their receptors can influence tumor biology of ULM. The aim of this study was to evaluate single nucleotide polymorphisms (SNPs) exhibited in the genes IL4 (rs2070874), IL4R (rs1801275), IL12RB1 (rs11575934), IL12B (rs6887695), IL13 (rs20541) and IL23R (rs7517847) as risk factors for ULM in Slovenian women and to identify associations between corresponding clinical parameters and the analyzed SNPs. In addition, solitary and multiple ULM were compared to identify clinical and/or genetic parameters influencing their occurrence. We conducted a case-control study that included 181 women with leiomyomas and 133 control subjects. Genotyping of selected SNPs was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and high resolution melting (HRM) techniques. The TT genotype of rs20541 (IL13) was significantly associated with decreased risk of ULM compared to both the CC and CT genotypes [p = 0.018; odds ratio (OR) = 0.184; 95% confidence interval (95% CI) = 0.048-0.7121. Using genetic and clinical data to develop a predictive model with logistic regression, we found that adenomyosis, higher age at diagnosis, family history of ULM occurrence, earlier menarche, lower number of pregnancies and lower age at first sexual intercourse, the G allele and genotypes AG and GG of rs1801275 (IL4R) were associated with an increased risk of multiple ULM occurrence. We also found an association between rs20541 (IL13) and 17ß-estradiol serum levels in patients with multiple ULM (p 0.003). Our study showed, for the first time, that rs20541 (IL13) may contribute to susceptibility of ULM development and that rs1801275 (IL4R) can predispose patients to develop multiple ULM. PMID:28289589

  18. [Myxofibrosarcoma in the abdominal cavity].

    PubMed

    Janů, F

    2016-01-01

    A number of benign and malignant tumors may develop in the abdominal cavity. Sarcomas are rather rare tumors of the abdominal cavity. They are often diagnosed at advanced growth stages as their local growth can cause clinical problems to the patients. The author presents a case report of myxofibrosarcoma in the abdominal cavity.Key words: myxofibrosarcoma.

  19. Congenital Giant Hydroureteric Cistern in a Duplex System of an Infant

    PubMed Central

    Awolaran, O. T.; Abdur-Rahman, L. O.; Bamigbola, K. T.; Adesiyun, O. M.; Nasir, A. A.

    2013-01-01

    Duplex collecting system is a congenital genitourinary anomaly commonly found incidentally. Our experience with a duplex system associated with giant hydroureter presenting as mobile abdominal swelling that was noticed from birth, constipation, and failure to thrive is described. Ultrasound and IVU did not assist in making the diagnosis, while a barium enema suggested a colonic duplication. Congenital giant hydroureter should be considered as a differential diagnosis in infants with cystic abdominal swelling. A preserved renal moiety attributed to a dilated ureteric cistern was a unique theory in this case. PMID:24171132

  20. Same day arterial embolisation followed by hepatic resection for treatment of giant haemangioma.

    PubMed

    Bailey, James; Di Carlo, Sara; Blackwell, James; Gomez, Dhanny

    2016-02-25

    Cavernous haemangiomas are the most common tumour of the liver; they are benign in nature and have an incidence of up to 7.3% at autopsy. Occasionally, they may cause symptoms necessitating intervention. We report the case of a woman who presented with non-specific abdominal pain and evidence of a giant hepatic haemangioma on abdominal imaging. She underwent selective hepatic arteriography with transcatheter arterial embolisation followed by same-day left hemi-hepatectomy, making an uneventful recovery. We discuss the management of giant hepatic haemangiomas and present same day transcatheter arterial embolisation prior to hepatic resection as a safe and viable treatment strategy in selected cases.

  1. Unexpectedly ease surgery for a worrisome abdominal mass: Pedunculated GISTs☆

    PubMed Central

    Baskiran, Adil; Otan, Emrah; Aydin, Cemalettin; Kayaalp, Cuneyt

    2013-01-01

    INTRODUCTION Discovery of abdominal masses often poses significant diagnostic difficulties. GISTs are mesenchymal masses, with specific histological features. Dimensions may vary from millimeters to giant tumours. We would like to present our case, which had an unexpectedly easy operative course which was easily handled with a simple surgical excision with a short operative duration. PRESENTATION OF CASE A 38 years old female patient was diagnosed to have an abdominal heterogen mass of 15 cm × 12 cm × 10 cm in dimension. Abdominal computed tomography revealed the solid mass between the stomach and pancreas corpus and tail, possibly orginating from the pancreas. With the preoperative diagnosis of locally invasive distal pancreas cancer the patient underwent laparotomy, following the dissection, the mass was observed to be originating from the posterior gastric Wall, extending exophytically with a peduncle of 5 cm in width, without any visual evidence for peritoneal invasion and metastasis. The tumour and the peduncle was resected with stapler device. Total operation time was 30 min. Postoperative course was uneventful. Pathologic diagnosis was gastrointestinal stromal tumour (GIST). DISCUSSION Pedunculated large GISTs are not frequent and they can enlarge as 15 cm in diameter and compress the neighbouring organs. When they were huge, it is difficult to differentiate the origin of the masses. GISTs should be considered in differential diagnosis of giant abdominal masses. CONCLUSION When GISTs are huge and pedunculated, it can be difficult to differentiate the origin of the masses. This case report presents unexpectedly ease surgery for a worrysome abdominal mass. PMID:23999120

  2. A Foregut Duplication Cyst of the Stomach in Association with a Gastrointestinal Stromal Tumor and a Leiomyoma: A Case Report

    PubMed Central

    Gagné, Andréanne; Sazonova, Olga; Marceau, Simon; Périgny, Martine

    2016-01-01

    Objectives. Duplication cysts are rare benign lesions usually arising in the gastrointestinal tract. We report a case of a 52-year-old woman with an incidental gastric mass found on computed tomography during a pregraft workup for a familial cardiomyopathy. Methods. The mass was completely excised by partial gastrectomy and gross examination revealed a cystic lesion containing two small solid nodules in its wall. Microscopic evaluation and immunohistochemistry study were performed to further characterize the cyst and the nodules. A comprehensive literature review of the NCBI database PubMed was also carried out. Results. While the cyst was diagnosed as a foregut duplication cyst, the solid nodules proved to be concomitant gastrointestinal stromal tumor (GIST) and leiomyoma. Both morphologic features and immunohistochemistry stains, including CD117, smooth muscle actin, and CD34 supported the diagnosis. Clinical course was benign and the patient had no clinical evidence of relapse ten months following the surgical procedure. The literature search did not reveal any other published case of a foregut duplication cyst presenting in combination with a GIST and a leiomyoma. Conclusions. To our knowledge, this is the first case of a composite lesion comprising a foregut duplication cyst of the stomach along with a leiomyoma and a GIST. PMID:28097030

  3. Ruptured abdominal aortic aneurysm.

    PubMed

    Sachs, T; Schermerhorn, M

    2010-06-01

    Ruptured abdominal aortic aneurysm (AAA) continues to be one of the most lethal vascular pathologies we encounter. Its management demands prompt and efficient evaluation and repair. Open repair has traditionally been the mainstay of treatment. However, the introduction of endovascular techniques has altered the treatment algorithm for ruptured AAA in most major medical centers. We present recent literature and techniques for ruptured AAA and its surgical management.

  4. The Abdominal Circulatory Pump

    PubMed Central

    Aliverti, Andrea; Bovio, Dario; Fullin, Irene; Dellacà, Raffaele L.; Lo Mauro, Antonella; Pedotti, Antonio; Macklem, Peter T.

    2009-01-01

    Blood in the splanchnic vasculature can be transferred to the extremities. We quantified such blood shifts in normal subjects by measuring trunk volume by optoelectronic plethysmography, simultaneously with changes in body volume by whole body plethysmography during contractions of the diaphragm and abdominal muscles. Trunk volume changes with blood shifts, but body volume does not so that the blood volume shifted between trunk and extremities (Vbs) is the difference between changes in trunk and body volume. This is so because both trunk and body volume change identically with breathing and gas expansion or compression. During tidal breathing Vbs was 50–75 ml with an ejection fraction of 4–6% and an output of 750–1500 ml/min. Step increases in abdominal pressure resulted in rapid emptying presumably from the liver with a time constant of 0.61±0.1SE sec. followed by slower flow from non-hepatic viscera. The filling time constant was 0.57±0.09SE sec. Splanchnic emptying shifted up to 650 ml blood. With emptying, the increased hepatic vein flow increases the blood pressure at its entry into the inferior vena cava (IVC) and abolishes the pressure gradient producing flow between the femoral vein and the IVC inducing blood pooling in the legs. The findings are important for exercise because the larger the Vbs the greater the perfusion of locomotor muscles. During asystolic cardiac arrest we calculate that appropriate timing of abdominal compression could produce an output of 6 L/min. so that the abdominal circulatory pump might act as an auxiliary heart. PMID:19440240

  5. Lateral Abdominal Wall Reconstruction

    PubMed Central

    Baumann, Donald P.; Butler, Charles E.

    2012-01-01

    Lateral abdominal wall (LAW) defects can manifest as a flank hernias, myofascial laxity/bulges, or full-thickness defects. These defects are quite different from those in the anterior abdominal wall defects and the complexity and limited surgical options make repairing the LAW a challenge for the reconstructive surgeon. LAW reconstruction requires an understanding of the anatomy, physiologic forces, and the impact of deinnervation injury to design and perform successful reconstructions of hernia, bulge, and full-thickness defects. Reconstructive strategies must be tailored to address the inguinal ligament, retroperitoneum, chest wall, and diaphragm. Operative technique must focus on stabilization of the LAW to nonyielding points of fixation at the anatomic borders of the LAW far beyond the musculofascial borders of the defect itself. Thus, hernias, bulges, and full-thickness defects are approached in a similar fashion. Mesh reinforcement is uniformly required in lateral abdominal wall reconstruction. Inlay mesh placement with overlying myofascial coverage is preferred as a first-line option as is the case in anterior abdominal wall reconstruction. However, interposition bridging repairs are often performed as the surrounding myofascial tissue precludes a dual layered closure. The decision to place bioprosthetic or prosthetic mesh depends on surgeon preference, patient comorbidities, and clinical factors of the repair. Regardless of mesh type, the overlying soft tissue must provide stable cutaneous coverage and obliteration of dead space. In cases where the fasciocutaneous flaps surrounding the defect are inadequate for closure, regional pedicled flaps or free flaps are recruited to achieve stable soft tissue coverage. PMID:23372458

  6. [Abdominal catastrophe--surgeon's view].

    PubMed

    Vyhnánek, F

    2010-07-01

    Abdominal catastrophe is a serious clinical condition, usually being a complication arising during treatment of intraabdominal nontraumatic disorders or abdominal injuries. Most commonly, inflamation- secondary peritonitis, is concerned. Abdominal catastrophe also includes secondary signs of sepsis, abdominal compartment syndrome and enterocutaneous fistules. Most septic abdominal disorders which show signs of abdominal catastrophy, require surgical intervention and reinterventions--planned or "on demand" laparotomies. During the postoperative period, the patient requires intensive care management, including steps taken to stabilize his/hers condition, management of sepsis and metabolic and nutritional support measures, as well as adequate indication for reoperations. New technologies aimed at prevention of complications in laparostomies and to improve conditions for final laparotomy closure are used in phase procedures for surgical management of intraabdominal infections. Despite the new technologies, abdominal catastrophe has higher morbidity and lethality risk rates.

  7. Abdominal SPECT imaging

    SciTech Connect

    Van Heertum, R.L.; Brunetti, J.C.; Yudd, A.P.

    1987-07-01

    Over the past several years, abdominal single photon emission computed tomography (SPECT) imaging has evolved from a research tool to an important clinical imaging modality that is helpful in the diagnostic assessment of a wide variety of disorders involving the abdominal viscera. Although liver-spleen imaging is the most popular of the abdominal SPECT procedures, blood pool imaging is becoming much more widely utilized for the evaluation of cavernous hemangiomas of the liver as well as other vascular abnormalities in the abdomen. Adjunctive indium leukocyte and gallium SPECT studies are also proving to be of value in the assessment of a variety of infectious and neoplastic diseases. As more experience is acquired in this area, SPECT should become the primary imaging modality for both gallium and indium white blood cells in many institutions. Renal SPECT, on the other hand, has only recently been used as a clinical imaging modality for the assessment of such parameters as renal depth and volume. The exact role of renal SPECT as a clinical tool is, therefore, yet to be determined. 79 references.

  8. Abdominal emergencies during pregnancy.

    PubMed

    Bouyou, J; Gaujoux, S; Marcellin, L; Leconte, M; Goffinet, F; Chapron, C; Dousset, B

    2015-12-01

    Abdominal emergencies during pregnancy (excluding obstetrical emergencies) occur in one out of 500-700 pregnancies and may involve gastrointestinal, gynecologic, urologic, vascular and traumatic etiologies; surgery is necessary in 0.2-2% of cases. Since these emergencies are relatively rare, patients should be referred to specialized centers where surgical, obstetrical and neonatal cares are available, particularly because surgical intervention increases the risk of premature labor. Clinical presentations may be atypical and misleading because of pregnancy-associated anatomical and physiologic alterations, which often result in diagnostic uncertainty and therapeutic delay with increased risks of maternal and infant morbidity. The most common abdominal emergencies are acute appendicitis (best treated by laparoscopic appendectomy), acute calculous cholecystitis (best treated by laparoscopic cholecystectomy from the first trimester through the early part of the third trimester) and intestinal obstruction (where medical treatment is the first-line approach, just as in the non-pregnant patient). Acute pancreatitis is rare, usually resulting from trans-ampullary passage of gallstones; it usually resolves with medical treatment but an elevated risk of recurrent episodes justifies laparoscopic cholecystectomy in the 2nd trimester and endoscopic sphincterotomy in the 3rd trimester. The aim of the present work is to review pregnancy-induced anatomical and physiological modifications, to describe the main abdominal emergencies during pregnancy, their specific features and their diagnostic and therapeutic management.

  9. Functional abdominal pain

    PubMed Central

    Matthews, P; Aziz, Q

    2005-01-01

    Functional abdominal pain or functional abdominal pain syndrome (FAPS) is an uncommon functional gut disorder characterised by chronic or recurrent abdominal pain attributed to the gut but poorly related to gut function. It is associated with abnormal illness behaviour and patients show psychological morbidity that is often minimised or denied in an attempt to discover an organic cause for symptoms. Thus the conventional biomedical approach to the management of such patients is unhelpful and a person's symptom experience is more usefully investigated using a biopsychosocial evaluation, which necessarily entails a multidisciplinary system of healthcare provision. Currently the pathophysiology of the disorder is poorly understood but is most likely to involve a dysfunction of central pain mechanisms either in terms of attentional bias, for example, hypervigilance or a failure of central pain modulation/inhibition. Although modern neurophysiological investigation of patients is promising and may provide important insights into the pathophysiology of FAPS, current clinical management relies on an effective physician-patient relationship in which limits on clinical investigation are set and achievable treatment goals tailored to the patient's needs are pursued. PMID:15998821

  10. Chylous ascites after resection of giant adrenocortical carcinoma

    PubMed Central

    Karakoyun, Rojbin; Demirci, Erkan; Alikanoglu, Arsenal Sezgin

    2016-01-01

    Postoperative chylous ascites (PCA) is a rare clinical state that occurs during abdominal surgery. Despite its rarity, the need to diagnose and treat PCA is increasing in importance with the increased number of wide resections and lymph node dissections being performed and the serious consequences of treatment. Here we describe the PCA complications we observed after resection for treating a case of giant adrenocortical carcinoma and we have the brief review of the PCA complication. PMID:28149812

  11. Abdominal tumors in children

    PubMed Central

    Oh, Chaeyoun; Youn, Joong Kee; Han, Ji-Won; Kim, Hyun-Young; Jung, Sung-Eun

    2016-01-01

    Abstract The use of minimally invasive surgery (MIS) in pediatric patients has been steadily increasing in recent years. However, its use for diagnosing and treating abdominal tumors in children is still limited compared with adults, especially when malignancy is a matter of debate. Here, we describe the experience at our center with pediatric abdominal tumors to show the safety and feasibility of MIS. Based on a retrospective review of patient records, we selected for study those pediatric patients who had undergone diagnostic exploration or curative resection for abdominal tumors at a single center from January 2010 through August 2015. Diagnostic exploration for abdominal tumors was performed in 32 cases and curative resection in 173 cases (205 operations). MIS was performed in 11 cases of diagnostic exploration (34.4%) and 38 cases of curative resection (21.9%). The mean age of the children who underwent MIS was 6.09 ± 5.2 years. With regard to diagnostic exploration, patient characteristics and surgical outcomes were found to be similar for MIS and open surgery. With regard to curative resection, however, the mean age was significantly lower among the patients who underwent open surgery (4.21 ± 4.20 vs 6.02 ± 4.99 for MIS, P = 0.047), and the proportion of malignancies was significantly higher (80% vs 39.4% for MIS, P < 0.001). MIS compared favorably with open surgery with respect to the rate of recurrence (6.7% vs 35.1%, P = 0.035), the rate of intraoperative transfusions (34.2% vs 58.5%, P = 0.01), the median amount of blood transfused (14 vs 22 mL/kg, P = 0.001), and the mean number of hospital days (4.66 ± 2.36 vs 7.21 ± 5.09, P < 0.001). Complication rates did not differ significantly between the MIS and open surgery groups. The operation was converted to open surgery in 3 cases (27.2%) of diagnostic MIS and in 5 cases (13.1%) of curative MIS. MIS was found to be both feasible and effective for the

  12. Unstable giant gravitons

    SciTech Connect

    Mello Koch, Robert de; Ives, Norman; Smolic, Jelena; Smolic, Milena

    2006-03-15

    We find giant graviton solutions in Frolov's three parameter generalization of the Lunin-Maldacena background. The background we study has {gamma}-tilde{sub 1}=0 and {gamma}-tilde{sub 2}={gamma}-tilde{sub 3}={gamma}-tilde. This class of backgrounds provides a nonsupersymmetric example of the gauge theory/gravity correspondence that can be tested quantitatively, as recently shown by Frolov, Roiban, and Tseytlin. The giant graviton solutions we find have a greater energy than the point gravitons, making them unstable states. Despite this, we find striking quantitative agreement between the gauge theory and gravity descriptions of open strings attached to the giant.

  13. Clinical predictors of successful magnetic resonance-guided focused ultrasound (MRgFUS) for uterine leiomyoma

    PubMed Central

    2013-01-01

    Background Magnetic resonance-guided focused ultrasound (MRgFUS) is a relatively new minimally invasive treatment, approved by the US Food and Drug Administration in 2004 for treatments of symptomatic uterine leiomyomas (fibroids). The purpose of this work is to present retrospective cohort analysis of women that underwent commercial MRgFUS treatment between 2005 and 2009 at a single center, to identify baseline patient characteristics that predict successful MRgFUS fibroid treatment. Identifying these clinical predictors of MRgFUS would be helpful to clinicians choosing the optimal patient for this treatment modality. Methods One hundred thirty women with symptomatic uterine leiomyomas who underwent MRgFUS were followed up with a mean length of follow up of 17.4 ± 10.3 months. The main outcome measure of the follow-up was to identify patients who required additional fibroid treatment due to continued fibroid symptoms. Additionally, patient medical history and radiological findings obtained prior to MRgFUS were reviewed, and statistical analysis was performed to identify factors associated with reduced risk of having additional fibroid treatment. Results Twenty-nine patients (22.3%) underwent additional fibroid treatment due to continued or recurrent fibroid symptoms during the follow up. Cumulative incidence of additional fibroid treatment was 9.7%, 29.3%, and 44.7% at 1, 2, and 3 years following MRgFUS, respectively. In multivariable Cox proportional hazard regression analyses, older age (hazard ratio (HR) 0.54 per 5-year increase in age, 95% confidence interval 0.39 to 0.76, p < 0.001), greater number of fibroids (HR 0.19 for more than three vs. one fibroid, 95% CI 0.05 to 0.67, p = 0.033), and greater fibroid volume (HR 0.70 per doubling in volume, 95% CI 0.51 to 0.96, p = 0.025) were significantly associated with less risk of having additional fibroid treatment. Conclusions Older age at treatment and having multiple fibroids with larger volume

  14. Abdominal perfusion computed tomography.

    PubMed

    Ogul, Hayri; Bayraktutan, Ummugulsum; Kizrak, Yesim; Pirimoglu, Berhan; Yuceler, Zeynep; Sagsoz, M Erdem; Yilmaz, Omer; Aydinli, Bulent; Ozturk, Gurkan; Kantarci, Mecit

    2013-02-01

    The purpose of this article is to provide an up to date review on the spectrum of applications of perfusion computed tomography (CT) in the abdomen. New imaging techniques have been developed with the objective of obtaining a structural and functional analysis of different organs. Recently, perfusion CT has aroused the interest of many researchers who are studying the applicability of imaging modalities in the evaluation of abdominal organs and diseases. Per-fusion CT enables fast, non-invasive imaging of the tumor vascular physiology. Moreover, it can act as an in vivo biomarker of tumor-related angiogenesis.

  15. Abdominal Perfusion Computed Tomography

    PubMed Central

    Ogul, Hayri; Bayraktutan, Ummugulsum; Kizrak, Yesim; Pirimoglu, Berhan; Yuceler, Zeynep; Sagsoz, M. Erdem; Yilmaz, Omer; Aydinli, Bulent; Ozturk, Gurkan; Kantarci, Mecit

    2013-01-01

    The purpose of this article is to provide an up to date review on the spectrum of applications of perfusion computed tomography (CT) in the abdomen. New imaging techniques have been developed with the objective of obtaining a structural and functional analysis of different organs. Recently, perfusion CT has aroused the interest of many researchers who are studying the applicability of imaging modalities in the evaluation of abdominal organs and diseases. Per-fusion CT enables fast, non-invasive imaging of the tumor vascular physiology. Moreover, it can act as an in vivo biomarker of tumor-related angiogenesis. PMID:25610249

  16. Recurrent pneumothorax following abdominal paracentesis.

    PubMed Central

    Stafford, P. J.

    1990-01-01

    A 62 year old man presented with abdominal ascites, without pleural effusion, due to peritoneal mesothelioma. He had chronic obstructive airways disease and a past history of right upper lobectomy for tuberculosis. On two occasions abdominal paracentesis was followed within 72 hours by pneumothorax. This previously unreported complication of abdominal paracentesis may be due to increased diaphragmatic excursion following the procedure and should be considered in patients with preexisting lung disease. PMID:2385561

  17. Abdominal Tuberculosis in Cairo, Egypt

    DTIC Science & Technology

    1994-01-01

    COW 03 PUBLICATION REPORT 94-30227 * ABDOMINAL TUBERCULOSIS IN CAIRO, BY RWIavni 0. IHibbs6 M. Kuanmm ad Z. Fun .Y .~ ... W I Form ApprovedREPORT...Leave blank) 2. REPORT DATE 3. REPORT TYPE AND DATES COVERED 8 April 1993 4. TITLE AND SUBTITLE S. FUNDING NUMBERS Abdominal Tuberculosis in Cairo...abdominal tuberculosis patients seen at Abbassia Fever Hospital in Cairo, Egypt from January 1990 to August 1992 are described; their mean age was 21.5

  18. Abdominal pregnancy- a case report.

    PubMed

    Okafor, Ii; Ude, Ac; Aderibigbe, Aso; Amu, Oc; Udeh, Pe; Obianyo, Nen; Ani, Coc

    2011-01-01

    A case of abdominal pregnancy in a 39 year old female gravida 4, para 0(+3) is presented. Ultrasonography revealed a viable abdominal pregnancy at 15 weeks gestational age. She was initially managed conservatively. Surgical intervention became necessary at 20 weeks gestational age following Ultrasound detection of foetal demise. The maternal outcome was favourable. This case is presented to highlight the dilemma associated with diagnosis and management of abdominal pregnancy with a review of literature.

  19. Equine histoplasmosis presenting as a tumor in the abdominal cavity.

    PubMed

    Nunes, Jairo; Mackie, John T; Kiupel, Matti

    2006-09-01

    A 3.5-year-old Thoroughbred mare presented at necropsy with a large mass at the root of the mesentery and multiple smaller mesenteric masses. The mucosa of the small intestine contained numerous raised nodules. Histologic examination revealed severe granulomatous mesenteric lymphadenitis and enteritis. Epithelioid macrophages and multinucleated giant cells frequently contained numerous intracytoplasmic yeast organisms, which were strongly positive on immunohistochemical staining when using a polyclonal antibody against Histoplasma spp. A diagnosis of abdominal histoplasmosis was made based on the gross, microscopic, and immunohistochemical findings.

  20. The Next Giant Step

    NASA Video Gallery

    Artist Robert McCall painted "The Next Giant Step" in 1979 to commemorate the heroism and courage of spaceflight pioneers. Located in the lobby of Johnson's building 2, the mural depicts America's ...

  1. The Giant Cell.

    ERIC Educational Resources Information Center

    Stockdale, Dennis

    1998-01-01

    Provides directions for the construction of giant plastic cells, including details for building and installing the organelles. Also contains instructions for preparing the ribosomes, nucleolus, nucleus, and mitochondria. (DDR)

  2. [Inflammatory abdominal aortic aneurysm].

    PubMed

    Siebenmann, R; Schneider, K; von Segesser, L; Turina, M

    1988-06-11

    348 cases of abdominal aortic aneurysm were reviewed for typical features of inflammatory aneurysm (IAAA) (marked thickening of aneurysm wall, retroperitoneal fibrosis and rigid adherence of adjacent structures). IAAA was present in 15 cases (14 male, 1 female). When compared with patients who had ordinary aneurysms, significantly more patients complained of back or abdominal pain (p less than 0.01). Erythrocyte sedimentation rate was highly elevated. Diagnosis was established in 7 of 10 computed tomographies. 2 patients underwent emergency repair for ruptured aneurysm. Unilateral ureteral obstruction was present in 4 cases and bilateral in 1. Repair of IAAA was performed by a modified technique. Histological examination revealed thickening of the aortic wall, mainly of the adventitial layer, infiltrated by plasma cells and lymphocytes. One 71-year-old patient operated on for rupture of IAAA died early, and another 78-year-old patient after 5 1/2 months. Control computed tomographies revealed spontaneous regression of inflammatory infiltration after repair. Equally, hydronephrosis due to ureteral obstruction could be shown to disappear or at least to decrease. IAAA can be diagnosed by computed tomography with high sensitivity. Repair involves low risk, but modification of technique is necessary. The etiology of IAAA remains unclear.

  3. Fertility after abdominal myomectomy.

    PubMed

    Connolly, G; Doyle, M; Barrett, T; Byrne, P; De Mello, M; Harrison, R F

    2000-07-01

    This study aimed to evaluate the morbidity and pregnancy outcome of myomectomy in infertile women with uterine fibroids. This was a cross-sectional study. Records were reviewed for 100 consecutive women in the Rotunda Hospital who underwent myomectomy in the years 1995-1996. A questionnaire regarding subsequent fertility was sent. The study was carried out in the infertility unit at the Rotunda Hospital, Dublin, Ireland. Seventy-five women responded. Multiple myomectomy was performed in 52 (70%). Mean fibroid size was 6.8 cm (range 2-14.5 cm). Nine women (12%) developed complications; five had menstrual problems, two had wound discomfort and two had abdominal discomfort. Twenty-five women (33%) became pregnant. Seven (28%) were IVF pregnancies. Overall six (24%) miscarried. In 19 of 25, pregnancy occurred where fibroids were the only identifiable cause of infertility. We conclude that abdominal myomectomy is associated with a favourable outcome in infertile women particularly if no other confounding variable is present.

  4. [Intra-abdominal mycoses].

    PubMed

    Boos, C; Kujath, P; Bruch, H-P

    2005-01-01

    The incidence of invasive mycoses in patients undergoing abdominal surgery amounts to approximately 8% and shows an upward trend in epidemiological studies. The lethality of these systemic mycoses, which are mostly based on Candida infections constitutes up to 60%. The development of a sytemic mycosis is marked by exogenic, endogenic and iatrogenic risk factors and typically displays tissue invasion after an initial fungal contamination or systemic dissemination via fungal sepsis. Fungal peritonitis is generally a monoinfection with Candida spp., where Candida albicans outweighs in 70% of cases. Aspergillus spp. are only detected abdominally in rare cases. The histological verification of a fungal invasion is regarded as proof of the existence of an invasive mycosis, but typical macroscopic findings with corresponding cultural findings can also confirm the diagnosis. Systemic mycosis requires an early initiation of a consistent antimycotic therapy as well as definitive surgical eradication of the focus in order to reduce high lethal rate. Resistances or incorrect dosages can be validated objectively by means of histological monitoring of the antimycotic therapy, thus affording early recognition of the need to change the substance class.

  5. Somatic mutational analysis of MED12 exon 2 in uterine leiomyomas of Iranian women

    PubMed Central

    Shahbazi, Shirin; Fatahi, Neda; Amini-Moghaddam, Soheila

    2015-01-01

    Uterine leiomyomas are steroid-hormone dependent tumors of myometrial smooth muscle cells that affect numerous women throughout the world. Based on previous studies, we evaluated the mutations of MED12 gene which encodes a co-activator protein involved in transcription regulation of the vast majority of RNA polymerase II-dependent genes. Exon 2 of MED12 gene was genotyped by PCR-sequencing method. To determine the proportion of mutation-containing transcripts, RNA was extracted from the tissue samples and the corresponding amplified cDNA was sequenced. We observed 11 mutation positive lesions, 7 of them were located in codon 44. The c.131G>A was found to be the most common somatic mutation in this study. Our investigation also demonstrated two unreported mutations , one large deletion and one insertion. cDNA analyzing revealed that the mutated transcripts were predominantly expressed in almost all changes including the new insertion mutation c.122-123ins15. Our study provides further evidence that the MED12 somatic mutations occur in a heterozygous manner and are mostly missense mutations in codon 44. The results displayed 47.8% mutation positive lesions in Iranian patients confirming the diversity between the populations. PMID:26396919

  6. Implanting intra-abdominal radiotransmitters with external whip antennas in ducks

    USGS Publications Warehouse

    Korschgen, C.E.; Kenow, K.P.; Gendron-Fitzpatrick, A.; Green, W.L.; Dein, F.J.

    1996-01-01

    We developed and evaluated a surgical procedure for implanting intra-abdominal radiotransmitters with external whip antennas in captive mallards (Anas platyrhynchos). Transmitters were implanted in the abdominal cavity and the antennas exited through the caudal abdominal wall and skin. Birds with implanted transmitters developed mild to moderate localized air sac reactions. These reactions involved adhesions of the right anterior abdominal air sac to the liver with contractions around the transmitters and antenna catheters. The adhesions were reinforced by a proliferation of connective tissue and lined by multinucleated giant cells (foreign body reaction). Casual observation indicated that neither behavior nor activity of the birds was altered by the histological reaction to the transmitter implant. No increase in systemic lesions (particularly liver or kidney) could be correlated with the histological reactions. Our evaluations indicate that the procedure is a reliable method for radiomarking ducks and the technique has been successfully used in 2 field studies.

  7. Novel KAT6B-KANSL1 Fusion Gene Identified by RNA Sequencing in Retroperitoneal Leiomyoma with t(10;17)(q22;q21)

    PubMed Central

    Panagopoulos, Ioannis; Gorunova, Ludmila; Bjerkehagen, Bodil; Heim, Sverre

    2015-01-01

    Retroperitoneal leiomyoma is a rare type of benign smooth muscle tumor almost exclusively found in women and with histopathological features similar to uterine leiomyomas. The pathogenesis of retroperitoneal leiomyoma is unclear and next to nothing is known about the cytogenetics and molecular genetics of the tumor. Here we present the first cytogenetically analyzed retroperitoneal leiomyoma. It had a t(10;17)(q22;q21) as the sole chromosomal abnormality. Using RNA-Sequencing and the ‘grep’ command to search the fastq files of the sequence data we found that the translocation resulted in fusion of the genes KAT6B (10q22) with KANSL1 (17q21). RT-PCR together with direct (Sanger) sequencing verified the presence of a KAT6B-KANSL1 fusion transcript. No reciprocal KANSL1-KAT6B transcript was amplified suggesting that it was either absent or unexpressed. The KAT6B-KANSL1 fusion transcript consists of exons 1 to 3 of KAT6B and exons 11 to 15 of KANSL1, is 3667 bp long, has a 1398 bp long open reading frame, and codes for a 466 amino acid residue protein. The corresponding KAT6B-KANSL1 protein contains the NEMM domain (including the linker histone H1/H5, domain H15) of KAT6B and the PEHE domain of KANSL1. The function of the fusion protein might be regulation of transcription with an affinity for chromatin (linker histone H1/H5) and interaction with the HAT domain of KAT8 (PEHE domain). The tumor expressed HMGA2 and HMGA1 even though 12q14-15 and 6p looked normal by G-banding analysis. The tumor also expressed MED12 in the absence of exon 2 mutations. Overall, the data show that the examined retroperitoneal leiomyoma resembles a subset of uterine leiomyomas in terms of histology and genetics. PMID:25621995

  8. [Abdominal approaches and drainages of the abdominal cavity].

    PubMed

    Hagel, C; Schilling, M

    2006-04-01

    Appropriate access to the abdominal cavity is the first and crucial step for successful abdominal surgical intervention. In planning the incision, several variables have to be considered, such as anatomy of the abdominal wall, localization of the target organ, and individual conditions (previous incisions, minimal access surgery, etc). Medial laparotomy is the preferred incision for emergency cases and ill-defined pathologies, allowing access and hence exploration to all quadrants. Transverse laparotomies give superior access to the dorsal and right aspects of the liver and cause less pain in patients unfit for regional anesthetic procedures. Draining of the abdominal cavity is used after various resective and reconstructive procedures, but there is little evidence for its use in a number of operations such as gastric, hepatic, and colorectal resections. Advantages and disadvantages of different abdominal wall incisions and drainages are discussed.

  9. How I Manage Abdominal Injuries.

    ERIC Educational Resources Information Center

    Haycock, Christine E.

    1986-01-01

    In sports, abdominal injuries occur most frequently in cycling, horseback riding, and skiing. Most involve children, not adults. Any athlete sustaining a severe blow to the abdomen should be examined. Guidelines are provided for recognizing and treating injuries to the abdominal muscles, kidneys, spleen, and liver. (Author/MT)

  10. CT of abdominal tuberculosis

    SciTech Connect

    Epstein, B.M.; Mann, J.H.

    1982-11-01

    Intraabdominal tuberculosis (TB) presents with a wide variety of clinical and radiologic features. Besides the reported computed tomographic (CT) finding of high-density ascites in tuberculous peritonitis, this report describes additional CT features highly suggestive of abdominal tuberculosis in eight cases: (1) irregular soft-tissue densities in the omental area; (2) low-density masses surrounded by thick solid rims; (3) a disorganized appearance of soft-tissue densities, fluid, and bowel loops forming a poorly defined mass; (4) low-density lymph nodes with a multilocular appearance after intravenous contrast administration; and (5) possibly high-density ascites. The differential diagnosis of these features include lymphoma, various forms of peritonitis, peritoneal carcinomatosis, and peritoneal mesothelioma. It is important that the CT features of intraabdominal tuberculosis be recognized in order that laparotomy be avoided and less invasive procedures (e.g., laparoscopy, biopsy, or a trial of antituberculous therapy) be instituted.

  11. Biological and Mechanistic Characterization of Novel Prodrugs of Green Tea Polyphenol Epigallocatechin Gallate Analogs in Human Leiomyoma Cell Lines.

    PubMed

    Ahmed, Reda Saber Ibrahim; Liu, Gang; Renzetti, Andrea; Farshi, Pershang; Yang, Huanjie; Soave, Claire; Saed, Ghassan; El-Ghoneimy, Ashraf Ahmed; El-Banna, Hossny Awad; Foldes, Robert; Chan, Tak-Hang; Dou, Q Ping

    2016-10-01

    Uterine fibroids (leiomyomas) are very common benign tumors grown on the smooth muscle layer of the uterus, present in up to 75% of reproductive-age women and causing significant morbidity in a subset of this population. Although the etiology and biology of uterine fibroids are unclear, strong evidence supports that cell proliferation, angiogenesis and fibrosis are involved in their formation and growth. Currently the only cure for uterine fibroids is hysterectomy; the available alternative therapies have limitations. Thus, there is an urgent need for developing a novel strategy for treating this condition. The green tea polyphenol epigallocatechin gallate (EGCG) inhibits the growth of uterine leiomyoma cells in vitro and in vivo, and the use of a green tea extract (containing 45% EGCG) has demonstrated clinical activity without side effects in women with symptomatic uterine fibroids. However, EGCG has a number of shortcomings, including low stability, poor bioavailability, and high metabolic transformations under physiological conditions, presenting challenges for its development as a therapeutic agent. We developed a prodrug of EGCG (Pro-EGCG or 1) which shows increased stability, bioavailability and biological activity in vivo as compared to EGCG. We also synthesized prodrugs of EGCG analogs, compounds 2a and 4a, in order to potentially reduce their susceptibility to methylation/inhibition by catechol-O-methyltransferase. Here, we determined the effect of EGCG, Pro-EGCG, and 2a and 4a on cultured human uterine leiomyoma cells, and found that 2a and 4a have potent antiproliferative, antiangiogenic, and antifibrotic activities. J. Cell. Biochem. 117: 2357-2369, 2016. © 2016 Wiley Periodicals, Inc.

  12. Targeted cellular process profiling approach for uterine leiomyoma using cDNA microarray, proteomics and gene ontology analysis

    PubMed Central

    Ahn, Woong Shick; Kim, Ko-Woon; Bae, Su Mi; Yoon, Joo Hee; Lee, Joon Mo; Namkoong, Sung Eun; Kim, Jin Hong; Kim, Chong Kook; Lee, Young Joo; Kim, Yong-Wan

    2003-01-01

    This study utilized both cDNA microarray and two-dimensional protein gel electrophoresis technology to investigate the multiple interactions of genes and proteins involved in uterine leiomyoma pathophysiology. Also, the gene ontology analysis was used to systematically characterize the global expression profiles at cellular process levels. We profiled differentially expressed transcriptome and proteome in six-paired leiomyoma and normal myometrium. Screening up to 17 000 genes identified 21 upregulated and 50 downregulated genes. The gene-expression profiles were classified into mutually dependent 420 functional sets, resulting in 611 cellular processes according to the gene ontology. Also, protein analysis using two-dimensional gel electrophoresis identified 33 proteins (17 upregulated and 16 downregulated) of more than 500 total spots, which was classified into 302 cellular processes. Of these functional profilings, downregulations of transcriptomes and proteoms were shown in cell adhesion, cell motility, organogenesis, enzyme regulator, structural molecule activity and response to external stimulus functional activities that are supposed to play important roles in pathophysiology. In contrast, the upregulation was only shown in nucleic acid-binding activity. Taken together, potentially significant pathogenetic cellular processes were identified and showed that the downregulated functional profiling has a significant impact on the discovery of pathogenic pathway in leiomyoma. Also, the gene ontology analysis can overcome the complexity of expression profiles of cDNA microarray and two-dimensional protein analysis via its cellular process-level approach. Therefore, a valuable prognostic candidate gene with relevance to disease-specific pathogenesis can be found at cellular process levels. PMID:14748746

  13. Abnormal uterine bleeding as a presenting symptom is related to multiple uterine leiomyoma: an ultrasound-based study

    PubMed Central

    Fonseca-Moutinho, José Alberto; Barbosa, Lígia Silva; Torres, Daniel Gonçalves; Nunes, Sara Morgado

    2013-01-01

    Purpose To determine the prevalence of uterine leiomyomas, diagnosed by ultrasound, in a private health care setting located in the central eastern region of Portugal, and to explore the demographic and clinical factors related to diagnosis and symptomatology. Patients and methods The files of 624 patients attending a private clinic in Covilhã, Portugal, from January 2 to December 31, 2010 were retrieved for evaluation. Pelvic ultrasound record, age, weight, height, age at menarche, number of pregnancies and deliveries, marital status, menstrual cycles characteristic, and contraceptive method at consultation were included in the analysis. Results Uterine leiomyoma (UL) was diagnosed by ultrasonography in 161 (25.8%) patients. A single UL was diagnosed in 80 (49.7%) patients. In 79 (49.1%) patients, the largest leiomyoma had a dimension <20 mm. Prevalence of UL was age dependent: at 11.0% for women 20–39 years old; 45.4% for those aged 40–59 years; and 19.5% for women 60 years or older. Metrorrhagia was the most distressing presenting symptom. When menorrhagia was the presenting symptom, the probability of having an ultrasound diagnosis of UL was 73.3%. Metrorrhagia or menorrhagia, as presenting symptom, was significantly related to the ultrasound diagnosis of multiple ULs. Conclusion UL was especially prevalent in women aged between 40 and 59 years. Patients with multiple ULs had significantly more abnormal uterine bleeding. In patients with menorrhagia or metrorrhagia, special attention should be taken in searching for the presence of multiple ULs during ultrasound. PMID:24194648

  14. Giant congenital melanocytic nevus*

    PubMed Central

    Viana, Ana Carolina Leite; Gontijo, Bernardo; Bittencourt, Flávia Vasques

    2013-01-01

    Giant congenital melanocytic nevus is usually defined as a melanocytic lesion present at birth that will reach a diameter ≥ 20 cm in adulthood. Its incidence is estimated in <1:20,000 newborns. Despite its rarity, this lesion is important because it may associate with severe complications such as malignant melanoma, affect the central nervous system (neurocutaneous melanosis), and have major psychosocial impact on the patient and his family due to its unsightly appearance. Giant congenital melanocytic nevus generally presents as a brown lesion, with flat or mammilated surface, well-demarcated borders and hypertrichosis. Congenital melanocytic nevus is primarily a clinical diagnosis. However, congenital nevi are histologically distinguished from acquired nevi mainly by their larger size, the spread of the nevus cells to the deep layers of the skin and by their more varied architecture and morphology. Although giant congenital melanocytic nevus is recognized as a risk factor for the development of melanoma, the precise magnitude of this risk is still controversial. The estimated lifetime risk of developing melanoma varies from 5 to 10%. On account of these uncertainties and the size of the lesions, the management of giant congenital melanocytic nevus needs individualization. Treatment may include surgical and non-surgical procedures, psychological intervention and/or clinical follow-up, with special attention to changes in color, texture or on the surface of the lesion. The only absolute indication for surgery in giant congenital melanocytic nevus is the development of a malignant neoplasm on the lesion. PMID:24474093

  15. Giant congenital melanocytic nevus.

    PubMed

    Viana, Ana Carolina Leite; Gontijo, Bernardo; Bittencourt, Flávia Vasques

    2013-01-01

    Giant congenital melanocytic nevus is usually defined as a melanocytic lesion present at birth that will reach a diameter ≥ 20 cm in adulthood. Its incidence is estimated in <1:20,000 newborns. Despite its rarity, this lesion is important because it may associate with severe complications such as malignant melanoma, affect the central nervous system (neurocutaneous melanosis), and have major psychosocial impact on the patient and his family due to its unsightly appearance. Giant congenital melanocytic nevus generally presents as a brown lesion, with flat or mammilated surface, well-demarcated borders and hypertrichosis. Congenital melanocytic nevus is primarily a clinical diagnosis. However, congenital nevi are histologically distinguished from acquired nevi mainly by their larger size, the spread of the nevus cells to the deep layers of the skin and by their more varied architecture and morphology. Although giant congenital melanocytic nevus is recognized as a risk factor for the development of melanoma, the precise magnitude of this risk is still controversial. The estimated lifetime risk of developing melanoma varies from 5 to 10%. On account of these uncertainties and the size of the lesions, the management of giant congenital melanocytic nevus needs individualization. Treatment may include surgical and non-surgical procedures, psychological intervention and/or clinical follow-up, with special attention to changes in color, texture or on the surface of the lesion. The only absolute indication for surgery in giant congenital melanocytic nevus is the development of a malignant neoplasm on the lesion.

  16. Bisphenol A, benzophenone-type ultraviolet filters, and phthalates in relation to uterine leiomyoma.

    PubMed

    Pollack, A Z; Buck Louis, G M; Chen, Z; Sun, L; Trabert, B; Guo, Y; Kannan, K

    2015-02-01

    Bisphenol A, benzophenone-type UV filters, and phthalates are chemicals in high production and use including in a range of personal care products. Exposure of humans to these chemicals has been shown to affect endocrine function. Although short-lived, widespread exposure may lead to continual opportunity for these chemicals to elicit health effects in humans. The association of these chemicals with incident uterine leiomyoma, an estrogen sensitive disease, is not known. Urinary concentrations of bisphenol A (BPA), five benzophenone-type UV filters (2-hydroxy-4-methoxybenzophenone (2OH-4MeO-BP), 2,4-dihydroxybenzophenone (2,4OH-BP), 2,2׳-dihydroxybenzophenone (2,2׳OH-4MeO-BP), 2,2׳4,4׳-tetrahydroxybenzophenone (2,2׳4,4׳OH-BP), and 4-hydroxybenzophenone (4OH-BP), and 14 phthalate monoesters were quantified in 495 women who later underwent laparoscopy/laparotomy at 14 clinical sites for the diagnosis of fibroids. Significantly higher geometric mean creatinine-corrected concentrations of BPA, 2,4OH-BP, and 2OH-4MeO-BP were observed in women with than without fibroids [BPA: 2.09µg/g vs. 1.46µg/g p=0.004; 2,4OH-BP:11.10µg/g vs. 6.71µg/g p=0.01; 2OH-4MeO-BP: 11.31µg/g vs. 6.10µg/g p=0.01]. Mono-methyl phthalate levels were significantly lower in women with than without fibroids (1.78µg/g vs. 2.40µg/g). However, none of the exposures were associated with a significant odds ratio even when adjusting for relevant covariates. There was a lack of an association between select nonpersistent chemicals and the odds of a fibroid diagnosis.

  17. Association between uterine leiomyoma and metabolic syndrome in parous premenopausal women

    PubMed Central

    Tak, Young Jin; Lee, Sang Yeoup; Park, Sun Ki; Kim, Yun Jin; Lee, Jeong Gyu; Jeong, Dong Wook; Kim, Seung Chul; Kim, In Joo; Yi, Yu Hyun

    2016-01-01

    Abstract Previous studies have reported that uterine leiomyoma (UL) may share pathogenic features with obesity and hypertension, which are components of metabolic syndrome (MetS). We examined the association between UL and MetS in premenopausal parous women. This 1:1 case–control study was conducted on 615 asymptomatic women with UL and 615 women without UL that were matched for age, reproductive history, and hormonal use, who underwent a comprehensive health examination. UL was diagnosed by a gynecologist based on transvaginal ultrasonography findings. Blood pressure (BP), body composition, fasting plasma glucose, lipid profiles, insulin, and HOMA-IR were checked. Median age of the 1230 study subjects was 44 (40–47) years and 7% had MetS. Women with UL had significantly higher waist circumferences and body fat, BP, and low-density lipoprotein cholesterol (LDL-C) than women without UL. Although nonsignificant, the prevalence of MetS was higher in the UL group than in the non-UL group (9.3% vs 5.7%). In addition, the prevalence of UL increased as the number of abnormal metabolic components increased and was higher than in women without UL. Conditional logistic regression analysis, after adjustment for confounding factors, showed that hyperglycemia was significantly associated with an increased risk of UL (odds ratio = 1.45; 95% confidence interval, 1.10–1.89). Prevalence of abnormal metabolic component was higher in premenopausal women with UL than in normal controls, regardless of age or reproductive history. Furthermore, the study suggests that UL may share pathogenic features with the components of MetS and that women with UL be considered eligible for the early screening of metabolic abnormalities. PMID:27861360

  18. Cyclin D1 G870A polymorphism: Association with uterine leiomyoma risk and in silico analysis

    PubMed Central

    Salimi, Saeedeh; Shahrakipour, Mahnaz; Hajizadeh, Azam; Mokhtari, Mojgan; Mousavi, Mahdieh; Teimoori, Batool; Yaghmaei, Minoo

    2017-01-01

    Uterine leiomyoma (UL) is the most common benign tumor causing considerable morbidity during the reproductive years in women. Cyclin D1 (CCND1) is a cell cycle regulatory protein that is required for the G1 phase, and increased expression levels of this protein may affect tumorigenesis. The present study aimed to assess the possible effect of the CCND1 G870A polymorphism on UL susceptibility. A total of 154 women with UL and 197 healthy women who were age-, body mass index (BMI)- and ethnicity-matched were genotyped for the CCND1 G870A (rs9344) polymorphism using the polymerase chain reaction-restriction fragment length polymorphism method. The effects of G870A transition on the structure of mRNA and proteins of CCND1 was evaluated using bioinformatics tools. The frequency of the CCND1 870AA genotype was significantly higher in women with UL compared with the control subjects, and the risk of UL was 1.4-fold higher in women with the AA genotype when compared with the GG genotype before and after adjusting for age, BMI, and ethnicity [odds ratio (OR), 1.4; 95% confidence interval (CI), 1.1–2 (P=0.02)]. The frequency of CCND1 870GA genotype was not significantly different between the two groups. The frequency of the CCND1 870A allele was significantly higher in the women with UL when compared with the control subjects (57 vs. 48%; P=0.02). The in silico analysis revealed that the G870A transition may fundamentally alter the structure of the CCND1-mRNA. Thus, the CCND1 870AA genotype was associated with UL susceptibility in a sample of women from the southeast of Iran. PMID:28357079

  19. CYP1A1 genetic polymorphisms and uterine leiomyoma risk: a meta-analysis

    PubMed Central

    Wang, Fen; Chen, Jiying; Wang, Lin; Ma, Yulan; Mayinuer, Niyazi

    2015-01-01

    Background: Some studies assessed the association between CYP1A1 MspI and Ile462Val polymorphisms and uterine leiomyoma (UL) risk. However, the results were controversial. We did this meta-analysis to determine the association between CYP1A1 MspI and Ile462Val polymorphisms and UL risk. Materials and methods: We searched databases containing PubMed, Springer Link, EMBASE, Chinese National Knowledge Infrastructure (CNKI) up to 11 October 2014. Pooled ORs and 95% CIs were used to assess the strength of the associations. Results: In total, 9 case-control studies with 2157 UL cases and 2197 healthy controls were included in this meta-analysis. CYP1A1 Ile462Val polymorphism was significantly associated with UL risk (OR = 2.29, 95% CI 1.75-2.99, P < 0.00001). In the subgroup analysis by race, significantly increased risks were found in the Asians (OR = 2.76, 95% CI 1.86-4.09, P < 0.00001) and Caucasians (OR = 1.87, 95% CI 1.30-2.68, P = 0.0007). However, MspI polymorphism was not significantly associated with UL risk (OR = 1.15, 95% CI 0.90-1.47, P = 0.27). In the subgroup analysis by race, no significant association was found in the Asians (OR = 1.15, 95% CI 0.86-1.54, P = 0.35). Conclusion: In summary, the results of the meta-analysis suggested that CYP1A1 Ile462Val polymorphism was significantly associated with UL risk. PMID:26064254

  20. Economics of abdominal wall reconstruction.

    PubMed

    Bower, Curtis; Roth, J Scott

    2013-10-01

    The economic aspects of abdominal wall reconstruction are frequently overlooked, although understandings of the financial implications are essential in providing cost-efficient health care. Ventral hernia repairs are frequently performed surgical procedures with significant economic ramifications for employers, insurers, providers, and patients because of the volume of procedures, complication rates, the significant rate of recurrence, and escalating costs. Because biological mesh materials add significant expense to the costs of treating complex abdominal wall hernias, the role of such costly materials needs to be better defined to ensure the most cost-efficient and effective treatments for ventral abdominal wall hernias.

  1. A bizarre abdominal cystic lesion.

    PubMed

    Zucchini, Giorgia; Pezzilli, Raffaele; Ricci, Claudio; Casadei, Riccardo; Santini, Donatella; Calculli, Lucia; Corinaldesi, Roberto

    2010-09-06

    In spite of careful intraoperative precautions and gauze counts, mistakes can still occur during surgery. In the case reported, a retained gauze leaved during a surgical approach for removing a solid-cystic papillary tumor localized in the pancreatic tail, caused both persistent abdominal discomfort and the presence of an abdominal cystic lesion at imaging techniques. When a previous operative history is present, a foreign body should be taken into account in the differential diagnosis of a patient with an intra-abdominal cystic mass. Finally, radio-opaque marker should be routinely used by surgeons in order to reach a correct diagnosis in operated patients having retained gauze.

  2. Acute incarcerated external abdominal hernia

    PubMed Central

    Yang, Xue-Fei

    2014-01-01

    External abdominal hernia occurs when abdominal organs or tissues leave their normal anatomic site and protrude outside the skin through the congenital or acquired weakness, defects or holes on the abdominal wall, including inguinal hernia, umbilical hernia, femoral hernia and so on. Acute incarcerated hernia is a common surgical emergency. With advances in minimally invasive devices and techniques, the diagnosis and treatment have witnessed major changes, such as the use of laparoscopic surgery in some cases to achieve minimally invasive treatment. However, strict adherence to the indications and contraindications is still required. PMID:25489584

  3. An Innocent Giant

    PubMed Central

    Solanki, Lakhan Singh; Dhingra, Mandeep; Raghubanshi, Gunjan; Thami, Gurvinder Pal

    2014-01-01

    A cutaneous horn (cornu cutaneum) is a protrusion from the skin composed of a cornified material. It may be associated with a benign, premalignant, or malignant lesion at the base, masking numerous dermatoses. In a 24-year-old female, a giant cutaneous horn arising from a seborrheic keratosis located on the leg is presented. This case has been reported to emphasize that a giant cutaneous horn may also occur in young patients, even in photoprotected areas, and are not always associated with malignancy. PMID:25484426

  4. [Penetrating abdominal injuries].

    PubMed

    Nesbakken, A; Pillgram-Larsen, J; Naess, F; Gerner, T; Solheim, K; Stadaas, J O; Gjøra, O

    1990-02-28

    We have reviewed the medical records of 111 patients treated for abdominal stab wounds during the period 1980-87. Our two hospitals serve a catchment area of about 450,000 people. Exploratory laparotomy was performed in 89 patients with suspected peritoneal penetration. In 16 patients the laparotomy was negative, and in 15 patients only minor injuries were noted. There were no serious complications in these 31 patients. Twenty-seven patients had thoracic wounds below the fourth intercostal space, 15 with intraabdominal injuries. The most common injuries were lacerations of the liver, the small bowel and the diaphragm. The mortality in the series was 2%. Stab wounds are infrequent in Norway, and most surgeons have limited experience of such injuries. We discuss whether to employ immediate exploratory laparotomy or selective management when the peritoneum has been penetrated. When there is no evidence of evisceration or omental protrusion, local exploration of the wound should be performed in order to confirm or exclude peritoneal penetration. Injury to the diaphragm and intraabdominal viscera should always be suspected in thoracic stab wounds below the fourth intercostal space.

  5. Abdominal aortic feminism.

    PubMed

    Mortimer, Alice Emily

    2014-11-14

    A 79-year-old woman presented to a private medical practice 2 years previously for an elective ultrasound screening scan. This imaging provided the evidence for a diagnosis of an abdominal aortic aneurysm (AAA) to be made. Despite having a number of recognised risk factors for an AAA, her general practitioner at the time did not follow the guidance set out by the private medical professional, that is, to refer the patient to a vascular specialist to be entered into a surveillance programme and surgically evaluated. The patient became symptomatic with her AAA, was admitted to hospital and found to have a tender, symptomatic, 6 cm leaking AAA. She consented for an emergency open AAA repair within a few hours of being admitted to hospital, despite the 50% perioperative mortality risk. The patient spent 4 days in intensive care where she recovered well. She was discharged after a 12 day hospital stay but unfortunately passed away shortly after her discharge from a previously undiagnosed gastric cancer.

  6. Raloxifene administration in women treated with gonadotropin-releasing hormone agonist for uterine leiomyomas: effects on bone metabolism.

    PubMed

    Palomba, Stefano; Orio, Francesco; Morelli, Michele; Russo, Tiziana; Pellicano, Massimilano; Nappi, Carmine; Mastrantonio, Pasquale; Lombardi, Gaetano; Colao, Annamaria; Zullo, Fulvio

    2002-10-01

    This prospective randomized, single-blind, placebo-controlled clinical trial was performed to evaluate the efficacy of raloxifene in preventing the bone loss associated with GnRH agonist (GnRH-a) administration. One hundred premenopausal women with uterine leiomyomas were treated with leuprolide acetate depot at a dosage of 3.75 mg/d for 28 d and then randomized into two groups to receive raloxifene hydrochloride at 60 mg/d (group A) or placebo (1 tablet/d; group B). Bone mineral density (BMD) and serum bone metabolism markers were evaluated at admission and after six treatment cycles. Posttreatment BMD differed significantly from baseline BMD in group B but not in group A. BMD was significantly higher in group A than in group B. In group A, serum osteocalcin and bone alkaline phosphatase levels and urinary deoxypyridinoline and pyrilinks-D excretion were unchanged vs. baseline. Differently, posttreatment concentrations of these bone turnover markers were significantly lower in group B compared with baseline and group A values. In conclusion, raloxifene prevents GnRH-a related bone loss in premenopausal women with uterine leiomyomas.

  7. MiRNA-TF-gene network analysis through ranking of biomolecules for multi-informative uterine leiomyoma dataset.

    PubMed

    Mallik, Saurav; Maulik, Ujjwal

    2015-10-01

    Gene ranking is an important problem in bioinformatics. Here, we propose a new framework for ranking biomolecules (viz., miRNAs, transcription-factors/TFs and genes) in a multi-informative uterine leiomyoma dataset having both gene expression and methylation data using (statistical) eigenvector centrality based approach. At first, genes that are both differentially expressed and methylated, are identified using Limma statistical test. A network, comprising these genes, corresponding TFs from TRANSFAC and ITFP databases, and targeter miRNAs from miRWalk database, is then built. The biomolecules are then ranked based on eigenvector centrality. Our proposed method provides better average accuracy in hub gene and non-hub gene classifications than other methods. Furthermore, pre-ranked Gene set enrichment analysis is applied on the pathway database as well as GO-term databases of Molecular Signatures Database with providing a pre-ranked gene-list based on different centrality values for comparing among the ranking methods. Finally, top novel potential gene-markers for the uterine leiomyoma are provided.

  8. Vascular leiomyoma of the oral cavity. Clinical, histopathological and immunohistochemical characteristics. Presentation of five cases and review of the literature.

    PubMed

    Gaitan Cepeda, Luis Alberto; Quezada Rivera, Daniel; Tenorio Rocha, Fernando; Leyva Huerta, Elba Rosa; Mendez Sánchez, Edgar Ramiro

    2008-08-01

    Leiomyoma, a benign neoplasia arising from smooth muscle is an uncommon neoplasia of the oral cavity. The most common histological subtype in the oral cavity is the vascular one. To supplement information on vascular leiomyoma of the oral cavity (VLOC), we present cases of VLOC describing their clinical, histological, and immunohistochemical characteristics. Case reports. Five cases of VLOC (3 females; 2 males) from the Clinical and Experimental Pathology Laboratory, Dental School, National Autonomous University of México, are included. The most frequent clinical characteristic of VLOC was a single, asymptomatic, slow growing nodule. The age average of the cases was 40.6, however 3 out of our 5 cases were < or = 40 years old at the moment of their diagnosis. The lesions were composed of fusiform cells arranged in bundles or fascicles. The neoplastic cells were characterized by eosinophilic cytoplasm and tapered nuclei. The presence of vascular spaces was prominent in all cases. The immunocharacteristics of VLOC neoplastic cells were: alpha smooth muscle (+); vimentin (+), desmin (+), CD34 (-) and S-100 protein (-). The endothelial cells of vascular spaces were CD34 (+). Differential diagnosis of VLOC with fusocellular neoplasm is discussed.

  9. Screening for Abdominal Aortic Aneurysm

    MedlinePlus

    ... signs or symptoms of an abdominal aortic aneurysm (AAA). The final recommendation statement summarizes what the Task ... the potential benefits and harms of screening for AAA: (1) Men ages 65 to 75 who smoke ...

  10. Children's (Pediatric) Abdominal Ultrasound Imaging

    MedlinePlus Videos and Cool Tools

    ... not use ionizing radiation, has no known harmful effects, and is particularly valuable for evaluating abdominal, pelvic ... of the reflected sound waves (called the Doppler effect). A computer collects and processes the sounds and ...

  11. Incentive spirometry after abdominal surgery.

    PubMed

    Davis, Suja P

    Patients face various possible complications after abdominal surgery. This article examines best practice in guiding and teaching them how to use an incentive spirometer to facilitate recovery and prevent respiratory complications.

  12. Abdominal Complications after Severe Burns

    DTIC Science & Technology

    2009-05-01

    abdominal compartment syndrome, schemic bowel, biliary disease, peptic ulcer disease and astritis requiring laparotomy, small bowel obstruction, rimary fungal...complications in- luded trauma exploratory laparotomy, abdominal com- artment syndrome, ischemic bowel, biliary disease, peptic lcer disease and gastritis, large...70%); 13 for other compli- ations, such as biliary or perineal conditions (26%); and 4 or feeding access (8%). For the civilians, 2 had trauma

  13. Giant scrotal elephantiasis.

    PubMed

    Kuepper, Daniel

    2005-02-01

    How much can a man carry? Penoscrotal elephantiasis is a debilitating syndrome. This is a case report of a patient with giant genital elephantiasis secondary to long-standing lymphogranuloma venereum infection in Ethiopia. Complete surgical resection of the pathologic tissue and penile reconstruction was undertaken with good cosmetic and functional results.

  14. Electroluminescence of Giant Stretchability.

    PubMed

    Yang, Can Hui; Chen, Baohong; Zhou, Jinxiong; Chen, Yong Mei; Suo, Zhigang

    2016-06-01

    A new type of electroluminescent device achieves giant stretchability by integrating electronic and ionic components. The device uses phosphor powders as electroluminescent materials, and hydrogels as stretchable and transparent ionic conductors. Subject to cyclic voltage, the phosphor powders luminesce, but the ionic conductors do not electrolyze. The device produces constant luminance when stretched up to an area strain of 1500%.

  15. Risk factors for uterine leiomyoma: a practice-based case-control study. I. African-American heritage, reproductive history, body size, and smoking.

    PubMed

    Faerstein, E; Szklo, M; Rosenshein, N

    2001-01-01

    The authors conducted a case-control study among premenopausal women in the Baltimore, Maryland, area to examine the associations of uterine leiomyoma with ethnicity and hormone-related characteristics. Cases of uterine leiomyoma (n = 318) were surgically or sonographically first confirmed between January 1990 and June 1993. A total of 394 controls were selected from women who were visiting their gynecologist for a routine checkup. Data were collected through telephone interviews and abstraction of medical records; 77.8% of eligible cases and 78.0% of eligible controls were interviewed. Positive adjusted associations were observed between risk of uterine leiomyoma and self-described African-American ethnicity (vs. Whites: odds ratio (OR) = 9.4; 95% confidence interval (CI): 5.7, 15.7), early menarche (<11 years vs. >13 years: OR = 2.4; 95% CI: 1.1, 5.6), and high body mass index (upper quartile vs. lower quartile: OR = 2.3; 95% CI: 1.4, 3.8). Inverse associations were observed with use of oral contraceptives (current use vs. never use: OR = 0.2, 95% CI: 0.1, 0.6) and duration of smoking (> or =19 years vs. never: OR = 0.6; 95% CI: 0.4, 1.1). Younger ages at infertility diagnosis and at first and last childbirth were more common among cases; however, analyses of data on tumor location suggested that these associations represent predominantly consequences of uterine leiomyoma. These results suggest that development of uterine leiomyoma is associated with increased exposure to ovarian hormones. Possible reasons for the very elevated risk among African-American women need further investigation.

  16. Primary Human Uterine Leiomyoma Cell Culture Quality Control: Some Properties of Myometrial Cells Cultured under Serum Deprivation Conditions in the Presence of Ovarian Steroids

    PubMed Central

    Sumikawa, Joana Tomomi; Batista, Fabrício Pereira; Paredes-Gamero, Edgar J.; Girão, Manoel J. B. C.; Oliva, Maria Luiza V.

    2016-01-01

    Cell culture is considered the standard media used in research to emulate the in vivo cell environment. Crucial in vivo experiments cannot be conducted in humans and depend on in vitro methodologies such as cell culture systems. However, some procedures involving the quality control of cells in culture have been gradually neglected by failing to acknowledge that primary cells and cell lines change over time in culture. Thus, we report methods based on our experience for monitoring primary cell culture of human myometrial cells derived from uterine leiomyoma. We standardized the best procedure of tissue dissociation required for the study of multiple genetic marker systems that include species-specific antigens, expression of myofibroblast or myoblast markers, growth curve, serum deprivation, starvation by cell cycle synchronization, culture on collagen coated plates, and 17 β-estradiol (E2) and progesterone (P4) effects. The results showed that primary myometrial cells from patients with uterine leiomyoma displayed myoblast phenotypes before and after in vitro cultivation, and leiomyoma cells differentiated into mature myocyte cells under the appropriate differentiation-inducing conditions (serum deprivation). These cells grew well on collagen coated plates and responded to E2 and P4, which may drive myometrial and leiomyoma cells to proliferate and adhere into a focal adhesion complex involvement in a paracrine manner. The establishment of these techniques as routine procedures will improve the understanding of the myometrial physiology and pathogenesis of myometrium-derived diseases such as leiomyoma. Mimicking the in vivo environment of fibrotic conditions can prevent false results and enhance results that are based on cell culture integrity. PMID:27391384

  17. Common abdominal emergencies in children.

    PubMed

    D'Agostino, James

    2002-02-01

    Because young children often present to EDs with abdominal complaints, emergency physicians must have a high index of suspicion for the common abdominal emergencies that have serious sequelae. At the same time, they must realize that less serious causes of abdominal symptoms (e.g., constipation or gastroenteritis) are also seen. A gentle yet thorough and complete history and physical examination are the most important diagnostic tools for the emergency physician. Repeated examinations and observation are useful tools. Physicians should listen carefully to parents and their children, respect their concerns, and honor their complaints. Ancillary tests are inconsistent in their value in assessing these complaints. Abdominal radiographs can be normal in children with intussusception and even malrotation and early volvulus. Unlike the classic symptoms seen in adults, young children can display only lethargy or poor feeding in cases of appendicitis or can appear happy and playful between paroxysmal bouts of intussusception. The emergency physician therefore, must maintain a high index of suspicion for serious pathology in pediatric patients with abdominal complaints. Eventually, all significant abdominal emergencies reveal their true nature, and if one can be patient with the child and repeat the examinations when the child is quiet, one will be rewarded with the correct diagnosis.

  18. Visceral scalloping on abdominal computed tomography due to abdominal tuberculosis

    PubMed Central

    Sharma, Vishal; Bhatia, Anmol; Malik, Sarthak; Singh, Navjeet; Rana, Surinder S.

    2017-01-01

    Objective: Scalloping of visceral organs is described in pseudomyxoma peritonei, malignant ascites, among other conditions, but not tuberculosis. Methods: We report findings from a retrospective study of patients with abdominal tuberculosis who had visceral scalloping on abdominal computed tomography (CT). Diagnosis of abdominal tuberculosis was made on the basis of combination of clinical, biochemical, radiological and microbiological criteria. The clinical data, hematological and biochemical parameters, and findings of chest X-ray, CT, Mantoux test, and HIV serology were recorded. Results: Of 72 patients with abdominal tuberculosis whose CT scans were included, seven patients had visceral scalloping. The mean age of these patients was 32.14 ± 8.43 years and four were men. While six patients had scalloping of liver, one had splenic scalloping. The patients presented with abdominal pain (all), abdominal distension (five patients), loss of weight or appetite (all), and fever (four patients). Mantoux test was positive in five, while none had HIV infection. The diagnosis was based on fluid (ascitic or collections) evaluation in four patients, ileo-cecal biopsy in one patient, fine needle aspiration from omental thickening in one patient, and sputum positivity for acid fast bacilli (AFB) in one patient. On CT examination, four patients had ascites, five had collections, one had lymphadenopathy, four had peritoneal involvement, three had pleural effusion, and two had ileo-cecal thickening. All except one patient received standard ATT for 6 months or 9 months (one patient). Pigtail drainage for collections was needed for two patients. Discussion: This report is the first description of visceral scalloping of liver and spleen in patients with abdominal tuberculosis. Previously, this finding has been reported primarily with pseudomyxoma peritonei and peritoneal carcinomatosis. Conclusion: Visceral scalloping may not conclusively distinguish peritoneal

  19. Bisphenol A, benzophenone-type ultraviolet filters, and phthalates in relation to uterine leiomyoma

    PubMed Central

    Pollack, AZ; Buck Louis, GM; Chen, Z; Sun, L; Trabert, B; Guo, Y; Kannan, K

    2014-01-01

    Bisphenol A, benzophenone-type UV filters, and phthalates are chemicals in high production and use including in a range of personal care products. Exposure of humans to these chemicals has been shown to affect endocrine function. Although short-lived, widespread exposure may lead to continual opportunity for these chemicals to elicit health effects in humans. The association of these chemicals with incident uterine leiomyoma, an estrogen sensitive disease, is not known. Urinary concentrations of bisphenol A (BPA), five benzophenone-type UV filters (2-hydroxy-4-methoxybenzophenone (2OH-4MeO-BP), 2,4-dihydroxybenzophenone (2,4OH-BP), 2,2′-dihydroxybenzophenone (2,2′OH-4MeO-BP), 2,2′4,4′-tetrahydroxybenzophenone (2,2′4,4′OH-BP), and 4-hydroxybenzophenone (4OH-BP), and 14 phthalate monoesters were quantified in 495 women who later underwent laparoscopy/laparotomy at 14 clinical sites for the diagnosis of fibroids. Significantly higher geometric mean creatinine-corrected concentrations of BPA, 2,4OH-BP, and 2OH-4MeO-BP were observed in women with than without fibroids [BPA: 2.09 μg/g vs. 1.46 μg/g p=0.004; 2,4OH-BP:11.10 μg/g vs. 6.71 μg/g p=0.01; 2OH-4MeO-BP: 11.31 μg/g vs. 6.10 μg/g p=0.01]. Mono-methyl phthalate levels were significantly lower in women with than without fibroids (1.78 μg/g vs. 2.40 μg/g). However, none of the exposures were associated with a significant odds ratio even when adjusting for relevant covariates. There was a lack of an association between select nonpersistent chemicals and the odds of a fibroid diagnosis. PMID:25531814

  20. [Giant mesenteric lipoma in children: A case-report].

    PubMed

    Hida, M; Azahouani, A; Elazzouzi, D

    2017-03-27

    Mesenteric lipoma is an extremely rare disease in children. Fewer than 50 cases have been reported in the literature. Diagnosis is based on clinical examination, ultrasound, and computed tomography (CT). However, only the histological study of the specimen during laparotomy or laparoscopy can confirm the diagnosis. Thus, surgery, be it by laparotomy or laparoscopic, is both a means of exploration and treatment in mesenteric lipoma. We report on a case of giant lipoma of the mesentery in a 7-year-old girl presenting paroxysmal abdominal pain with a subocclusive syndrome lasting 1 week.

  1. Dioctophyme renale (Goeze, 1782) in the abdominal cavity of a domestic cat from Brazil.

    PubMed

    Verocai, Guilherme G; Measures, Lena N; Azevedo, Felipe D; Correia, Thais R; Fernandes, Julio I; Scott, Fabio B

    2009-05-12

    This study reports a case of parasitism by the giant kidney worm, Dioctophyme renale (Goeze, 1782), in the abdominal cavity of a domestic cat from Brazil. A female adult cat presenting prostration, dehydration, physical debility, pronounced jaundice and ascitis, was taken to the Department of Animal Parasitology of the Veterinary Institute of the Universidade Federal Rural do Rio de Janeiro, Brazil. Clinical signs suggested a case of peritonitis. The cat's clinical condition was grave and death occurred within a few days. During necropsy, a brownish-red nematode, 24.9cm long, was found in the abdominal cavity and was identified as a male adult D. renale. This study reports the first confirmed case of dioctophymatosis in the domestic cat. The parasite's aberrant location in the abdominal cavity suggests that the domestic cat is not a suitable host.

  2. [Abdominal pregnancy care. Case report].

    PubMed

    Morales Hernández, Sara; Díaz Velázquez, Mary Flor; Puello Tamara, Edgardo; Morales Hernández, Jorge; Basavilvazo Rodríguez, Maria Antonia; Cruz Cruz, Polita del Rocío; Hernández Valencia, Marcelino

    2008-10-01

    Abdominal pregnancies are the implantation of gestation in some of the abdominal structures. This kind of pregnancies represents sevenfold maternal death risk than tubarian ectopic pregnancies, and 90-fold death risk than normal ones. Previous cases have erroneously reported as abscess in Douglas punch, and frequently result in obitus or postnatal deaths. We report a case of a patient with 27 years old, and diagnosis of 25.2 weeks of pregnancy, prior placenta and anhidramnios, referred due to difficult in uterine contour delimitation, easy palpation of fetal parts, cephalic pole in left hypochondrious and presence of mass in hypogastria, no delimitations, pain with mobilization, no transvaginal bleed and fetal movements. Interruption of pregnancy is decided by virtue of severe oligohidramnios, retardation in fetal intrabdominal growth, and recurrent maternal abdominal pain. Surgical intervention was carried out for resolution of the obstetrical event, in which was found ectopic abdominal pregnancy with bed placental in right uterine horn that corresponded to a pregnancy of 30 weeks of gestation. Abdominal pregnancy is still a challenge for obstetrics due to its diagnosis and treatment. Early diagnosis is oriented to prevent an intrabdominal hemorrhage that is the main maternal cause of mortality.

  3. Ice Giant Exploration

    NASA Astrophysics Data System (ADS)

    Rymer, A. M.; Arridge, C. S.; Masters, A.; Turtle, E. P.; Simon, A. A.; Hofstadter, M. D.; Turrini, D.; Politi, R.

    2015-12-01

    The Ice Giants in our solar system, Uranus and Neptune, are fundamentally different from their Gas Giant siblings Jupiter and Saturn, from the different proportions of rock and ice to the configuration of their planetary magnetic fields. Kepler space telescope discoveries of exo-planets indicate that planets of this type are among the most ubiquitous universally and therefore a future mission to explore the nature of the Ice Giants in our own solar system will provide insights into the nature of extra-solar system objects in general. Uranus has the smallest self- luminosity of all the planets, potentially related to catastrophic events early in the planet's history, which also may explain Uranus' large obliquity. Uranus' atmosphere is subject to extreme seasonal forcing making it unique in the Solar System. Neptune is also unique in a number of ways, notably its large moon Triton which is likely a captured Kuiper Belt Object and one of only two moons in the solar system with a robustly collisional atmosphere. Similar to Uranus, the angle between the solar wind and the magnetic dipole axis is subject to large-amplitude variations on both diurnal and seasonal timescales, but peculiarly it has one of the quietest magnetospheres of the solar system, at least according to Voyager 2, the only spacecraft to encounter Neptune to date. A comprehensive mission, as advocated in the Decadal Survey, would provide enormous science return but is also challenging and expensive. In this presentation we will discuss mission scenarios and suggest how collaboration between disciplines and internationally can help us to pursue a mission that includes Ice Giant exploration.

  4. Giant Cell Arteritis.

    PubMed

    Hoffman, Gary S

    2016-11-01

    This issue provides a clinical overview of giant cell arteritis, focusing on diagnosis, treatment, and practice improvement. The content of In the Clinic is drawn from the clinical information and education resources of the American College of Physicians (ACP), including MKSAP (Medical Knowledge and Self-Assessment Program). Annals of Internal Medicine editors develop In the Clinic in collaboration with the ACP's Medical Education and Publishing divisions and with the assistance of additional science writers and physician writers.

  5. Abdominal radiation causes bacterial translocation

    SciTech Connect

    Guzman-Stein, G.; Bonsack, M.; Liberty, J.; Delaney, J.P.

    1989-02-01

    The purpose of this study was to determine if a single dose of radiation to the rat abdomen leads to bacterial translocation into the mesenteric lymph nodes (MLN). A second issue addressed was whether translocation correlates with anatomic damage to the mucosa. The radiated group (1100 cGy) which received anesthesia also was compared with a control group and a third group which received anesthesia alone but no abdominal radiation. Abdominal radiation lead to 100% positive cultures of MLN between 12 hr and 4 days postradiation. Bacterial translocation was almost nonexistent in the control and anesthesia group. Signs of inflammation and ulceration of the intestinal mucosa were not seen until Day 3 postradiation. Mucosal damage was maximal by Day 4. Bacterial translocation onto the MLN after a single dose of abdominal radiation was not apparently dependent on anatomical, histologic damage of the mucosa.

  6. [Giant renal angiomyolipoma].

    PubMed

    Gutiérrez Fernández, G; Mansilla Roselló, A; Rubio Gil, F; Martínez Domínguez, A P; Villar Del Moral, J; Ferrón Orihuela, A

    2003-06-01

    We present a case report of a renal angiomyolipoma with the special feature of its big size at the moment of the diagnosis. It is appreciated an important alteration of the kidney morphology and the repercussion produced in the rest of the abdominal organs. Due to this an exeresis with nefrectomy is performed. We do a bibliographic review and we analyzed the relevant aspects of this tumour.

  7. Tumours of the anterior uvea. III. Oxytalan fibres in the differential diagnosis of leiomyoma and malignant melanoma of the iris.

    PubMed Central

    Noor Sunba, M. S.; Rahi, A. H.; Garner, A.; Alexander, R. A.; Morgan, G.

    1980-01-01

    The diagnostic potential of oxytalan fibre demonstration in differentiating between leiomyomas and spindle-cell malignant melanomas of the iris was investigated. It was found that oxytalan fibres were abundant in leiomyomata, both between and around the tumour cells, whereas they were found in small numbers only and usually near the iris muscle in malignant melanomata. Their presence and distribution, therefore, appear to offer a satisfactory method of differentiating between these tumours. Since the human choroid and ciliary body normally contain oxytalan fibres, the above findings are not relevant to malignant melanoma of these structures. Naevi and regressing aggregates of iris melanoma cells away from the main tumour mass may similarly be surrounded by misleading amounts of these fibres. Images PMID:7426559

  8. Chronic obstipation in a leopard (Panthera pardus) caused by intrapelvic uterine leiomyoma compression of the distal colon.

    PubMed

    Siegal-Willott, Jessica L; Henrikson, Todd; Carpenter, James W; Andrews, Gordon A

    2005-09-01

    A 6-yr-old female leopard (Panthera pardus) was evaluated for a history of chronic obstipation of 4-mo duration. Radiographic, ultrasonographic, and computed tomographic evaluation revealed an intrapelvic mass that was compressing the distal colon. Because of the difficulties of postsurgical management of this animal, the owner requested euthanasia. On postmortem examination, a mass measuring 3 times 5 times 10 cm was found arising from the body of the uterus. Histopathologic evaluation of the mass revealed a leiomyoma of the uterus. This case report documents the presence of a uterine tumor in a large felid that resulted in constipation and obstipation. Additionally, the value and limitations of the imaging modalities used to provide diagnostic, prognostic, and treatment options are discussed.

  9. Abdominal Bloating: Pathophysiology and Treatment

    PubMed Central

    Seo, A Young; Oh, Dong Hyun

    2013-01-01

    Abdominal bloating is a very common and troublesome symptom of all ages, but it has not been fully understood to date. Bloating is usually associated with functional gastrointestinal disorders or organic diseases, but it may also appear alone. The pathophysiology of bloating remains ambiguous, although some evidences support the potential mechanisms, including gut hypersensitivity, impaired gas handling, altered gut microbiota, and abnormal abdominal-phrenic reflexes. Owing to the insufficient understanding of these mechanisms, the available therapeutic options are limited. However, medical treatment with some prokinetics, rifaximin, lubiprostone and linaclotide could be considered in the treatment of bloating. In addition, dietary intervention is important in relieving symptom in patients with bloating. PMID:24199004

  10. [Gallstone ileus. Abdominal CT usefulness].

    PubMed

    Sukkarieh, F; Brasseur, P; Bissen, L

    2004-06-01

    The authors report the case of a 93-year old woman referred to the emergency department and presenting with an intestinal obstruction. Abdominal CT reveals a biliary ileus caused by the migration and the impaction of a 3 cm gallstone in the small bowel. Surgical treatment by enterolithotomy was successful. In over 90% of cases, gallstone ileus is a complication of cholelithiasis and accounts for 25% of intestinal obstruction in patients over 65 years. To reduce morbidity and mortality, early diagnosis and prompt treatment are essential. Abdominal CT-scan is the gold standard technique.

  11. Abdominal obesity and metabolic syndrome.

    PubMed

    Després, Jean-Pierre; Lemieux, Isabelle

    2006-12-14

    Metabolic syndrome is associated with abdominal obesity, blood lipid disorders, inflammation, insulin resistance or full-blown diabetes, and increased risk of developing cardiovascular disease. Proposed criteria for identifying patients with metabolic syndrome have contributed greatly to preventive medicine, but the value of metabolic syndrome as a scientific concept remains controversial. The presence of metabolic syndrome alone cannot predict global cardiovascular disease risk. But abdominal obesity - the most prevalent manifestation of metabolic syndrome - is a marker of 'dysfunctional adipose tissue', and is of central importance in clinical diagnosis. Better risk assessment algorithms are needed to quantify diabetes and cardiovascular disease risk on a global scale.

  12. Abdominal surgery in neonatal foals.

    PubMed

    Bryant, James E; Gaughan, Earl M

    2005-08-01

    Abdominal surgery in foals under 30 days old has become more common with improved neonatal care. Early recognition of a foal at risk and better nursing care have increased the survival rates of foals that require neonatal care. The success of improved neonatal care also has increased the need for accurate diagnosis and treatment of gastrointestinal, umbilical, and bladder disorders in these foals. This chapter focuses on the early and accurate diagnosis of specific disorders that require abdominal exploratory surgery and the specific treatment considerations and prognosis for these disorders.

  13. A 57-year-old Brazilian woman with a giant mucinous cystadenocarcinoma of the ovary: a case report

    PubMed Central

    2014-01-01

    Introduction Giant cystadenocarcinomas of the ovary are rarely described conditions. Case presentation The authors describe a 57-year-old Brazilian woman who presented with an increase in abdominal girth in February 2003. Imaging studies showed a giant abdominal pelvic mass with probable origin in the right ovary. Cancer antigen-125 was elevated, while carcinoembrionic antigen and alpha-fetoprotein were normal. Total abdominal hysterectomy, bilateral salpingoophorectomy and omentectomy were done. The mass weighed 40Kg, and the histopathology study revealed a mucinous cystadenocarcinoma. She underwent chemotherapy with paclitaxel and cisplatin with no side effects. Under follow-up for more than 10 years, she is asymptomatic and with normal imaging and laboratory parameters, including the cancer antigen-125 marker. Conclusion This huge tumor evolved for a long time unsuspected and without metastases in a patient from a developing region. The diagnostic and management challenges posed by this unexpected and unusual presentation of an ovarian cystadenocarcinoma are discussed. PMID:24594205

  14. Functional Abdominal Pain in Children

    MedlinePlus

    ... the child’s mood and emotions, and in turn cause depression and anxiety. Screening/Diagnosis Detailed information regarding the location of abdominal pain, the frequency (number of times per week) and ... about the cause, and will guide further testing. Other important pieces ...

  15. Undifferentiated Carcinoma with Osteoclast-Like Giant Cells of the Pancreas in a Patient with New Diagnosis of Follicular Non-Hodgkin's Lymphoma.

    PubMed

    Shah, Apeksha; Khurana, Tanvi; Freid, Lauren; Siddiqui, Ali A

    2014-01-01

    Pancreatic tumors with osteoclast-like giant cells are rare, with only 50 cases published to date. We report a case of a 67-year-old male with a new diagnosis of follicular non-Hodgkin's lymphoma with an incidental pancreatic body mass on abdominal imaging. Cytology from the pancreatic mass obtained via endoscopic ultrasound-directed fine-needle aspiration (EUS-FNA) revealed an undifferentiated carcinoma with osteoclast-like giant cells.

  16. Abdominal Pain (Stomach Pain), Short-Term

    MedlinePlus

    ... myhealthfinder Immunization Schedules Nutrient Shortfall Questionnaire Abdominal Pain (Stomach Pain), Short-termJust about everyone has had a " ... time or another. But sudden severe abdominal pain (stomach pain), also called acute pain, shouldn't be ...

  17. Imaging of gastrointestinal and abdominal tuberculosis.

    PubMed

    Vanhoenacker, F M; De Backer, A I; Op de, Beeck B; Maes, M; Van Altena, R; Van Beckevoort, D; Kersemans, P; De Schepper, A M

    2004-03-01

    This article discusses the range of manifestations of tuberculosis (TB) of the abdomen, including involvement of the gastrointestinal tract, the peritoneum, mesentery, omentum, abdominal lymph nodes, solid abdominal organs, the genital system and the abdominal aorta. Abdominal TB is a diagnostic challenge, particularly when pulmonary TB is absent. It may mimic many other abdominal diseases, both clinically and radiologically. An early correct diagnosis, however, is important in order to ensure proper treatment and a favorable outcome. Modern imaging is a cornerstone in the early diagnosis of abdominal TB and may prevent unnecessary morbidity and mortality. Generally, CT appears to be the imaging modality of choice in the detection and assessment of abdominal tuberculosis, other than gastrointestinal TB. Barium studies remain superior for demonstrating mucosal intestinal lesions. Ultrasound may be used for follow-up to monitor therapy response. The diagnosis of abdominal TB should be considered if suggestive imaging findings are found in patients with a high index of suspicion.

  18. Abdominal pain - children under age 12

    MedlinePlus

    Stomach pain in children; Pain - abdomen - children; Abdominal cramps in children; Belly ache in children ... When your child complains of abdominal pain, see if they can describe ... kinds of pain: Generalized pain or pain over more than half ...

  19. Transcatheter Arterial Embolization Alone for Giant Hepatic Hemangioma

    PubMed Central

    Zhang, Yue-Lin; Zhou, Guan-Hui; Ai, Jing; Zhou, Tan-Yang; Zhu, Tong-Yin; Zhang, Ai-Bin; Wang, Wei-Lin; Zheng, Shu-Sen

    2015-01-01

    Giant hepatic hemangioma is a benign liver condition that may be treated using surgery. We studied the digital subtraction angiographic (DSA) characteristics of giant hepatic hemangioma, and the effectiveness of transcatheter arterial embolization (TAE) alone for its treatment. This was a retrospective study of 27 patients diagnosed with giant hepatic hemangioma and treated with TAE alone (using lipiodol mixed with pingyangmycin) at the Division of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University, between January 2010 and March 2013. The feeding arteries were identified using DSA. All patients were followed up for between three weeks and 12 months. Changes in tumor diameter and symptoms were observed. The 27 patients included had giant hepatic hemangiomas ranging from 5.3 to 24.5 cm (mean, 11.24±5.08 cm) in the right (n = 13), left (n = 1) or both (n = 13) lobes. Preoperative hepatic angiography showed multiple abnormal vascular lakes in the early phase, known as the “early leaving but late returning, hanging nut on a twig” sign. On the day after TAE, hepatic transaminase levels were increased (ALT: 22.69±17.95 to 94.88±210.32 U/L; ALT: 24.00±12.37 to 99.70±211.54 U/L; both P<0.05), but not total bilirubin. Six patients complained of abdominal pain, and 12 experienced transient fever. In the months after TAE, tumor size decreased (baseline: 11.24±5.08; 3 months: 8.95±4.33; 6 months: 7.60±3.90 cm; P<0.05), and the patients’ condition improved. These results indicated that TAE was effective and safe for treating giant hepatic hemangioma. TAE may be a useful alternative to surgery for the treatment of hepatic hemangioma. PMID:26287964

  20. Imaging Extrasolar Giant Planets

    NASA Astrophysics Data System (ADS)

    Bowler, Brendan P.

    2016-10-01

    High-contrast adaptive optics (AO) imaging is a powerful technique to probe the architectures of planetary systems from the outside-in and survey the atmospheres of self-luminous giant planets. Direct imaging has rapidly matured over the past decade and especially the last few years with the advent of high-order AO systems, dedicated planet-finding instruments with specialized coronagraphs, and innovative observing and post-processing strategies to suppress speckle noise. This review summarizes recent progress in high-contrast imaging with particular emphasis on observational results, discoveries near and below the deuterium-burning limit, and a practical overview of large-scale surveys and dedicated instruments. I conclude with a statistical meta-analysis of deep imaging surveys in the literature. Based on observations of 384 unique and single young (≈5-300 Myr) stars spanning stellar masses between 0.1 and 3.0 M ⊙, the overall occurrence rate of 5-13 M Jup companions at orbital distances of 30-300 au is {0.6}-0.5+0.7 % assuming hot-start evolutionary models. The most massive giant planets regularly accessible to direct imaging are about as rare as hot Jupiters are around Sun-like stars. Dividing this sample into individual stellar mass bins does not reveal any statistically significant trend in planet frequency with host mass: giant planets are found around {2.8}-2.3+3.7 % of BA stars, <4.1% of FGK stars, and <3.9% of M dwarfs. Looking forward, extreme AO systems and the next generation of ground- and space-based telescopes with smaller inner working angles and deeper detection limits will increase the pace of discovery to ultimately map the demographics, composition, evolution, and origin of planets spanning a broad range of masses and ages.

  1. A Rare Cause of Childhood Ileus: Giant Mesenteric Lipoma and a Review of the Literature

    PubMed Central

    Turk, Erdal; Edirne, Yesim; Karaca, Fahri; Memetoglu, Mehmet Erdal; Unal, Emel; Ermumcu, Ozgur

    2013-01-01

    Mesenteric lipomas are benign tumors of mature fat cells. They are usually asymptomatic and create a clinical picture that depends on the localization and size of the lipoma. Although rare, unusually large mesenteric giant lipomas can cause partial or complete bowel obstruction. Lipomas resulting in partial bowel obstruction can present with symptoms such as intermittent abdominal pain and abdominal distention. With complete obstruction, a child can present with an acute abdomen. Treatment is the excision of the mass along with the affected portion of bowel. In this case study, a 2-year-old female presented with a bowel obstruction due to the presence of a giant mesenteric lipoma. Clinical features of 16 cases published in the English literature to date are presented. PMID:25610284

  2. A Giant Urethral Calculus.

    PubMed

    Sigdel, G; Agarwal, A; Keshaw, B W

    2014-01-01

    Urethral calculi are rare forms of urolithiasis. Majority of the calculi are migratory from urinary bladder or upper urinary tract. Primary urethral calculi usually occur in presence of urethral stricture or diverticulum. In this article we report a case of a giant posterior urethral calculus measuring 7x3x2 cm in a 47 years old male. Patient presented with acute retention of urine which was preceded by burning micturition and dribbling of urine for one week. The calculus was pushed in to the bladder through the cystoscope and was removed by suprapubic cystolithotomy.

  3. Giant left ventricular pseudoaneurysm.

    PubMed

    Prakash, Sumi; Garg, Nadish; Xie, Gong-Yuan; Dellsperger, Kevin C

    2010-01-01

    Left ventricular (LV) pseudoaneurysm (PS) is an uncommon, often fatal complication associated with myocardial infarction, cardiothoracic surgery, trauma, and, rarely, infective endocarditis. A 28-year-old man with prior history of bioprosthetic mitral valve replacement presented with congestive heart failure and bacteremia with Abiotrophia granulitica. Transesophageal echocardiogram showed bioprosthesis dysfunction, large vegetations, mitral regurgitation, and probable PS. Cardiac and chest CT confirmed a PS communicating with the left ventricle Patient had pulseless electrical activity and died. Autopsy showed a giant PS with layered thrombus and pseudo-endothelialized cavity. Our case highlights the importance of multimodality imaging as an important tool in management of PS.

  4. Blunt traumatic abdominal wall disruption with evisceration

    PubMed Central

    McDaniel, Ellen; Stawicki, Stanislaw PA; Bahner, David P

    2011-01-01

    Blunt traumatic abdominal wall disruptions associated with evisceration are very rare. The authors describe a case of traumatic abdominal wall disruption with bowel evisceration that occurred after a middle-aged woman sustained direct focal blunt force impact to the lower abdomen. Abdominal exploration and surgical repair of the abdominal wall defect were performed, with good clinical outcome. A brief overview of literature pertinent to this rare trauma scenario is presented. PMID:22229144

  5. Giant gallbladder: A case report and review of literature

    PubMed Central

    Kuznetsov, A.V.; Borodach, A.V.; Fedin, E.N.; Khromova, A.D.

    2014-01-01

    INTRODUCTION Reports of a giant gallbladder are rare. PRESENTATION OF CASE A 77-year-old woman was admitted with complaints of dull pain in the right half of the abdomen and a palpable mass at the same place. A computerized tomography scan revealed an extremely enlarged gallbladder. Open cholecystectomy was performed. The volume of the removed organ was as much as 3.35 L. Follow-up after 18 months showed that the patient was well. Examination revealed no significant acquired or congenital anomalies that might explain the excessive enlargement of the gallbladder. DISCUSSION We define a ‘giant’ gallbladder as an extreme enlargement of the organ with a volume exceeding 1.5 L, so that its weight is comparable to or even exceeds the mean (estimated) weight of the adult liver (1.5 kg). The first clinical presentation of such an enlargement is likely to differ from any other gallbladder disease, but rather to resemble a tumour or cyst of the abdominal cavity. CONCLUSION A giant gallbladder is a special clinical and pathological entity in surgical practice, of unknown origin. It may develop in patients of any age, and mimics a large abdominal tumour or peritoneal cyst. Both the diagnostic process and surgical treatment demand non-routine approaches. Early and late follow-up results seem to be favourable. PMID:25194602

  6. Laser-induced interstitial thermotherapy (LITT) for treatment of uterine leiomyomas: 750 myomas were treated by LITT and the results over a five-year period are analyzed

    NASA Astrophysics Data System (ADS)

    Chapman, Roxana

    1997-05-01

    Approximately 750 leiomyomas of 250 symptomatic patients were treated by LITT over a five-year period. Only 12% were lost to follow-up. Most were treated by a combination of the KTP/YAG laser, rarely by one or the other alone, and a few with the diode laser. The fiber optic was inserted 2 cm apart and, depending on the size of the tumor, 480 - 20,000 Joules were required. Most were treated laparoscopically but very large myomas were treated percutaneously under ultrasound control. Symptoms were nearly always relieved and the six failures were found to be due to unrecognized adenomyosis and other associated pathology. Half the patients complaining of infertility became pregnant and, in those whose only pathology had been leiomyomas it approached 90%. Vaginal delivery was not found to be contraindicated. Finally, oestrogen receptors and epidermal growth factor were found to be destroyed. It is concluded that LITT enables leiomyomas of all sizes and locations to be treated by a minimally invasive method with preservation of the uterus.

  7. Does life-course socioeconomic position influence racial inequalities in the occurrence of uterine leiomyoma? Evidence from the Pró-Saúde Study.

    PubMed

    Boclin, Karine de Limas Irio; Faerstein, Eduardo; Szklo, Moyses

    2014-02-01

    We aimed to investigate whether life-course socioeconomic position mediates the association between skin color/race and occurrence of uterine leiomyomas. We analyzed 1,475 female civil servants with baseline data (1999-2001) of the Pró-Saúde Study in Rio de Janeiro State, Brazil. Life-course socioeconomic position was determined by parental education (early life socioeconomic position), participant education (socioeconomic position in early adulthood) and their combination (cumulative socioeconomic position). Gynecological/breast exams and health insurance status were considered markers of access to health care. Hazard ratios (HR) and 95% confidence intervals (95%CI) were estimated using Cox proportional hazards models. Compared with white women, black and parda ("brown") women had higher risk of reporting uterine leiomyomas, respectively HR: 1.6, 95%CI: 1.2-2.1; HR: 1.4, 95%CI: 0.8-2.5. Estimates were virtually identical in models including different variables related to life-course socioeconomic position. This study corroborated previous evidence of higher uterine leiomyomas risk in women with darker skin color, and further suggest that life-course socioeconomic position adversity does not influence this association.

  8. Aortitis due to giant cell arteritis and psoriatic arthritis: An uncommon association.

    PubMed

    García-Cezón de la Cruz, M Del Pilar; Almodóvar, Raquel; García Pérez, Javier; Dhimes, Patricia Fanny; Zarco, Pedro

    2016-04-27

    We report the case of a 65-year-old woman with psoriatic arthritis who developed aortitis secondary to giant cell arteritis. She presented with a 2-mounth history of dry cough, fever and fatigue. There was no evidence of tumor or infectious processes. Abdominal computed tomographic and computed tomography coronary angiographic findings were suggestive of aortitis. Histological study of a temporal artery biopsy confirmed temporal arteritis. We also review the available literature on this uncommon condition.

  9. Non-intubated laparoscopic repair of giant Morgagni’s hernia for a young man

    PubMed Central

    Zhang, Miao; Wang, Heng; Liu, Dong; Pan, Xuefeng; Wu, Wenbin; Hu, Zhengqun

    2016-01-01

    An asymptomatic patient was admitted as his chest photograph and computed tomography scans showed a giant Morgagni’s hernia (MH). And it was repaired by laparoscopic approach under epidural anesthesia without endotracheal intubation. The hernia content of omentum was repositioned back into the abdominal cavity, and the diaphragmatic defect was repaired with composite mesh. Which indicated that non-intubated laparoscopic mesh repair via epidural anesthesia is reliable and satisfactory for MH. PMID:27621903

  10. Giant papillary conjunctivitis.

    PubMed Central

    Donshik, P C

    1994-01-01

    Giant papillary conjunctivitis is a syndrome found frequently as a complication of contact lenses. Many variables can affect the onset and severity of the presenting signs and symptoms. Rigid gas permeable contact lenses appear to result in less severe signs and symptoms, with a longer time before the development of giant papillary conjunctivitis. Nonionic, low-water-content soft contact lenses tend to produce less severe signs and symptoms than ionic, low-water-content soft contact lenses. Enzymatic treatment appears to lessen the severity of signs and symptoms. The association of an allergy appears to play a role in the onset of the severity of the signs and symptoms but does not appear to affect the final ability of the individual to wear contact lenses. Using multiple treatment options, such as changing the polymer to a glyceryl methyl methacrylate or a rigid lens, or utilizing a soft lens on a frequent-replacement basis, can result in a success rate of over 90%. In individuals who still have a return of symptoms, the use of topical mast cell stabilizers or a nonsteroidal anti-inflammatory drug as an adjunctive therapy offers the added possibility of keeping these patients in contact lenses. Images FIGURE 1 FIGURE 2 FIGURE 3 FIGURE 4 FIGURE 5 FIGURE 6 FIGURE 7 FIGURE 11 A FIGURE 11 B FIGURE 11 C FIGURE 11 D PMID:7886881

  11. Giant extragenital Bowen's disease.

    PubMed

    Bakardzhiev, Ilko; Chokoeva, Anastasiya Atanasova; Tchernev, Georgi

    2015-12-01

    Giant extragenital forms of Morbus Bowen are extremely rare. The already described cases in the word literature are most commonly with periungual localization, as well as located on the foot and neck area. The clinical manifestation is presented most commonly by non-specific erythematous to erythematous-squamous plaques or papules, which is confusing to the clinician. From the pathogenic point of view, it is important to be confirmed or rejected the presence of human papilloma viruses (HPVs) in each case of affected patient, as this information is mandatory in respect to the adequate selection of the subsequent regimen. If HPVs are detected, systemic antiviral therapy could be initiated to reduce the size of the lesions before subsequent surgical eradication. A postoperative prevention through vaccination could be also considered additionally. In cases of HPV-negative giant extragenital forms of Morbus Bowen (as in the described patient), the focus should be on local immunomodulation by substances such as imiquimod, which reduce the size of the lesions, thereby creating optimal opportunities for their future surgical eradication. Other possible options described in the literature include topical application of 5-fluorouracil, photodynamic therapy, cryotherapy, and laser therapy (carbon dioxide laser). The choice of the most appropriate regimen should have been an individual decision of the clinician, considering also the location and the extent of the lesion.

  12. Gas Giants Form Quickly

    NASA Technical Reports Server (NTRS)

    2007-01-01

    This is an artist's concept of a hypothetical 10-million-year-old star system. The bright blur at the center is a star much like our sun. The other orb in the image is a gas-giant planet like Jupiter. Wisps of white throughout the image represent traces of gas.

    Astronomers using NASA's Spitzer Space Telescope have found evidence showing that gas-giant planets either form within the first 10 million years of a sun-like star's life, or not at all. The lifespan for sun-like stars is about 10 billion years.

    The scientists came to this conclusion after searching for traces of gas around 15 different sun-like stars, most with ages ranging from 3 million to 30 million years. With the help of Spitzer's Infrared Spectrometer instrument, they were able to search for relatively warm gas in the inner regions of these star systems, an area comparable to the zone between Earth and Jupiter in our own solar system. They also used ground-based radio telescopes to search for cooler gas in the outer regions of these systems, an area comparable to the zone around Saturn and beyond.

  13. Giant Intradiverticular Bladder Tumor

    PubMed Central

    Noh, Mohamad Syafeeq Faeez Md; Aziz, Ahmad Fuad Abdul; Ghani, Khairul Asri Mohd; Siang, Christopher Lee Kheng; Yunus, Rosna; Yusof, Mubarak Mohd

    2017-01-01

    Patient: Male, 74 Final Diagnosis: Giant intradiverticular bladder tumor with metastasis Symptoms: Hematuria Medication:— Clinical Procedure: — Specialty: Urology Objective: Rare disease Background: Intradiverticular bladder tumors are rare. This renders diagnosis of an intradiverticular bladder tumor difficult. Imaging plays a vital role in achieving the diagnosis, and subsequently staging of the disease. Case Report: A 74-year-old male presented to our center with a few months history of constitutional symptoms. Upon further history, he reported hematuria two months prior to presentation, which stopped temporarily, only to recur a few days prior to coming to the hospital. The patient admitted to having lower urinary tract symptoms. However, there was no dysuria, no sandy urine, and no fever. Palpation of his abdomen revealed a vague mass at the suprapubic region, which was non tender. In view of his history and the clinical examination findings, an ultrasound of the abdomen and computed tomography (CT) was arranged. These investigations revealed a giant tumor that seemed to be arising from a bladder diverticulum, with a mass effect and hydronephrosis. He later underwent operative intervention. Conclusions: Intradiverticular bladder tumors may present a challenge to the treating physician in an atypical presentation; thus requiring a high index of suspicion and knowledge of tumor pathophysiology. As illustrated in our case, CT with its wide availability and multiplanar imaging capabilities offers a useful means for diagnosis, disease staging, operative planning, and follow-up. PMID:28246375

  14. Intra-Abdominal Actinomycosis Mimicking Malignant Abdominal Disease

    PubMed Central

    Oguejiofor, Njideka; Al-Abayechi, Sarah; Njoku, Emmanuel

    2017-01-01

    Abdominal actinomycosis is a rare infectious disease, caused by gram positive anaerobic bacteria, that may appear as an abdominal mass and/or abscess (Wagenlehner et al. 2003). This paper presents an unusual case of a hemodynamically stable 80-year-old man who presented to the emergency department with 4 weeks of worsening abdominal pain and swelling. He also complains of a 20-bound weight loss in 2 months. A large tender palpable mass in the right upper quadrant was noted on physical exam. Laboratory studies showed a normal white blood cell count, slightly decreased hemoglobin and hematocrit, and mildly elevated total bilirubin and alkaline phosphatase. A CT with contrast was done and showed a liver mass. Radiology and general surgery suspected malignancy and recommended CT guided biopsy. The sample revealed abundant neutrophils and gram positive rods. Cytology was negative for malignancy and cultures eventually grew actinomyces. High dose IV penicillin therapy was given for 4 weeks and with appropriate response transitioned to oral antibiotic for 9 months with complete resolution of symptoms. PMID:28299215

  15. Reinflating Giant Planets

    NASA Astrophysics Data System (ADS)

    Kohler, Susanna

    2017-01-01

    Two new, large gas-giant exoplanets have been discovered orbiting close to their host stars. A recent study examining these planets and others like them may help us to better understand what happens to close-in hot Jupiters as their host stars reach the end of their main-sequence lives.OversizedGiantsUnbinned transit light curves for HAT-P-65b. [Adapted from Hartman et al. 2016]The discovery of HAT-P-65b and HAT-P-66b, two new transiting hot Jupiters, is intriguing. These planets have periods of just under 3 days and masses of roughly 0.5 and 0.8 times that of Jupiter, but their sizes are whats really interesting: they have inflated radii of 1.89 and 1.59 times that of Jupiter.These two planets, discovered using the Hungarian-made Automated Telescope Network (HATNet) in Arizona and Hawaii, mark the latest in an ever-growing sample of gas-giant exoplanets with radii larger than expected based on theoretical planetary structure models.What causes this discrepancy? Did the planets just fail to contract to the expected size when they were initially formed, or were they reinflated later in their lifetimes? If the latter, how? These are questions that scientists are only now starting to be able to address using statistics of the sample of close-in, transiting planets.Unbinned transit light curves for HAT-P-66b. [Hartman et al. 2016]Exploring Other PlanetsLed by Joel Hartman (Princeton University), the team that discovered HAT-P-65b and HAT-P-66b has examined these planets observed parameters and those of dozens of other known close-in, transiting exoplanets discovered with a variety of transiting exoplanet missions: HAT, WASP, Kepler, TrES, and KELT. Hartman and collaborators used this sample to draw conclusions about what causes some of these planets to have such large radii.The team found that there is a statistically significant correlation between the radii of close-in giant planets and the fractional ages of their host stars (i.e., the stars age divided by its full

  16. Allometry indicates giant eyes of giant squid are not exceptional

    PubMed Central

    2013-01-01

    Background The eyes of giant and colossal squid are among the largest eyes in the history of life. It was recently proposed that sperm whale predation is the main driver of eye size evolution in giant squid, on the basis of an optical model that suggested optimal performance in detecting large luminous visual targets such as whales in the deep sea. However, it is poorly understood how the eye size of giant and colossal squid compares to that of other aquatic organisms when scaling effects are considered. Results We performed a large-scale comparative study that included 87 squid species and 237 species of acanthomorph fish. While squid have larger eyes than most acanthomorphs, a comparison of relative eye size among squid suggests that giant and colossal squid do not have unusually large eyes. After revising constants used in a previous model we found that large eyes perform equally well in detecting point targets and large luminous targets in the deep sea. Conclusions The eyes of giant and colossal squid do not appear exceptionally large when allometric effects are considered. It is probable that the giant eyes of giant squid result from a phylogenetically conserved developmental pattern manifested in very large animals. Whatever the cause of large eyes, they appear to have several advantages for vision in the reduced light of the deep mesopelagic zone. PMID:23418818

  17. Case Report: A giant but silent adrenal pheochromocytoma – a rare entity

    PubMed Central

    Munakomi, Sunil; Rajbanshi, Saroj; Adhikary, Prof Shailesh

    2016-01-01

    Herein we report a rare entity of a giant adrenal pheochromocytoma in a fifty-year-old male presenting with a vague abdominal pain. A computerised tomogram of the abdomen revealed a well-defined  left supraadrenal giant lesion with no evidence of invasion to surrounding structures.The patient underwent surgical excision without any untoward postoperative events. Histopathological study revealed a benign pheochromocytoma. This report highlights the importance of acknowledging the fact that sometimes a giant adrenal pheochromocytoma can present with paucity of clinical  signs and symptoms.Thorough investigations and a multidisciplinary team approach may lead  to a better outcome in these patients. PMID:27785358

  18. Laparoscopic examination and resection for giant lipoma of the omentum: a case report and review of related literature.

    PubMed

    Shiroshita, Hidefumi; Komori, Yoko; Tajima, Masaaki; Bandoh, Toshio; Arita, Tsuyoshi; Shiraishi, Norio; Kitano, Seigo

    2009-10-01

    We report herein the case of a giant lipoma of the greater omentum that was treated by laparoscopic surgery. A 71-year-old male patient was admitted with a diagnosis of sigmoid colon cancer. During preoperative examination, a gallbladder stone and an intra-abdominal giant lipoma were accidentally diagnosed. Laparoscopic examination revealed a smooth-surfaced, giant yellow tumor at the lower border of the greater omentum that was unattached to the surrounding organs. After laparoscopic resection of the tumor and cholecystectomy, a 10-cm midline incision was made in the lower abdomen to remove the tumor and the gallbladder. We then performed a sigmoidectomy for sigmoid colon cancer through the same laparotomy. The resected tumor measured 29 x 19 x 3 cm and weighed 1250 g, and a histopathologic examination revealed a benign lipoma. Laparoscopic examination and resection of a giant lipoma of the omentum are particularly useful.

  19. Primary Giant Splenic Echinococcal Cyst Treated by Laparoscopy

    PubMed Central

    Arce, Maira A.; Limaylla, Himerón; Valcarcel, Maria; Garcia, Hector H.; Santivañez, Saul J.

    2016-01-01

    Cystic echinococcosis (CE) is a zoonosis caused by the larval stage of the dog tapeworm Echinococcus granulosus. Liver and lungs are the most commonly affected organs whereas splenic infection is rarer and its primary involvement occurs in less than 2% of abdominal CE. We report a case of primary giant splenic hydatid cyst in a 75-year-old Peruvian woman that was laparoscopically removed without any complications, perioperative prophylactic chemotherapy with albendazole 400 mg twice a day 5 days before, and 7 days after the surgical procedure was administered, postoperative recovery was uneventful, and; at her 3-month follow-up the patient remains asymptomatic and an abdominal computed tomography scan demonstrated a cystic cavity of 15 cm diameter with no daughter vesicles, neither other abdominal organ involvement. This case is in line with the existing literature on laparoscopical treatment of splenic cystic hydatid disease, suggesting that laparoscopical treatment is a safe and effective approach for large splenic hydatid cysts to be preferred to open surgical techniques. PMID:26556833

  20. Primary Giant Splenic Echinococcal Cyst Treated by Laparoscopy.

    PubMed

    Arce, Maira A; Limaylla, Himerón; Valcarcel, Maria; Garcia, Hector H; Santivañez, Saul J

    2016-01-01

    Cystic echinococcosis (CE) is a zoonosis caused by the larval stage of the dog tapeworm Echinococcus granulosus. Liver and lungs are the most commonly affected organs whereas splenic infection is rarer and its primary involvement occurs in less than 2% of abdominal CE. We report a case of primary giant splenic hydatid cyst in a 75-year-old Peruvian woman that was laparoscopically removed without any complications, perioperative prophylactic chemotherapy with albendazole 400 mg twice a day 5 days before, and 7 days after the surgical procedure was administered, postoperative recovery was uneventful, and; at her 3-month follow-up the patient remains asymptomatic and an abdominal computed tomography scan demonstrated a cystic cavity of 15 cm diameter with no daughter vesicles, neither other abdominal organ involvement. This case is in line with the existing literature on laparoscopical treatment of splenic cystic hydatid disease, suggesting that laparoscopical treatment is a safe and effective approach for large splenic hydatid cysts to be preferred to open surgical techniques.

  1. [Giant esophageal fibrovascular polyp].

    PubMed

    Palacios, Fernando; Contardo, Carlos; Guevara, Jorge; Vera, Augusto; Aguilar, Luis; Huamán, Manuel; Palomino, Américo; Yabar, Alejandro

    2003-01-01

    Fibrovascular polyps are extremely rare benign neoplasias of the esophagus, which usually originate in the lower cricoid area. They do not produce any discomfort in the patient for a long time, however it may make itself evident by the patient's regurgitation of the polyp, producing asphyxia or, more frequently, dysphagia. The case of a 58 year old male patient is presented herein, with a 9 month record of dysphagia, weight loss and intermittent melena. The barium x-ray showed a distended esophagus, with a tumor running from the upper esophageal sphincter to the cardia. The endoscopy confirmed the presence of a pediculated tumor, implanted in the cervical esophagus. Surgeons suspected the potential malignancy of the tumor and performed a transhiatal esophagectomy. The final pathologic diagnosis was giant fibrovascular esophageal polyp.

  2. A Giant Lumbar Pseudomeningocele in a Patient with Neurofibromatosis Type 1: A Case Report

    PubMed Central

    Iacoangeli, Maurizio; Ruscelli, Paolo; Della Costanza, Martina; Nasi, Davide; Scerrati, Massimo

    2017-01-01

    This is a rare case of giant lumbar pseudomeningocele with intra-abdominal extension in patient with neurofibromatosis type 1 (NF1). The patient's clinical course is retrospectively reviewed. A 34-year-old female affected by NF1 was referred to our institution for persistent low back pain and MRI diagnosis of pseudomeningocele located at L3 level with paravertebral extension. From the first surgical procedure by a posterior approach until the relapse of the pseudomeningocele documented by MRI, the patient underwent two subsequent posterior surgical procedures to repair the dural sac defect with fat graft and fibrin glue. One month after the third operation, the abdominal MRI showed a giant intra-abdominal pseudomeningocele causing compression of visceral structures. The patient was asymptomatic. The pseudomeningocele was treated with an anterior abdominal approach and the use of the acellular dermal matrix (ADM) sutured directly on the dural defect on the anterolateral wall of the spinal canal. After six months of follow-up the MRI showed no relapse of the pseudomeningocele. Our case highlights the possible use of ADM as an effective and safe alternative to the traditional fat graft to repair challenging and large dural defects. PMID:28250774

  3. Giant resonances: Progress, new directions, new challenges

    SciTech Connect

    Bertrand, J.R.; Beene, J.R.

    1989-01-01

    A review of some recent developments in the field of giant multipole resonances is presented. Particular emphasis is placed on directions that the authors feel will be followed in this field during the next several years. In particular, the use of high-energy heavy ions to excite the giant resonances is shown to provide exciting new capabilities for giant resonance studies. Among subjects covered are: Coulomb excitation of giant resonances, photon decay of giant resonances, the recent controversy over the identity of the giant monopole resonance, the most recent value for incompressibility of nuclear matter from analysis of giant monopole data, the isospin character of the 63 A/sup /minus/1/3/ GQR, agreement between (e,e/prime/) and (hadron, hadron/prime/) excitation of the giant quadrupole resonance, prospects for multiphonon giant resonance observation, and isolation of the isovector giant quadrupole resonance. 55 refs., 23 figs., 4 tabs.

  4. giant is a bona fide gap gene in the intermediate germband insect, Oncopeltus fasciatus

    PubMed Central

    Liu, Paul Z.; Patel, Nipam H.

    2010-01-01

    Drosophila undergoes a form of development termed long germ segmentation, where all segments are specified nearly simultaneously so that by the blastoderm stage, the entire body plan has been determined. This mode of segmentation is evolutionarily derived. Most insects undergo short or intermediate germ segmentation, where only anterior segments are specified early, and posterior segments are sequentially specified during germband elongation. These embryological differences imply that anterior and posterior segments might rely upon different molecular mechanisms. In Drosophila, embryos mutant for giant show a gap in the anterior as well fusions of several abdominal segments. In Tribolium, a short germ beetle, giant is required for segmental identity, but not formation, in gnathal segments and also for segmentation of the entire abdomen. This raises the possibility that giant might not act as a gap gene in short and intermediate germ insects. Oncopeltus fasciatus is an intermediate germ insect that is an outgroup to the clade containing Drosophila and Tribolium. We cloned the Oncopeltus homolog of giant and determined its expression and function during segmentation. We find that Oncopeltus giant is a canonical gap gene in the maxillary and labial segments and also plays a gap-like role in the first four abdominal segments. Our results suggest that giant was a bona fide gap gene in the ancestor of these insects with this role being lost in the lineage leading towards Tribolium. This highlights the conservation of anterior patterning and evolutionary plasticity of the genetic regulation controlling posterior segmentation, even in short and intermediate germ insects. PMID:20147384

  5. Giant Hedge-Hogs: Spikes on Giant Gravitons

    SciTech Connect

    Sadri, D

    2004-01-28

    We consider giant gravitons on the maximally supersymmetric plane-wave background of type IIB string theory. Fixing the light-cone gauge, we work out the low energy effective light-cone Hamiltonian of the three-sphere giant graviton. At first order, this is a U(1) gauge theory on R x S{sup 3}. We place sources in this effective gauge theory. Although non-vanishing net electric charge configurations are disallowed by Gauss' law, electric dipoles can be formed. From the string theory point of view these dipoles can be understood as open strings piercing the three-sphere, generalizing the usual BIons to the giant gravitons, BIGGons. Our results can be used to give a two dimensional (worldsheet) description of giant gravitons, similar to Polchinski's description for the usual D-branes, in agreement with the discussions of hep-th/0204196.

  6. A giant Ordovician anomalocaridid.

    PubMed

    Van Roy, Peter; Briggs, Derek E G

    2011-05-26

    Anomalocaridids, giant lightly sclerotized invertebrate predators, occur in a number of exceptionally preserved early and middle Cambrian (542-501 million years ago) biotas and have come to symbolize the unfamiliar morphologies displayed by stem organisms in faunas of the Burgess Shale type. They are characterized by a pair of anterior, segmented appendages, a circlet of plates around the mouth, and an elongate segmented trunk lacking true tergites with a pair of flexible lateral lobes per segment. Disarticulated body parts, such as the anterior appendages and oral circlet, had been assigned to a range of taxonomic groups--but the discovery of complete specimens from the middle Cambrian Burgess Shale showed that these disparate elements all belong to a single kind of animal. Phylogenetic analyses support a position of anomalocaridids in the arthropod stem, as a sister group to the euarthropods. The anomalocaridids were the largest animals in Cambrian communities. The youngest unequivocal examples occur in the middle Cambrian Marjum Formation of Utah but an arthropod retaining some anomalocaridid characteristics is present in the Devonian of Germany. Here we report the post-Cambrian occurrence of anomalocaridids, from the Early Ordovician (488-472 million years ago) Fezouata Biota in southeastern Morocco, including specimens larger than any in Cambrian biotas. These giant animals were an important element of some marine communities for about 30 million years longer than previously realized. The Moroccan specimens confirm the presence of a dorsal array of flexible blades attached to a transverse rachis on the trunk segments; these blades probably functioned as gills.

  7. Giant gastrointestinal stromal tumor of the stomach.

    PubMed

    Ionescu, Sever; Barbu, Emil; Ionescu, Călin; Costache, Adrian; Bălăşoiu, Maria

    2015-01-01

    Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal malignancies of the digestive tract. Gastric localization is the most frequent. The aim of this study is to evaluate the importance of immunohistochemical factors (CD117, CD34, α-SMA, vimentin, p53, Ki67) in diagnostic and size tumor and mitotic activity as prognostic factors for these tumors. We present the case of a 66-year-old male patient with a giant gastric GIST. Like in the vast majority, the symptomatology in this patient has long been faint, despite the large tumor size, and when it became manifest, it was nonspecific. Imagery wise, the computer tomography (CT) scan was the most efficient, showing the origin of the tumor from the greater curvature of the stomach, its dimensions, as well as the relations with the other abdominal viscera. Surgery in this patient was en-bloc, according to the principles of GIST. The histological aspect is characterized by a proliferation of spindle cells positive for CD117 and CD34. Despite complete microscopic resection, the size of the tumor (25×20×27 cm) and the mitotic activity (21÷5 mm2) remains important relapse factor.

  8. Pharma giants swap research programs.

    PubMed

    2014-07-01

    Pharmaceutical giants Novartis and GlaxoSmithKline (GSK) agreed in late April to swap some assets, with Novartis handing off its vaccine business to GSK and getting most of the British company's cancer portfolio in return.

  9. Theories of Giant Planet Formation

    NASA Technical Reports Server (NTRS)

    Lissauer, Jack J.; Young, Richard E. (Technical Monitor)

    1998-01-01

    An overview of current theories of planetary formation, with emphasis on giant planets, is presented. The most detailed models are based upon observations of our own Solar System and of young stars and their environments. While these models predict that rocky planets should form around most single stars, the frequency of formation of gas giant planets is more difficult to predict theoretically. Terrestrial planets are believed to grow via pairwise accretion until the spacing of planetary orbits becomes large enough that the configuration is stable for the age of the system. Giant planets begin their growth as do terrestrial planets, but they become massive enough that they are able to accumulate substantial amounts of gas before the protoplanetary disk dissipates. Most models for extrasolar giant planets suggest that they formed as did Jupiter and Saturn (in nearly circular orbits, far enough from the star that ice could), and subsequently migrated to their current positions, although some models suggest in situ formation.

  10. Lichens On Galapagos Giant Tortoises.

    PubMed

    Hendrickson, J R; Weber, W A

    1964-06-19

    The association of Physcia picta with the giant Galdpagos tortoise is believed to be the first reported occurrence of lichens on land animals. The habitat is restricted to specific sites on the carapace of male tortoises.

  11. Landscape of the lost giants

    NASA Astrophysics Data System (ADS)

    2013-09-01

    The Pleistocene megafauna extinction erased a group of remarkable animals. Whether humans had a prominent role in the extinction remains controversial, but it is emerging that the disappearance of the giants has markedly affected the environment.

  12. Atmospheres of Extrasolar Giant Planets

    NASA Technical Reports Server (NTRS)

    Marley, Mark

    2006-01-01

    The next decade will almost certainly see the direct imaging of extrasolar giant planets around nearby stars. Unlike purely radial velocity detections, direct imaging will open the door to characterizing the atmosphere and interiors of extrasola planets and ultimately provide clues on their formation and evolution through time. This process has already begun for the transiting planets, placing new constraints on their atmospheric structure, composition, and evolution. Indeed the key to understanding giant planet detectability, interpreting spectra, and constraining effective temperature and hence evolution-is the atmosphere. I will review the universe of extrasolar giant planet models, focusing on what we have already learned from modeling and what we will likely be able to learn from the first generation of direct detection data. In addition to these theoretical considerations, I will review the observations and interpretation of the - transiting hot Jupiters. These objects provide a test of our ability to model exotic atmospheres and challenge our current understanding of giant planet evolution.

  13. Giants in the Local Region

    NASA Astrophysics Data System (ADS)

    Luck, R. Earle; Heiter, Ulrike

    2007-06-01

    We present parameter and abundance data for a sample of 298 nearby giants. The spectroscopic data for this work have a resolution of R~60,000, S/N>150, and spectral coverage from 475 to 685 nm. Overall trends in the Z>10 abundances are dominated by Galactic chemical evolution, while the light-element abundances are influenced by stellar evolution, as well as Galactic evolution. We find several super-Li stars in our sample and confirm that Li abundances in the first giant branch are related to mixing depths. Once astration of lithium on the main sequence along with the overall range of main-sequence lithium abundances are taken into account, the lithium abundances of the giants are not dramatically at odds with the predictions of standard stellar evolution. We find the giants to be carbon-diluted in accord with standard stellar evolution and that the carbon and oxygen abundances determined for the local giants are consistent with those found in local field dwarfs. We find that there is evidence for systematic carbon variations in the red giant clump in the sense that the blue side of the clump is carbon-poor (more diluted) than the red side.

  14. Low-power interstitial photocoagulation of uterine leiomyomas by KTP/YAG laser: a review of 50 consecutive cases

    NASA Astrophysics Data System (ADS)

    Chapman, Roxana

    1994-12-01

    Interstitial laser photocoagulation (ILP), which is a new method of low power laser destruction of tumors, has been used to treat laparoscopically 50 consecutive patients with symptomatic uterine leiomyomas which were difficult or impossible to remove via laparoscopy. The KTP/YAG laser, with wavelengths of 532 and 1064 nm respectively, was employed. Holes 2 cm apart were drilled with a 600 micrometers quartz laser fiber employing the KTP component at 8 W and subsequent coagulation of the surrounding myoma tissue was accomplished during the withdrawal of the fiber over the course of 10 - 30 s but using the YAG component at 8 W until the whole myoma had been treated. Thirty seven became symptom free and have remained so. Six were lost to follow up. Of 10 complaining of subfertility 4, in whom uterine myomas were the only etiological factor, have become pregnant. Seven patients required further treatment: Two were retreated because their myomas were excessively large and did not completely disappear with the initial ILP, 2 received further ILP because of the development of new myomas and 3 were subjected to laparoscopically assisted vaginal hysterectomy at patients' request (2 because of the development of new myomas and 1 because of the development of further endometriosis). Finally, in 7 cases, residual tumor or scar tissue was biopsied and examined for the presence of oestrogen and progesterone receptors. None was discovered and in 2 subsequent pregnancy did not cause further growth of residual myoma tissue.

  15. Novel hormonal therapy for the treatment of benign metastasizing leiomyoma: an analysis of 5 cases and literature review

    PubMed Central

    Lewis, Erin I.; Chason, Rebecca J.; DeCherney, Alan H.; Armstrong, Alicia; Elkas, John; Venkatesan, Aradhana M.

    2013-01-01

    Objective To evaluate novel hormonal therapies in patients with unresectable Benign Metastasizing Leiomyoma (BML) disease. Design Case series. Setting National Institutes of Health (NIH). Patients 5 subjects with the diagnosis of BML based on imaging and/or histopathologic diagnosis. Interventions Four patients were treated with single or combination therapy of Leuprolide acetate and/or an aromatase inhibitor. One patient was treated with an antiprogestin (CDB-2914). Main Outcome Measures Response to therapy was measured by tumor burden on cross-sectional imaging employing RECIST (Response Evaluation Criteria in Solid Tumours) 1.1 guidelines. Results Four patients treated with single or combination therapy of Leuprolide acetate and/or an aromatase inhibitor demonstrated stable disease with reduction in tumor burden. The fifth patient treated with antiprogestin (CDB-2914) had degeneration of her tumor, progression of its size and an improvement in symptoms. Conclusions Hormonal treatment with GnRH agonism and/or aromatase inhibition may be a therapeutic option to reduce tumor burden in unresectable BML disease or for those patients who wish to avoid surgical intervention. RECIST 1.1 guidelines, while traditionally used to evaluate tumor response to cancer therapeutics, may be useful in evaluating BML tumor burden response to hormonal therapy. PMID:23465706

  16. Leu/Val SNP polymorphism of CYP1B1 and risk of uterine leiomyoma in a Black population.

    PubMed

    Bideau, Virgil S; Alleyne, Angela T

    2016-03-01

    Uterine leiomyoma (UL) is the most commonly occurring benign tumor that affects women of reproductive ages. Studies strongly suggest that ULs are hormonally dependent and that genes acting in estrogen metabolism might be involved in their development. The focus of this case-control study was to determine whether the Leucine432Valine single-nucleotide polymorphism (SNP) in the gene encoding cytochrome P450 1B1 (CYP1B1) was associated with an increased risk of UL in Black Barbadian women. The investigation comprised 37 women clinically diagnosed with UL and 52 controls. The CYP1B1 Leu432Val polymorphism (Leu/Val) was analyzed using the polymerase chain reaction-restriction fragment length polymorphism method. The homozygous Valine432 variant (Val/Val) was predominant in both cases and controls for this population (89 and 83 %, respectively). The odds ratio for risk of developing the disease was 1.33, but this was not statistically significant. We discuss a possible protective function for CYP1B1 based on the high prevalence of this mutant SNP and its lack of association with UL.

  17. Combination effect of cytochrome P450 1A1 gene polymorphisms on uterine leiomyoma: A case-control study

    PubMed Central

    Salimi, Saeedeh; Sajadian, Mojtaba; Khodamian, Maryam; Yazdi, Atefeh; Rezaee, Soodabeh; Mohammadpour-Gharehbagh, Abbas; Mokhtari, Mojgan; Yaghmaie, Minoo

    2016-01-01

    Uterine leiomyoma (UL) is an estrogen-dependent neoplasm of the uterus, and estrogen metabolizing enzymes affect its progression. This study aimed to evaluate the association between two single-nucleotide polymorphisms of cytochrome P450 1A1 (CYP1A1) gene and UL risk. The study consisted of 105 patients with UL and 112 healthy women as controls. Ile462Val (A/G) and Asp449Asp (T/C) polymorphisms of CYP1A1 gene were analyzed by DNA sequencing and polymerase chain reaction-restriction fragment length polymorphism methods, respectively. The findings indicated no association between Ile462Val (A/G) and Asp449Asp (T/C) polymorphisms of CYP1A1 gene and UL (p < 0.05). However, the combination effect of TT/AG genotypes of the Asp449Asp (T/C) and Ile462Val (A/G) polymorphisms was associated with 4.3-fold higher risk of UL. In addition, haplotype analysis revealed that TG haplotype of the Asp449Asp (T/C) and Ile462Val (A/G) polymorphisms could increase the UL risk nearly 4.9-fold. Asp449Asp (T/C) and Ile462Val (A/G) polymorphisms of CYP1A1 gene were not associated with UL susceptibility; however, the combination of the TT/AG genotypes and TG haplotype could increase the UL risk. PMID:27333216

  18. [Dirofilaria in the abdominal cavity].

    PubMed

    Révész, Erzsébet; Markovics, Gabriella; Darabos, Zoltán; Tóth, Ildikó; Fok, Eva

    2008-10-01

    Number of cases of filariasis have been recently reported in the Hungarian medical literature, most of them caused by Dirofilaria repens . Dirofilaria repens is a mosquito-transmitted filarioid worm in the subcutaneous tissue of dogs and cats. Human infection manifests as either subcutaneous nodules or lung parenchymal disease, which may even be asymptomatic. The authors report a human Dirofilaria repens infection of the abdominal cavity in a 61-year-old man,who underwent laparotomy for acute abdomen. Intraoperatively, local peritonitis was detected caused by a white nemathhelminth, measured 8 cm in size. Histocytology confirmed that the infection was caused by Dirofilaria repens.

  19. Technical aspects of abdominal stomas.

    PubMed

    Link, Brian A; Kropp, Bradley; Frimberger, Dominic

    2007-01-01

    Continent urinary diversion has gained increasing popularity in the pediatric population during the last few decades. In adults, continent diversions are usually needed to replace a bladder after cystectomy for invasive carcinoma. Subsequently, the creation of functional and cosmetically hidden urinary and cecal abdominal stomas has become an integral part of many urinary reconstructive procedures. These techniques, originally developed for pediatric urinary reconstruction have gained increasing popularity for adult patients in need of a continence procedure. In the current manuscript, we review the technical aspects of site selection, mucocutaneous anastomosis, cosmetic appearance, and management of associated complications.

  20. The Giant Magnetocaloric Effect

    NASA Astrophysics Data System (ADS)

    Pecharsky, Vitalij K.

    1998-03-01

    Since the discovery of the magnetocaloric effect in pure iron by E.Warburg in 1881, it has been measured experimentally on many magnetic metals and compounds. The majority of the materials studied order magnetically undergoing a second order phase transformation. The magnetocaloric effect, typically peaking near the Curie or the Néel temperature, generally ranges from 0.5 to 2 K (in terms of adiabatic temperature change) or at 1 to 4 J/kg K (in terms of isothermal magnetic entropy change) per 1 T magnetic field change. The giant magnetocaloric effect recently discovered in Gd_5(Si_xGe_1-x)4 alloys, where x <= 0.5, is associated with a first order magnetic phase transition and it reaches values of 3 to 4 K and 6 to 10 J/kg K per 1 T field change, respectively. The refrigerant capacity, which is the measure of how much heat can be transferred from a cold to a hot reservoir in one ideal thermodynamic cycle, is larger than that of the best second order phase transition materials by 25 to 100%. When the Gd_5(Si_xGe_1-x)4 alloys are compared with other known materials, which show first order magnetic phase transition, such as Dy, Ho, Er, HoCo_2, NdMn_2Si_2, Fe_0.49Rh_0.51, and (Hf_0.83Ta_0.17)Fe_2+x, only Fe_0.49Rh_0.51 has comparable magnetocaloric properties. However, the first order magnetic phase transition in Fe_0.49Rh_0.51 is irreversible, and the magnetocaloric effect disappears after one magnetizing/demagnetizing cycle. A study of the crystal structure, thermodynamics, and magnetism of the Gd_5(Si_xGe_1-x)4 alloys, where 0 <= x <= 1 allowed us to obtain a qualitative understanding of the basic relations between the composition, the crystal structure, and the change in thermodynamics and magnetocaloric properties, which occur in the Gd_5(Si_xGe_1-x)4 system, and which brings about the giant magnetocaloric effect when x <= 0.5.

  1. Abdominal Compartment Syndrome After Hip Arthroscopy

    DTIC Science & Technology

    2010-01-01

    K. Intra- abdominal compartment syndrome as a complication of ruptured abdomi- nal aortic aneurysm repair. Am Surg 1989;55:396-402. 6. Sugrue M...00-00-2010 to 00-00-2010 4. TITLE AND SUBTITLE Abdominal Compartment Syndrome After Hip Arthroscopy 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c...unclassified Standard Form 298 (Rev. 8-98) Prescribed by ANSI Std Z39-18 Author’s personal copy Case Report Abdominal Compartment Syndrome After

  2. Abdominal Mass Secondary to Human Toxocariasis

    PubMed Central

    Ghoroobi, Javad; Khoddami, Maliheh; Mirshemirani, Alireza; Sadeghian, Naser; Mahdavi, Alireza; Hatefi, Sayeh

    2017-01-01

    Toxocariasis is an extensive helminthic infection that leads to visceral larva migrans in humans. A 2.5-year-old girl referred for abdominal mass. She had history of pharyngitis for two weeks. There were no other symptoms. Abdominal examination revealed an irregular solid mass in right lower quadrant (RLQ). Abdominal ultrasonography revealed an echohetrogenic large mass in RLQ, liver, and retroperitoneal area. Abdominal CT scan showed a huge mass. At laparotomy a large retroperitoneal mass that involved right liver lobe, bladder, ileocecal valve, small and large intestines was found. At histopathology diagnosis of toxocariasis was made. PMID:28164001

  3. [Diagnostic imaging and acute abdominal pain].

    PubMed

    Liljekvist, Mads Svane; Pommergaard, Hans-Christian; Burcharth, Jakob; Rosenberg, Jacob

    2015-01-19

    Acute abdominal pain is a common clinical condition. Clinical signs and symptoms can be difficult to interpret, and diagnostic imaging may help to identify intra-abdominal disease. Conventional X-ray, ultrasound (US) and computed tomography (CT) of the abdomen vary in usability between common surgical causes of acute abdominal pain. Overall, conventional X-ray cannot confidently diagnose or rule out disease. US and CT are equally trustworthy for most diseases. US with subsequent CT may enhance diagnostic precision. Magnetic resonance seems promising for future use in acute abdominal imaging.

  4. Empyema following intra-abdominal sepsis.

    PubMed

    Ballantyne, K C; Sethia, B; Reece, I J; Davidson, K G

    1984-09-01

    Over the past 9 years, ten patients have presented to the Thoracic Unit, Glasgow Royal Infirmary, with 12 empyemas secondary to intra-abdominal sepsis. In eight patients, the presenting signs and symptoms were wrongly attributed to primary intra-thoracic pathology. All were subsequently found to have intra-abdominal sepsis. The presence of empyema after recent abdominal surgery or abdominal pain strongly suggests a diagnosis of ipsilateral subphrenic abscess. Adequate surgical drainage is essential. In our experience, limited thoracotomy with subdiaphragmatic extension offers the best access to both pleural and subphrenic spaces and provides the greatest chance of eradicating infection on both sides of the diaphragm.

  5. Mechanical ventilation in abdominal surgery.

    PubMed

    Futier, E; Godet, T; Millot, A; Constantin, J-M; Jaber, S

    2014-01-01

    One of the key challenges in perioperative care is to reduce postoperative morbidity and mortality. Patients who develop postoperative morbidity but survive to leave hospital have often reduced functional independence and long-term survival. Mechanical ventilation provides a specific example that may help us to shift thinking from treatment to prevention of postoperative complications. Mechanical ventilation in patients undergoing surgery has long been considered only as a modality to ensure gas exchange while allowing maintenance of anesthesia with delivery of inhaled anesthetics. Evidence is accumulating, however, suggesting an association between intraoperative mechanical ventilation strategy and postoperative pulmonary function and clinical outcome in patients undergoing abdominal surgery. Non-protective ventilator settings, especially high tidal volume (VT) (>10-12mL/kg) and the use of very low level of positive end-expiratory pressure (PEEP) (PEEP<5cmH2O) or no PEEP, may cause alveolar overdistension and repetitive tidal recruitment leading to ventilator-associated lung injury in patients with healthy lungs. Stimulated by previous findings in patients with acute respiratory distress syndrome, the use of lower tidal volume ventilation is becoming increasingly more common in the operating room. However, lowering tidal volume, though important, is only part of the overall multifaceted approach of lung protective mechanical ventilation. In this review, we aimed at providing the most recent and relevant clinical evidence regarding the use of mechanical ventilation in patients undergoing abdominal surgery.

  6. A unique advantage for giant eyes in giant squid.

    PubMed

    Nilsson, Dan-Eric; Warrant, Eric J; Johnsen, Sönke; Hanlon, Roger; Shashar, Nadav

    2012-04-24

    Giant and colossal deep-sea squid (Architeuthis and Mesonychoteuthis) have the largest eyes in the animal kingdom [1, 2], but there is no explanation for why they would need eyes that are nearly three times the diameter of those of any other extant animal. Here we develop a theory for visual detection in pelagic habitats, which predicts that such giant eyes are unlikely to evolve for detecting mates or prey at long distance but are instead uniquely suited for detecting very large predators, such as sperm whales. We also provide photographic documentation of an eyeball of about 27 cm with a 9 cm pupil in a giant squid, and we predict that, below 600 m depth, it would allow detection of sperm whales at distances exceeding 120 m. With this long range of vision, giant squid get an early warning of approaching sperm whales. Because the sonar range of sperm whales exceeds 120 m [3-5], we hypothesize that a well-prepared and powerful evasive response to hunting sperm whales may have driven the evolution of huge dimensions in both eyes and bodies of giant and colossal squid. Our theory also provides insights into the vision of Mesozoic ichthyosaurs with unusually large eyes.

  7. A rare complication of colonic diverticulosis: giant diverticulum. Case report and overview of pathophysiology, diagnosis and therapeutic options.

    PubMed

    Vanderstappen, J H H; Hoofwijk, A G M; Sikkink, C J J M

    2014-01-01

    A rare complication of diverticulosis of the colon is giant colonic diverticulum, an entity first described by Bonvin in 1946. The experience of any surgeon with this problem is at the most still small and reported management in the literature has been varied. We present the case of a 84-year-old woman presenting with a painless abdominal mass and constipation. A 30 x 10 cm gas-filled cyst was discovered on abdominal X-ray and CT examination. Furthermore, we provide an overview of pathophysiology, diagnosis and therapeutic options.

  8. A Giant Thoracic Duct Cyst as the Cause of Abdomen Pain: A Case Report and Review of the Literature

    PubMed Central

    Wan, Xinyue

    2015-01-01

    Thoracic duct cysts, which may be of congenital or degenerative origin, are very rare lesions. Most patients are asymptomatic, but when symptoms are present they include cough, dyspnea, dysphagia and chest pain. However, in this case report a 35-year-old male patient presented to us with intermittent abdomen pain. Clinical symptoms and radiographic findings helped to identify a giant thoracic duct cyst in this patient. Surgical resection of the cyst resolved the abdominal symptoms. This was the first case reported in the literature of a thoracic duct cyst with the symptoms of abdominal pain. PMID:26004105

  9. The morphology and fine structure of the giant interneurons of the wood cricket Nemobius sylvestris.

    PubMed

    Insausti, T C; Lazzari, C R; Casas, J

    2011-02-01

    The structural and ultrastructural characteristics of giant interneurons in the terminal abdominal ganglion of the cricket Nemobius sylvestris were investigated by means of cobalt and fluorescent dye backfilling and transmission electron microscopy. The projections of the 8 eight pairs of the biggest ascending interneurons (giant interneurons) are described in detail. The somata of all interneurons analyzed are located contralateral to their axons, which project to the posterior region of the terminal ganglion and arborise in the cercal glomerulus. Neuron 7-1a is an exception, because its arborisation is restricted to the anterior region of the ganglion. The fine structure of giant interneurons shows typical features of highly active cells. We observed striking indentations in the perineural layer, enabling the somata of the giant interneurons to be very close to the haemolymph. The cercal glomerulus exhibits a high diversity of synaptic contacts (i.e. axo-dendritic, axo-axonic, dendro-axonic, and dendro-dendritic), as well as areas of tight junctions. Electrical synapses seem to be present, as well as mixed synapses. The anatomical organization of the giant interneurons is finally discussed in terms of functional implications and on a comparative basis.

  10. Formation of the giant planets

    NASA Technical Reports Server (NTRS)

    Lissauer, Jack J.

    2006-01-01

    The observed properties of giant planets, models of their evolution and observations of protoplanetary disks provide constraints on the formation of gas giant planets. The four largest planets in our Solar System contain considerable quantities of hydrogen and helium, which could not have condensed into solid planetesimals within the protoplanetary disk. All three (transiting) extrasolar giant planets with well determined masses and radii also must contain substantial amounts of these light gases. Jupiter and Saturn are mostly hydrogen and helium, but have larger abundances of heavier elements than does the Sun. Neptune and Uranus are primarily composed of heavier elements. HD 149026 b, which is slightly more massive than is Saturn, appears to have comparable quantities of light gases and heavy elements. HD 209458 b and TrES-1 are primarily hydrogen and helium, but may contain supersolar abundances of heavy elements. Spacecraft flybys and observations of satellite orbits provide estimates of the gravitational moments of the giant planets in our Solar System, which in turn provide information on the internal distribution of matter within Jupiter, Saturn, Uranus and Neptune. Atmospheric thermal structure and heat flow measurements constrain the interior temperatures of planets. Internal processes may cause giant planets to become more compositionally differentiated or alternatively more homogeneous; high-pressure laboratory .experiments provide data useful for modeling these processes. The preponderance of evidence supports the core nucleated gas accretion model. According to this model, giant planets begin their growth by the accumulation of small solid bodies, as do terrestrial planets. However, unlike terrestrial planets, the growing giant planet cores become massive enough that they are able to accumulate substantial amounts of gas before the protoplanetary disk dissipates. The primary questions regarding the core nucleated growth model is under what conditions

  11. Clump Giants in the Hyades

    NASA Technical Reports Server (NTRS)

    Mushotzky, Richard F. (Technical Monitor); Brickhouse, Nancy

    2003-01-01

    The project is entitled 'Clump Giants in the Hyades.' This observation of one of the late-type Hyades giants (Gamma Tau) has implications for understanding the formation of late-type stellar coronae as a function of the evolutionary state of the star. The Hyades giants are interesting because they are all clump giants in the Helium burning phase, similar to the cool primary of Capella. The Hyades giants show significantly more magnetic activity than expected from their state of evolution (and slowed-down rotation). Thus these systems provide an important clue to dynamo action. The data were obtained by the satellite on 13 March 2001 for a total RGS exposure of 58220 seconds. These data were delivered to the PI on 7 August 2001. The data could not be reprocessed until SAS Version 5.3.3 which became available 7 June 2002. Although the guidelines for assessing background rates suggested that half the data were contaminated, it does not appear that the spectral region of the RGS was adversely affected by unusually high background. The spectra show strong lines of Fe XVII and XVIII, O VII and VIII, Ne IX and X, along with numerous weaker lines. The emission measure distribution is highly reminiscent of Capella; if anything, the emission measure distribution is steeper at 6 million K than for Capella. Gamma Tau is the second brightest of the Hyades clump giants. Pallavicini et al. have shown that the luminosity of the brightest Hyades giant (Theta Tau) is remarkably similar to its luminosity as measured by Einstein. Short-term variability is also modest. We are addressing the variability issue now for Gamma Tau. Initial results were reported at the 2003 Seattle AAS meeting. A paper is in preparation for submission to the Astrophysical Journal.

  12. Open questions about giant viruses.

    PubMed

    Claverie, Jean-Michel; Abergel, Chantal

    2013-01-01

    The recent discovery of giant viruses exhibiting double-stranded DNA genomes larger than a million base pairs, encoding more than a thousand proteins and packed in near micron-sized icosahedral particles, opened a new and unexpected chapter in virology. As of today, these giant viruses and their closest relatives of lesser dimensions infect unicellular eukaryotes found in aquatic environments, but belonging to a wide diversity of early branching phyla. This broad phylogenetic distribution of hosts is consistent with the hypothesis that giant viruses originated prior to the radiation of the eukaryotic domain and/or might have been involved in the partition of nuclear versus cytoplasmic functions in ancestral cells. The distinctive features of the known giant viruses, in particular the recurrent presence of components of the translation apparatus in their proteome, raise a number of fundamental questions about their origin, their mode of evolution, and the relationship they may entertain with other dsDNA viruses, the genome size of which exhibits the widest distribution among all biological entities, from less than 5 kb to more than 1.25 Mb (a ratio of 1:250). At a more conceptual level, the convergence between the discovery of increasingly reduced parasitic cellular organisms and that of giant viruses exhibiting a widening array of cellular-like functions may ultimately abolish the historical discontinuity between the viral and the cellular world.

  13. Giant Magellan Telescope: overview

    NASA Astrophysics Data System (ADS)

    Johns, Matt; McCarthy, Patrick; Raybould, Keith; Bouchez, Antonin; Farahani, Arash; Filgueira, Jose; Jacoby, George; Shectman, Steve; Sheehan, Michael

    2012-09-01

    The Giant Magellan Telescope (GMT) is a 25-meter optical/infrared extremely large telescope that is being built by an international consortium of universities and research institutions. It will be located at the Las Campanas Observatory, Chile. The GMT primary mirror consists of seven 8.4-m borosilicate honeycomb mirror segments made at the Steward Observatory Mirror Lab (SOML). Six identical off-axis segments and one on-axis segment are arranged on a single nearly-paraboloidal parent surface having an overall focal ratio of f/0.7. The fabrication, testing and verification procedures required to produce the closely-matched off-axis mirror segments were developed during the production of the first mirror. Production of the second and third off-axis segments is underway. GMT incorporates a seven-segment Gregorian adaptive secondary to implement three modes of adaptive-optics operation: natural-guide star AO, laser-tomography AO, and ground-layer AO. A wide-field corrector/ADC is available for use in seeing-limited mode over a 20-arcmin diameter field of view. Up to seven instruments can be mounted simultaneously on the telescope in a large Gregorian Instrument Rotator. Conceptual design studies were completed for six AO and seeing-limited instruments, plus a multi-object fiber feed, and a roadmap for phased deployment of the GMT instrument suite is being developed. The partner institutions have made firm commitments for approximately 45% of the funds required to build the telescope. Project Office efforts are currently focused on advancing the telescope and enclosure design in preparation for subsystem- and system-level preliminary design reviews which are scheduled to be completed in the first half of 2013.

  14. Ultrasonographic, computed tomographic, and operative findings in dogs infested with giant kidney worms (Dioctophyme renale).

    PubMed

    Rahal, Sheila C; Mamprim, Maria J; Oliveira, Hugo S; Mesquita, Luciane R; Faria, Luis G; Takahira, Regina K; Matsubara, Lídia M; Agostinho, Felipe S

    2014-03-01

    OBJECTIVE--To compare ultrasonographic, CT, and surgical findings in dogs infested with giant kidney worms (Dioctophyme renale). DESIGN--Case series. ANIMALS--15 crossbred dogs infected with D renale. PROCEDURES--Immediately after ultrasonography was performed with dogs in dorsal recumbency, sequential transverse images of the abdomen were acquired with a helical CT scanner. After plain CT, contrast CT was performed with a nonionic iodinated contrast agent. Subsequently, exploratory celiotomy was performed. RESULTS--In the corticomedullary area of the right kidney of 12 dogs, ultrasonography revealed several ring-like structures with an echogenic wall and anechoic central area in the transverse plane and arrayed as bands in the longitudinal plane. Similar structures were observed in the abdominal cavity of 10 dogs. In 13 dogs, CT revealed loss of corticomedullary differentiation in the right kidney, with discrete uptake of contrast material in the periphery of the kidney, and several ring-like or elongated structures with a hyperdense wall and hypodense center. In 11 dogs, the same structures were observed free in the abdominal cavity. Surgery revealed that 13 dogs had a damaged right kidney that required nephrectomy. Parasites were found free in the abdominal cavity of 7 dogs. CONCLUSIONS AND CLINICAL RELEVANCE--Ultrasonography and CT were effective imaging methods for detecting D renale in the kidney and less effective for detecting parasites in the abdominal cavity. Care should be taken to avoid erroneously interpreting normal structures as parasites, especially in the abdominal cavity.

  15. Abdominal aortic aneurysms in women

    PubMed Central

    Lo, Ruby C.; Schermerhorn, Marc L.

    2015-01-01

    Abdominal aortic aneurysm (AAA) has long been recognized as a condition predominantly afflicting males, with sex-associated differences described for almost every aspect of the disease from pathophysiology and epidemiology to morbidity and mortality. Women are generally spared from AAA formation by the immunomodulating effects of estrogen but once they develop, the natural history of AAAs in women appears to be more aggressive, with more rapid expansion, a higher tendency to rupture at smaller diameters, and higher mortality following rupture. However, simply repairing AAA at smaller diameters in women is a debatable solution, as even elective endovascular AAA repair (EVAR) is fraught with higher morbidity and mortality in women compared to men. The goal of this review is to summarize what is currently known about the effect of gender on AAA presentation, treatment, and outcomes. Additionally, we aim to review current controversies over screening recommendations and threshold for repair in women. PMID:26747679

  16. Gallstone ileus with a giant stone and associated multiple stones.

    PubMed

    Ozbalci, G S; Tanrikulu, Y; Kismet, K; Dinc, S; Akkus, M A

    2012-01-01

    Gallstone ileus is an uncommon cause of small bowel obstruction. Gallstone ileus accounts for only about 1-3 % of cases of mechanical obstructions of the small bowel. It usually occurs in the elderly with a female predominance and may result in high mortality rates. The diagnosis is difficult and early diagnosis reduces the mortality. Terminal ileum is the most common site of gallstone impaction. We report a case of gallstone ileus in an 81-year-old female patient who was admitted to our clinic for abdominal pain, vomiting and constipation. The ultrasonography of abdomen revealed a decrease in bowel motion, and dilated bowel segments. Intraoperatively, a giant gallstone and associated multiple stones were found in the ileum 80 cm from the ileocecal valve and extracted from a longitudinal enterotomy (Fig. 4, Ref. 24).

  17. [Spontaneous rupture of giant subcapsular hemangioma of the liver with hemoperitoneum and hemorrhagic shock: a case report].

    PubMed

    Griffa, Baldovino; Basilico, Valerio; Bellotti, Raffaele; Griffa, Andrea; Senatore, Sergio; Capriata, Giulio

    2005-01-01

    Cavernous hemangioma is the most common benign tumour of the liver and is found quite commonly during abdominal ultrasonography performed for other diseases. It is often asymptomatic and undergoes enlargement in fewer than 10% of cases. Spontaneous rupture of a giant hepatic hemangioma (diameter > 4 cm) with hemoperitoneum occurs very rarely. Only 32 cases have been reported in a recent review of the medical literature, with an operative mortality of more than 35%. We describe a new case of a giant subcapsular hemangioma localised in hepatic segments II and III in an 84-year-old woman, which ruptured spontaneously into the abdominal cavity and presented with hemoperitoneum and hypovolaemic shock. The hemangioma was diagnosed preoperatively by spiral CAT and treated successfully with emergency hepatic bisegmentectomy.

  18. Polymyalgia Rheumatica and Giant Cell Arteritis

    MedlinePlus

    ... Clinical Trial Journal Articles Polymyalgia Rheumatica and Giant Cell Arteritis May 2016 Questions and Answers about Polymyalgia Rheumatica and Giant Cell Arteritis This publication contains general information about polymyalgia ...

  19. Pulmonary complications of abdominal wall defects.

    PubMed

    Panitch, Howard B

    2015-01-01

    The abdominal wall is an integral component of the chest wall. Defects in the ventral abdominal wall alter respiratory mechanics and can impair diaphragm function. Congenital abdominal wall defects also are associated with abnormalities in lung growth and development that lead to pulmonary hypoplasia, pulmonary hypertension, and alterations in thoracic cage formation. Although infants with ventral abdominal wall defects can experience life-threatening pulmonary complications, older children typically experience a more benign respiratory course. Studies of lung and chest wall function in older children and adolescents with congenital abdominal wall defects are few; such investigations could provide strategies for improved respiratory performance, avoidance of respiratory morbidity, and enhanced exercise ability for these children.

  20. Giant lobelias exemplify convergent evolution

    PubMed Central

    2010-01-01

    Giant lobeliads on tropical mountains in East Africa and Hawaii have highly unusual, giant-rosette growth forms that appear to be convergent on each other and on those of several independently evolved groups of Asteraceae and other families. A recent phylogenetic analysis by Antonelli, based on sequencing the widest selection of lobeliads to date, raises doubts about this paradigmatic example of convergent evolution. Here I address the kinds of evidence needed to test for convergent evolution and argue that the analysis by Antonelli fails on four points. Antonelli's analysis makes several important contributions to our understanding of lobeliad evolution and geographic spread, but his claim regarding convergence appears to be invalid. Giant lobeliads in Hawaii and Africa represent paradigmatic examples of convergent evolution. PMID:20074322

  1. Atmospheres of Extrasolar Giant Planets

    NASA Astrophysics Data System (ADS)

    Marley, M. S.; Fortney, J.; Seager, S.; Barman, T.

    The key to understanding an extrasolar giant planet's spectrum - and hence its detectability and evolution - lies with its atmosphere. Now that direct observations of thermal emission from extrasolar giant planets (EGPs) are in hand, atmosphere models can be used to constrain atmospheric composition, thermal structure, and ultimately the formation and evolution of detected planets. We review the important physical processes that influence the atmospheric structure and evolution of EGPs and consider what has already been learned from the first generation of observations and modeling. We pay particular attention to the roles of cloud structure, metallicity, and atmospheric chemistry in affecting detectable properties through Spitzer Space Telescope observations of the transiting giant planets. Our review stresses the uncertainties that ultimately limit our ability to interpret EGP observations. Finally we will conclude with a look to the future as characterization of multiple individual planets in a single stellar system leads to the study of comparative planetary architectures.

  2. CMB lensing and giant rings

    SciTech Connect

    Rathaus, Ben; Itzhaki, Nissan E-mail: ben.rathaus@gmail.com

    2012-05-01

    We study the CMB lensing signature of a pre-inationary particle (PIP), assuming it is responsible for the giant rings anomaly that was found recently in the WMAP data. Simulating Planck-like data we find that generically the CMB lensing signal to noise ratio associated with such a PIP is quite small and it would be difficult to cross correlate the temperature giant rings with the CMB lensing signal. However, if the pre-inationary particle is also responsible for the bulk flow measured from the local large scale structure, which happens to point roughly at the same direction as the giant rings, then the CMB lensing signal to noise ratio is fairly significant.

  3. Structure of giant muscle proteins

    PubMed Central

    Meyer, Logan C.; Wright, Nathan T.

    2013-01-01

    Giant muscle proteins (e.g., titin, nebulin, and obscurin) play a seminal role in muscle elasticity, stretch response, and sarcomeric organization. Each giant protein consists of multiple tandem structural domains, usually arranged in a modular fashion spanning 500 kDa to 4 MDa. Although many of the domains are similar in structure, subtle differences create a unique function of each domain. Recent high and low resolution structural and dynamic studies now suggest more nuanced overall protein structures than previously realized. These findings show that atomic structure, interactions between tandem domains, and intrasarcomeric environment all influence the shape, motion, and therefore function of giant proteins. In this article we will review the current understanding of titin, obscurin, and nebulin structure, from the atomic level through the molecular level. PMID:24376425

  4. Dysfunctional MnSOD leads to redox dysregulation and activation of prosurvival AKT signaling in uterine leiomyomas

    PubMed Central

    Vidimar, Vania; Gius, David; Chakravarti, Debabrata; Bulun, Serdar E.; Wei, Jian-Jun; Kim, J. Julie

    2016-01-01

    AKT signaling promotes cell growth and survival and is often dysregulated via multiple mechanisms in different types of cancer, including uterine leiomyomas (ULMs). ULMs are highly prevalent fibrotic tumors that arise from the smooth muscular layer of the uterus, the myometrium (MM). ULMs pose a major public health issue because they can cause severe morbidity and poor pregnancy outcomes. ‬We investigate the mechanisms driving ULM growth and survival via aberrant activation of AKT. We demonstrate that an acetylation-mediated impairment of the manganese superoxide dismutase (MnSOD) activity is prevalent in ULM cells compared to the normal-matched MM from the same patients. This impairment increases the levels of superoxide and oxidative stress, which activate AKT via oxidative inactivation of the phosphatase and tensin homolog deleted on chromosome 10 (PTEN). Redox activation of AKT promotes ULM cell survival under conditions of moderate but persistent oxidative stress that are compatible with ULM’s prooxidative microenvironment. Moreover, because of impaired MnSOD activity, ULM cells are sensitive to high levels of reactive oxygen species (ROS) and superoxide-generating compounds, resulting in decreased ULM cell viability. On the contrary, MM cells with functional MnSOD are more resistant to high levels of oxidants. This study demonstrates a causative role of acetylation-mediated MnSOD dysfunction in activating prosurvival AKT signaling in ULMs. The specific AKT and redox states of ULM cells provide a potential novel therapeutic rationale to selectively target ULM cells because of their defective ROS-scavenging system.‬‬‬‬‬‬‬‬ PMID:27847869

  5. A rare case of fetal spondylocostal dysostosis - prenatal diagnosis and perinatal care in a patient with multiple large leiomyomas.

    PubMed

    Cirstoiu, M; Munteanu, O; Bodean, O; Cirstoiu, C

    2013-03-15

    The spondylocostal dysostosis (SCD) is one of the two major clinico-radiological subtypes of the Jarcho-Levin syndrome (JLS). The JLS is a rare heterogeneous entity characterized by facial dysmorphism, short-neck, short-trunk, normal sizes limbs, with multiple vertebral anomalies at all levels of the vertebral column and costal defects. The JLS has been classified into 2 major clinical phenotypes, based on the extent and distribution of skeletal anomalies, the pattern of inheritance and the prognosis. We report the case of a non-consanguineous 35-year-old female patient, with a history of multiple large leiomyomas gravida 1, para 1. A three-dimensional ultrasound at 18 weeks of gestation revealed: thoracic and lumbar hemivertebrae with abnormal alignment of the vertebral bodies and kypho-scoliosis, also the absence of two right ribs and abnormal shaped ribs. The biometric measurement was appropriate for gestational age and no other malformations were found. Although there was no previous history, based on the three-dimensional ultrasound findings a mild subtype of JLS was suspected. At term, the patient gave birth, by Cesarean section, to a male fetus, with a weight of 2700g, a length of 50cm and a calculated Apgar score of 9. The postpartum examination of the fetus confirmed the diagnose of SCD. The evolution of the newborn was good - he had no respiratory difficulty; he will benefit from an experimental surgery involving expandable titanium ribs. Our case illustrates the importance of an accurate ultrasound examination, which can be hindered by multiple large leyomiomas, in order to diagnose and to differentiate the two subtypes of JLS. The SCD can have a favorable evolution with the appropriate perinatal and postpartum care.

  6. A rare case of fetal spondylocostal dysostosis - prenatal diagnosis and perinatal care in a patient with multiple large leiomyomas

    PubMed Central

    Cirstoiu, M; Munteanu, O; Bodean, O; Cirstoiu, C

    2013-01-01

    The spondylocostal dysostosis (SCD) is one of the two major clinico-radiological subtypes of the Jarcho-Levin syndrome (JLS). The JLS is a rare heterogeneous entity characterized by facial dysmorphism, short-neck, short-trunk, normal sizes limbs, with multiple vertebral anomalies at all levels of the vertebral column and costal defects. The JLS has been classified into 2 major clinical phenotypes, based on the extent and distribution of skeletal anomalies, the pattern of inheritance and the prognosis. We report the case of a non-consanguineous 35-year-old female patient, with a history of multiple large leiomyomas gravida 1, para 1. A three-dimensional ultrasound at 18 weeks of gestation revealed: thoracic and lumbar hemivertebrae with abnormal alignment of the vertebral bodies and kypho-scoliosis, also the absence of two right ribs and abnormal shaped ribs. The biometric measurement was appropriate for gestational age and no other malformations were found. Although there was no previous history, based on the three-dimensional ultrasound findings a mild subtype of JLS was suspected. At term, the patient gave birth, by Cesarean section, to a male fetus, with a weight of 2700g, a length of 50cm and a calculated Apgar score of 9. The postpartum examination of the fetus confirmed the diagnose of SCD. The evolution of the newborn was good - he had no respiratory difficulty; he will benefit from an experimental surgery involving expandable titanium ribs. Our case illustrates the importance of an accurate ultrasound examination, which can be hindered by multiple large leyomiomas, in order to diagnose and to differentiate the two subtypes of JLS. The SCD can have a favorable evolution with the appropriate perinatal and postpartum care. PMID:23599829

  7. A giant colonic diverticulum presenting as a 'phantom mass': a case report

    PubMed Central

    2009-01-01

    Introduction Diverticulosis coli is the most common disease of the colon in Western countries. Giant colonic diverticulum, defined as a colonic diverticulum measuring 4 cm in size or larger, represents an unusual manifestation of this common clinical entity. Case presentation A 68-year-old Caucasian British woman with a history of intermittent lower abdominal mass, leg swelling and focal neurological symptoms underwent extensive non-diagnostic investigations over a significant period under a number of disciplines. The reason for a diagnosis being elusive in part related to the fact that the mass was never found on clinical and ultrasound examination. As a result, the patient's validity was questioned. Ultimately, this 'phantom-mass' was diagnosed as a giant colonic diverticulum causing intermittent compression of the iliac vein and obturator nerve. Conclusion Intermittent compression of the iliac vein and the obturator nerve by a colonic diverticulum has not previously been reported. A giant colonic diverticulum presenting as an intermittent mass is very rare. This case also illustrates two factors. First, the patient is often right. Second, the optimal mode of investigation for any proven or described abdominal mass with referred symptoms is cross-sectional imaging, typically a computed tomography scan, irrespective whether the mass or symptoms are constant or intermittent. PMID:19173728

  8. Giant right atrial thrombi treated with thrombolysis.

    PubMed

    Ruiz-Bailén, Manuel; López-Caler, Carmen; Castillo-Rivera, Ana; Rucabado-Aguilar, Luis; Ramos Cuadra, José Angel; Lara Toral, Juan; Lozano Cabezas, Cristobal; Fernández Guerrero, Juan Carlos

    2008-04-01

    The present report describes giant atrial thrombi that were treated with thrombolysis in a community hospital. Two patients with giant atrial thrombi whose treatment involved complications are presented. Both patients developed cardiogenic shock and were treated unsuccessfully with thrombolysis. Because thrombolysis of giant thrombi may be ineffective, patients in this situation may require surgery.

  9. Giant right atrial thrombi treated with thrombolysis

    PubMed Central

    Ruiz-Bailén, Manuel; López-Caler, Carmen; Castillo-Rivera, Ana; Rucabado-Aguilar, Luis; Cuadra, José Ángel Ramos; Toral, Juan Lara; Cabezas, Cristobal Lozano; Guerrero, Juan Carlos Fernández

    2008-01-01

    The present report describes giant atrial thrombi that were treated with thrombolysis in a community hospital. Two patients with giant atrial thrombi whose treatment involved complications are presented. Both patients developed cardiogenic shock and were treated unsuccessfully with thrombolysis. Because thrombolysis of giant thrombi may be ineffective, patients in this situation may require surgery. PMID:18401474

  10. Cabergoline treatment in invasive giant prolactinoma.

    PubMed

    Alsubaie, Sadeem; Almalki, Mussa H

    2014-01-01

    Patients with invasive giant prolactinoma suffer from a constellation of symptoms including headache, blurred vision, lethargy, and sexual dysfunction. Cabergoline, a potent dopamine agonist, is a known medication prescribed for the treatment of invasive giant prolactinoma. Here, we report a case of invasive giant prolactinoma in a 52-year-old Saudi male with dramatic response to cabergoline treatment clinically, biochemically, and radiologically.

  11. Charting the Giants

    NASA Astrophysics Data System (ADS)

    2004-06-01

    zero expansion asymptotically after an infinite time and has a flat geometry). All three observational tests by means of supernovae (green), the cosmic microwave background (blue) and galaxy clusters converge at a Universe around Ωm ~ 0.3 and ΩΛ ~ 0.7. The dark red region for the galaxy cluster determination corresponds to 95% certainty (2-sigma statistical deviation) when assuming good knowledge of all other cosmological parameters, and the light red region assumes a minimum knowledge. For the supernovae and WMAP results, the inner and outer regions corespond to 68% (1-sigma) and 95% certainty, respectively. References: Schuecker et al. 2003, A&A, 398, 867 (REFLEX); Tonry et al. 2003, ApJ, 594, 1 (supernovae); Riess et al. 2004, ApJ, 607, 665 (supernovae) Galaxy clusters are far from being evenly distributed in the Universe. Instead, they tend to conglomerate into even larger structures, "super-clusters". Thus, from stars which gather in galaxies, galaxies which congregate in clusters and clusters tying together in super-clusters, the Universe shows structuring on all scales, from the smallest to the largest ones. This is a relict of the very early (formation) epoch of the Universe, the so-called "inflationary" period. At that time, only a minuscule fraction of one second after the Big Bang, the tiny density fluctuations were amplified and over the eons, they gave birth to the much larger structures. Because of the link between the first fluctuations and the giant structures now observed, the unique REFLEX catalogue - the largest of its kind - allows astronomers to put considerable constraints on the content of the Universe, and in particular on the amount of dark matter that is believed to pervade it. Rather interestingly, these constraints are totally independent from all other methods so far used to assert the existence of dark matter, such as the study of very distant supernovae (see e.g. ESO PR 21/98) or the analysis of the Cosmic Microwave background (e

  12. Intestinal injury mechanisms after blunt abdominal impact.

    PubMed

    Cripps, N P; Cooper, G J

    1997-03-01

    Intestinal injury is frequent after non-penetrating abdominal trauma, particularly after modern, high-energy transfer impacts. Under these circumstances, delay in the diagnosis of perforation is a major contributor to morbidity and mortality. This study establishes patterns of intestinal injury after blunt trauma by non-penetrating projectiles and examines relationships between injury distribution and abdominal wall motion. Projectile impacts of variable momentum were produced in 31 anaesthetised pigs to cause abdominal wall motion of varying magnitude and velocity. No small bowel injury was observed at initial impact velocity of less than 40 m/s despite gross abdominal compression. At higher velocity, injury to the small bowel was frequent, irrespective of the degree of abdominal compression (P = 0.00044). Large bowel injury was observed at all impact velocities and at all degrees of abdominal compression. This study confirms the potential for intestinal injury in high velocity, low momentum impacts which do not greatly compress the abdominal cavity and demonstrates apparent differences in injury mechanisms for the small bowel and colon. Familiarity with injury mechanisms may reduce delays in the diagnosis of intestinal perforation in both military and civilian situations.

  13. Traumatic abdominal hernia complicated by necrotizing fasciitis.

    PubMed

    Martínez-Pérez, Aleix; Garrigós-Ortega, Gonzalo; Gómez-Abril, Segundo Ángel; Martí-Martínez, Eva; Torres-Sánchez, Teresa

    2014-11-01

    Necrotizing fasciitis is a critical illness involving skin and soft tissues, which may develop after blunt abdominal trauma causing abdominal wall hernia and representing a great challenge for physicians. A 52-year-old man was brought to the emergency department after a road accident, presenting blunt abdominal trauma with a large non-reducible mass in the lower-right abdomen. A first, CT showed abdominal hernia without signs of complication. Three hours after ICU admission, he developed hemodynamic instability. Therefore, a new CT scan was requested, showing signs of hernia complication. He was moved to the operating room where a complete transversal section of an ileal loop was identified. Five hours after surgery, he presented a new episode of hemodynamic instability with signs of skin and soft tissue infection. Due to the high clinical suspicion of necrotizing fasciitis development, wide debridement was performed. Following traumatic abdominal wall hernia (TAWH), patients can present unsuspected injuries in abdominal organs. Helical CT can be falsely negative in the early moments, leading to misdiagnosis. Necrotizing fasciitis is a potentially fatal infection and, consequently, resuscitation measures, wide-spectrum antibiotics, and early surgical debridement are required. This type of fasciitis can develop after blunt abdominal trauma following wall hernia without skin disruption.

  14. The prognosis of childhood abdominal migraine

    PubMed Central

    Dignan, F; Abu-Arafeh, I; Russell, G

    2001-01-01

    AIMS—To determine the clinical course of childhood abdominal migraine, seven to 10 years after the diagnosis.
METHODS—A total of 54 children with abdominal migraine were studied; 35 were identified from a population survey carried out on Aberdeen schoolchildren between 1991 and 1993, and 19 from outpatient records of children in the same age group who had attended the Royal Aberdeen Children's Hospital. Controls were 54 children who did not have abdominal pain in childhood, matched for age and sex, obtained from either the population survey or the patient administration system. Main outcome measures were presence or resolution of abdominal migraine and past or present history of headache fulfilling the International Headache Society (IHS) criteria for the diagnosis of migraine.
RESULTS—Abdominal migraine had resolved in 31 cases (61%). Seventy per cent of cases with abdominal migraine were either current (52%) or previous (18%) sufferers from headaches that fulfilled the IHS criteria for migraine, compared to 20% of the controls.
CONCLUSIONS—These results support the concept of abdominal migraine as a migraine prodrome, and suggest that our diagnostic criteria for the condition are robust.

 PMID:11316687

  15. Management of intra-abdominal hypertension and abdominal compartment syndrome: a review

    PubMed Central

    2014-01-01

    Patients in the intensive care unit (ICU) are at risk of developing of intra abdominal hypertension (IAH) and abdominal compartment syndrome (ACS). Aim: This review seeks to define IAH and ACS, identify the aetiology and presentation of IAH and ACS, identify IAP measurement techniques, identify current management and discuss the implications of IAH and ACS for nursing practice. A search of the electronic databases was supervised by a health librarian. The electronic data bases Cumulative Index of Nursing and Allied Health Literature (CINAHL); Medline, EMBASE, and the World Wide Web was undertaken from 1996- January 2011 using MeSH and key words which included but not limited to: abdominal compartment syndrome, intra -abdominal hypertension, intra-abdominal pressure in adult populations met the search criteria and were reviewed by three authors using a critical appraisal tool. Data derived from the retrieved material are discussed under the following themes: (1) etiology of intra-abdominal hypertension; (2) strategies for measuring intra-abdominal pressure (3) the manifestation of abdominal compartment syndrome; and (4) the importance of nursing assessment, observation and interventions. Intra-abdominal pressure (IAP) and abdominal compartment syndrome (ACS) have the potential to alter organ perfusion and compromise organ function. PMID:24499574

  16. Torsion of an intra-abdominal testis.

    PubMed

    Lewis; Roller; Parra; Cotlar

    2000-09-01

    To present a case of torsion of a nonneoplastic intra-abdominal testis with an unusual clinical presentation.A 26-year-old active duty Navy Petty Officer presented to the emergency department on 3 occasions over a 5-day period with lower abdominal pain. Physical examination demonstrated acute tenderness in the left lower quadrant with sugestion of a normal spermatic cord and atrophic testis in the left scrotum. Computed tomography scan demonstrated an intra-abdominal lesion near the internal inguinal ring. The patient underwent surgical exploration through an inguinal incision. Torsion of a nonviable intra-abdominal testis was present. The scrotum contained only the vas deferens and cremasteric muscle. An orchiectomy was performed with removal of the vas deferens and other cord structures.The unusual clinical finding of acute torsion of an intra-abdominal testis, associated with an apparent atrophic scrotal testis, presented a confusing clinical picture. Computed tomography scan did not clarify the issue sufficiently to establish a definite preoperative diagnosis. Clinical suspicion prompted early surgical intervention. Review of the current literature produced 60 reported cases of torsion of an intra-abdominal testis. Two thirds of these involved testicular neoplasm, usually seminoma. Although the clinical presentation varied, most patients had recent onset of lower abdominal pain associated with tenderness and, in half the cases, a mass. Patients almost always presented with an absent scrotal testis on the involved side, and not infrequently reported previous surgery thought to be an orchiectomy.Diagnosis of an intra-abdominal testicular torsion is rare, particularly when no neoplasm is present. A high index of suspicion must be maintained whenever there is abdominal pain and undescended testis. The surgical history and imaging studies may not clarify a confusing clinical picture.

  17. Advances in abdominal MR imaging.

    PubMed

    Ferrucci, J T

    1998-01-01

    Major technical advances in MR imaging have led to its wider use in the evaluation of abdominal disease. The principle new pulse sequence is the RARE sequence for T2-weighted imaging. Multishot and breath-hold single-shot RARE techniques are now widely used, and both have performed as well as conventional spin-echo imaging with far shorter acquisition times. The most notable improvements have been in the detection and characterization of hepatic lesions. Two liver-specific contrast agents received FDA approval during 1997: SPIO particles or ferumoxide and mangafodipir trisodium, a hepatocyte-specific agent. Both of these agents provide considerable benefit in the detection and characterization of hepatic lesions. Manganese enhancement has also proved useful in MR imaging of the pancreas, although fat-suppressed T1-weighted imaging with dynamic gadolinium enhancement has also yielded results comparable with those of contrast-enhanced CT. MR hydrography, a generic term for static fluid imaging, is another derivative of RARE fast T2-weighted imaging. MRCP, the best known example of MR hydrography, has been rapidly and widely employed as a primary method for imaging the biliary and pancreatic ducts and has become competitive with ERCP. MR vascular imaging, especially portal venography, has been used for noninvasive imaging of portal venous disease in Budd Chiari disease, before placement of transjugular intrahepatic portosystemic shunts, and for pancreatic cancer staging. Finally, the development of conventional phased-array body coils and endorectal coils has enabled high-quality MR imaging of perirectal disease (including Crohn disease, fistula in ano, and postpartum sphincter dysfunction). Future abdominal applications of MR imaging will involve second-generation MR interventional techniques, including use of open systems, functional or diffusion-weighted imaging exploiting the molecular activity of tissues, and virtual MR endoscopy. Although CT continues to evolve

  18. Multiple giant duodenal ulcers associated with duodenal gastrinoma.

    PubMed

    Fujihara, Shintaro; Mori, Hirohito; Nishiyama, Noriko; Kobayashi, Mitsuyoshi; Kobara, Hideki; Masaki, Tsutomu

    2012-02-01

    A 59-year-old Japanese man with a history of chronic hepatitis C and cirrhosis was admitted to hospital because of severe abdominal pain and diarrhea. His discomfort had begun 2 months earlier and was localized to the upper abdomen. Upper gastrointestinal endoscopy showed multiple ulcerative lesions from the duodenal bulb to the descending part of the duodenum, one of which was a giant ulcer that filled half of the intestinal lumen. Despite continuous intravenous lansoprazole therapy, his abdominal symptoms did not improve. Upper gastrointestinal endoscopy was again performed to detect the tumor, but it was difficult to observe the tumor with a conventional endoscope. We then inverted a transnasal endoscope into the duodenum, and this enabled us to detect a 15-mm submucosal tumor in the upper wall of the duodenal bulb. Examination of specimens from endoscopic ultrasonography fine-needle aspiration biopsy of the tumor revealed gastrinoma in the duodenal bulb. We decided to perform an operative resection. The patient's symptoms resolved after surgery, and he remained asymptomatic at follow-up 18 months later. Therefore, when it is difficult to detect the tumor directly by conventional endoscopy, we recommend that attempts be made to detect the tumor by inverting a transnasal endoscope into the duodenal bulb.

  19. Giant Serpentine Aneurysms: Multidisciplinary Management

    PubMed Central

    Anshun, W.; Feng, L.; Daming, W.

    2000-01-01

    Summary Sixty-five cases of intracranial giant serpentine aneurysms (GSΛs), including 61 cases reported in the literature and four additional cases presented in this study were reviewed. The clinical presentation, possible causes, natural history, and especially management of GSAs are discussed with emphasis on the need for aggressive intervention and multidisciplinary management. PMID:20667180

  20. On the Shoulders of Giants...

    DTIC Science & Technology

    2013-01-01

    REFERENCES 1. Newton I. Turnbull HW, ed. Correspondence of Isaac Newton . Vol I: 1661Y1675. Cambridge, United Kingdom: Cambridge University Press; 1959:416...calendar), Sir Isaac Newtonopined to Robert Hooke, ‘‘If I have seen further [than you and Descartes], it is by standing on the shoulders of giants.’’1 That

  1. The giant panda gut microbiome.

    PubMed

    Wei, Fuwen; Wang, Xiao; Wu, Qi

    2015-08-01

    Giant pandas (Ailuropoda melanoleuca) are bamboo specialists that evolved from carnivores. Their gut microbiota probably aids in the digestion of cellulose and this is considered an example of gut microbiota adaptation to a bamboo diet. However, this issue remains unresolved and further functional and compositional studies are needed.

  2. [Laparoscopic abdominal drainage by sterile destructive pancreatitis].

    PubMed

    Kuznetsov, N A; Rodoman, G V; Shalaeva, T I; Trefilova, O I; Sosikova, N L

    2009-01-01

    90 patients with acute pancreatitis were observed, in 60 of them laparoscopic drainage was performed. The procedure by sterile pancreatonecrosis is indicated only in presence of extent amount of exudate in abdominal cavity. Duration of draining the abdominal cavity should be strictly limited because of the high risk of septic complications. Contraindications for the abdominal drainage by acute necrotic pancreatitis are not only adhesions in the abdomen and shock state of the patient at the moment of procedure necessity, but also unstable hemodynamics in anamnesis and even by the arterial pressure downtrend.

  3. Soft tissue coverage in abdominal wall reconstruction.

    PubMed

    Baumann, Donald P; Butler, Charles E

    2013-10-01

    Abdominal wall defects requiring soft tissue coverage can be either partial-thickness defects or full-thickness composite defects. Soft tissue flap reconstruction offers significant advantages in defects that cannot be closed primarily. Flap reconstruction is performed in a single-stage procedure obviating chronic wound management. If the defect size exceeds the availability of local soft tissue for coverage, regional pedicled flaps can be delivered into the abdominal wall while maintaining blood supply from their donor site. Microsurgical free tissue transfer increases the capacity to provide soft tissue coverage for abdominal wall defects that are not amenable to either local or regional flap coverage.

  4. Intra-abdominal bleeding in appendicitis.

    PubMed

    Thongprayoon, C; Pasa-Arj, S

    1991-08-01

    A 34-year-old woman, gravida 6 with 10 weeks of gestation was admitted because of abdominal pain and fainting. On physical examination she had hypotension, was pale with abdominal tenderness and guarding. Culdocentesis yielded unclotted blood. Immediate laparotomy was performed, because a diagnosis of ectopic pregnancy was made. About 2,500 ml of fresh blood was found in the abdominal cavity. Appendicular artery tear caused active arterial bleeding. The torn appendicular artery was observed to be the consequence of perforated appendicitis, which, in turn, was caused by a faecalith. Appendectomy was performed and she made a good recovery.

  5. Laparoscopic repair of abdominal incisional hernia

    PubMed Central

    Yang, Xue-Fei

    2016-01-01

    Abdominal incisional hernia is a common complication after open abdominal operations. Laparoscopic procedures have obvious mini-invasive advantages for surgical treatment of abdominal incisional hernia, especially to cases with big hernia defect. Laparoscopic repair of incisional hernia has routine mode but the actual operations will be various according to the condition of every hernia. Key points of these operations include design of the position of trocars, closure of defects and fixation of meshes. The details of these issues and experiences of perioperative evaluation and treatment will be talked about in this article. PMID:27761446

  6. Nursery of Giants

    NASA Technical Reports Server (NTRS)

    2004-01-01

    Hidden behind a shroud of dust in the constellation Cygnus is a stellar nursery called DR21, which is giving birth to some of the most massive stars in our galaxy. Visible light images reveal no trace of this interstellar cauldron because of heavy dust obscuration. In fact, visible light is attenuated in DR21 by a factor of more than 10,000,000,000,000,000,000,000,000,000,000,000,000,000 (ten thousand trillion heptillion).

    New images from NASA's Spitzer Space Telescope allow us to peek behind the cosmic veil and pinpoint one of the most massive natal stars yet seen in our Milky Way galaxy. The never-before-seen star is 100,000 times as bright as the Sun. Also revealed for the first time is a powerful outflow of hot gas emanating from this star and bursting through a giant molecular cloud.

    This image is a large-scale mosaic assembled from individual photographs obtained with the InfraRed Array Camera (IRAC) aboard Spitzer. The image covers an area about two times that of a full moon. The mosaic is a composite of images obtained at mid-infrared wavelengths of 3.6 microns (blue), 4.5 microns (green), 5.8 microns (orange) and 8 microns (red). The brightest infrared cloud near the top center corresponds to DR21, which presumably contains a cluster of newly forming stars at a distance of 10,000 light-years.

    Protruding out from DR21 toward the bottom left of the image is a gaseous outflow (green), containing both carbon monoxide and molecular hydrogen. Data from the Spitzer spectrograph, which breaks light into its constituent individual wavelengths, indicate the presence of hot steam formed as the outflow heats the surrounding molecular gas. Outflows are physical signatures of processes that create supersonic beams, or jets, of gas. They are usually accompanied by discs of material around the new star, which likely contain the materials from which future planetary systems are formed. Additional newborn stars, depicted in green, can be seen surrounding the

  7. [Churg-Strauss abdominal manifestation].

    PubMed

    Suarez-Moreno, Roberto; Ponce-Pérez, Luis Virgilio; Margain-Paredes, Miguel Angel; Garza-de la Llave, Heriberto; Madrazo-Navarro, Mario; Espinosa-Álvarez, Arturo

    2014-01-01

    Antecedentes: la enfermedad de Churg-Strauss es poco común, idiopática, caracterizada por hipereosinofilia en sangre y tejidos, aunada a vasculitis sistémica en pacientes con antecedentes de asma o rinitis alérgica. Las manifestaciones gastrointestinales del síndrome de Churg Strauss se caracterizan por dolor abdominal, seguido de diarrea y hemorragia en 31-45% de los casos. Caso clínico: paciente masculino con antecedente de asma que acudió a consulta por abdomen agudo con probable apendicitis aguda; durante el protocolo de estudio se diagnosticó síndrome de Churg Strauss, con manifestaciones intestinales. Conclusión: el síndrome de Churg Strauss es una vasculitis poco frecuente que puede manifestarse con síntomas intestinales, como en este caso; es importante tenerlo en mente a la hora de los diagnósticos diferenciales. Existen pocos reportes con este síndrome asociado con abdomen agudo, todos ellos con mal pronóstico.

  8. A giant inguinoscrotal hernia associated with other abdominal wall defects A case report.

    PubMed

    Iovino, Francesco; Auriemma, Pasquale Pio; Dani, Luca; Giordano, Giovanni; Barbarisi, Alfonso

    2016-04-29

    Le ernie giganti sono rare nei Paesi sviluppati ed ancora più raramente sono associate ad altre ernie della parete addominale, come un’ernia inguinale controlaterale o un’ernia ombelicale. La presenza di più difetti di parete facilità il riposizionamento in addome del contenuto di una voluminosa ernia inguinale senza compromettere la funzionalità cardiorespiratoria, ma il rischio di intasamento o strozzamento intestinale negli altri orifizi erniari aumenta. In letteratura non esistono opinioni convergenti se riparare simultaneamente o in maniera sequenziale, cioè in maniera distanziata nel tempo, le diverse ernie di parete, quando sono associate ad un’ernia gigante. Riportiamo in questo lavoro il caso clinico di un uomo di 60 anni, italiano, che si recò nel nostro ambulatorio di chirurgia lamentando da molti anni la presenza di un’ernia inguinale gigante associata ad un’ernia inguinale controlaterale ed un’ernia ombelicale. Il paziente alla visita presentava difficoltà di deambulazione, ma non riferiva disturbi di canalizzazione. Aveva diverse comorbidità e tra queste quella più importante era una insufficienza respiratoria severa. Dopo un accurato studio cardiologico, respiratorio e metabolico il paziente fu sottoposto a riparazione delle ernie a partire da quella gigante, in maniera sequenziale ed in anestesia spinale secondo la tecnica di Lichtenstein. L’ernia ombelicale fu riparata per ultima con tecnica diretta, senza protesi, ed anch’essa in anestesia spinale. Il decorso operatorio fu regolare dopo i tre interventi e non si ebbe alcuna complicanza respiratoria, cardiologica né di canalizzazione. In conclusione riteniamo che nei pazienti con importanti comorbidità la riparazione di un’ernia gigante associata ad altre ernie di parete debba avvenire in maniera sequenziale, monitorando con attenzione la canalizzazione e soprattutto il progressivo adattamento dei visceri in addome attraverso la palpazione degli orifizi erniari. I dati della letteratura sono pochi ed ulteriori esperienze sono richieste.

  9. The Tribolium homeotic gene Abdominal is homologous to abdominal-A of the Drosophila bithorax complex

    NASA Technical Reports Server (NTRS)

    Stuart, J. J.; Brown, S. J.; Beeman, R. W.; Denell, R. E.; Spooner, B. S. (Principal Investigator)

    1993-01-01

    The Abdominal gene is a member of the single homeotic complex of the beetle, Tribolium castaneum. An integrated developmental genetic and molecular analysis shows that Abdominal is homologous to the abdominal-A gene of the bithorax complex of Drosophila. abdominal-A mutant embryos display strong homeotic transformations of the anterior abdomen (parasegments 7-9) to PS6, whereas developmental commitments in the posterior abdomen depend primarily on Abdominal-B. In beetle embryos lacking Abdominal function, parasegments throughout the abdomen are transformed to PS6. This observation demonstrates the general functional significance of parasegmental expression among insects and shows that the control of determinative decisions in the posterior abdomen by homeotic selector genes has undergone considerable evolutionary modification.

  10. [Inflammatory aneurysms of the abdominal aorta].

    PubMed

    Tovar Martín, E; Acea Nebril, B

    1993-01-01

    Approximately 10 per cent of abdominal aneurysms have an excessively thick wall that sometimes involve duodenum, cava or colon by an inflammatory process. Between February 1986 and December 1992, 147 patients with abdominal aortic aneurysm (AAA) were treated surgically and in 13 (8.8%) the aneurysms were found to be inflammatory. Their mean age was 67.3 years (70.1 years in non inflammatory group) and all were symptomatics initially (abdominal pain in 53%, rupture in 23%, mass in 15%). The operative mortality for elective resection was 37% in patients with inflammatory abdominal aortic aneurysms (IAAA) decreasing to 9% in the AAA group without inflammatory involvement. We conclude that surgery is indicated in these patients to prevent rupture and to hasten the subsidense of inflammatory process ever with postoperative morbi-mortality increased.

  11. Intravenous dihydroergotamine therapy for pediatric abdominal migraines.

    PubMed

    Raina, Madiha; Chelimsky, Gisela; Chelimsky, Thomas

    2013-10-01

    Abdominal migraines present with debilitating symptoms in adolescence. At our institution, the gastroenterology, neurology, and autonomic departments collaborated in treating patients with such presentations. This case series describes 6 patients who were given intravenous dihydroergotamine (DHE) for presumed abdominal migraines. DHE was only used when other agents like amitriptyline, verapamil, topiramate, or depakote had proved ineffective. DHE was started at 0.5 mg dose and on average 7 to 9 mg were given on each hospitalization. Patient ages ranged from 13 to 19 years with the majority being female. One patient did not respond to treatment. One patient was admitted 4 times for symptoms of abdominal migraines resolving with DHE. The average time between symptom relapse was about 5 to 12 months. Five of our 6 patients responded to the infusion without significant side effects. Based on these case series, DHE may be a treatment option in children with intractable abdominal migraine.

  12. Treatment of a giant inguinal hernia using transabdominal pre-peritoneal repair

    PubMed Central

    Momiyama, Masato; Mizutani, Fumitoshi; Yamamoto, Tatsuyoshi; Aoyama, Yoshinori; Hasegawa, Hiroshi; Yamamoto, Hideo

    2016-01-01

    We present the case of a male Japanese patient with a giant inguinal hernia that extended to his knees while standing. A transabdominal pre-peritoneal (TAPP) repair was performed under general anesthesia. Complete reduction of the contents of the hernia was achieved within 2 h 50 min. A blood loss of approximately 700 ml was noted. The patient was discharged from the hospital on post-operative Day 12, with no recurrence of the hernia 6 months post-surgery. Factors contributing to the successful outcomes included preparation of several reduction methods before surgery, use of a large size mesh and implementation of pre-operative measures to prevent abdominal compartment syndrome. Further studies are required to evaluate the feasibility of laparoscopic repair in the management of giant inguinal hernia. PMID:27672103

  13. [Late primary abdominal pregnancy. Case report].

    PubMed

    Farías, Emigdio Torres; Gómez, Luis Guillermo Torres; Allegre, René Márquez; Higareda, Salvador Hernández

    2008-09-01

    Abdominal advanced pregnancy is an obstetric complication that put at risk maternal and fetal life. We report a case of advanced abdominal pregnancy with intact ovaries and fallopian tubes, without ureteroperitoneal fistulae and, late prenatal diagnosis, in a multiparous patient without risk factors, with alive newborn, and whose pregnancy was attended at Unidad Medica de Alta Especialidad, Hospital de Gineco-Obstetricia, Centro Medico Nacional de Occidente del IMSS, Guadalajara, Jalisco, México.

  14. Selective Nonoperative Management of Abdominal Stab Wounds.

    PubMed

    Murry, Jason S; Hoang, David M; Ashragian, Sogol; Liou, Doug Z; Barmparas, Galinos; Chung, Rex; Alban, Rodrigo F; Margulies, Daniel R; Ley, Eric J

    2015-10-01

    Stab wounds (SW) to the abdomen traditionally require urgent exploration when associated with shock, evisceration, or peritonitis. Hemodynamically stable patients without evisceration may benefit from serial exams even with peritonitis. We compared patients taken directly to the operating room with abdominal SWs (ED-OR) to those admitted for serial exams (ADMIT). We retrospectively reviewed hemodynamically stable patients presenting with any abdominal SW between January 2000 and December 2012. Exclusions included evidence of evisceration, systolic blood pressure ≤110 mm Hg, or blood transfusion. NON-THER was defined as abdominal exploration without identification of intra-abdominal injury requiring repair. Of 142 patients included, 104 were ED-OR and 38 were ADMIT. When ED-OR was compared with ADMIT, abdominal Abbreviated Injury Score was higher (2.4 vs 2.1; P = 0.01) and hospital length of stay was longer (4.8 vs 3.3 days; P = 0.04). Incidence of NON-THER was higher in ED-OR cohort (71% vs 13%; P ≤ 0.001). In a regression model, ED-OR was a predictor of NON-THER (adjusted odds ratio 16.6; P < 0.001). One patient from ED-OR expired after complications from NON-THER. There were no deaths in the ADMIT group. For those patients with abdominal SWs who present with systolic blood pressure ≥110 mm Hg, no blood product transfusion in the emergency department and lacking evisceration, admission for serial abdominal exams may be preferred regardless of abdominal exam.

  15. Progress in Fully Automated Abdominal CT Interpretation

    PubMed Central

    Summers, Ronald M.

    2016-01-01

    OBJECTIVE Automated analysis of abdominal CT has advanced markedly over just the last few years. Fully automated assessment of organs, lymph nodes, adipose tissue, muscle, bowel, spine, and tumors are some examples where tremendous progress has been made. Computer-aided detection of lesions has also improved dramatically. CONCLUSION This article reviews the progress and provides insights into what is in store in the near future for automated analysis for abdominal CT, ultimately leading to fully automated interpretation. PMID:27101207

  16. Abdominal apoplexy resulting in small bowel obstruction

    PubMed Central

    Le, Don; Guileyardo, Joseph; Casanova, Mark

    2016-01-01

    Abdominal apoplexy is a rare hemorrhagic condition involving the small arteries or veins within the abdominal cavity. A high degree of clinical suspicion, followed by appropriate diagnostic workup and therapeutic intervention, is critical, as nonoperative mortality approaches 100%. Contrary to most previously reported cases, which were associated with hemoperitoneum, we present a patient in which gastroduodenal artery dissection resulted in an organized retroperitoneal hematoma with local compression of the duodenum and subsequent bowel obstruction, resulting in vomiting, aspiration, and death. PMID:27695177

  17. Giant Cystic Pheochromocytoma with Low Risk of Malignancy: A Case Report and Literature Review

    PubMed Central

    Maharaj, Ravi; Baijoo, Shanta; Greaves, Wesley; Harnanan, Dave

    2017-01-01

    Giant pheochromocytomas are rare silent entities that do not present with the classical symptoms commonly seen in catecholamine-secreting tumors. In many cases they are accidentally discovered. The algorithm to diagnose a pheochromocytoma consists of biochemical evaluation and imaging of a retroperitoneal mass. The female patient in this case report presented with a palpable abdominal mass and was cured with surgical resection. She suffered no recurrence or complications on follow-up. The left retroperitoneal mass measured 27 × 18 × 12 cm and weighed 3,315 grams. Biochemical, radiological, and pathological examinations confirmed the diagnosis of a pheochromocytoma. In this paper, we report on our experience treating this patient and provide a summary of all giant pheochromocytomas greater than 10 cm reported to date in English language medical journals. Our patient's giant cystic pheochromocytoma was the fourth heaviest and fifth largest maximal diameter identified using our literature search criteria. Additionally, this tumor had the largest maximal diameter of all histologically confirmed benign/low metastatic risk pheochromocytomas. Giant cystic pheochromocytomas are rare entities requiring clinical suspicion coupled with strategic diagnostic evaluation to confirm the diagnosis.

  18. Pathological and microbiological findings from mortality of the Chinese giant salamander (Andrias davidianus).

    PubMed

    Meng, Yan; Ma, Jie; Jiang, Nan; Zeng, Ling-Bing; Xiao, Han-Bing

    2014-06-01

    The Chinese giant salamander, Andrias davidianus, is a nationally protected and cultured species in China. Recently, a severe epizootic occurred in cultured Chinese giant salamanders in Hubei, Hunan, Sichuan, Shaanxi, and Zhejiang provinces of China, causing substantial economic losses. The typical clinical signs of diseased larval animals were jaw and abdominal swelling and subcutaneous hemorrhaging. Diseased adult animals exhibited skin hemorrhages, ulceration of the hind limbs, and multiple hemorrhagic spots in the visceral organs. Histopathological observation indicated tissue necrosis and cytoplasmic inclusions in the spleen, liver and kidney, suggestive of viral disease. A viral agent was isolated from affected tissues in cell culture. The virus was determined to be pathogenic after experimental infection. Electron microscopy revealed iridovirus-like virions with a size of 140-180 nm in diameter inside the kidney of naturally infected animals and in cell culture. The major capsid protein (MCP) of the virus exhibited 98-99 % sequence identity to ranaviruses. Additionally, phylogenetic analysis indicated that the virus belonged to the genus Ranavirus. Comparative analysis of the MCP gene sequence with those of other viruses previously isolated from Chinese giant salamanders revealed that these isolates were highly similar, although a few variations were observed. The virus was preliminarily named Chinese giant salamander iridovirus (GSIV).

  19. Factors associated with abdominal obesity in children

    PubMed Central

    Melzer, Matheus Ribeiro Theodósio Fernandes; Magrini, Isabella Mastrangi; Domene, Semíramis Martins Álvares; Martins, Paula Andrea

    2015-01-01

    Objective: To identify the association of dietary, socioeconomic factors, sedentary behaviors and maternal nutritional status with abdominal obesity in children. Methods: A cross-sectional study with household-based survey, in 36 randomly selected census tracts in the city of Santos, SP. 357 families were interviewed and questionnaires and anthropometric measurements were applied in mothers and their 3-10 years-old children. Assessment of abdominal obesity was made by maternal and child's waist circumference measurement; for classification used cut-off points proposed by World Health Organization (1998) and Taylor et al. (2000) were applied. The association between variables was performed by multiple logistic regression analysis. Results: 30.5% of children had abdominal obesity. Associations with children's and maternal nutritional status and high socioeconomic status were shown in the univariate analysis. In the regression model, children's body mass index for age (OR=93.7; 95%CI 39.3-223.3), female gender (OR=4.1; 95%CI 1.8-9.3) and maternal abdominal obesity (OR=2.7; 95%CI 1.2-6.0) were significantly associated with children's abdominal obesity, regardless of the socioeconomic status. Conclusions: Abdominal obesity in children seems to be associated with maternal nutritional status, other indicators of their own nutritional status and female gender. Intervention programs for control of childhood obesity and prevention of metabolic syndrome should consider the interaction of the nutritional status of mothers and their children. PMID:26298655

  20. Abdominal aortic aneurysm: A comprehensive review

    PubMed Central

    Aggarwal, Sourabh; Qamar, Arman; Sharma, Vishal; Sharma, Alka

    2011-01-01

    An arterial aneurysm is defined as a focal dilation of a blood vessel with respect to the original artery. The risk of abdominal aortic aneurysms (AAAs) increases dramatically in the presence of the following factors: age older than 60 years, smoking, hypertension and Caucasian ethnicity. The likelihood that an aneurysm will rupture is influenced by the aneurysm size, expansion rate, continued smoking and persistent hypertension. The majority of AAAs are asymptomatic and are detected as an incidental finding on ultrasonography, abdominal computed tomography or magnetic resonance imaging performed for other purposes. It can also present with abdominal pain or complications such as thrombosis, embolization and rupture. Approximately 30% of asymptomatic AAAs are discovered as a pulsatile abdominal mass on routine physical examination. Abdominal ultrasonography is considered the screening modality of choice for detecting AAAs because of its high sensitivity and specificity, as well as its safety and relatively lower cost. The decision to screen for AAAs is challenging. The United States Preventive Services Task Force recommended that men between the age of 65 to 75 years who have ever smoked should be screened at least once for AAAs by abdominal ultrasonography. Management options for patients with an asymptomatic AAA include reduction of risk factors such as smoking, hypertension and dyslipidemia; medical therapy with beta-blockers; watchful waiting; endovascular stenting; and surgical repair depending on the size and expansion rate of the aneurysm and underlying comorbidities. PMID:21523201

  1. Giant Herbig-Haro Flows

    NASA Astrophysics Data System (ADS)

    Reipurth, Bo; Bally, John; Devine, David

    1997-12-01

    We present the discovery of a number of Herbig-Haro flows which extend over parsec-scale distances. The largest of these is the well known HH 111 jet complex, which is shown, through CCD images and a proper motion study, to have an angular extent of almost one degree on the sky, corresponding to 7.7 pc, making it the largest known HH flow. In our imaging survey we also found that T Tauri is at the center of a huge bipolar HH flow, HH 355, with a total extent of 38 arcmin, corresponding to 1.55 pc, and aligned with the axis of the tiny HH 255 flow surrounding the infrared companion T Tau S. We additionally have found a number of other giant HH flow candidates, including HH 315 at PV Cep, HH 41/295 at Haro 5a/6a, HH 300 in Bl8w, HH 354 in Li 165, HH 376 in Li 152, and HH 114/115 and HH 243/244/245/179 in the X Orionis molecular ring. It thus appears that it is common for HH flows to attain parsec-scale dimensions. The ubiquity of parsec-scale HH flows profoundly alters our view of the impact of young stars on their environment. Giant flows have dynamical ages comparable to the duration of the accretion phase of the sources, and provide a fossil record of their mass loss and accretion history. Multiple internal working surfaces and their S-shaped point symmetry provide evidence for variability of ejection velocity and orientation of the source jets. Giant HH flows are either longer or comparable in length to associated CO outflows, providing evidence for unified models in which HH flows power CO flows. Many giant flows have burst out of their source cloud cores and are dissociating molecules and injecting momentum and kinetic energy into the interclump medium of the host clouds. They contribute to the UV radiation field, and may produce C I and C ii in cloud interiors. Giant flows may contribute to the chemical rejuvenation of clouds, the generation of turbulent motions, and the self-regulation of star formation. The terminal working surfaces of giant flows may be

  2. Retroperitoneal tumor: giant cavernous hemangioma – case presentation and literature review

    PubMed Central

    Haponiuk, Ireneusz; Jaworski, Radoslaw; Peksa, Rafal; Irga-Jaworska, Ninela; Jaskiewicz, Janusz

    2016-01-01

    Retroperitoneal hemangiomas are very rare. This paper presents the case of a 71-year-old female patient with giant cavernous hemangioma of the retroperitoneum who underwent surgical treatment for abdominal pain and left lower limb edema. Interventional staged treatment with percutaneous transcatheter arterial embolization prior to surgery was considered. Radical resection of the tumor was performed, which caused the symptoms to abate. Additionally a literature review of cases involving cavernous hemangioma in the retroperitoneal space is presented. No description of retroperitoneal cavernous hemangioma originating from the bowel was found in the analyzed reports. PMID:28096841

  3. Proteorhodopsin genes in giant viruses.

    PubMed

    Yutin, Natalya; Koonin, Eugene V

    2012-10-04

    Viruses with large genomes encode numerous proteins that do not directly participate in virus biogenesis but rather modify key functional systems of infected cells. We report that a distinct group of giant viruses infecting unicellular eukaryotes that includes Organic Lake Phycodnaviruses and Phaeocystis globosa virus encode predicted proteorhodopsins that have not been previously detected in viruses. Search of metagenomic sequence data shows that putative viral proteorhodopsins are extremely abundant in marine environments. Phylogenetic analysis suggests that giant viruses acquired proteorhodopsins via horizontal gene transfer from proteorhodopsin-encoding protists although the actual donor(s) could not be presently identified. The pattern of conservation of the predicted functionally important amino acid residues suggests that viral proteorhodopsin homologs function as sensory rhodopsins. We hypothesize that viral rhodopsins modulate light-dependent signaling, in particular phototaxis, in infected protists.

  4. Giant viruses come of age.

    PubMed

    Fischer, Matthias G

    2016-06-01

    Viruses with genomes up to a few megabases in length are a common occurrence in nature, even though they have escaped our notice until recently. These giant viruses infect mainly single-celled eukaryotes and isolation efforts concentrating on amoebal hosts alone have spawned hundreds of viral isolates, featuring viruses with previously unseen virion morphologies and the largest known viral genomes and particles. One of the challenges that lie ahead is to analyze and categorize the available data and to establish an approved classification system that reflects the evolutionary relationships and biological properties of these viruses. Extensive sampling of Acanthamoeba-infecting mimiviruses and initial characterization of their virophage parasites have provided a first blueprint of the genetic diversity and composition of a giant virus clade that will facilitate the taxonomic grouping of these fascinating microorganisms.

  5. Giant thermoelectric effect in graphene

    NASA Astrophysics Data System (ADS)

    Dragoman, D.; Dragoman, M.

    2007-11-01

    The paper predicts a giant thermoelectric coefficient in a nanostructure consisting of metallic electrodes periodically patterned over graphene, which is deposited on a silicon dioxide substrate. The Seebeck coefficient in this device attains 30mV/K, this value being among the largest reported ever. The calculations are based on a transfer matrix approach that takes a particular form for graphene-based devices. The results are important for future nanogenerators with applications in the area of sensors, energy harvesting, and scavenging.

  6. Observed Properties of Giant Cells

    NASA Technical Reports Server (NTRS)

    Hathaway, David H.; Upton, Lisa; Colegrove, Owen

    2014-01-01

    The existence of Giant Cells has been suggested by both theory and observation for over 45 years. We have tracked the motions of supergranules in SDO/HMI Doppler velocity data and find larger (Giant Cell) flows that persist for months. The flows in these cells are clockwise around centers of divergence in the north and counter-clockwise in the south. Equatorward flows are correlated with prograde flows - giving the transport of angular momentum toward the equator that is needed to maintain the Sun's rapid equatorial rotation. The cells are most pronounced at mid- and high-latitudes where they exhibit the rotation rates representative of those latitudes. These are clearly large, long-lived, cellular features, with the dynamical characteristics expected from the effects of the Sun's rotation, but the shapes of the cells are not well represented in numerical models. While the Giant Cell flow velocities are small (<10 m/s), their long lifetimes should nonetheless substantially impact the transport of magnetic flux in the Sun's near surface layers.

  7. KEPLER RAPIDLY ROTATING GIANT STARS

    SciTech Connect

    Costa, A. D.; Martins, B. L. Canto; Bravo, J. P.; Paz-Chinchón, F.; Chagas, M. L. das; Leão, I. C.; Oliveira, G. Pereira de; Silva, R. Rodrigues da; Roque, S.; Oliveira, L. L. A. de; Silva, D. Freire da; De Medeiros, J. R.

    2015-07-10

    Rapidly rotating giant stars are relatively rare and may represent important stages of stellar evolution, resulting from stellar coalescence of close binary systems or accretion of substellar companions by their hosting stars. In the present Letter, we report 17 giant stars observed in the scope of the Kepler space mission exhibiting rapid rotation behavior. For the first time, the abnormal rotational behavior for this puzzling family of stars is revealed by direct measurements of rotation, namely from photometric rotation period, exhibiting a very short rotation period with values ranging from 13 to 55 days. This finding points to remarkable surface rotation rates, up to 18 times the rotation of the Sun. These giants are combined with six others recently listed in the literature for mid-infrared (IR) diagnostics based on Wide-field Infrared Survey Explorer information, from which a trend for an IR excess is revealed for at least one-half of the stars, but at a level far lower than the dust excess emission shown by planet-bearing main-sequence stars.

  8. Hairpin Furans and Giant Biaryls.

    PubMed

    Geng, Xin; Mague, Joel T; Donahue, James P; Pascal, Robert A

    2016-05-06

    The thermal reaction of two cyclopentadienones with 5,5'-binaphthoquinone or 6,6'-dimethoxy-5,5'-binaphthoquinone in refluxing nitrobenzene (210 °C) gives, in a single synthetic step that includes two Diels-Alder additions, two decarbonylations, and two dehydrogenations, giant biaryl bisquinones (compounds 13, 14, 15, 18, and 21). However, when two cyclopentadienones react with 6,6'-dimethoxy-5,5'-binaphthoquinone in nitrobenzene at higher temperatures (250-260 °C), the resulting products are molecular ribbons composed of two twisted aromatic systems fused to a heteropentahelicene (19, 20, and 22). These molecules are representatives of a new class of chiral polycyclic aromatic compounds, the "hairpin furans". Interestingly, reheating a dimethoxy-substituted giant biaryl (e.g., 21) in nitrobenzene at 260 °C does not yield the corresponding hairpin furan (22), and mechanistic studies indicate that some intermediate or byproduct of the synthesis of the giant biaryls is a reagent or catalyst necessary for the conversion of the dimethoxybiaryl to the furan.

  9. Electrodynamics in Giant Planet Atmospheres

    NASA Astrophysics Data System (ADS)

    Koskinen, T.; Yelle, R. V.; Lavvas, P.; Cho, J.

    2014-12-01

    The atmospheres of close-in extrasolar giant planets such as HD209458b are strongly ionized by the UV flux of their host stars. We show that photoionization on such planets creates a dayside ionosphere that extends from the thermosphere to the 100 mbar level. The resulting peak electron density near the 1 mbar level is higher than that encountered in any planetary ionosphere of the solar system, and the model conductivity is in fact comparable to the atmospheres of Sun-like stars. As a result, the momentum and energy balance in the upper atmosphere of HD209458b and similar planets can be strongly affected by ion drag and resistive heating arising from wind-driven electrodynamics. Despite much weaker ionization, electrodynamics is nevertheless also important on the giant planets of the solar system. We use a generic framework to constrain the conductivity regimes on close-in extrasolar planets, and compare the results with conductivites based on the same approach for Jupiter and Saturn. By using a generalized Ohm's law and assumed magnetic fields, we then demonstrate the basic effects of wind-driven ion drag in giant planet atmospheres. Our results show that ion drag is often significant in the upper atmosphere where it can also substantially alter the energy budget through resistive heating.

  10. Reconstruction of complex abdominal wall defects.

    PubMed

    Leppäniemi, A; Tukiainen, E

    2013-01-01

    Complex abdominal wall defects refer to situations where simple ventral hernia repair is not feasible because the defect is very large, there is a concomitant infection or failed previous re-pair attempt, or if there is not enough original skin to cover the repair. Usually a complex abdominal wall repair is preceded by a period of temporary abdominal closure where the short-term aims include closure of the catabolic drain, protection of the viscera and preventing fistula formation, preventing bowel adherence to the abdominal wall, and enabling future fascial and skin closure. Currently the best way to achieve these goals is the vacuum- and mesh-mediated fascial traction method achieving close to 90% fascial closure rates. The long-term aims of an abdominal closure following a planned hernia strategy include intact skin cover, fascial closure at midline (if possible), good functional outcome with innervated abdominal musculature, no pain and good cosmetic result. The main methods of abdominal wall reconstruction include the use of prosthetic (mesh) or autologous material (tissue flaps). In patients with original skin cover over the fascial defect (simple ventral hernia), the most commonly used method is hernia repair with an artificial mesh. For more complex defects, our first choice of reconstruction is the component separation technique, sometimes combined with a mesh. In contaminated fields where component separation alone is not feasible, a combination with a biological mesh can be used. In large defects with grafted skin, a free TFL flap is the best option, sometimes reinforced with a mesh and enhanced with components separation.

  11. Management of a Giant Omphalocele with Non–Cross-Linked Intact Porcine-Derived Acellular Dermal Matrix (Strattice) Combined with Vacuum Therapy

    PubMed Central

    Travassos, Daisy Vieira; van Eerde, Albertien M.; Kramer, William L.M.

    2015-01-01

    The management of giant omphaloceles at our department is primarily conservative. However, management can be challenging if the omphalocele is ruptured or the sac has to be removed. We report a case in which a giant omphalocele in a newborn female patient was managed by covering the abdominal defect with non–cross-linked intact porcine-derived acellular dermal matrix (Strattice reconstructive tissue matrix, LifeCell Corp., Branchburg, New Jersey, United States) sutured to the fascia combined with vacuum therapy. PMID:26788448

  12. Giant-cell granuloma of the axis.

    PubMed

    González-Martínez, Emilio; Santamarta, David; Lomas-García, Jesús; Ibáñez-Plágaro, F Javier; Fernández-Fernández, J Javier; Ariño, Teresa Ribas; García-Cosamalón, José

    2012-02-01

    Giant-cell granuloma is a benign and nonneoplastic lesion with an expansive and locally destructive behavior. It typically involves the mandible and the maxilla. Only 1 case arising from the odontoid process of the axis has been reported previously. The authors report on a 64-year-old man with a giant-cell granuloma of the axis. They review this uncommon entity, emphasizing the complexity of differentiating between this lesion and other giant-cell tumors.

  13. Cabergoline Treatment in Invasive Giant Prolactinoma

    PubMed Central

    Alsubaie, Sadeem; Almalki, Mussa H

    2014-01-01

    Patients with invasive giant prolactinoma suffer from a constellation of symptoms including headache, blurred vision, lethargy, and sexual dysfunction. Cabergoline, a potent dopamine agonist, is a known medication prescribed for the treatment of invasive giant prolactinoma. Here, we report a case of invasive giant prolactinoma in a 52-year-old Saudi male with dramatic response to cabergoline treatment clinically, biochemically, and radiologically. PMID:25002819

  14. PI3K-Akt-mTOR and MAPK signaling pathways in polycystic ovarian syndrome, uterine leiomyomas and endometriosis: an update.

    PubMed

    Makker, Annu; Goel, Madhu Mati; Das, Vinita; Agarwal, Anjoo

    2012-03-01

    PI3K-Akt-mTOR and MAP kinase are two important cell signaling pathways that are activated by steroid hormones and growth factors leading to cellular events including gene expression, cell proliferation and survival. These pathways are considered as an attractive target for the development of novel anticancer molecules, and selective inhibitors specifically targeting different components of these cascades have been developed. This review summarizes the current available knowledge on the PI3K-Akt-mTOR and MAPK pathways and their targeting in estrogen-dependent benign gynecological disorders viz. polycystic ovarian syndrome, uterine leiomyomas and endometriosis, which are a significant cause of high morbidity in women of reproductive age group. Increasing knowledge about the role of the two growth regulatory pathways in the pathogenesis of these disorders may give the opportunity to use specific signal transduction inhibitors for management of these patients in future.

  15. Guiding the Giant

    NASA Astrophysics Data System (ADS)

    1998-08-01

    New ESO Survey Provides Targets for the VLT Giant astronomical telescopes like the ESO Very Large Telescope (VLT) must be used efficiently. Observing time is expensive and there are long waiting lines of excellent research programmes. Thus the work at the telescope must be very well prepared and optimized as much as possible - mistakes should be avoided and no time lost! Astronomers working with the new 8-m class optical/infrared telescopes must base their observations on detailed lists of suitable target objects if they want to perform cutting-edge science. This is particularly true for research programmes that depend on observations of large samples of comparatively rare, distant objects. This type of work requires that extensive catalogues of such objects must be prepared in advance. One such major catalogue - that will serve as a very useful basis for future VLT observations - has just become available from the new ESO Imaging Survey (EIS). The Need for Sky Surveys Astronomers have since long recognized the need to carry out preparatory observations with other telescopes in order to "guide" large telescopes. To this end, surveys of smaller or larger parts of the sky have been performed by wide-field telescopes, paving the way for subsequent work at the limits of the largest available ground-based telescopes. For instance, a complete photographic survey of the sourthern sky (declination < -17.5°) was carried out in the 1970's with the ESO 1-metre Schmidt Telescope in support of the work at the 3.6-m telescope at the ESO La Silla observatory. However, while until recently most observational programmes could rely on samples of objects found on photographic plates, this is no longer possible. New image surveys must match the fainter limiting magnitudes reached by the new and larger telescopes. Modern digital, multi-colour, deep imaging surveys have thus become an indispensable complement to the 8-m telescopes. The new generation of imaging surveys will, without

  16. Intra-abdominal pressure: an integrative review.

    PubMed

    Milanesi, Rafaela; Caregnato, Rita Catalina Aquino

    2016-01-01

    There is a growing request for measuring intra-abdominal pressure in critically ill patients with acute abdominal pain to be clarified. Summarizing the research results on measurement of vesical intra-abdominal pressure and analyzing the level of evidence were the purposes of this integrative literature review, carried out based on the databases LILACS, MEDLINE and PubMed, from 2005 to July 2012. Twenty articles were identified, in that, 12 literature reviews, 4 descriptive and exploratory studies, 2 expert opinions, one prospective cohort study and one was an experience report. The vesical intra-abdominal pressure measurement was considered gold standard. There are variations in the technique however, but some common points were identified: complete supine position, in absence of abdominal contracture, in the end of expiration and expressed in mmHg. Most research results indicate keeping the transducer zeroed at the level of the mid-axillary line at the iliac crest level, and instill 25mL of sterile saline. Strong evidence must be developed. RESUMO Em pacientes críticos com quadros abdominais agudos a esclarecer é crescente a solicitação da aferição da pressão intra-abdominal. Sintetizar resultados de pesquisas sobre a mensuração da pressão intra-abdominal pela via vesical e analisar o nível de evidência foram os objetivos desta revisão integrativa da literatura, realizada nas bases LILACS, MEDLINE e PubMed, no período de 2005 a julho de 2012. Identificaram-se 20 artigos, sendo 12 revisões de literatura, 4 estudos exploratório-descritivos, 2 opiniões de especialistas, 1 estudo de coorte prospectivo e 1 relato de experiência. O método vesical para mensuração da pressão intra-abdominal foi considerado padrão-ouro. Existem variações na técnica, entretanto pontos em comum foram identificados: posição supina completa, na ausência de contratura abdominal, ao final da expiração e expressa em mmHg. A maioria indica posicionar o ponto zero do

  17. Red giants: then and now

    NASA Astrophysics Data System (ADS)

    Faulkner, John

    Fred Hoyle's work on the structure and evolution of red giants, particularly his pathbreaking contribution with Martin Schwarzschild (Hoyle and Schwarzschild 1955), is both lauded and critically assessed. In his later lectures and work with students in the early 1960s, Hoyle presented more physical ways of understanding some of the approximations used, and results obtained, in that seminal paper. Although later ideas by other investigators will be touched upon, Hoyle's viewpoint - that low-mass red giants are essentially white dwarfs with a serious mass-storage problem - is still extremely fruitful. Over the years, I have further developed his method of attack. Relatively recently, I have been able to deepen and broaden the approach, finally extending the theory to provide a unifying treatment of the structure of low-mass stars from the main sequence though both the red-giant and horizontal-branch phases of evolution. Many aspects of these stars that had remained puzzling, even mysterious, for decades have now fallen into place, and some questions have been answered that were not even posed before. With low-mass red giants as the simplest example, this recent work emphasizes that stars, in general, may have at least two distinct but very important centres: (I) a geometrical centre, and (II) a separate nuclear centre, residing in a shell outside a zero-luminosity dense core for example. This two-centre perspective leads to an explicit, analytical, asymptotic theory of low-mass red-giant structure. It enables one to appreciate that the problem of understanding why such stars become red giants is one of anticipating a remarkable yet natural structural bifurcation that occurs in them. This bifurcation occurs because of a combination of known and understandable facts just summarized namely that, following central hydrogen exhaustion, a thin nuclear-burning shell does develop outside a more-or-less dense core. In the resulting theory, both ρsh/ρolinec and

  18. Spontaneous thrombosis in giant intracranial aneurysms.

    PubMed Central

    Whittle, I R; Dorsch, N W; Besser, M

    1982-01-01

    Twelve patients in a series of 22 with giant intracranial aneurysms demonstrated neuroradiological features of partial or total spontaneous intra-aneurysmal thrombosis. The presence of this intra-aneurysmal clot significantly altered the computed tomographic appearance of the giant aneurysm. Massive intra-aneurysmal thrombosis did not protect against subarachnoid haemorrhage and the likelihood of rupture of a clot containing giant aneurysm was not significantly different from that of a non-thrombosed giant aneurysm. Although parent artery occlusion from a thrombosed giant aneurysm, and massive aneurysmal thrombosis leading to the formation of giant serpentine aneurysm were documented, these are rare epiphenomena. The risk of embolisation from a partially thrombosed giant aneurysm, which was documented in one case, would appear to be greater than that from a non-thrombosed giant aneurysm. The findings in this series, and a review of literature, suggest that the presence of intra-aneurysmal clot in giant intracranial aneurysms has little prognostic significance and does not alter the management or outcome after treatment. Images PMID:7175528

  19. ORIGIN OF LITHIUM ENRICHMENT IN K GIANTS

    SciTech Connect

    Kumar, Yerra Bharat; Reddy, Bacham E.; Lambert, David L.

    2011-03-20

    In this Letter, we report on a low-resolution spectroscopic survey for Li-rich K giants among 2000 low-mass (M {<=} 3 M{sub sun}) giants spanning the luminosity range from below to above the luminosity of the clump. Fifteen new Li-rich giants including four super Li-rich K giants (log {epsilon}(Li) {>=}3.2) were discovered. A significant finding is that there is a concentration of Li-rich K giants at the luminosity of the clump or red horizontal branch. This new finding is partly a consequence of the fact that our low-resolution survey is the first large survey to include giants well below and above the red giant branch (RGB) bump and clump locations in the H-R diagram. Origin of the lithium enrichment may be plausibly attributed to the conversion of {sup 3}He via {sup 7}Be to {sup 7}Li by the Cameron-Fowler mechanism but the location for the onset of the conversion is uncertain. Two possible opportunities to effect this conversion are discussed: the bump in the first ascent of the RGB and the He-core flash at the tip of the RGB. The finite luminosity spread of the Li-rich giants serves to reject the idea that Li enhancement is, in general, a consequence of a giant swallowing a large planet.

  20. Intra-abdominal pressure: an integrative review

    PubMed Central

    Milanesi, Rafaela; Caregnato, Rita Catalina Aquino

    2016-01-01

    ABSTRACT There is a growing request for measuring intra-abdominal pressure in critically ill patients with acute abdominal pain to be clarified. Summarizing the research results on measurement of vesical intra-abdominal pressure and analyzing the level of evidence were the purposes of this integrative literature review, carried out based on the databases LILACS, MEDLINE and PubMed, from 2005 to July 2012. Twenty articles were identified, in that, 12 literature reviews, 4 descriptive and exploratory studies, 2 expert opinions, one prospective cohort study and one was an experience report. The vesical intra-abdominal pressure measurement was considered gold standard. There are variations in the technique however, but some common points were identified: complete supine position, in absence of abdominal contracture, in the end of expiration and expressed in mmHg. Most research results indicate keeping the transducer zeroed at the level of the mid-axillary line at the iliac crest level, and instill 25mL of sterile saline. Strong evidence must be developed. PMID:26958978

  1. Imaging the Abdominal Manifestations of Cystic Fibrosis

    PubMed Central

    McDermott, S.; Chan, V. O.; Ridge, C. A.

    2017-01-01

    Cystic fibrosis (CF) is a multisystem disease with a range of abdominal manifestations including those involving the liver, pancreas, and kidneys. Recent advances in management of the respiratory complications of the disease has led to a greater life expectancy in patients with CF. Subsequently, there is increasing focus on the impact of abdominal disease on quality of life and survival. Liver cirrhosis is the most important extrapulmonary cause of death in CF, yet significant challenges remain in the diagnosis of CF related liver disease. The capacity to predict those patients at risk of developing cirrhosis remains a significant challenge. We review representative abdominal imaging findings in patients with CF selected from the records of two academic health centres, with a view to increasing familiarity with the abdominal manifestations of the disease. We review their presentation and expected imaging findings, with a focus on the challenges facing diagnosis of the hepatic manifestations of the disease. An increased familiarity with these abdominal manifestations will facilitate timely diagnosis and management, which is paramount to further improving outcomes for patients with cystic fibrosis. PMID:28250993

  2. Functional bowel disorders and functional abdominal pain

    PubMed Central

    Thompson, W; Longstreth, G; Drossman, D; Heaton, K; Irvine, E; Muller-Lissner, S

    1999-01-01

    The Rome diagnostic criteria for the functional bowel disorders and functional abdominal pain are used widely in research and practice. A committee consensus approach, including criticism from multinational expert reviewers, was used to revise the diagnostic criteria and update diagnosis and treatment recommendations, based on research results. The terminology was clarified and the diagnostic criteria and management recommendations were revised. A functional bowel disorder (FBD) is diagnosed by characteristic symptoms for at least 12 weeks during the preceding 12 months in the absence of a structural or biochemical explanation. The irritable bowel syndrome, functional abdominal bloating, functional constipation, and functional diarrhea are distinguished by symptom-based diagnostic criteria. Unspecified FBD lacks criteria for the other FBDs. Diagnostic testing is individualized, depending on patient age, primary symptom characteristics, and other clinical and laboratory features. Functional abdominal pain (FAP) is defined as either the FAP syndrome, which requires at least six months of pain with poor relation to gut function and loss of daily activities, or unspecified FAP, which lacks criteria for the FAP syndrome. An organic cause for the pain must be excluded, but aspects of the patient's pain behavior are of primary importance. Treatment of the FBDs relies upon confident diagnosis, explanation, and reassurance. Diet alteration, drug treatment, and psychotherapy may be beneficial, depending on the symptoms and psychological features.


Keywords: functional bowel disorder; functional constipation; functional diarrhea; irritable bowel syndrome; functional abdominal pain; functional abdominal bloating; Rome II PMID:10457044

  3. Creation of Abdominal Adhesions in Mice.

    PubMed

    Marshall, Clement D; Hu, Michael S; Leavitt, Tripp; Barnes, Leandra A; Cheung, Alexander T M; Malhotra, Samir; Lorenz, H Peter; Longaker, Michael T

    2016-08-27

    Abdominal adhesions consist of fibrotic tissue that forms in the peritoneal space in response to an inflammatory insult, typically surgery or intraabdominal infection. The precise mechanisms underlying adhesion formation are poorly understood. Many compounds and physical barriers have been tested for their ability to prevent adhesions after surgery with varying levels of success. The mouse and rat are important models for the study of abdominal adhesions. Several different techniques for the creation of adhesions in the mouse and rat exist in the literature. Here we describe a protocol utilizing abrasion of the cecum with sandpaper and sutures placed in the right abdominal sidewall. The mouse is anesthetized and the abdomen is prepped. A midline laparotomy is created and the cecum is identified. Sandpaper is used to gently abrade the surface of the cecum. Next, several figure-of-eight sutures are placed into the peritoneum of the right abdominal sidewall. The abdominal cavity is irrigated, a small amount of starch is applied, and the incision is closed. We have found that this technique produces the most consistent adhesions with the lowest mortality rate.

  4. Abdominal sarcoidosis: cross-sectional imaging findings

    PubMed Central

    Gezer, Naciye Sinem; Başara, Işıl; Altay, Canan; Harman, Mustafa; Rocher, Laurence; Karabulut, Nevzat; Seçil, Mustafa

    2015-01-01

    Sarcoidosis is a multisystem inflammatory disease of unknown etiology. The lungs and the lymphoid system are the most commonly involved organs. Extrapulmonary involvement is reported in 30% of patients, and the abdomen is the most common extrapulmonary site with a frequency of 50%–70%. Although intra-abdominal sarcoidosis is usually asymptomatic, its presence may affect the prognosis and treatment options. The lesions are less characteristic and may mimick neoplastic or infectious diseases such as lymphoma, diffuse metastasis, and granulomatous inflammation. The liver and spleen are the most common abdominal sites of involvement. Sarcoidosis of the gastrointestinal system, pancreas, and kidneys are extremely rare. Adenopathy which is most commonly found in the porta hepatis, exudative ascites, and multiple granulomatous nodules studding the peritoneum are the reported manifestations of abdominal sarcoidosis. Since abdominal sarcoidosis is less common and long-standing, unrecognized disease can result in significant morbidity and mortality. Imaging contributes to diagnosis and management of intra-abdominal sarcoidosis. In this report we reviewed the cross-sectional imaging findings of hepatobiliary, gastrointestinal, and genitourinary sarcoidosis. PMID:25512071

  5. HMGA2 and the p19Arf-TP53-CDKN1A axis: a delicate balance in the growth of uterine leiomyomas.

    PubMed

    Markowski, Dominique Nadine; von Ahsen, Inga; Nezhad, Maliheh Hashemi; Wosniok, Werner; Helmke, Burkhard Maria; Bullerdiek, Jörn

    2010-08-01

    Pathogenetically, uterine leiomyomas (ULs) can be interpreted as the result of a monoclonal abnormal proliferation of myometrial cells. Oncogene-induced senescence (OIS) is a frequent phenomenon in premalignant lesions that leads to a growth arrest mainly by the activation of two potent growth-inhibitory pathways as represented by p16(Ink4a) and p19(Arf). The relevance of OIS for the development of UL has not been addressed, but HMGA2, encoded by a major target gene of recurrent chromosomal abnormalities in UL, has been implicated in the repression of the Ink4a/Arf (CDKN2A) locus. This prompted us to examine if HMGA2 contributes to the growth of leiomyomas by repressing this locus. Contrary to the expectations, we were able to show that generally ULs express significantly higher levels of p19(Arf) mRNA than myometrium and that UL with 12q14 approximately 15 rearrangements showed higher expression levels than UL with other cytogenetic aberrations. Furthermore, the finding of a significant correlation between the expressions of p19(Arf) and CDKN1A shows that p19(Arf) triggers senescence rather than apoptosis in UL. Furthermore, the expression levels of HMGA2, p19(Arf), and CDKN1A were found to be correlated with the size of the tumors, indicating that an enhanced growth potential is counterbalanced by the p19(Arf) pathway. Mechanistically, the UL may thus execute a program already present in their cell of origin, where it is activated to protect the genome, for example, in the case of enhanced proliferation. In summary, the results identify the p19(Arf)-TP53-CDKN1A pathway as a major player in the growth control and genomic stability of uterine fibroids.

  6. An essential role of p27 downregulation in fenvalerate-induced cell growth in human uterine leiomyoma and smooth muscle cells

    PubMed Central

    Gao, Xiaohua; Yu, Linda; Castro, Lysandra; Tucker, Charles J.; Moore, Alicia B.; Xiao, Hang

    2012-01-01

    Previously, we reported that fenvalerate (Fen) promotes proliferation of human uterine leiomyoma (UtLM) cells by enhancing progression of cells from G0-G1 to S phase through molecular mechanisms independent of estrogen receptor-α and -β. The cyclin-dependent kinase (CDK) inhibitor p27, which blocks G1 to S phase transitions and is an important regulator of CDK2, is often decreased in hormonally regulated diseases, including uterine leiomyomas. Therefore, we were interested in whether Fen could regulate the expression of p27 and whether p27 might play a role in Fen-induced cell proliferation. Expression of p27 in Fen-treated UtLM and uterine smooth muscle cells (UtSMCs) was examined. We found that p27 mRNA was significantly downregulated and that protein levels were decreased in both cell types treated with 10 μM Fen for 24 h compared with respective controls. Overexpression of p27 in UtLM cells and UtSMCs using an adenovirus doxycycline (Dox)-regulated Tet-off system abrogated the proliferative effects of Fen, as evidenced by decreased total cell numbers and BrdU incorporation. Fen treatment increased CDK2 mRNA expression levels; however, overexpression of p27 also abolished this effect. In contrast, Dox treatment dramatically restored the above muted responses. Finally, we utilized siRNA to knock down p27 expression. After transfection, mRNA levels of p27 were downregulated in UtLM cells and UtSMCs and total cell numbers and BrdU incorporation increased significantly compared with nontransfected cells. Fen treatment in the presence of p27 silencing enhanced the increased cell counts and BrdU labeling in UtLM cells and UtSMCs. Taken together, these results indicate that p27 downregulation is critical for Fen-induced cell proliferation. PMID:22850687

  7. [Duodenal perforation after blunt abdominal trauma].

    PubMed

    Schneider, R; Moebius, C; Thelen, A; Jonas, S

    2009-12-01

    Duodenal perforation after a blunt abdominal trauma is a rare emergency situation that can result in life-threatening complications. We report on a woman who had a perforation of the duodenum after a supposed mild blunt abdominal trauma. Unremarkable at the initial presentation, the patient presented with acute abdominal pain and a retroperitoneal abscess five days after the initial trauma. The duodenal repair was performed with a Roux-Y anastomosis. Difficulties in diagnosis are very common, but the early recognition of the rupture is essential. The contrast-enhanced CT scan is the gold standard for diagnosis. Surgical management depends on the severity of the trauma and must be chosen on an individual basis.

  8. Electromyographic analysis of four popular abdominal exercises.

    PubMed

    Piering, A W; Janowski, A P; Wehrenberg, W B; Moore, M T; Snyder, A C

    1993-01-01

    This study was designed to evaluate the effects of four specific sit-up exercises on muscular activity of the rectus abdominis. Pairs of surface electrodes were placed unilaterally on four quadrants of the rectus abdominis, delimited by tendinous inscriptions, in four male subjects. Electromyographic (EMG) recordings were taken while the subjects performed four different abdominal exercises. Each abdominal exercise was hypothesized to have a specific effect on one of the four quadrants of the rectus abdominis. The four exercises analyzed were: 1) long lying crunch, 2) bent knee crunch, 3) leg raise, and 4) vertical leg crunch. Analysis of the standardized EMG recordings demonstrated no significant differences in the mean muscle activity between the four different quadrants, in the mean muscle activity between the four different exercises, and in interactions between the exercises and the quadrants of the rectus abdominis. We conclude that none of the four abdominal exercises studied are specific for strengthening individual muscle quadrants of the rectus abdominis.

  9. Decompressive laparotomy for abdominal compartment syndrome

    PubMed Central

    Kimball, E.; Malbrain, M.; Nesbitt, I.; Cohen, J.; Kaloiani, V.; Ivatury, R.; Mone, M.; Debergh, D.; Björck, M.

    2016-01-01

    Background The effect of decompressive laparotomy on outcomes in patients with abdominal compartment syndrome has been poorly investigated. The aim of this prospective cohort study was to describe the effect of decompressive laparotomy for abdominal compartment syndrome on organ function and outcomes. Methods This was a prospective cohort study in adult patients who underwent decompressive laparotomy for abdominal compartment syndrome. The primary endpoints were 28‐day and 1‐year all‐cause mortality. Changes in intra‐abdominal pressure (IAP) and organ function, and laparotomy‐related morbidity were secondary endpoints. Results Thirty‐three patients were included in the study (20 men). Twenty‐seven patients were surgical admissions treated for abdominal conditions. The median (i.q.r.) Acute Physiology And Chronic Health Evaluation (APACHE) II score was 26 (20–32). Median IAP was 23 (21–27) mmHg before decompressive laparotomy, decreasing to 12 (9–15), 13 (8–17), 12 (9–15) and 12 (9–14) mmHg after 2, 6, 24 and 72 h. Decompressive laparotomy significantly improved oxygenation and urinary output. Survivors showed improvement in organ function scores, but non‐survivors did not. Fourteen complications related to the procedure developed in eight of the 33 patients. The abdomen could be closed primarily in 18 patients. The overall 28‐day mortality rate was 36 per cent (12 of 33), which increased to 55 per cent (18 patients) at 1 year. Non‐survivors were no different from survivors, except that they tended to be older and on mechanical ventilation. Conclusion Decompressive laparotomy reduced IAP and had an immediate effect on organ function. It should be considered in patients with abdominal compartment syndrome. PMID:26891380

  10. Warm Disks from Giant Impacts

    NASA Astrophysics Data System (ADS)

    Kohler, Susanna

    2015-10-01

    In the process of searching for exoplanetary systems, weve discovered tens of debris disks close around distant stars that are especially bright in infrared wavelengths. New research suggests that we might be looking at the late stages of terrestrial planet formation in these systems.Forming Terrestrial PlanetsAccording to the widely-accepted formation model for our solar-system, protoplanets the size of Mars formed within a protoplanetary disk around our Sun. Eventually, the depletion of the gas in the disk led the orbits of these protoplanets to become chaotically unstable. Finally, in the giant impact stage, many of the protoplanets collided with each other ultimately leading to the formation of the terrestrial planets and their moons as we know them today.If giant impact stages occur in exoplanetary systems, too leading to the formation of terrestrial exoplanets how would we detect this process? According to a study led by Hidenori Genda of the Tokyo Institute of Technology, we might be already be witnessing this stage in observations of warm debris disks around other stars. To test this, Genda and collaborators model giant impact stages and determine what we would expect to see from a system undergoing this violent evolution.Modeling CollisionsSnapshots of a giant impact in one of the authors simulations. The collision causes roughly 0.05 Earth masses of protoplanetary material to be ejected from the system. Click for a closer look! [Genda et al. 2015]The collaborators run a series of simulations evolving protoplanetary bodies in a solar system. The simulations begin 10 Myr into the lifetime of the solar system, i.e., after the gas from the protoplanetary disk has had time to be cleared and the protoplanetary orbits begin to destabilize. The simulations end when the protoplanets are done smashing into each other and have again settled into stable orbits, typically after ~100 Myr.The authors find that, over an average giant impact stage, the total amount of

  11. Imaging for chronic abdominal pain in adults.

    PubMed

    Mendelson, Richard

    2015-04-01

    Diagnostic imaging is often not indicated in chronic abdominal pain. In particular, undifferentiated abdominal pain is rarely an indication for a CT scan. CT scanning is overused even when imaging is required. Other modalities may be preferable. A normal CT scan does not rule out cancer. Alarm symptoms, including anaemia, blood in the stool, waking at night with gastrointestinal symptoms, and weight loss, should be investigated. The most appropriate modality depends on the symptoms. Clinical information on request forms for CT scans should be specific and include the suspected condition as this helps the radiologist to determine an appropriate imaging protocol.

  12. [Penetrating abdominal wounds. Apropos of 330 cases].

    PubMed

    Nejjar, M; Bennani, S; Zerouali, O N

    1991-01-01

    Penetrating abdominal wounds are frequent and serious. 330 cases have been treated in the Department of Emergencies and visceral Surgery at Averroes Hospital of Casablanca from 1980 to 1990. The predominance of male sex is noted, and these wounds are always the result of aggression by white arm. All patients have been operated, the white laparotomy rate is of 36%. The classic interventionist attitude is still recommended in spite of this high rate, because our present conditions can't permit us a rigorous watching. According to abdominal lesions, the different interventions are reviewed, and their indications are detailed.

  13. Hypovolemic shock in children: abdominal CT manifestations.

    PubMed

    Taylor, G A; Fallat, M E; Eichelberger, M R

    1987-08-01

    The authors describe a "hypoperfusion complex," seen on abdominal computed tomography, which consists of marked, diffuse dilatation of the intestine with fluid; abnormally intense contrast enhancement of the bowel wall, mesentery, kidneys, and/or pancreas; decreased caliber of the abdominal aorta and inferior vena cava; and moderate to large peritoneal fluid collections. This complex was present in three patients less than 2 years of age and was associated with severe injury and a poor outcome. Recognition of this constellation of findings may help direct attention to the patient's serious hemodynamic abnormality as much as to individual organ defects.

  14. [Intraabdominal hypertension and abdominal compartment syndrome].

    PubMed

    Sonne, Morten; Hillingsø, Jens

    2008-02-11

    Intraabdominal hypertension (IAH) and abdominal compartment syndrome (ACS) are rare conditions with high mortality. IAH is an intraabdominal pressure (IAP) above 12 mmHg and ACS an IAP above 20 mmHg with evidence of organ dysfunction. IAP is measured indirectly via the bladder or stomach. Various medical and surgical conditions increase the intraabdominal volume. When the content exceeds the compliance of the abdominal wall, the IAP rises. Increased IAP affects the functioning of the brain, lungs, circulation, kidneys, and bowel. The treatment of ACS is a reduction of IAP.

  15. Abdominal Migraine in a Middle-aged Woman

    PubMed Central

    Kunishi, Yosuke; Iwata, Yuri; Ota, Mitsuyasu; Kurakami, Yuichi; Matsubayashi, Mao; Kanno, Masatomo; Kuboi, Yoriko; Yoshie, Koichiro; Kato, Yoshio

    2016-01-01

    A 52-year-old woman presented with recurrent, severe abdominal pain. Laboratory tests and imaging were insignificant, and treatment for functional dyspepsia was ineffective. The poorly localized, dull, and severe abdominal pain, associated with anorexia, nausea, and vomiting, was consistent with abdominal migraine. The symptoms were relieved by loxoprofen and lomerizine, which are used in the treatment of migraine. We herein report a case of abdominal migraine in a middle-aged woman. Abdominal migraine should be considered as a cause of abdominal pain as it might easily be relieved by appropriate treatment. PMID:27725538

  16. Comparison of the Efficacy of the Embolic Agents Acrylamido Polyvinyl Alcohol Microspheres and Tris-Acryl Gelatin Microspheres for Uterine Artery Embolization for Leiomyomas: A Prospective Randomized Controlled Trial

    SciTech Connect

    Worthington-Kirsch, Robert L.; Chesnick, Richard

    2011-06-15

    Objective: To evaluate the efficacy of acrylamido polyvinyl alcohol microspheres (a-PVAM) as an embolic agent for uterine artery embolization (UAE) compared with Tris-acryl gelatin microspheres (TAGM).Design, Setting, ParticipantsProspective randomized double-blind noninferiority trial. Conducted at two sites both with regional UAE practices. Forty-six women with symptomatic leiomyomas.InterventionUAE procedure was performed with either of the two embolic agents. Either 700-900-{mu}m a-PVAM or 500-700-{mu}m TAGM was used.Main Outcome MeasuresChanges in leiomyoma perfusion, overall uterine volume, and dominant leiomyomas volume measured by contrast-enhanced magnetic resonance imaging at 1 week, 3 months, and 6 months after UAE by a reader blinded to the embolic agent used. Changes in Uterine Fibroid Symptoms and Quality of Life questionnaire scores were measured at 3, 6, and 12 months after UAE. Results: Forty-six patients were randomized and treated under the study protocol (a-PVAM n = 22, TAGM n = 24). There were no procedure-related complications. Two patients were excluded from analysis (one technical failure of the procedure, one withdrawal from study). Successful (>90%) leiomyoma devascularization was observed in 81% of subjects at 1 week after UAE, 97% at 3 months after UAE, and 95% at 6 months after UAE. No significant differences were observed in 14 of 15 outcome measurements, consistent with noninferiority. TAGM was slightly superior to a-PVAM on one comparison (overall quality of life at 3 months after UAE).

  17. Infection with the strobilocercus of Taenia taeniaeformis in a Malagasy giant jumping rat (Hypogeomys antimena).

    PubMed

    Widmer, Dimitri; Jurczynski, Kerstin

    2012-12-01

    An adult male Malagasy giant jumping rat (Hypogeomys antimena) kept at Zoo Duisburg was presented for clinical examination because of a distended abdomen and a history of lethargy and weakness. General examination findings consisted of an enlarged soft and fluctuating abdomen, suggestive of ascites. Digital radiography revealed multiple cloud-like radiopaque lesions in the cranial abdominal area, as well as an overall decrease in visibility of detail of the abdominal organs. Ultrasound examination showed circumscribed hypo- to anechogenic areas in the liver, measuring from 1 to 3 cm in diameter, some containing irregular, convoluted structures. Exploratory laparotomy confirmed the presence of a large amount of clear, pale-yellow fluid in the peritoneal cavity, as well as multiple cystic lesions in the liver and in the greater omentum. Extirpated cysts placed in sterile saline solution or fixed in formalin were sent to the Institut für Parasitologie der Tierärztlichen Hochschule, Hannover, Germany, and were identified as larval stages of the cestode Taenia taeniaeformis. Unfortunately, the rat died a few hours after surgery. To the authors' knowledge, this is the first report of infection with strobilocerci of T. taeniaeformis in a Malagasy giant jumping rat.

  18. Sodium in weak G-band giants

    NASA Technical Reports Server (NTRS)

    Drake, Jeremy J.; Lambert, David L.

    1994-01-01

    Sodium abundances have been determined for eight weak G-band giants whose atmospheres are greatly enriched with products of the CN-cycling H-burning reactions. Systematic errors are minimized by comparing the weak G-band giants to a sample of similar but normal giants. If, further, Ca is selected as a reference element, model atmosphere-related errors should largely be removed. For the weak-G-band stars (Na/Ca) = 0.16 +/- 0.01, which is just possibly greater than the result (Na/Ca) = 0.10 /- 0.03 from the normal giants. This result demonstrates that the atmospheres of the weak G-band giants are not seriously contaminated with products of ON cycling.

  19. Abdominal manifestations of actinomycosis in IUD users.

    PubMed

    Asuncion, C M; Cinti, D C; Hawkins, H B

    1984-08-01

    The use of an intrauterine device (IUD) is associated with the presence of actinomyces in the female genital tract. Since IUD use is currently so prevalent, IUD-related pelvic inflammatory disease occasionally spreads to the rest of the abdomen. Two patients with abdominal actinomycosis in association with an IUD illustrate the problem; we review the general problem.

  20. Genetics Home Reference: abdominal wall defect

    MedlinePlus

    ... Aug;6(4):232-6. Citation on PubMed Islam S. Clinical care outcomes in abdominal wall defects. Curr ... Site Map Customer Support Selection Criteria for Links USA.gov Copyright Privacy Accessibility FOIA Viewers & Players U.S. ...

  1. [Albert Einstein and his abdominal aortic aneurysm].

    PubMed

    Cervantes Castro, Jorge

    2011-01-01

    The interesting case of Albert Einstein's abdominal aortic aneurysm is presented. He was operated on at age 69 and, finding that the large aneurysm could not be removed, the surgeon elected to wrap it with cellophane to prevent its growth. However, seven years later the aneurysm ruptured and caused the death of the famous scientist.

  2. Physical activity and abdominal obesity in youth.

    PubMed

    Kim, YoonMyung; Lee, SoJung

    2009-08-01

    Childhood obesity continues to escalate despite considerable efforts to reverse the current trends. Childhood obesity is a leading public health concern because overweight-obese youth suffer from comorbidities such as type 2 diabetes mellitus, nonalcoholic fatty liver disease, metabolic syndrome, and cardiovascular disease, conditions once considered limited to adults. This increasing prevalence of chronic health conditions in youth closely parallels the dramatic increase in obesity, in particular abdominal adiposity, in youth. Although mounting evidence in adults demonstrates the benefits of regular physical activity as a treatment strategy for abdominal obesity, the independent role of regular physical activity alone (e.g., without calorie restriction) on abdominal obesity, and in particular visceral fat, is largely unclear in youth. There is some evidence to suggest that, independent of sedentary activity levels (e.g., television watching or playing video games), engaging in higher-intensity physical activity is associated with a lower waist circumference and less visceral fat. Several randomized controlled studies have shown that aerobic types of exercise are protective against age-related increases in visceral adiposity in growing children and adolescents. However, evidence regarding the effect of resistance training alone as a strategy for the treatment of abdominal obesity is lacking and warrants further investigation.

  3. Giant Planets in Open Clusters

    NASA Astrophysics Data System (ADS)

    Quinn, S. N.; White, R. J.; Latham, D. W.

    2015-10-01

    Two decades after the discovery of 51 Peg b, more than 200 hot Jupiters have now been confirmed, but the details of their inward migration remain uncertain. While it is widely accepted that short period giant planets could not have formed in situ, several different mechanisms (e.g., Type II migration, planet-planet scattering, Kozai-Lidov cycles) may contribute to shrinking planetary orbits, and the relative importance of each is not well-constrained. Migration through the gas disk is expected to preserve circular, coplanar orbits and must occur quickly (within ˜ 10 Myr), whereas multi-body processes should initially excite eccentricities and inclinations and may take hundreds of millions of years. Subsequent evolution of the system (e.g., orbital circularization and inclination damping via tidal interaction with the host star) may obscure these differences, so observing hot Jupiters soon after migration occurs can constrain the importance of each mechanism. Fortunately, the well-characterized stars in young and adolescent open clusters (with known ages and compositions) provide natural laboratories for such studies, and recent surveys have begun to take advantage of this opportunity. We present a review of the discoveries in this emerging realm of exoplanet science, discuss the constraints they provide for giant planet formation and migration, and reflect on the future direction of the field.

  4. Experimental study regarding the biocompatibility test of the Prolene (polypropylene abdominal mesh) product.

    PubMed

    Radu, Elena Violeta; Coman, IonuŢ Simion; David, Oana Ilona; Bedereag, Ştefan Iulian; Sinescu, Ruxandra Diana; Grigorean, Valentin Titus; Popescu, Mihai; Lupaşcu, Cristian Dumitru; Straja, Nicolae Dan; Florescu, Ioan Petre

    2016-01-01

    The polypropylene mesh, although is one of the most used prosthetic biomaterials for abdominal wall defects, proved not to be completely inert, generating from precocious foreign body inflammatory reactions (varying by individual reactivity, the amount of used material and its structure), to late complications such as chronic infections, stercoral fistulae or mesh migration. The present paper was aimed at studying the behavior of implants of this material in three different areas of the body of experimental animals, as follows: intramuscular, intraperitoneal and extraperitoneal. The observation time was 21 days and 90 days. We observed foreign body reactions induced locally by the mesh that remains temporary, generating a moderate number of macrophages and foreign body giant cells. The material did not systemically affect the healing and the scaring of the surgical wounds, but in all three implant areas, the polypropylene mesh generated locally a fibrous proliferation reaction of neoformation tissue, which wrapped and secured the implanted product on all surfaces.

  5. Assessment of the patient with acute abdominal pain.

    PubMed

    Cole, Elaine; Lynch, Antonia; Cugnoni, Helen

    Abdominal pain has many causes, from simple to complex presentations. Patients with abdominal pain may have a number of physiological and psychological needs. Nurses have a key role to play in patient assessment, history talking and management.

  6. Talk to Your Doctor about Abdominal Aortic Aneurysm

    MedlinePlus

    ... español Talk to Your Doctor about Abdominal Aortic Aneurysm Browse Sections The Basics Overview What is AAA? ... doctor about getting screened (tested) for abdominal aortic aneurysm (AAA). If AAA isn't found and treated ...

  7. [Lymphosarcoma of abdominal lymph nodes in children].

    PubMed

    Kvirikashvili, T O

    2006-01-01

    We investigated 79 patients (76.0%) with lymphosarcoma of abdominal lymph nodes among all 104 with general abdominal lymphosarcoma. Ultrasound tomography was used in 98.1 % cases; also, in the urgent cases cancer transcutaneal puncture was performed with the purpose of cytological investigation. In complicated situations computer tomography was considered as a highly informative method of investigation. Surgical intervention and radial therapy is inexpedient in a treatment program of lymphosarcoma of abdominal lymph nodes in children. Besides, it is shown the superiority of intensive program of polychemical therapy OMDV: vincristine (oncovin) -- 1.5 mg/m(2) i/v in the 1 day; metotrexate -- 250 mg/m(2) i/v drop by drop in the I day; dexamethazone 10 mg/m(2) per os 1-5 day; vepesid -- 100 mg/m(2) i/v drop by drop in the 4 and 5 days.) in comparison with the ACOP scheme: adriamicine or rubomicine - 30 mg/m(2) i/v 1 time in week (N 4-6); cyclophosphane -- 600 mg/m(2) i/v 1 time in week (N 4-6); vincristine (oncovin) -- 1.4 mg/m(2) i/v 1 time in week (N 4-6); prednisolone -- 40 mg/m(2) every day 4-6 week quitting gradually) for treatment of lymphosarcoma of abdominal lymph nodes in childhood age. General recovery without recurrence in children with lymphosarcoma of abdominal lymph nodes was occurred in 44.2% cases. In the case of polychemical therapy according to ACOP scheme, recovery was 20% and in the case of polychemical therapy following OMDV scheme, 78.1% of the children recovered.

  8. Combined Gastric and Duodenal Perforation Through Blunt Abdominal Trauma

    PubMed Central

    Kaur, Adarshpal; Singla, Archan Lal; Kumar, Ashwani; Yadav, Manish

    2015-01-01

    Blunt abdominal traumas are uncommonly encountered despite their high prevalence, and injuries to the organ like duodenum are relatively uncommon (occurring in only 3%-5% of abdominal injuries) because of its retroperitoneal location. Duodenal injury combined with gastric perforation from a single abdominal trauma impact is rarely heard. The aim of this case report is to present a rare case of blunt abdominal trauma with combined gastric and duodenal injuries. PMID:25738037

  9. Abdominal cavity myolipoma presenting as an enlarging incisional hernia.

    PubMed

    Moore, Mark O; Richardson, Michael L; Rubin, Brian P; Baird, Geoffrey S

    2006-01-01

    We present a case of an abdominal cavity myolipoma which herniated through a low transverse abdominal (Pfannenstiel) incision, and presented as an enlarging abdominal wall mass. Magnetic resonance imaging (MRI) prior to surgery demonstrated an encapsulated solid tumor mass demonstrating fat signal and and increased T2-weighted signal. Postsurgical histological tissue diagnosis was myolipoma. Recognition of the intra- and extraperitoneal location of this abdominal tumor was essential for accurate surgical planning.

  10. [Approaches to the abdominal cavity and closure of the abdominal wall].

    PubMed

    Dittmar, Y; Rauchfuss, F; Ardelt, M; Settmacher, U

    2011-12-01

    Although minimally invasive approaches to the abdominal cavity are becoming increasingly more important, open surgical techniques are still of essential interest and must be mastered by general and visceral surgeons. The choice of the particular approach depends on the specificity and location of the scheduled procedure. The following article is intended to give an overview on the current literature as well as experiences in the field of open surgical approaches to the abdominal cavity.

  11. Lateral abdominal muscle size at rest and during abdominal drawing-in manoeuvre in healthy adolescents.

    PubMed

    Linek, Pawel; Saulicz, Edward; Wolny, Tomasz; Myśliwiec, Andrzej; Kokosz, Mirosław

    2015-02-01

    Lateral abdominal wall muscles in children and adolescents have not been characterised to date. In the present report, we examined the reliability of the ultrasound measurement and thickness of the oblique external muscle (OE), oblique internal muscle (OI) and transverse abdominal muscle (TrA) at rest and during abdominal drawing-in manoeuvre (ADIM) on both sides of the body in healthy adolescents. We also determined possible differences between boys and girls and defined any factors-such as body mass, height and BMI-that may affect the thickness of the abdominal muscles. B-mode ultrasound was used to assess OE, OI and TrA on both sides of the body in the supine position. Ultrasound measurements at rest and during ADIM were reliable in this age group (ICC3,3 > 0.92). OI was always the thickest and TrA the thinnest muscle on both sides of the body. In this group, an identical pattern of the contribution of the individual muscles to the structure of the lateral abdominal wall (OI > OE > TrA) was observed. At rest and during ADIM, no statistically significant side-to-side differences were demonstrated in either gender. The body mass constitutes between 30% and <50% of the thickness differences in all muscles under examination at rest and during ADIM. The structure of lateral abdominal wall in adolescents is similar to that of adults. During ADIM, the abdominal muscles in adolescents react similarly to those in adults. This study provided extensive information regarding the structure of the lateral abdominal wall in healthy adolescents.

  12. Giant serous microcystic pancreas adenoma.

    PubMed

    Dikmen, Kursat; Bostanci, Hasan; Yildirim, Ali Cihat; Sakrak, Omer; Kerem, Mustafa

    2012-10-10

    Serous cystadenomas are rare tumors comprising 1-2% of exocrine pancreas tumors. They are mostly known as benign conditions but malign transformation as serous cystadenocarcinoma is also reported. It is usually seen in females. Non-specific symptoms, such as abdominal pain or symptoms due to mass affect, are usually seen. A 64-year old female patient was investigated for abdominal pain. Physical and laboratory findings were normal. Abdomen ultrasonography confirmed an 11×9.5 cm solid cystic lesion and abdomen computed tomography scan confirmed a 12×11 cm lobulated cystic solid lesion which had central cystic necrotic areas extending from liver hilus inferiorly. Fine needle biopsy confirmed benign cytology and trucut biopsy of the pancreatic mass reported chronic inflamation. Nevertheless, this mass could have malignant contents and transformation potential. A laparatomy was decided due to patient's symptoms and mass effect. Due to vascular invasion of the tumor, Whipple procedure was performed. The pathology report confirmed serous microcystic adenoma. These rare tumors are usually benign but pre-operative malignity criterias are not identified. There are few differential diagnostic tools for excluding malignity. We suggest surgical resection as best treatment approach for selected cases.

  13. Separating gas-giant and ice-giant planets by halting pebble accretion

    NASA Astrophysics Data System (ADS)

    Lambrechts, M.; Johansen, A.; Morbidelli, A.

    2014-12-01

    In the solar system giant planets come in two flavours: gas giants (Jupiter and Saturn) with massive gas envelopes, and ice giants (Uranus and Neptune) with much thinner envelopes around their cores. It is poorly understood how these two classes of planets formed. High solid accretion rates, necessary to form the cores of giant planets within the life-time of protoplanetary discs, heat the envelope and prevent rapid gas contraction onto the core, unless accretion is halted. We find that, in fact, accretion of pebbles (~cm sized particles) is self-limiting: when a core becomes massive enough it carves a gap in the pebble disc. This halt in pebble accretion subsequently triggers the rapid collapse of the super-critical gas envelope. Unlike gas giants, ice giants do not reach this threshold mass and can only bind low-mass envelopes that are highly enriched by water vapour from sublimated icy pebbles. This offers an explanation for the compositional difference between gas giants and ice giants in the solar system. Furthermore, unlike planetesimal-driven accretion scenarios, our model allows core formation and envelope attraction within disc life-times, provided that solids in protoplanetary discs are predominantly made up of pebbles. Our results imply that the outer regions of planetary systems, where the mass required to halt pebble accretion is large, are dominated by ice giants and that gas-giant exoplanets in wide orbits are enriched by more than 50 Earth masses of solids.

  14. Diagnostic yield of oesophagogastroduodenoscopy in children with abdominal pain

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Abdominal pain is the most common indication for OGD in children. However, existing studies examining the diagnostic outcomes of OGD in children with abdominal pain are limited. We conducted the current study to examine the diagnostic yield of OGD with biopsy in the evaluation of abdominal pain and ...

  15. 2013 WSES guidelines for management of intra-abdominal infections

    PubMed Central

    2013-01-01

    Despite advances in diagnosis, surgery, and antimicrobial therapy, mortality rates associated with complicated intra-abdominal infections remain exceedingly high. The 2013 update of the World Society of Emergency Surgery (WSES) guidelines for the management of intra-abdominal infections contains evidence-based recommendations for management of patients with intra-abdominal infections. PMID:23294512

  16. Relative Activity of Abdominal Muscles during Commonly Prescribed Strengthening Exercises.

    ERIC Educational Resources Information Center

    Willett, Gilbert M.; Hyde, Jennifer E.; Uhrlaub, Michael B.; Wendel, Cara L.; Karst, Gregory M.

    2001-01-01

    Examined the relative electromyographic (EMG) activity of upper and lower rectus abdominis (LRA) and external oblique (EOA) muscles during five abdominal strengthening exercises. Isometric and dynamic EMG data indicated that abdominal strengthening exercises activated various abdominal muscle groups. For the LRA and EOA muscle groups, there were…

  17. Symptomatic giant peritoneal loose body in the pelvic cavity: A case report

    PubMed Central

    Elsner, Andreas; Walensi, Mikolaj; Fuenfschilling, Maya; Rosenberg, Robert; Mechera, Robert

    2016-01-01

    Introduction Giant peritoneal loose bodies (gPLB) occur rarely and therefore only few have been described. Often they are found incidentally and have no clinical relevance, whereas symptomatic forms may require surgical removal. Presentation of case We report the case of a male patient suffering from abdominal discomfort with alternating localizations for several years, actually presenting with a proctitis. With elevated inflammatory markers, a conspicuous resistance in the lower abdomen and in order to evaluate further affection of the colon, an abdominal CT-scan was performed. It revealed a spherical mass in the lesser pelvis. A colonoscopy confirmed the proctitis, showing no further pathologies. Due to the symptoms and the uncertain entity of the mass, a diagnostic laparoscopy was performed and a boiled egg-like structure (diameter 5.2 cm) was removed. The patient recovered well and was free of symptoms. Discussion The patient had two potential reasons for his symptoms, one of them being a suspected leftover foreign body years after an appendectomy. The proctitis was treated conservatively but without complete remission of the abdominal discomfort. Therefore, a diagnostic laparoscopy was performed and the mass turned out to be a gPLB. Conclusion To obtain a fast diagnosis and to perform an adequate conservative or surgical therapy, the knowledge about the rare entity of a gPLB is necessary. An exact anamnesis, clinical examination and the knowledge about the diagnostic values of radiological and endoscopic investigations are crucial. PMID:26901087

  18. Giant tunneling magnetoresistance in silicene

    SciTech Connect

    Wang, Yu; Lou, Yiyi

    2013-11-14

    We have theoretically studied ballistic electron transport in silicene under the manipulation of a pair of ferromagnetic gate. Transport properties like transmission and conductance have been calculated by the standard transfer matrix method for parallel and antiparallel magnetization configurations. It is demonstrated here that, due to the stray field-induced wave-vector filtering effect, remarkable difference in configuration-dependent transport gives rise to a giant tunneling magnetoresistance. In combination with the peculiar buckled structure of silicene and its electric tunable energy gap, the receiving magnetoresistance can be efficiently modulated by the externally-tunable stray field, electrostatic potential, and staggered sublattice potential, providing some flexible strategies to construct silicene-based nanoelectronic device.

  19. [Endovascular treatment of giant intracranial aneurysms].

    PubMed

    Bracard, S; Derelle, A L; Tonnelet, R; Barbier, C; Proust, F; Anxionnat, R

    2016-02-01

    Giant aneurysms are defined as having a maximal diameter higher than 25mm. The dynamic aspect of giant aneurysms, in particular, is its growth, which was responsible for parenchyma sequellae either due to haemorrhagic complications or a compression of cranial nerves. The treatment of these giant aneurysms was challenging because of its size, the mass effect and the neck diameter. These morphologic conditions required complex endovascular procedures such as remodelling, stenting, using flow diverters. Subsequently, the complex procedures increased the risk of morbidity because of ischemic complications. Despite these procedures, the risk of recurrence was high.

  20. SYNOVIAL GIANT CELL TUMOR OF THE KNEE.

    PubMed

    Abdalla, Rene Jorge; Cohen, Moisés; Nóbrega, Jezimar; Forgas, Andrea

    2009-01-01

    Synovial giant cell tumor is a benign neoplasm, rarely reported in the form of malignant metastasis. Synovial giant cell tumor most frequently occurs on the hand, and, most uncommon, on the ankle and knee. In the present study, the authors describe a rare case of synovial giant cell tumor on the knee as well as the treatment approach. Arthroscopy has been shown, in this case, to be the optimal method for treating this kind of lesion, once it allowed a less aggressive approach, while providing good visualization of all compartments of knee joint and full tumor resection.

  1. Idiopathic Giant Cell Myocarditis: A Case Report

    PubMed Central

    Kumari M.K., Kalpana; Mysorekar, Vijaya V.; S., Praveen

    2012-01-01

    Giant-cell myocarditis is a disease of relatively young, predominantly healthy adults. The patients usually die of heart failure and ventricular arrhythmia unless a cardiac transplantation is performed. We are reporting here an autopsy case of idiopathic giant cell myocarditis with no symptoms in a 27-year old -worker who died suddenly. The purpose of this report was to emphasize that idiopathic giant cell myocarditis was a rare disease and that it could exist in the absence of any symptomatic heart disease. PMID:23205365

  2. Rotation and macroturbulence in bright giants

    SciTech Connect

    Gray, D.F.; Toner, C.G.

    1986-11-01

    Spectral line profiles of 35 F, G, and K bright giants were analyzed to obtain rotation rates, v sin i, and macroturbulence dispersion. This sample indicates that rotation rates of cool class II giants is less than 11 km/s, in contrast with some recent periodicity measurements. Macroturbulence dispersion generally increases with effective temperature, but the range of values at a given effective temperature is much larger than seen for lower luminosity classes; this is interpreted in terms of red-giant and blue-loop evolution. No evidence is found for angular momentum dissipation on the first crossing of the H-R diagram. 57 references.

  3. SYNOVIAL GIANT CELL TUMOR OF THE KNEE

    PubMed Central

    Abdalla, Rene Jorge; Cohen, Moisés; Nóbrega, Jezimar; Forgas, Andrea

    2015-01-01

    Synovial giant cell tumor is a benign neoplasm, rarely reported in the form of malignant metastasis. Synovial giant cell tumor most frequently occurs on the hand, and, most uncommon, on the ankle and knee. In the present study, the authors describe a rare case of synovial giant cell tumor on the knee as well as the treatment approach. Arthroscopy has been shown, in this case, to be the optimal method for treating this kind of lesion, once it allowed a less aggressive approach, while providing good visualization of all compartments of knee joint and full tumor resection. PMID:27004193

  4. Direct Imaging of Giant Exoplanets

    NASA Astrophysics Data System (ADS)

    Tamura, Motohide

    Since the first detection of exoplanets around a Sun-like star 51 Peg in 1995, their detection and characterization are mainly led by indirect methods such as radial velocity and transit methods. However, recent progresses of observational techniques have finally enabled the direct imaging observations of giant planets of solar-system-scale orbit (with their semi-major axes less than about 50 AU) around A-type stars (e.g., Marois et al. 2008, 2010) and G-type stars (e.g., Kuzuhara et al. 2013). Direct imaging is useful to obtain the physical and atmospheric parameters of exoplanets. In fact not only colors but also a medium-resolution spectroscopy of such planets has been successfully obtained for their atmospheric characterization (Barman et al. 2013). Their masses are typically a few to ~10 Jupiter masses and they orbit at a Saturn- to-Pluto distance. Therefore, like hot-Jupiters and super-Earths they are unlike any solar-system planets, and called wide-orbit giant planets. A recent large search for planets and disk on the Subaru 8.2-m telescope (SEEDS project) has detected a 3-5 Jupiter-masses planet around a Sun-like star GJ 504 (Kuzuhara et al. 2013). It is the coolest planetary companion so far directly imaged and its near-infrared color is “bluer” than that of other directly imaged planets. In this contribution, I will review the recent progresses on direct imaging of exoplanets, highlight the results of the SEEDS project, and discuss the future developments.

  5. Giant invasive mole presenting as a cause of abdominopelvic mass in a perimenopausal woman: An unusual presentation of a rare pathology

    PubMed Central

    Şimşek, Memet; Üçer, Özlem

    2016-01-01

    Invasive mole is a benign gestational trophoblastic disease that arises from the myometrial invasion of any gestational event via direct extension through tissue or vascular structures. Invasive mole (and other gestational trophoblastic diseases) may present with life-threatening complications including uterine perforation, excessive bleeding, acute hemoperitoneum, and abdominal pain. We report a case of invasive mole presenting as abdominal distention in a 51-year-old perimenopausal woman (gravida 12, para 12, abortion 0). The patient was admitted to the gynecology clinic with a giant uterine mass filling the pelvic and abdominal cavity. To our knowledge, this is the first case in the literature of a gestational trophoblastic neoplasia presenting with uterine mass of 28 weeks' gestational size in this age group. Interestingly, complications such as uterine rupture or invasion of the adjacent structures (such as parametrial tissues or blood vessels) had not developed in our patient despite the considerable enlargement of the uterus. PMID:27896261

  6. Proceedings from the Third National Institutes of Health International Congress on Advances in Uterine Leiomyoma Research: comprehensive review, conference summary and future recommendations

    PubMed Central

    Segars, James H.; Parrott, Estella C.; Nagel, Joan D.; Guo, Xiaoxiao Catherine; Gao, Xiaohua; Birnbaum, Linda S.; Pinn, Vivian W.; Dixon, Darlene

    2014-01-01

    BACKGROUND Uterine fibroids are the most common gynecologic tumors in women of reproductive age yet the etiology and pathogenesis of these lesions remain poorly understood. Age, African ancestry, nulliparity and obesity have been identified as predisposing factors for uterine fibroids. Symptomatic tumors can cause excessive uterine bleeding, bladder dysfunction and pelvic pain, as well as associated reproductive disorders such as infertility, miscarriage and other adverse pregnancy outcomes. Currently, there are limited noninvasive therapies for fibroids and no early intervention or prevention strategies are readily available. This review summarizes the advances in basic, applied and translational uterine fibroid research, in addition to current and proposed approaches to clinical management as presented at the ‘Advances in Uterine Leiomyoma Research: 3rd NIH International Congress’. Congress recommendations and a review of the fibroid literature are also reported. METHODS This review is a report of meeting proceedings, the resulting recommendations and a literature review of the subject. RESULTS The research data presented highlights the complexity of uterine fibroids and the convergence of ethnicity, race, genetics, epigenetics and environmental factors, including lifestyle and possible socioeconomic parameters on disease manifestation. The data presented suggest it is likely that the majority of women with uterine fibroids will have normal pregnancy outcomes; however, additional research is warranted. As an alternative to surgery, an effective long-term medical treatment for uterine fibroids should reduce heavy uterine bleeding and fibroid/uterine volume without excessive side effects. This goal has not been achieved and current treatments reduce symptoms only temporarily; however, a multi-disciplined approach to understanding the molecular origins and pathogenesis of uterine fibroids, as presented in this report, makes our quest for identifying novel

  7. Proceedings from the Third National Institutes of Health International Congress on Advances in Uterine Leiomyoma Research: comprehensive review, conference summary and future recommendations.

    PubMed

    Segars, James H; Parrott, Estella C; Nagel, Joan D; Guo, Xiaoxiao Catherine; Gao, Xiaohua; Birnbaum, Linda S; Pinn, Vivian W; Dixon, Darlene

    2014-01-01

    BACKGROUND Uterine fibroids are the most common gynecologic tumors in women of reproductive age yet the etiology and pathogenesis of these lesions remain poorly understood. Age, African ancestry, nulliparity and obesity have been identified as predisposing factors for uterine fibroids. Symptomatic tumors can cause excessive uterine bleeding, bladder dysfunction and pelvic pain, as well as associated reproductive disorders such as infertility, miscarriage and other adverse pregnancy outcomes. Currently, there are limited noninvasive therapies for fibroids and no early intervention or prevention strategies are readily available. This review summarizes the advances in basic, applied and translational uterine fibroid research, in addition to current and proposed approaches to clinical management as presented at the 'Advances in Uterine Leiomyoma Research: 3rd NIH International Congress'. Congress recommendations and a review of the fibroid literature are also reported. METHODS This review is a report of meeting proceedings, the resulting recommendations and a literature review of the subject. RESULTS The research data presented highlights the complexity of uterine fibroids and the convergence of ethnicity, race, genetics, epigenetics and environmental factors, including lifestyle and possible socioeconomic parameters on disease manifestation. The data presented suggest it is likely that the majority of women with uterine fibroids will have normal pregnancy outcomes; however, additional research is warranted. As an alternative to surgery, an effective long-term medical treatment for uterine fibroids should reduce heavy uterine bleeding and fibroid/uterine volume without excessive side effects. This goal has not been achieved and current treatments reduce symptoms only temporarily; however, a multi-disciplined approach to understanding the molecular origins and pathogenesis of uterine fibroids, as presented in this report, makes our quest for identifying novel targets

  8. Peno-scrotal limphedema with giant hydrocele - surgical treatment particularities

    PubMed Central

    Mischianu, Dan; Florescu, Ioan; Madan, Victor; Iatagan, Cristian; Bratu, Ovidiu; Oporan, Anca; Giublea, C

    2009-01-01

    Introduction: The necessity for complex and multidisciplinary approach of “border” surgical pathology has unanimously been agreed upon for such a long period of time, its advantages becoming even more obvious in rare, particular cases. Patients and methods: We report the case of a 39 year-old man diagnosed with lymphangiomatosis back in his childhood. He is admitted with a giant pseudotumoral scrotal mass presenting an important scrotal enlargement (40/35 cm). Physical examination, blood tests, ultrasound, IVP, abdominal and chest CT, psychiatric and plastic surgery evaluation established the diagnosis: peno-scrotal lymphedema with gigantic hydrocele and depressive disorder. Taking into account the important enlargement of the scrotum associated with the alteration of the local skin, we decided to form a mixed surgical team: urology - plastic and reconstructive surgery. We performed bilateral surgical therapy of hydrocele with partial excision and eversion of sac edges, excision of peno-scrotal skin and subcutaneous tissue surplus. At the end we made a reconstruction by using a partial-thickness graft from the normal skin of the left thigh. Results: Spinal anaesthesia was sufficient in order to perform a qualitative complex surgery. Intra and postoperative course was uneventful with minimal blood loss. Conclusion: Rare cases like this one clearly reveal the advantages of a multidisciplinary surgical team by combining usual surgical procedures from different specialities that could lead to spectacular results. PMID:20108494

  9. Laparoscopic Repair and Percutaneous Endoscopic Gastrostomy to Treat Giant Esophageal Hiatal Hernia with Gastric Obstruction: A Case Report.

    PubMed

    Hamai, Yoichi; Hihara, Jun; Tanabe, Kazuaki; Furukawa, Takaoki; Yamakita, Ichiko; Ibuki, Yuta; Okada, Morihito

    2015-06-01

    We describe a 74-year-old man with repeated aspiration pneumonia who developed gastric obstruction due to giant esophageal hiatal hernia (EHH). We repaired the giant EHH by laparoscopic surgery and subsequently anchored the stomach to the abdominal wall by percutaneous endoscopic gastrostomy (PEG) using gastrofiberscopy. Thereafter, the patient resumed oral intake and was discharged on postoperative day 21. At two years after these procedures, the patient has adequate oral intake and lives at home. Because this condition occurs more frequently in the elderly with comorbidities, laparoscopic surgery contributes to minimally invasive treatment. Furthermore, the procedure combined with concurrent gastropexy via PEG is useful for treating patients who have difficulty swallowing and for preventing recurrent hernia.

  10. Giant bilateral renal angiomyolipomas and lymphangioleiomyomatosis presenting after two successive pregnancies successfully treated with surgery and rapamycin.

    PubMed

    Peces, Ramón; Cuesta-López, Emilio; Peces, Carlos; Selgas, Rafael

    2011-01-01

    We report the case of a 25-year-old woman who presented with abdominal and flank pain with two successive pregnancies and was diagnosed of giant bilateral renal AMLs and pulmonary LAM associated with TSC in the post-partum of her second pregnancy. This case illustrates that in women with TSC rapid growth from renal AMLs and development of LAM may occur with successive pregnancies. It also stresses the potential for preservation of renal function despite successive bilateral renal surgery of giant AMLs. Moreover, the treatment with a low-dose rapamycin may be an option for LAM treatment. Finally, a low-dose rapamycin may be considered as an adjuvant treatment together to kidney-sparing conservative surgery for renal AMLs.

  11. [Surgical correction of infrarenal abdominal aorta aneurysms].

    PubMed

    Khamitov, F F; Matochkin, E A; Vertkina, N V; Kizyma, A G; Lisitskiĭ, D A

    2008-01-01

    The authors compare various surgical strategies of infrarenal abdominal aorta aneurysm (IAAA) repair based on the experience of the Department of Cardiovascular Surgery, Urban Clinical Hospital No.81. Total 198 patients underwent aneurysm resection and grafting through conventional (90) or minilaparotomy (108) approaches. Mini-approach was shown to improve significantly both perioperative course and outcomes of IAAA correction. The main advantage of this approach comprised limited invasiveness together with sufficient exposure of abdominal aorta and its branches. Abandoning small bowel evisceration helps to preserve ther-moregulation and achieve volemic homeostasis with less fluid volume. Postoperative period after surgical mini-approach was characterized by shorter period of mechanical ventilation and ICU stay, earlier restoration of bowel motility, conversion to usual nutrition, patient mobilization and discharge. Minimally invasive technology significantly broadens feasibility of radical aortic reconstructions for patients with serious cardio-vascular comorbidities.

  12. Missed Gastric Injuries in Blunt Abdominal Trauma

    PubMed Central

    Naiem, Ahmed A.; Taqi, Kadhim M.; Al-Kendi, Badriya H.; Al-Qadhi, Hani

    2016-01-01

    Hollow viscus injuries of the digestive tract are an uncommon occurrence in blunt abdominal trauma. We report a 39-year-old male who was hit by a vehicle as a pedestrian and admitted to the Sultan Qaboos University Hospital, Muscat, Oman, in 2015. He underwent an exploratory laparotomy which revealed injuries to the distal stomach, liver and descending colon. Postoperatively, the patient was febrile, tachycardic and hypotensive. Abdominal examination revealed distention and tenderness. The next day, a repeat laparotomy identified a gastric injury which had not been diagnosed during the initial laparotomy. Although the defect was repaired, the patient subsequently died as a result of multiorgan failure. Missed gastric injuries are rare and are associated with a grave prognosis, particularly for trauma patients. Delays in diagnosis, in addition to associated injuries, contribute to a high mortality rate. PMID:28003902

  13. Refractory Abdominal Pain in a Hemodialysis Patient

    PubMed Central

    Qian, Ying; Chen, Xiao-nong; Shi, Hao; Xie, Jingyuan; Chen, Nan

    2015-01-01

    Nonocclusive mesenteric ischemia (NOMI) is a rare disorder. Failure of an early diagnosis may cause progressive intestinal ischemia, leading to abdominal pain, sepsis, and death. Patients with end-stage renal disease are among the highest risk populations for developing this lethal complication. The key to a correct diagnosis at an early stage is a high index of suspicion in predisposed patients. In our case, we present a 62-year-old female undergoing maintenance hemodialysis for 8 years; she complained of abdominal pain after hemodialysis in the last 3 months; NOMI was suspected after a CT angiography. She partially recovered after multiple clinical interventions such as decreased ultrafiltration, an increased dose of low molecular-weight heparin and the use of vasoactive drugs. In conclusion, NOMI can be reversible if it is diagnosed as early as possible and after the necessary diagnostic measurements are initiated. PMID:26266246

  14. [Abdominal bloating: an up-to-date].

    PubMed

    Ducrotté, P

    2009-10-01

    Bloating is a common symptom, especially in women. In the clinical practice, it remains a therapeutic challenge. Since recently, its pathophysiology is better understood: an impaired transit of gas (particularly in the small bowel) or a visceral hypersensitivity leading to the induction of an abdominal discomfort despite a normal volume of gas are two of the main causes, far more frequent than an excessive production of gas. Moreover, bloating can be related to abnormal viscera-somatic reflexes promoting both an abdomino-phrenic dyssynergia and the relaxation of the muscles of the abdominal wall. From a therapeutic point of view, the efficacy of the gas absorbants remains to be more documented. Besides the treatment of a constipation and the avoidance of nutrients either highly fermentable or rich in fructose, other therapeutic options include prokinetics and drugs acting on visceral sensitivity. Probiotics are another promising option. In some centers, a non pharmacological therapeutic approach, mainly based on hypnosis, is discussed.

  15. [Normal abdominal ultrasound anatomy. Examination procedure].

    PubMed

    Salcedo Joven, I; Segura Grau, A; Rodríguez Lorenzo, A; Segura Cabral, J M

    2014-01-01

    To carry out an abdominal ultrasound examination with the highest degree of accuracy and thoroughness, it is essential to have a good knowledge of the anatomy and the normal measurements of the different organs. In this way, we can determine their normal condition and identify the pathology and its location more easily. It is very important to adopt a correct examination procedure, systematically sweeping the scan in the same direction and not leaving any organ unexamined. We suggest a procedure consisting of longitudinal, cross-sectional and oblique scans to view all the abdominal organs, starting the examination in the epigastric region, scanning first the right upper quadrant, then the left upper quadrant, both iliac fossa, and lastly the hypogastric region.

  16. Abdominal abscesses in adolescents with Crohn's disease.

    PubMed

    Biller, J A; Grand, R J; Harris, B H

    1987-09-01

    Little information is available about the development of abdominal abscesses in adolescents with Crohn's disease. We report the clinical presentation of five adolescents with Crohn's disease who developed this complication. The mean time from diagnosis until development of an abdominal abscess was 1.7 years. The admitting diagnosis was an acute abdomen in two patients and recurrent Crohn's disease in the other three. No features of the clinical presentation or laboratory data distinguished this group from other adolescents with Crohn's disease. The use of ultrasound and CT scanning was helpful in making this diagnosis preoperatively. Those patients with active Crohn's disease who do not respond promptly to medical therapy should be evaluated for the development of this complication.

  17. Color Doppler ultrasonography of the abdominal aorta.

    PubMed

    Battaglia, S; Danesino, G M; Danesino, V; Castellani, S

    2010-09-01

    Alterations of the abdominal aorta are relatively common, particularly in older people. Technological advances in the fields of ultrasonography, computed tomography, angiography, and magnetic resonance imaging have greatly increased the imaging options for the assessment of these lesions. Because it can be done rapidly and is also non-invasive, ultrasonography plays a major role in the exploration of the abdominal aorta, from its emergence from the diaphragm to its bifurcation. It is indicated for the diagnosis and follow-up of various aortic diseases, especially aneurysms. It can be used to define the shape, size, and location of these lesions, the absence or presence of thrombi and their characteristics. It is also useful for monitoring the evolution of the lesion and for postoperative follow-up. However, its value is limited in surgical planning and in emergency situations.

  18. Percutaneous endoscopic gastrostomy following previous abdominal surgery.

    PubMed Central

    Stellato, T A; Gauderer, M W; Ponsky, J L

    1984-01-01

    During a 36-month period, 89 patients have undergone percutaneous endoscopic gastrostomy without mortality. Of these patients, 25 (13 infants and children, 12 adults) had prior abdominal procedures that increased their risk for the endoscopic procedure. With two exceptions, all gastrostomies were performed utilizing local anesthesia. There was one major complication, a gastrocolic fistula, which was successfully managed by repeating the endoscopic gastrostomy procedure at a location more cephalad in the stomach. Twenty-two of the gastrostomies were placed for feeding purposes and all of these patients were able to leave the hospital with alimentation accomplished via the tube. Three of the endoscopically placed gastrostomies were for gastrointestinal tract decompression. A total of 255 patient months have been accumulated in these patients with the endoscopically placed gastrostomy in situ. The technique can be safely performed in patients with prior abdominal surgery and in the majority of cases is the technique of choice for establishing a tube gastrostomy. PMID:6428334

  19. [Postoperative foreign objects in the abdominal cavity].

    PubMed

    Kazarian, V M

    2008-01-01

    The study was designed to elucidate the circumstances under which iatrogenic foreign objects can be mistakenly left inside the patient's body after surgical interventions and to outline measures to prevent such errors. The data obtained in forensic medical examination of two cases of urgent surgery on abdominal organs are analysed. They indicate that the main causes of leaving behind foreign bodies in a patient include improper organization of emergency medical aid, personal qualities of the surgeon, and psycho-emotional atmosphere during the operation. Comprehensive evaluation of the associated clinical symptoms and their dynamics is necessary for early identification and removal of foreign objects left in the abdominal cavity. It would help to avoid undesirable outcomes of surgery and reduce the number of legal proceedings against medical and preventive treatment facilities.

  20. Malignant peritoneal mesothelioma after remote abdominal radiation

    SciTech Connect

    Gilks, B.; Hegedus, C.; Freeman, H.; Fratkin, L.; Churg, A.

    1988-05-15

    Peritoneal mesothelioma in a 61-year-old man, occurred 26 years after abdominal radiotherapy for a testicular seminoma. The patient had no history of asbestos exposure. After asbestos, radiation is the second most frequent defined cause of mesothelioma in North America, but the number of well-documented cases is small; this case represents only the fifth example of peritoneal mesothelioma after therapeutic irradiation of the abdomen. 16 references.

  1. Erysipelothrix rhusiopathiae intra-abdominal abscess.

    PubMed

    Feasi, Marcello; Bacigalupo, Lorenzo; Cappato, Stefano; Pontali, Emanuele; Usiglio, David; Rollandi, Gian Andrea; Filauro, Marco; Mori, Marco; Cassola, Giovanni

    2010-01-01

    Erysipelothrix rhusiopathiae is a Gram-positive bacillus that is infrequently responsible for infections in humans. Most human cases present as localized or generalized cutaneous infections. An invasive septic form, usually associated with endocarditis, has rarely been described. We report here an invasive infection caused by E. rhusiopathiae without endocardium involvement. To our knowledge, this is the first report of an intra-abdominal abscess due to this pathogen.

  2. Abdominal surgical emergencies in the puerperium.

    PubMed Central

    Munro, A; Jones, P F

    1975-01-01

    Since surgical emergencies in the puerperium are rare, surgeons and obstetricians amass little experience of them. There may be considerable delay in making a diagnosis, firstly, because the abdominal symptoms are thought to be related to the pregnancy, and, secondly, because the signs are rarely convincing in contrast to the symptoms. Any of the common surgical emergencies may occur in pregnancy and the puerperium and there are some others that appear to be a particullar problem of the puerperium. PMID:1203726

  3. Abdominal manifestations of extranodal lymphoma: pictorial essay*

    PubMed Central

    Fajardo, Laís; Ramin, Guilherme de Araujo; Penachim, Thiago José; Martins, Daniel Lahan; Cardia, Patrícia Prando; Prando, Adilson

    2016-01-01

    In the appropriate clinical setting, certain aspects of extranodal abdominal lymphoma, as revealed by current cross-sectional imaging techniques, should be considered potentially diagnostic and can hasten the diagnosis. In addition, diagnostic imaging in the context of biopsy-proven lymphoma can accurately stage the disease for its appropriate treatment. The purpose of this article was to illustrate the various imaging aspects of extranodal lymphoma in the abdomen. PMID:28057966

  4. Robot-Assisted Abdominal Cerclage During Pregnancy

    PubMed Central

    Zeybek, Burak; Hill, Amanda; Menderes, Gulden; Borahay, Mostafa A.; Azodi, Masoud

    2016-01-01

    Background and Objectives: Cervical insufficiency is a difficult condition to diagnose and can lead to preterm birth, miscarriage, or perinatal infant morbidity and mortality. We conducted this retrospective case study and literature review to evaluate the safety and efficacy of robot-assisted abdominal cerclage during pregnancy. Methods: We conducted a case series and a systematic review that included patients who underwent robot-assisted abdominal cerclage during pregnancy from January 2010 through March 2016. Results: Six patients met the criteria for the case series. Median age was 34 years (range, 28–37) at the time of the procedure. In 5 cases, the indication for transabdominal cerclage was a failed vaginal cerclage in a previous pregnancy, whereas a scarred and shortened cervix caused by a previous dilatation and curettage–induced cervical laceration was the indication in the remaining case. Median operating time was 159.5 minutes (range, 124–204), and median estimated blood loss was 25 mL (range, 10–25). No surgeries were converted to laparotomies; all patients were discharged on postoperative day 1. The median gestational age at delivery was 37.5 weeks (range, 22–39). Five patients delivered between 36 and 39 weeks. No patients had chorioamnionitis or preterm premature rupture of membranes. One patient went into preterm labor at 22 weeks, and the cerclage was removed via minilaparotomy. Eight articles met the criteria for systematic review. Sixteen patients underwent robot-assisted abdominal cerclage during pregnancy. Median age was 31.5 years (range, 25–37). The major indication in most articles was previous failed transvaginal cerclage. The median gestational ages at time of procedure and delivery were 12 weeks (range, 10–15) and 37 weeks (range, 33–39), respectively. Conclusion: Robot-assisted abdominal cerclage is safe and effective during pregnancy. PMID:27904309

  5. Effect of laparoscopic abdominal surgery on splanchnic circulation: historical developments.

    PubMed

    Hatipoglu, Sinan; Akbulut, Sami; Hatipoglu, Filiz; Abdullayev, Ruslan

    2014-12-28

    With the developments in medical technology and increased surgical experience, advanced laparoscopic surgical procedures are performed successfully. Laparoscopic abdominal surgery is one of the best examples of advanced laparoscopic surgery (LS). Today, laparoscopic abdominal surgery in general surgery clinics is the basis of all abdominal surgical interventions. Laparoscopic abdominal surgery is associated with systemic and splanchnic hemodynamic alterations. Inadequate splanchnic perfusion in critically ill patients is associated with increased morbidity and mortality. The underlying pathophysiological mechanisms are still not well understood. With experience and with an increase in the number and diversity of the resulting data, the pathophysiology of laparoscopic abdominal surgery is now better understood. The normal physiology and pathophysiology of local and systemic effects of laparoscopic abdominal surgery is extremely important for safe and effective LS. Future research projects should focus on the interplay between the physiological regulatory mechanisms in the splanchnic circulation (SC), organs, and diseases. In this review, we discuss the effects of laparoscopic abdominal surgery on the SC.

  6. Mesh Sutured Repairs of Abdominal Wall Defects

    PubMed Central

    Lanier, Steven T.; Jordan, Sumanas W.; Miller, Kyle R.; Ali, Nada A.; Stock, Stuart R.

    2016-01-01

    Background: A new closure technique is introduced, which uses strips of macroporous polypropylene mesh as a suture for closure of abdominal wall defects due to failures of standard sutures and difficulties with planar meshes. Methods: Strips of macroporous polypropylene mesh of 2 cm width were passed through the abdominal wall and tied as simple interrupted sutures. The surgical technique and surgical outcomes are presented. Results: One hundred and seven patients underwent a mesh sutured abdominal wall closure. Seventy-six patients had preoperative hernias, and the mean hernia width by CT scan for those with scans was 9.1 cm. Forty-nine surgical fields were clean-contaminated, contaminated, or dirty. Five patients had infections within the first 30 days. Only one knot was removed as an office procedure. Mean follow-up at 234 days revealed 4 recurrent hernias. Conclusions: Mesh sutured repairs reliably appose tissue under tension using concepts of force distribution and resistance to suture pull-through. The technique reduces the amount of foreign material required in comparison to sheet meshes, and avoids the shortcomings of monofilament sutures. Mesh sutured closures seem to be tolerant of bacterial contamination with low hernia recurrence rates and have replaced our routine use of mesh sheets and bioprosthetic grafts. PMID:27757361

  7. Quantification of abdominal aortic deformation after EVAR

    NASA Astrophysics Data System (ADS)

    Demirci, Stefanie; Manstad-Hulaas, Frode; Navab, Nassir

    2009-02-01

    Quantification of abdominal aortic deformation is an important requirement for the evaluation of endovascular stenting procedures and the further refinement of stent graft design. During endovascular aortic repair (EVAR) treatment, the aortic shape is subject to severe deformation that is imposed by medical instruments such as guide wires, catheters, and, the stent graft. This deformation can affect the flow characteristics and morphology of the aorta which have been shown to be elicitors for stent graft failures and be reason for reappearance of aneurysms. We present a method for quantifying the deformation of an aneurysmatic aorta imposed by an inserted stent graft device. The outline of the procedure includes initial rigid alignment of the two abdominal scans, segmentation of abdominal vessel trees, and automatic reduction of their centerline structures to one specified region of interest around the aorta. This is accomplished by preprocessing and remodeling of the pre- and postoperative aortic shapes before performing a non-rigid registration. We further narrow the resulting displacement fields to only include local non-rigid deformation and therefore, eliminate all remaining global rigid transformations. Finally, deformations for specified locations can be calculated from the resulting displacement fields. In order to evaluate our method, experiments for the extraction of aortic deformation fields are conducted on 15 patient datasets from endovascular aortic repair (EVAR) treatment. A visual assessment of the registration results and evaluation of the usage of deformation quantification were performed by two vascular surgeons and one interventional radiologist who are all experts in EVAR procedures.

  8. [Hereditary angioedema: strange cause of abdominal pain].

    PubMed

    Salas-Lozano, Nereo Guillermo; Meza-Cardona, Javier; González-Fernández, Coty; Pineda-Figueroa, Laura; de Ariño-Suárez, Mauricio

    2014-01-01

    Antecedentes: el angioedema hereditario es un trastorno inflamatorio episódico, que se hereda de manera autosómica dominante y se caracteriza por episodios de edema periférico. Los pacientes pueden tener edema de la pared de cualquier víscera hueca, incluido el intestino. Caso clínico: se comunica el caso de un paciente masculino de 33 años de edad, sin antecedentes de importancia, con dolor abdominal, localizado en el epigastrio, irradiado al cuadrante inferior derecho, acompañado de 5 vómitos. La tomografía abdominal mostró engrosamiento de la pared de la segunda y tercera porción del duodeno, con infiltración de grasa y líquido libre. Los exámenes de laboratorio mostraron: concentraciones bajas del complemento C4 (5.5 mg/dL) y actividad del inhibidor de C1 del complemento de 30%. Conclusiones: el angioedema hereditario es consecuencia de la deficiencia (tipo I) o disfunción (tipo II) del inhibidor C1 del complemento. El dolor abdominal asociado con angioedema es de inicio súbito, como dolor cólico, recurrente y de intensidad moderada. En la actualidad existen dos medicamentos aprobados por la Food and Drug Administration para el tratamiento de pacientes con esta afección.

  9. Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells: a rare case report and review of the literature.

    PubMed

    Sah, Shambhu K; Li, Ying; Li, Yongmei

    2015-01-01

    Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells (UCPOGC) is an extremely rare non-endocrine pancreatic tumor. To date, some cases have been reported, however, histogenesis and biologic behavior of UCPOGC remain controversial. We report a case of an UCPOGC in a 54-year-old female, who presented with a three-month history of recurrent abdominal pain without any incentive. Abdominal computed tomography (CT) revealed a large cystic mass of 10.5 × 9.3 cm in the body and tail of the pancreas compressing the adjacent bowel loop and stomach. The preliminary diagnosis was considered as a malignant tumor of body and tail of the pancreas. The patient had open distal pancreatic mass resection with splenectomy and according to the results of histopathological and immunohistochemical studies, the diagnosis of an UCPOGC was established.

  10. Lithium Abundance in M3 Red Giant

    NASA Astrophysics Data System (ADS)

    Givens, Rashad; Pilachowski, Catherine A.

    2015-01-01

    We present the abundance of lithium in the red giant star vZ 1050 (SK 291) in the globular cluster M3. A previous survey of giants in the cluster showed that like IV-101, vZ 1050 displays a prominent Li I 6707 Å feature. vZ 1050 lies on the blue side of the red giant branch about 1.3 magnitudes above the level of the horizontal branch, and may be an asymptotic giant branch star. A high resolution spectrum of M3 vZ1050 was obtained with the ARC 3.5m telescope and the ARC Echelle Spectrograph (ARCES). Atmospheric parameters were determined using Fe I and Fe II lines from the spectrum using the MOOG spectral analysis program, and the lithium abundance was determined using spectrum synthesis.

  11. Giant cell arteritis presenting as scalp necrosis.

    PubMed

    Maidana, Daniel E; Muñoz, Silvia; Acebes, Xènia; Llatjós, Roger; Jucglà, Anna; Alvarez, Alba

    2011-07-07

    The differential of scalp ulceration in older patients should include several causes, such as herpes zoster, irritant contact dermatitis, ulcerated skin tumors, postirradiation ulcers, microbial infections, pyoderma gangrenosum, and giant cell arteritis. Scalp necrosis associated with giant cell arteritis was first described in the 1940s. The presence of this dermatological sign within giant cell arteritis represents a severity marker of this disease, with a higher mean age at diagnosis, an elevated risk of vision loss and tongue gangrene, as well as overall higher mortality rates, in comparison to patients not presenting this manifestation. Even though scalp necrosis due to giant cell arteritis is exceptional, a high level of suspicion must be held for this clinical finding, in order to initiate prompt and proper treatment and avoid blindness.

  12. Mass loss in red giants and supergiants

    NASA Technical Reports Server (NTRS)

    Sanner, F.

    1975-01-01

    The circumstellar envelopes surrounding late-type giants and supergiants were studied using high resolution, photoelectric scans of strong optical resonance lines. A method for extracting the circumstellar from the stellar components of the lines allowed a quantitative determination of the physical conditions in the envelopes and the rates of mass loss at various positions in the red giant region of the HR diagram. The observed strengthening of the circumstellar spectrum with increasing luminosity and later spectral type is probably caused by an increase in the mass of the envelopes. The mass loss rate for individual stars is proportional to the visual luminosity; high rates for the supergiants suggest that mass loss is important in their evolution. The bulk of the mass return to the interstellar medium in the red giant region comes from the normal giants, at a rate comparable to that of planetary nebulae.

  13. "GIANT" Steps to Create Online Orientations

    ERIC Educational Resources Information Center

    Bacon, Pamela

    2005-01-01

    Online orientation is provided due to the flexibility of online learning. The online orientation consists of the GIANT steps which stands for Get support, Identify your curriculum, Assemble your program, Navigate students through the pilot project and Test students.

  14. Tests of the Giant Impact Hypothesis

    NASA Technical Reports Server (NTRS)

    Jones, J. H.

    1998-01-01

    The giant impact hypothesis has gained popularity as a means of explaining a volatile-depleted Moon that still has a chemical affinity to the Earth. As Taylor's Axiom decrees, the best models of lunar origin are testable, but this is difficult with the giant impact model. The energy associated with the impact would be sufficient to totally melt and partially vaporize the Earth. And this means that there should he no geological vestige of Barber times. Accordingly, it is important to devise tests that may be used to evaluate the giant impact hypothesis. Three such tests are discussed here. None of these is supportive of the giant impact model, but neither do they disprove it.

  15. Giant salivary calculi of the submandibular gland

    PubMed Central

    Fowell, C; MacBean, A

    2012-01-01

    Sialolithasis is the most common salivary gland disease. A case of an unusually large sialolith arising in the submandibular gland is presented, along with a review of the management of giant salivary gland calculi. PMID:24960792

  16. Spontaneous abscesses of the abdominal wall, omentum and abdominal cavity caused by group G streptococci: a case report.

    PubMed

    De Brabandere, K; Vanpaemel, G; Verheyen, L

    2008-01-01

    We report the first case, to our knowledge, of spontaneous abscess of the abdominal wall, omentum and abdominal cavity caused by group G streptococci. A 52-year-old diabetic woman presented with abdominal tenderness and weight loss that had persisted for a few weeks. CT scan showed several abscesses of the abdominal wall, omentum and abdominal cavity. The abscesses were drained laparoscopically and antibiotics were given postoperatively. Biopsies and cultures showed group G streptococci. The patient recovered without any complication and left our hospital on the 17th postoperative day.

  17. Is abdominal wall tenderness a useful sign in the diagnosis of non-specific abdominal pain?

    PubMed Central

    Gray, D. W.; Dixon, J. M.; Seabrook, G.; Collin, J.

    1988-01-01

    Pain arising from the abdominal wall has been implicated as a cause of non-specific abdominal pain (NSAP), and the presence of abdominal wall tenderness (AWT) has been proposed as an accurate diagnostic test for NSAP. One hundred and fifty eight patients admitted to hospital with abdominal pain were tested for the presence of positive AWT. In 53 patients the final diagnosis was appendicitis and positive AWT was found in five. Thirty eight patients were found to have a variety of other recognised pathological diagnoses, none of whom had a positive AWT. In 67 patients a diagnosis of NSAP was made in the absence of other pathological diagnosis, 19 of whom had positive AWT, which was significantly different from the other diagnostic groups. This study confirms the presence of AWT in up to 28% of patients with NSAP, and suggests that testing for AWT is of value in patients with abdominal pain, although a positive AWT is not as accurate a predictor of NSAP as previously reported. PMID:2970820

  18. Transversus abdominal plane block as a sole anesthetic technique for abdominal wall hematoma drainage.

    PubMed

    Varela, N; Golvano, M; Monedero, P

    2016-10-01

    Transversus abdominal plane (TAP) block is a known and useful technique, widely used for postoperative pain management of abdominal wall incisions. During the past years, and following the expansion of ultrasound guided techniques, its use has even gained more adepts. It is usually used as an adjuvant technique, primarily in order to control postoperative pain and reduce opioids consumption. We report the case of an 82 years old patient admitted for drainage of a postoperative abdominal wall hematoma after correction of a McBurney incisional hernia. The corrective surgery had gone on without incident, under general anesthesia with laryngeal mask. Two weeks later, the patient came back to our emergency department with a clear hematoma of the abdominal wall. Surgery was decided. A sole local anesthetic technique was achieved, using a TAP block. The block was performed under ultrasound guidance, using a subcostal approach. The surgery went on without complications. Therefore, TAP block offers a hemodynamic stability, appropriate intra-operative anesthesia and post-surgical analgesia of the abdominal wall.

  19. Arterial Embolization of Giant Hepatic Hemangiomas

    SciTech Connect

    Giavroglou, Constantinos; Economou, Hippolete; Ioannidis, Ioannis

    2003-02-15

    Hepatic cavernous hemangiomas are usually small and asymptomatic. They are usually discovered incidentally and only a few require treatment. However, giant hemangiomas may cause symptoms,which are indications for treatment. We describe four cases of symptomatic giant hepatic hemangiomas successfully treated with transcatheter arterial embolization, performed with polyvinyl alcohol particles. There were no complications. Follow-up with clinical and imaging examinations showed disappearance of symptoms and decrease in size of lesions.

  20. Dietary Shifts May Trigger Dysbiosis and Mucous Stools in Giant Pandas (Ailuropoda melanoleuca)

    PubMed Central

    Williams, Candace L.; Dill-McFarland, Kimberly A.; Vandewege, Michael W.; Sparks, Darrell L.; Willard, Scott T.; Kouba, Andrew J.; Suen, Garret; Brown, Ashli E.

    2016-01-01

    Dietary shifts can result in changes to the gastrointestinal tract (GIT) microbiota, leading to negative outcomes for the host, including inflammation. Giant pandas (Ailuropoda melanoleuca) are physiologically classified as carnivores; however, they consume an herbivorous diet with dramatic seasonal dietary shifts and episodes of chronic GIT distress with symptoms including abdominal pain, loss of appetite and the excretion of mucous stools (mucoids). These episodes adversely affect the overall nutritional and health status of giant pandas. Here, we examined the fecal microbiota of two giant pandas’ non-mucoid and mucoid stools and compared these to samples from a previous winter season that had historically few mucoid episodes. To identify the microbiota present, we isolated and sequenced the 16S rRNA using next-generation sequencing. Mucoids occurred following a seasonal feeding switch from predominately bamboo culm (stalk) to leaves. All fecal samples displayed low diversity and were dominated by bacteria in the phyla Firmicutes and to a lesser extent, Proteobacteria. Fecal samples immediately prior to mucoid episodes had lower microbial diversity as compared to mucoids. Mucoids were mostly comprised of common mucosal-associated taxa including Streptococcus and Leuconostoc species, and exhibited increased abundance for bacteria in the family Pasteurellaceae. Taken together, these findings indicate that mucoids may represent an expulsion of the mucosal lining that is driven by changes in diet. We suggest that these occurrences serve to reset their GIT microbiota following changes in bamboo part preference, as giant pandas have retained a carnivorous GIT anatomy while shifting to an herbivorous diet. PMID:27199976

  1. Spontaneous rupture of a giant renal angiomyolipoma—Wunderlich’s syndrome: Report of a case

    PubMed Central

    Chronopoulos, Panagiotis Nikolaos; Kaisidis, Georgios Nikolaos; Vaiopoulos, Christos Konstantinos; Perits, Dragana Milosav; Varvarousis, Michail Nikolaos; Malioris, Apostolos Vasilios; Pazarli, Elissabeth; Skandalos, Ioannis Konstantinos

    2015-01-01

    Introduction Herein we present a rare case of pontaneous rupture of a giant renal angiomyolipoma (AML), with symptoms of hypovolemic shock (Wunderlich’s syndrome), which was managed by urgent total nephrectomy. Presentation of case A 53 year old female was transferred to the emergency room with progressive acute painful swelling of the left lateral abdominal area, duration of 5 h. An emergent ultrasonic examination, revealed a heterogeneous—solid mass with maximum diameter of 23 cm, with probable origin from the left kidney. Due to worsening of the clinical status (hypovolemic shock), loss of consciousness and acute drop of haematocrit level to 17.8%, the patient was urgently intubated in the emergency room and transferred to the operating theater. A giant haemorrhagic mass was found originating from the left kidney, which removed en-block with the left kidney. The patient was transferred to the intensive care unit. Her recovery was uneventful. The histopathologic examination revealed a giant renal angiomyolipoma (25 × 18 × 8 cm) with extensive bleeding. Discussion Enlarged renal AMLs can rupture. This can be sudden and painful with manifestations of hypovolemic shock. The management of AMLs has been correlated with symptoms. Patients with life-threatening retroperitoneal haemorrhage, require urgent exploration as retroperitoneal bleeding can lead to severe complications, increasing morbidity. Conclusion In case of giant angiomyolipoma with intratumoral haemorrhage, and symptoms of Wunderlich’s syndrome, partial or total nephrectomy is a good treatment option in order to save the patient’s life. PMID:26764888

  2. Bayesian Inference of Giant Exoplanet Physics

    NASA Astrophysics Data System (ADS)

    Thorngren, Daniel; Fortney, Jonathan J.

    2017-01-01

    The physical processes within a giant planet directly set its observed radius for a given mass, age, and insolation. The important aspects are the planet’s bulk composition and its interior thermal evolution. By studying many giant planets as an ensemble, we can gain insight into this physics. We demonstrate two novel examples here. We examine 50 cooler transiting giant planets, whose insolation is sufficiently low (T_eff < 1000 K) that they are not affected by the hot Jupiter radius inflation effect. For these planets, the thermal evolution is relatively well understood, and we show that the bulk planet metallicity increases with the total planet mass, which directly impacts plans for future atmospheric studies. We also examine the relation with stellar metallicity and discuss how these relations place new constraints on the core accretion model of planet formation. Our newest work seeks to quantify the flow of energy into hot Jupiters needed to explain their enlarged radii, in addition to their bulk composition. Because the former is related to stellar insolation and the latter is related to mass, we are able to create a hierarchical Bayesian model to disentangle the two effects in our sample of ~300 transiting giant planets. Our results show conclusively that the inflation power is not a simple fraction of stellar insolation: instead, the power increases with incident flux at a much higher rate. We use these results to test published models of giant planet inflation and to provide accurate empirical mass-radius relations for giant planets.

  3. Formation of Giant Planets and Brown Dwarves

    NASA Technical Reports Server (NTRS)

    Lissauer, Jack J.

    2003-01-01

    According to the prevailing core instability model, giant planets begin their growth by the accumulation of small solid bodies, as do terrestrial planets. However, unlike terrestrial planets, the growing giant planet cores become massive enough that they are able to accumulate substantial amounts of gas before the protoplanetary disk dissipates. Models predict that rocky planets should form in orbit about most stars. It is uncertain whether or not gas giant planet formation is common, because most protoplanetary disks may dissipate before solid planetary cores can grow large enough to gravitationally trap substantial quantities of gas. Ongoing theoretical modeling of accretion of giant planet atmospheres, as well as observations of protoplanetary disks, will help decide this issue. Observations of extrasolar planets around main sequence stars can only provide a lower limit on giant planet formation frequency . This is because after giant planets form, gravitational interactions with material within the protoplanetary disk may cause them to migrat inwards and be lost to the central star. The core instability model can only produce planets greater than a few jovian masses within protoplanetary disks that are more viscous than most such disks are believed to be. Thus, few brown dwarves (objects massive enough to undergo substantial deuterium fusion, estimated to occur above approximately 13 jovian masses) are likely to be formed in this manner. Most brown dwarves, as well as an unknown number of free-floating objects of planetary mass, are probably formed as are stars, by the collapse of extended gas/dust clouds into more compact objects.

  4. A multicenter case-control study on screening of single nucleotide polymorphisms in estrogen-metabolizing enzymes and susceptibility to uterine leiomyoma in han chinese.

    PubMed

    Shen, Yang; Ren, Mu-Lan; Xu, Jie; Xu, Qian; Ding, Yi-Qian; Wu, Zhi-Cong; Zhang, Hai-Bao; Huang, Xian-Xia; Cai, Yun-Lang

    2014-01-01

    Uterine leiomyoma (UL) is an estrogen-responsive benign tumor in the female reproductive system and the main risk of hysterectomy for women. However, gene polymorphism of estrogen-metabolizing enzymes may lead to the different susceptibility to UL. We detected 10 single mucleotide polymorphisms in three key estrogen metabolite enzymes (COMT, CYP1A1, CYP1B1) in a Chinese Han population consisting of 800 patients and 800 healthy women from five different medical centers. The genetic polymorphism of rs3087869 (IVS1+2329C>T) (OR 3.200, 95% CI 1.614-6.345) and rs4680 (Val158Met) (OR 5.675, 95% CI 2.696-11.942) loci on COMT, rs1048943 (Ile462Val) (OR 4.629, 95% CI 2.216-9.672) and rs4646422 (Gly45Asp) (OR 3.240, 95% CI 1.624-6.461) loci on CYP1A1 and rs1065827 (Ala119Ser) (OR 5.635, 95% CI 2.990-10.619) locus on CYP1B1 were the risk factors to UL development and rs1056836 (Leu432Val) (OR 0.188, 95% CI 0.061-0.575) locus on CYB1B1 may be the protective factor to UL. The results provide a theoretical basis for genetic screening and early intervention to UL-susceptible populations.

  5. Association of polymorphisms and haplotypes in the cytochrome P450 1B1 gene with uterine leiomyoma: A case control study

    PubMed Central

    SALIMI, SAEEDEH; KHODAMIAN, MARYAM; NAROOIE-NEJAD, MEHRNAZ; HAJIZADEH, AZAM; FAZELI, KIMIA; NAMAZI, LIDA; YAGHMAEI, MINOO

    2015-01-01

    Uterine leiomyoma (UL) is an estrogen-dependent neoplasm of the uterus and estrogen metabolizing enzymes affect its promotion and progression. The aim of the present study was to evaluate the association between four single-nucleotide polymorphisms (SNPs) of the cytochrome P450 1B1 (CYP1B1) gene and UL risk. Four SNPs of the CYP1B1 gene in 105 UL patients and 112 unrelated healthy controls were genotyped using a direct sequencing method. Haplotype analyses were performed with UNPHASED software and linkage disequilibrium (LD) was assessed by Haploview software. There were no associations between Leu432Val (rs1056836), Asp449Asp (rs1056837) and Asn453Ser (rs1800440) polymorphisms of the CYP1B1 gene and UL. Although the genotypic frequencies of the Arg368His (rs79204362) polymorphism did not differ between the two groups, the frequency of A (His) allele was significantly higher in UL females (P=0.02). In addition, the frequency of GTAA haplotype was significantly higher in the controls and played a protective role in UL susceptibility. A strong LD between the three common SNPs (rs1056836, rs1056837 and rs1800440) in the CYP1B1 gene was observed in the population. In conclusion, a higher frequency of the CYP1B1 368His (A) allele was observed in UL females. The frequency of the GTAA haplotype was significantly higher in healthy females and this haplotype played a protective role in UL susceptibility. PMID:26075073

  6. Association of polymorphisms and haplotypes in the cytochrome P450 1B1 gene with uterine leiomyoma: A case control study.

    PubMed

    Salimi, Saeedeh; Khodamian, Maryam; Narooie-Nejad, Mehrnaz; Hajizadeh, Azam; Fazeli, Kimia; Namazi, Lida; Yaghmaei, Minoo

    2015-03-01

    Uterine leiomyoma (UL) is an estrogen-dependent neoplasm of the uterus and estrogen metabolizing enzymes affect its promotion and progression. The aim of the present study was to evaluate the association between four single-nucleotide polymorphisms (SNPs) of the cytochrome P450 1B1 (CYP1B1) gene and UL risk. Four SNPs of the CYP1B1 gene in 105 UL patients and 112 unrelated healthy controls were genotyped using a direct sequencing method. Haplotype analyses were performed with UNPHASED software and linkage disequilibrium (LD) was assessed by Haploview software. There were no associations between Leu432Val (rs1056836), Asp449Asp (rs1056837) and Asn453Ser (rs1800440) polymorphisms of the CYP1B1 gene and UL. Although the genotypic frequencies of the Arg368His (rs79204362) polymorphism did not differ between the two groups, the frequency of A (His) allele was significantly higher in UL females (P=0.02). In addition, the frequency of GTAA haplotype was significantly higher in the controls and played a protective role in UL susceptibility. A strong LD between the three common SNPs (rs1056836, rs1056837 and rs1800440) in the CYP1B1 gene was observed in the population. In conclusion, a higher frequency of the CYP1B1 368His (A) allele was observed in UL females. The frequency of the GTAA haplotype was significantly higher in healthy females and this haplotype played a protective role in UL susceptibility.

  7. [Intra-abdominal pressure as a surgery predictor in patients with acute abdominal pain].

    PubMed

    Campos-Muñoz, Manuel Alejandro; Villarreal-Ríos, Enrique; Chimal-Torres, Mariano; Pozas-Medina, Josué Atila

    2016-01-01

    Introducción: la presión intraabdominal es el estado de equilibrio de la presión de la cavidad abdominal en reposo y puede presentar cambios durante la ventilación mecánica o espontánea. El objetivo fue determinar la presión intraabdominal como predictor de cirugía en el paciente con dolor abdominal agudo. Métodos: se llevó a cabo un estudio de casos y controles anidado en una cohorte de pacientes con dolor abdominal agudo en el servicio de urgencias de un hospital de segundo nivel, en el periodo comprendido entre abril y diciembre de 2013. Se incluyeron 37 pacientes, todos fueron intervenidos quirúrgicamente con previa toma de la presión intraabdominal. Se formaron los grupos con el resultado del estudio anatomopatológico: con evidencia de proceso inflamatorio abdominal agudo (n = 28) y sin evidencia de proceso inflamatorio abdominal agudo (n = 9). Resultados: en los casos el 100 % presentó presión intraabdominal alta con una p = 0.01, RM: 5 (IC 95 %: 2.578-9.699). En los casos la media de la presión intraabdominal fue de 11.46 y en los controles de 9.2 (p = 0.183). Conclusiones: el dolor abdominal que requiere cirugía para su resolución tiene relación directa con una presión intraabdominal > 5 mmHg.

  8. Abdominal scar characteristics as a predictor of cervical stenosis after abdominal radical trachelectomy

    PubMed Central

    Li, Xiaoqi; Li, Jin; Ju, Xingzhu; Chen, Xiaojun; Wu, Xiaohua

    2016-01-01

    To investigate whether abdominal scar characteristics could predict the occurrence of cervical stenosis after abdominal radical trachelectomy (ART), we conducted a retrospective study and investigated the relationship between abdominal scar characteristics and the occurrence of cervical stenosis in patients one year after undergoing ART. The abdominal scars were evaluated using the Vancouver Scar Scale (VSS). Seventy-two participants were enrolled in the study, including 15 (20.8%) women with cervical stenosis, and 57 (79.2%) without stenosis. Results showed that the mean abdominal scar score assessed by VSS was higher in patients with cervical stenosis (7, range: 1–10) compared to those without stenosis (4, range: 0–9) (P = 0.001). Incidence rates of cervical stenosis increased with the VSS score. For women with VSS scores of 0 to 4, 5, 6, 7, 8, 9 and 10, respectively, the occurrences of cervical stenosis were 6.1%, 16.7%, 16.7%, 27.3%, 37.5%, 50% and 100%. The cutoff point of VSS score was 7 according to the receiver operating characteristic (ROC) curve. Fourteen of the 15 stenosis happened either in patients without anti-stenosis tools (Foley catheters or tailed intrauterine devices) placed during the surgery or after the devices were removed. Our results demonstrated that VSS is an effective approach to assess the presence of cervical stenosis after ART. Women who have an abdominal scar with a VSS score > 7 have a high risk of developing isthmic stenosis without anti-stenosis tools in place. PMID:27191256

  9. Remote revascularization of abdominal wall transplants using the forearm.

    PubMed

    Giele, H; Bendon, C; Reddy, S; Ramcharan, R; Sinha, S; Friend, P; Vaidya, A

    2014-06-01

    Primary abdominal wall closure following small bowel transplantation is frequently impossible due to contraction of the abdominal domain. Although abdominal wall transplantation was reported 10 years ago this, technique has not been widely adopted, partly due to its complexity, but largely because of concerns that storing the abdominal allograft until the end of a prolonged intestinal transplant procedure would cause severe ischemia-reperfusion injury. We report six cases of combined small bowel and abdominal wall transplantation where the ischemic time was minimized by remotely revascularizing the abdominal wall on the forearm vessels, synchronous to the intestinal procedure. When the visceral transplant was complete, the abdominal wall was removed from the forearm and revascularized on the abdomen (n = 4), or used to close the abdomen while still vascularized on the forearm (n = 2). Primary abdominal wall closure was achieved in all. Mean cold ischemia was 305 min (300-330 min), and revascularization on the arm was 50 min (30-60 min). Three patients had proven abdominal wall rejection, all treated successfully. Immediate revascularization of the abdominal wall allograft substantially reduces cold ischemia without imposing constraints on the intestinal transplant. Reducing storage time may also have benefits with respect to ischemia-reperfusion-related graft immunogenicity.

  10. Biomass yield comparisons of giant miscanthus, giant reed, and miscane grown under irrigated and rainfed conditions

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The U.S. Department of Energy has initiated efforts to decrease the nation’s dependence on imported oil by developing domestic renewable sources of cellulosic-derived bioenergy. In this study, giant miscanthus (Miscanthus x giganteus), sugarcane (complex hybrid of Saccharum spp.), and giant reed (Ar...

  11. Migration of accreting giant planets

    NASA Astrophysics Data System (ADS)

    Crida, A.; Bitsch, B.; Raibaldi, A.

    2016-12-01

    We present the results of 2D hydro simulations of giant planets in proto-planetary discs, which accrete gas at a more or less high rate. First, starting from a solid core of 20 Earth masses, we show that as soon as the runaway accretion of gas turns on, the planet is saved from type I migration : the gap opening mass is reached before the planet is lost into its host star. Furthermore, gas accretion helps opening the gap in low mass discs. Consequently, if the accretion rate is limited to the disc supply, then the planet is already inside a gap and in type II migration. We further show that the type II migration of a Jupiter mass planet actually depends on its accretion rate. Only when the accretion is high do we retrieve the classical picture where no gas crosses the gap and the planet follows the disc spreading. These results impact our understanding of planet migration and planet population synthesis models. The e-poster presenting these results in French can be found here: L'e-poster présentant ces résultats en français est disponible à cette adresse: http://sf2a.eu/semaine-sf2a/2016/posterpdfs/156_179_49.pdf.

  12. The Giant Planet Satellite Exospheres

    NASA Astrophysics Data System (ADS)

    McGrath, M. A.

    2014-12-01

    Exospheres are relatively common in the outer solar system among the moons of the gas giant planets. They span the range from very tenuous, surface-bounded exospheres (e.g., Rhea, Dione) to quite robust exospheres with exobase above the surface (e.g., Io, Triton), and include many intermediate cases (e.g., Europa, Ganymede, Enceladus). The exospheres of these moons exhibit an interesting variety of sources, from surface sputtering, to frost sublimation, to active plumes, and also well illustrate another common characteristic of the outer planet satellite exospheres, namely, that the primary species often exists both as a gas in atmosphere, and a condensate (frost or ice) on the surface. As described by Yelle et al. (1995) for Triton, "The interchange of matter between gas and solid phases on these bodies has profound effects on the physical state of the surface and the structure of the atmosphere." A brief overview of the exospheres of the outer planet satellites will be presented, including an inter-comparison of these satellites exospheres with each other, and with the exospheres of the Moon and Mercury.

  13. A giant thunderstorm on Saturn.

    PubMed

    Fischer, G; Kurth, W S; Gurnett, D A; Zarka, P; Dyudina, U A; Ingersoll, A P; Ewald, S P; Porco, C C; Wesley, A; Go, C; Delcroix, M

    2011-07-06

    Lightning discharges in Saturn's atmosphere emit radio waves with intensities about 10,000 times stronger than those of their terrestrial counterparts. These radio waves are the characteristic features of lightning from thunderstorms on Saturn, which last for days to months. Convective storms about 2,000 kilometres in size have been observed in recent years at planetocentric latitude 35° south (corresponding to a planetographic latitude of 41° south). Here we report observations of a giant thunderstorm at planetocentric latitude 35° north that reached a latitudinal extension of 10,000 kilometres-comparable in size to a 'Great White Spot'-about three weeks after it started in early December 2010. The visible plume consists of high-altitude clouds that overshoot the outermost ammonia cloud layer owing to strong vertical convection, as is typical for thunderstorms. The flash rates of this storm are about an order of magnitude higher than previous ones, and peak rates larger than ten per second were recorded. This main storm developed an elongated eastward tail with additional but weaker storm cells that wrapped around the whole planet by February 2011. Unlike storms on Earth, the total power of this storm is comparable to Saturn's total emitted power. The appearance of such storms in the northern hemisphere could be related to the change of seasons, given that Saturn experienced vernal equinox in August 2009.

  14. Atmospheres of the Giant Planets

    NASA Technical Reports Server (NTRS)

    Ingersoll, Andrew P.

    2002-01-01

    The giant planets, Jupiter, Saturn, Uranus, and Neptune, are fluid objects. They have no solid surfaces because the light elements constituting them do not condense at solar-system temperatures. Instead, their deep atmospheres grade downward until the distinction between gas and liquid becomes meaningless. The preceding chapter delved into the hot, dark interiors of the Jovian planets. This one focuses on their atmospheres, especially the observable layers from the base of the clouds to the edge of space. These veneers arc only a few hundred kilometers thick, less than one percent of each planet's radius, but they exhibit an incredible variety of dynamic phenomena. The mixtures of elements in these outer layers resemble a cooled-down piece of the Sun. Clouds precipitate out of this gaseous soup in a variety of colors. The cloud patterns are organized by winds, which are powered by heat derived from sunlight (as on Earth) and by internal heat left over from planetary formation. Thus the atmospheres of the Jovian planets are distinctly different both compositionally and dynamically from those of the terrestrial planets. Such differences make them fascinating objects for study, providing clues about the origin and evolution of the planets and the formation of the solar system.

  15. Treatment of Giant Intracranial Aneurysms

    PubMed Central

    Lv, X.; Jiang, C.; Li, Y.; Yang, X.; Zhang, J.; Wu, Z.

    2009-01-01

    Summary We report on report the clinical outcome obtained in treatment of giant intracranial aneurysms (GAs). Between 2005 and 2007, 51 patients with 51 GAs presented at our hospital. Twentynine were treated with primary parent vessel occlusion without distal bypass and ten underwent treatment preserving the parent artery. Twelve patients could not be treated endovascularly. Selective embolization (including two remodeling techniques and two stent-coil embolizations) resulted in only one cure. Two patients died as a result of subarachnoid hemorrhage periprocedurely. Twenty-nine patients treated primarily with parent vessel occlusion and three patients treated with covered stent were considered cured after their treatments. Only one patient treated with parent vessel occlusion experienced ischemia during follow-up, which resulted in a mild neurological deficit. Of the twelve patients who could not be treated endovascularly, one succumbed to surgery, four died while being treated conservatively, and three were lost to follow-up. Parent artery occlusion, covered stent and coil occlusion provide effective protection against bleeding. In treatment of paraclinoid GAs of the internal carotid artery, the use of a stent, and stent-assisted coil embolization may be a pitfall. PMID:20465907

  16. Giant electrocaloric effect around Tc.

    PubMed

    Rose, Maimon C; Cohen, R E

    2012-11-02

    We use molecular dynamics with a first-principles-based shell model potential to study the electrocaloric effect (ECE) in lithium niobate, LiNbO(3), and find a giant electrocaloric effect along a line passing through the ferroelectric transition. With an applied electric field, a line of maximum ECE passes through the zero field ferroelectric transition, continuing along a Widom line at high temperatures with increasing fields, and along the instability that leads to homogeneous ferroelectric switching below T(c) with an applied field antiparallel to the spontaneous polarization. This line is defined as the minimum in the inverse capacitance under an applied electric field. We investigate the effects of pressure, temperature and an applied electric field on the ECE. The behavior we observe in LiNbO(3) should generally apply to ferroelectrics; we therefore suggest that the operating temperature for refrigeration and energy scavenging applications should be above the ferroelectric transition region to obtain a large electrocaloric response. The relationship between T(c), the Widom line, and homogeneous switching should be universal among ferroelectrics, relaxors, multiferroics, and the same behavior should be found under applied magnetic fields in ferromagnets.

  17. Red Giant Plunging Through Space

    NASA Technical Reports Server (NTRS)

    2006-01-01

    [figure removed for brevity, see original site] Poster Version

    This image from NASA's Spitzer Space Telescope (left panel) shows the 'bow shock' of a dying star named R Hydrae, or R Hya, in the constellation Hydra.

    Bow shocks are formed where the stellar wind from a star are pushed into a bow shape (illustration, right panel) as the star plunges through the gas and dust between stars. Our own Sun has a bow shock, but prior to this image one had never been observed around this particular class of red giant star.

    R Hya moves through space at approximately 50 kilometers per second. As it does so, it discharges dust and gas into space. Because the star is relatively cool, that ejecta quickly assumes a solid state and collides with the interstellar medium. The resulting dusty nebula is invisible to the naked eye but can be detected using an infrared telescope. This bow shock is 16,295 astronomical units from the star to the apex and 6,188 astronomical units thick (an astronomical unit is the distance between the sun and Earth). The mass of the bow shock is about 400 times the mass of the Earth.

    The false-color Spitzer image shows infrared emissions at 70 microns. Brighter colors represent greater intensities of infrared light at that wavelength. The location of the star itself is drawn onto the picture in the black 'unobserved' region in the center.

  18. The Giant Planet Satellite Exospheres

    NASA Technical Reports Server (NTRS)

    McGrath, Melissa A.

    2014-01-01

    Exospheres are relatively common in the outer solar system among the moons of the gas giant planets. They span the range from very tenuous, surface-bounded exospheres (e.g., Rhea, Dione) to quite robust exospheres with exobase above the surface (e.g., lo, Triton), and include many intermediate cases (e.g., Europa, Ganymede, Enceladus). The exospheres of these moons exhibit an interesting variety of sources, from surface sputtering, to frost sublimation, to active plumes, and also well illustrate another common characteristic of the outer planet satellite exospheres, namely, that the primary species often exists both as a gas in atmosphere, and a condensate (frost or ice) on the surface. As described by Yelle et al. (1995) for Triton, "The interchange of matter between gas and solid phases on these bodies has profound effects on the physical state of the surface and the structure of the atmosphere." A brief overview of the exospheres of the outer planet satellites will be presented, including an inter-comparison of these satellites exospheres with each other, and with the exospheres of the Moon and Mercury.

  19. Giant resonances of endohedral atoms

    NASA Astrophysics Data System (ADS)

    Amusia, M. Ya.; Baltenkov, A. S.; Chernysheva, L. V.

    2008-04-01

    It is demonstrated for the first time that the effect of a fullerene shell on the photoionization of a “caged” atom in an endohedral can result in the formation of giant endohedral resonances or GER. This is illustrated by the concrete case of the Xe@C60 photoionization cross section that, at 17 eV, exhibits a powerful resonance with total oscillator strengths of about 25. The prominent modification of the 5 p 6 electron photoionization cross section of Xe@C60 takes place due to the strong fullerene shell polarization under the action of the incoming electromagnetic wave and the oscillation of this cross section due to the reflection of the photoelectron from Xe by the C60. These two factors transform the smoothly decreasing 5 p 6 cross section of Xe into a rather complex curve with a powerful maximum for Xe@C60, with the oscillator strength of it being equal to 25. We also present the results for the dipole angular anisotropy parameter that is strongly affected by the reflection of the photoelectron waves, but not modified by C60 polarization.

  20. Giant resonances of endohedral atoms

    NASA Astrophysics Data System (ADS)

    Amusia, M. Ya.; Baltenkov, Arkadiy; Chernysheva, Larissa

    2008-05-01

    We demonstrate for that the effect of fullerene shell upon photoionization of the ``caged'' atom in an endohedral can result in formation of Giant Endohedral Resonances or GER. This is illustrated by the concrete case of Xe@C60 photoionization cross-section that exhibits at 17 eV a powerful resonance with total oscillator strengths of about 25. The prominent modification of the 5p^6 electron photoionization cross-section of Xe@C60 takes place due to strong fullerene shell polarization under the action of the incoming electromagnetic wave and oscillation of this cross-section due to the reflection of the photoelectron from Xe by the C60. These two factors transform the smoothly decreasing 5p^6 cross-section of Xe into a rather complex curve with a powerful maximum for Xe@C60, with the oscillator strength of it being equal to 25! We present also the results for the dipole angular anisotropy parameter that is strongly affected by the reflection of the photoelectron waves but not modified by C60 polarization.

  1. The "Giant Virus Finder" discovers an abundance of giant viruses in the Antarctic dry valleys.

    PubMed

    Kerepesi, Csaba; Grolmusz, Vince

    2017-02-28

    Mimivirus was identified in 2003 from a biofilm of an industrial water-cooling tower in England. Later, numerous new giant viruses were found in oceans and freshwater habitats, some of them having 2,500 genes. We have demonstrated their likely presence in four soil samples taken from the Kutch Desert (Gujarat, India). Here we describe a bioinformatics work-flow, called the "Giant Virus Finder" that is capable of discovering the likely presence of the genomes of giant viruses in metagenomic shotgun-sequenced datasets. The new workflow is applied to numerous hot and cold desert soil samples as well as some tundra- and forest soils. We show that most of these samples contain giant viruses, especially in the Antarctic dry valleys. The results imply that giant viruses could be frequent not only in aqueous habitats, but in a wide spectrum of soils on our planet.

  2. Giant elves: Lightning-generated electromagnetic pulses in giant planets.

    NASA Astrophysics Data System (ADS)

    Luque Estepa, Alejandro; Dubrovin, Daria; José Gordillo-Vázquez, Francisco; Ebert, Ute; Parra-Rojas, Francisco Carlos; Yair, Yoav; Price, Colin

    2015-04-01

    We currently have direct optical observations of atmospheric electricity in the two giant gaseous planets of our Solar System [1-5] as well as radio signatures that are possibly generated by lightning from the two icy planets Uranus and Neptune [6,7]. On Earth, the electrical activity of the troposphere is associated with secondary electrical phenomena called Transient Luminous Events (TLEs) that occur in the mesosphere and lower ionosphere. This led some researchers to ask if similar processes may also exist in other planets, focusing first on the quasi-static coupling mechanism [8], which on Earth is responsible for halos and sprites and then including also the induction field, which is negligible in our planet but dominant in Saturn [9]. However, one can show that, according to the best available estimation for lightning parameters, in giant planets such as Saturn and Jupiter the effect of the electromagnetic pulse (EMP) dominates the effect that a lightning discharge has on the lower ionosphere above it. Using a Finite-Differences, Time-Domain (FDTD) solver for the EMP we found [10] that electrically active storms may create a localized but long-lasting layer of enhanced ionization of up to 103 cm-3 free electrons below the ionosphere, thus extending the ionosphere downward. We also estimate that the electromagnetic pulse transports 107 J to 1010 J toward the ionosphere. There emissions of light of up to 108 J would create a transient luminous event analogous to a terrestrial elve. Although these emissions are about 10 times fainter than the emissions coming from the lightning itself, it may be possible to target them for detection by filtering the appropiate wavelengths. [1] Cook, A. F., II, T. C. Duxbury, and G. E. Hunt (1979), First results on Jovian lightning, Nature, 280, 794, doi:10.1038/280794a0. [2] Little, B., C. D. Anger, A. P. Ingersoll, A. R. Vasavada, D. A. Senske, H. H. Breneman, W. J. Borucki, and The Galileo SSI Team (1999), Galileo images of

  3. YOUNG SOLAR SYSTEM's FIFTH GIANT PLANET?

    SciTech Connect

    Nesvorny, David

    2011-12-15

    Studies of solar system formation suggest that the solar system's giant planets formed and migrated in the protoplanetary disk to reach the resonant orbits with all planets inside {approx}15 AU from the Sun. After the gas disk's dispersal, Uranus and Neptune were likely scattered by the gas giants, and approached their current orbits while dispersing the transplanetary disk of planetesimals, whose remains survived to this time in the region known as the Kuiper Belt. Here we performed N-body integrations of the scattering phase between giant planets in an attempt to determine which initial states are plausible. We found that the dynamical simulations starting with a resonant system of four giant planets have a low success rate in matching the present orbits of giant planets and various other constraints (e.g., survival of the terrestrial planets). The dynamical evolution is typically too violent, if Jupiter and Saturn start in the 3:2 resonance, and leads to final systems with fewer than four planets. Several initial states stand out in that they show a relatively large likelihood of success in matching the constraints. Some of the statistically best results were obtained when assuming that the solar system initially had five giant planets and one ice giant, with the mass comparable to that of Uranus and Neptune, and which was ejected to interstellar space by Jupiter. This possibility appears to be conceivable in view of the recent discovery of a large number of free-floating planets in interstellar space, which indicates that planet ejection should be common.

  4. Cytoreductive strategy for multiple intra-abdominal and abdominal wall desmoid tumors in familial adenomatous polyposis: report of three cases.

    PubMed

    Tanaka, Koji; Toiyama, Yuji; Okugawa, Yoshinaga; Hiro, Junichiro; Kawamoto, Aya; Inoue, Yasuhiro; Uchida, Keiichi; Araki, Toshimitsu; Mohri, Yasuhiko; Kusunoki, Masato

    2012-10-01

    Desmoid tumors (DTs) are benign myofibroblastic neoplasms originating from the fascia or muscle aponeurosis, which occur in one-third of patients with familial adenomatous polyposis (FAP). Most FAP-associated DTs occur in the intra-abdominal or abdominal wall region, thus, their infiltrative or expansive growth causes life-threatening organ damage, such as intestinal obstruction, urethral obstruction, and mesenteric infiltration with the involvement of mesenteric vessels. Treatments including surgical resection, cytotoxic chemotherapy, nonsteroidal anti-inflammatory drugs and anti-estrogen therapy have all been tried with variable success. Here, we report on three patients with FAP who developed multiple intra-abdominal and abdominal wall DTs after total proctocolectomy and ileal pouch-anal anastomosis. Two cases underwent surgical resection of uncontrolled abdominal wall DTs after successful control of intra-abdominal DTs by systemic chemotherapy. The remaining case underwent repeated surgical resections of multiple intra-abdominal and abdominal wall DTs, and consequently had recurrent intra-abdominal DTs, with involvement of the small bowel and ureter. Surgical intervention as tumor volume reduction (cytoreduction) may be useful for cases with medical treatment-refractory or symptomatic FAP-associated abdominal DTs.

  5. Standard versus Abdominal Lifting and Compression CPR

    PubMed Central

    Liu, Qing; Han, Shupeng; Zhang, Ziran; Zhang, Yan; Liu, Yahua; Li, Jing

    2016-01-01

    Background. This study compared outcomes of abdominal lifting and compression cardiopulmonary resuscitation (ALP-CPR) with standard CPR (STD-CPR). Materials and Methods. Patients with cardiac arrest seen from April to December 2014 were randomized to receive standard CPR or ALP-CPR performed with a novel abdominal lifting/compression device. The primary outcome was return of spontaneous circulation (ROSC). Results. Patients were randomized to receive ALP-CPR (n = 40) and STD-CPR (n = 43), and the groups had similar baseline characteristics. After CPR, 9 (22.5%) and 7 (16.3%) patients in the ALP-CPR and STD-CPR groups, respectively, obtained ROSC. At 60 minutes after ROSC, 7 (77.8%) and 2 (28.6%) patients, respectively, in the ALP-CPR and STD-CPR groups survived (P = 0.049). Patients in the ALP-CPR group had a significantly higher heart rate and lower mean arterial pressure (MAP) than those in the STD-CPR group (heart rate: 106.8 versus 79.0, P < 0.001; MAP: 60.0 versus 67.3 mm Hg, P = 0.003). The posttreatment PCO2 was significantly lower in ALP-CPR group than in STD-CPR group (52.33 versus 58.81, P = 0.009). PO2 was significantly increased after ALP-CPR (45.15 to 60.68, P < 0.001), but it was not changed after STD-CPR. PO2 after CPR was significantly higher in the ALP-CPR group (60.68 versus 44.47, P < 0.001). There were no differences between genders and for patients who are > 65 or ≤ 65 years of age. Conclusions. The abdominal lifting and compression cardiopulmonary resuscitation device used in this study is associated with a higher survival rate after ROSC than standard CPR. PMID:27882073

  6. Duodenal perforation as result of blunt abdominal trauma in childhood.

    PubMed

    Hartholt, Klaas Albert; Dekker, Jan Willem T

    2015-12-23

    Blunt abdominal trauma may cause severe intra-abdominal injuries, while clinical findings could be mild or absent directly after the trauma. The absence of clinical findings could mislead physicians into underestimating the severity of the injury at the primary survey, and inevitably leads to a delay in the diagnosis. The Blunt Abdominal Trauma in Children (BATiC) score may help to identify children who are at a high risk for intra-abdominal injuries in an early stage and requires additional tests directly. A case of a 10-year-old girl with a duodenal perforation after a blunt abdominal trauma is presented. A delay in diagnosis may lead to an increased morbidity and mortality rate. A low admission threshold for children with abdominal pain after a blunt trauma is recommended.

  7. Vertically transmitted hypoplasia of the abdominal wall musculature.

    PubMed

    Chan, Yuin-Chew; Bird, Lynne M

    2004-01-01

    The prune belly syndrome (OMIM 100100) is an association of bladder dilation with hypoplasia of the abdominal wall muscles. This malformation sequence is due to early urethral obstruction. We report a family with abdominal wall muscular hypoplasia as an isolated defect, not associated with the urethral obstruction sequence. The proband is a q3-year-old male who presented with abdominal wall laxity and severe constipation. His mother, maternal grandmother and younger brother had varying degrees of abdominal wall muscular deficiency and constipation. His mother's condition was aggravated by her 2 pregnancies. This family shows vertical transmission (compatible with autosomal dominant or mitochondrial inheritance) of the abdominal phenotype of prune belly sequence without any evidence of urinary tract or renal pathology. The expression in the sons may remain incomplete because abdominal distention due to pregnancy will not occur.

  8. [Unusual abdominal complication of ventriculoperitoneal shunt].

    PubMed

    Guillén, A; Costa, J M; Castelló, I; Claramunt, E; Cardona, E

    2002-10-01

    The most common complications after CSF shunting to treat hydrocephalus are shunt infection and obstruction. Although ventriculoperitoneal (VP) diversion of the CSF using artificial shunt devices is an accepted method for the management of hydrocephalus, high rates of various complications have been reported, ranging from 24% to 47%. Among these, abdominal complications account for approximately 25%. The incidence of bowel perforation by shunt-catheter is known to be as low as 0.1-0.7%. We describe a case of migration af a peritoneal catheter through a congenital hernia of Morgagni.

  9. Should intensivist do routine abdominal ultrasound?

    PubMed Central

    Samanta, Sukhen; Samanta, Sujay; Soni, Kapil Dev; Aggarwal, Richa

    2015-01-01

    Roundworm infestation is common in tropical climate population with a low socioeconomic status. We describe a case of a young male with polytrauma accident who presented with small bowel dysfunction with a high gastric residual volume during enteral feeding. While searching the etiology, the intensivist performed bedside abdominal ultrasound (USG) as a part of whole body USG screening along with clinical examination using different frequency probes to examine bowel movement and ultimately found ascariasis to be the cause. This case report will boost up the wide use of bedside USG by critical care physicians in their patient workup. PMID:26430346

  10. Abdominal vascular syndromes: characteristic imaging findings.

    PubMed

    Cardarelli-Leite, Leandro; Velloni, Fernanda Garozzo; Salvadori, Priscila Silveira; Lemos, Marcelo Delboni; D'Ippolito, Giuseppe

    2016-01-01

    Abdominal vascular syndromes are rare diseases. Although such syndromes vary widely in terms of symptoms and etiologies, certain imaging findings are characteristic. Depending on their etiology, they can be categorized as congenital-including blue rubber bleb nevus syndrome, Klippel-Trenaunay syndrome, and hereditary hemorrhagic telangiectasia (Rendu-Osler-Weber syndrome)-or compressive-including "nutcracker" syndrome, median arcuate ligament syndrome, Cockett syndrome (also known as May-Thurner syndrome), and superior mesenteric artery syndrome. In this article, we aimed to illustrate imaging findings that are characteristic of these syndromes, through studies conducted at our institution, as well as to perform a brief review of the literature on this topic.

  11. Abdominal Wall Haematoma Complicating Laparoscopic Cholecystectomy

    PubMed Central

    Tate, J. J. T.; Davidson, B. R.; Hobbs, K. E. F.

    1994-01-01

    Of 61 consecutive patients undergoing laparoscopic cholecystectomy, 4 (6.25%) developed abdominal wall haematomas. This complication of laparoscopic cholecystectomy may occur more commonly than existing literature suggests, and manifests in the post-operative period (days 2 to 6) by visible bruising, excessive pain or an asymptomatic drop in haematocrit. It is readily confirmed by ultrasonography. While no specific treatment is necessary apart from replacement of significant blood loss, the patient requires reassurance that this apparently alarming complication will rapidly resolve. PMID:8204548

  12. Surrogate Markers of Abdominal Aortic Aneurysm Progression.

    PubMed

    Wanhainen, Anders; Mani, Kevin; Golledge, Jonathan

    2016-02-01

    The natural course of many abdominal aortic aneurysms (AAA) is to gradually expand and eventually rupture and monitoring the disease progression is essential to their management. In this publication, we review surrogate markers of AAA progression. AAA diameter remains the most widely used and important marker of AAA growth. Standardized reporting of reproducible methods of measuring AAA diameter is essential. Newer imaging assessments, such as volume measurements, biomechanical analyses, and functional and molecular imaging, as well as circulating biomarkers, have potential to add important information about AAA progression. Currently, however, there is insufficient evidence to recommend their routine use in clinical practice.

  13. Standing diagnostic and therapeutic equine abdominal surgery.

    PubMed

    Graham, Sarah; Freeman, David

    2014-04-01

    The widespread use of laparoscopy in equine surgery has increased interest in the standing approach to a wide range of procedures typically regarded as feasible only through a ventral midline incision. Although a commonly cited benefit of standing surgery relates to avoiding costs of general anesthesia and risks associated with it, some procedures and horses are not suitable candidates for standing abdominal procedures. Some procedures, such as nephrectomy, colostomy, and closure of the nephrosplenic space, are not only suitable for standing surgery but are performed more easily and more safely through this approach than with general anesthesia.

  14. THE PRESENT STATUS OF ABDOMINAL FASCIAL TRANSPLANTS

    PubMed Central

    Lowman, C. L.

    1949-01-01

    In recent years improvements have been made in techniques for transplanting fascia into the muscles of the abdomen to take over the function of paralyzed muscles. The techniques are described in this presentation. Since muscular coordination of pelvis and thorax plays an important part in control of the extremities, better methods of placing transplants across the abdomen to link these regions offer, coincidentally, the benefit of better use of muscles in the arms and legs. If done early and skillfully, abdominal fascial transplants and allied transplants not only aid in restoring function but often prevent deformities. PMID:18149114

  15. Isolated Abdominal Wall Metastasis of Endometrial Carcinoma

    PubMed Central

    Simões, Jorge; Gonçalves, Matilde; Matos, Isabel

    2014-01-01

    A woman in her mid-60s presented with a bulky mass on the anterior abdominal wall. She had a previous incidental diagnosis of endometrial adenocarcinoma FIGO stage IB following a vaginal hysterectomy. Physical exam and imaging revealed a well circumscribed bulging tumour at the umbilical region, measuring 10 × 9 × 9 cm, with overlying intact skin and subcutaneous tissue. Surgical resection was undertaken, and histological examination showed features of endometrial carcinoma. She began chemotherapy and is alive with no signs of recurrent disease one year after surgery. This case brings up to light an atypical location of a solitary metastasis of endometrial carcinoma. PMID:25349753

  16. Abdominal Pain Caused by a Potentially Fatal Attraction.

    PubMed

    Mercurio, Danielle Claire; Scace, Candace; Shah, Bhairav; Weiner, Evan; Prasad, Rajeev

    2016-11-19

    Abdominal pain is a challenging presentation in children. Examination findings and etiology vary greatly, spanning a vast spectrum from flatulence to frank peritonitis with septic shock. Here, we discuss a 10-year-old boy with 24 hours of progressively worsening lower abdominal pain, nausea, and subjective fevers. History and physical examination findings were consistent with appendicitis. However, physicians were surprised when the single-view abdominal radiograph showed an unanticipated, somewhat perplexing discovery.

  17. Modern reconstructive techniques for abdominal wall defects after oncologic resection.

    PubMed

    Khansa, Ibrahim; Janis, Jeffrey E

    2015-04-01

    Resection of abdominal wall tumors often leaves patients with debilitating soft tissue defects. Modern reconstructive techniques can be used to restore abdominal wall integrity. In this article, we present an overview of preoperative patient evaluation, analysis of the defect, surgical planning, and the spectrum of available surgical techniques, ranging from simple to complex. The established clinical evidence in the field of abdominal wall reconstruction is summarized and a case example is provided.

  18. Wireless system for monitoring Intra-abdominal pressure in patient with severe abdominal pathology

    NASA Astrophysics Data System (ADS)

    Sokolovskiy, S. S.; Shtotskiy, Y. V.; Leljanov, A. D.

    2017-01-01

    The paper discusses an experimental design of the wireless system for monitoring intra-abdominal pressure (IAP) using Bluetooth Low Energy technology. The possibility of measuring IAP via the bladder using a wireless pressure sensor with a hydrophobic bacteria filter between the liquid transmitting medium and the sensor element is grounded.

  19. [Abdominal artery aneurysm and associated surgical abdominal diseases: towards optimal timing].

    PubMed

    Stilo, Francesco; Mirenda, Francesco; Mandolfino, Tommaso; La Spada, Michele; D'Alfonso, Mario; Carmignani, Amedeo; De Caridi, Giovanni; Benedetto, Filippo; Spinelli, Francesco

    2003-01-01

    The purpose of this study was to assess which modalities offered the best timing in the treatment of abdominal aortic aneurysms associated with other abdominal surgical diseases. From January 1984 to December 2002, 372 patients underwent surgery for abdominal aortic aneurysms, 350 men (94%) and 22 women (6%), mean age 72 years. Of these 10% were operated on urgently. The traditional open technique was used in 307 patients, and the endovascular method in the remaining 65 cases. In 40 patients (11%) we observed other associated abdominal diseases which were treated during the same operation in 34 cases (85%). We had three deaths in the 34 cases treated in the same operation (9%). In the remaining cases no perioperative mortality was registered. There were no cases of prosthesis infection. The mean hospital stay was 9 days. Simultaneous treatment appears, on the one hand, to carry an increased operative risk and increased mortality and, on the other, to present the advantage of having to perform only one surgical procedure. The advent of the endovascular method allows us to postpone the treatment of the associated disease without increasing the technical difficulty of the second operation.

  20. Intra-abdominal pulmonary secuestration as an exceptional cause of abdominal mass in the adult☆

    PubMed Central

    Moreno-Sanz, C.; Herrero Bogajo, M.L.; Picazo-Yeste, J.; Morandeira Rivas, A.; Manzanera-Diaz, M.; Sedano-Vizcaino, C.

    2013-01-01

    INTRODUCTION Pulmonary sequestration (PS) is an extremely rare malformation defined as a portion of lung tissue isolated from the pulmonary system. PSs are classified into intralobar type and intra-abdominal PS that represents only 2.5% of cases. There are 20 cases of PS reported in adults and only two were managed by laparoscopic approach. We report a case of intra-abdominal PS mimicking a gastroesophageal duplication cyst in an adult. Besides its rarity, this is the first intra-abdominal PS in an adult managed by an anterior laparoscopic approach. PRESENTATION OF CASE A 60-year-old female patient had had epigastric and left upper quadrant pain for several days. Physical examination was normal. Image test were consistent with a gastroesophageal duplication. The patient was taken to the operating room for laparoscopic exploration and resection. The pathological diagnosis was extralobar pulmonary sequestration. DISCUSSION Less than 20 cases of PS have been reported in adults and only two cases were managed by a lateral laparoscopic approach. In contrast to these reports, we used an anterior approach due to the GEJ suspected origin of the mass. CONCLUSION Extralobar intra-abdominal PS is an extremely rare condition during adulthood but this diagnosis should be included in the differential diagnosis of a left-sided suprarenal mass. Due to the difficulty in achieving a definitive preoperative diagnosis, surgery is recommended. Laparoscopic resection is safe and effective but careful preoperative imaging studies are recommended in order to plan the most suitable approach. PMID:24091075