Science.gov

Sample records for spontaneous uterine rupture

  1. [Spontaneous uterine rupture due to uterine leiomyosarcoma].

    PubMed

    Boussouni, Khouloud; Benoulaid, Meryem; Dafiri, Rachida

    2016-01-01

    Uterine sarcomas are rare cancers characterized by clinical and histological polymorphism. They are malignant tumors of poor prognosis. Inaugural manifestation of acute abdomen with hemo-pneumoperitoneum and spontaneous uterine rupture remains exceptional. The authors report the case of a uterine leiomyosarcoma manifesting itself as an inaugural generalized acute peritonitis in a 43 year old woman. Uterine rupture due to malignant tumor was suspected during urgent preoperative imaging (ultrasound and CT scan) and confirmed histologically. PMID:27642425

  2. Spontaneous rupture of uterine leiomyoma during labour.

    PubMed

    Ramskill, Nikki; Hameed, Aisha; Beebeejaun, Yusuf

    2014-09-08

    Uterine rupture in labour requires an emergency caesarean section. In women with a uterine scar, either from gynaecological surgery or from a previous caesarean section, it is well documented that the risk of rupture is higher than in those without. Spontaneous uterine rupture in a uterus with fibroids during pregnancy or labour is extremely rare. We present a case of a 33-year-old, unbooked pregnant woman from Nigeria who had a uterine rupture secondary to fibroids. She required an emergency caesarean section in labour. The fibroids were not removed. Her baby was born alive and in good condition and she made an uneventful recovery.

  3. Spontaneous rupture of uterine leiomyoma during labour

    PubMed Central

    Ramskill, Nikki; Hameed, Aisha; Beebeejaun, Yusuf

    2014-01-01

    Uterine rupture in labour requires an emergency caesarean section. In women with a uterine scar, either from gynaecological surgery or from a previous caesarean section, it is well documented that the risk of rupture is higher than in those without. Spontaneous uterine rupture in a uterus with fibroids during pregnancy or labour is extremely rare. We present a case of a 33-year-old, unbooked pregnant woman from Nigeria who had a uterine rupture secondary to fibroids. She required an emergency caesarean section in labour. The fibroids were not removed. Her baby was born alive and in good condition and she made an uneventful recovery. PMID:25199188

  4. MRI diagnosis of spontaneous uterine rupture of an unscarred uterus.

    PubMed

    Hruska, Karim M; Coughlin, Bret F; Coggins, Allahna A; Wiczyk, Halina P

    2006-05-01

    Spontaneous uterine rupture is a rare, potentially catastrophic complication of pregnancy, and its prompt diagnosis and treatment are essential in limiting morbidity and mortality. Clinical diagnosis is difficult and relies heavily on diagnostic imaging. Radiological diagnosis is also often difficult with most documented cases involving the use of ultrasound and computed tomography. Although magnetic resonance imaging (MRI) is being used more frequently to assess patients, there are few reports illustrating the utility of MRI and its advantages over other imaging modalities in the diagnosis of uterine rupture. This report documents a case of spontaneous uterine rupture diagnosed by MRI in a postpartum patient with an unscarred uterus.

  5. Spontaneous Uterine Rupture of an Unscarred Uterus before Labour.

    PubMed

    Guèye, Mamour; Mbaye, Magatte; Ndiaye-Guèye, Mame Diarra; Kane-Guèye, Serigne Modou; Diouf, Abdoul Aziz; Niang, Mouhamadou Mansour; Diaw, Hannegret; Moreau, Jean Charles

    2012-01-01

    Uterine rupture is a public health problem in developing countries. When it is spontaneous, it occurs most often during labor in a context of scarred uterus. Uterine rupture during pregnancy is a rare situation. The diagnosis is not always obvious and morbidity and maternal and fetal mortality is still high. We report a case of spontaneous uterine rupture during pregnancy at 35 weeks of an unscarred uterus before labour. This is an exceptional case that we observe for the first time in our unit.

  6. Spontaneous uterine rupture at 32 weeks of gestation after previous uterine artery embolization.

    PubMed

    Takeda, Jun; Makino, Shintaro; Ota, Atsuyuki; Tawada, Tetsuo; Mitsuhashi, Naoki; Takeda, Satoru

    2014-01-01

    Uterine artery embolization (UAE) is a common treatment for post-partum hemorrhage and uterine fibroids. However, the effects of UAE on subsequent pregnancies have not been established. Here, we present a case of spontaneous uterine rupture after previous UAE. A 31-year-old woman underwent UAE for a cervical ectopic pregnancy. Contrast-enhanced magnetic resonance imaging (MRI) at days 5 and 25 post-UAE suggested a regionally decreased blood supply in the mid-posterior wall of the uterine fundus. During a subsequent pregnancy at age 35 years, she underwent an emergency cesarean delivery due to spontaneous uterine rupture at the mid-posterior wall of the uterus at 32 weeks of gestation. Obstetricians should be attentive to the possibility of spontaneous uterine rupture in pregnant women who have previously undergone UAE. Detection of ischemic uterine muscle on MRI may predict potential for uterine rupture in a subsequent pregnancy.

  7. Silent Spontaneous Uterine Rupture at 36 Weeks of Gestation

    PubMed Central

    Woo, J. Y.; Tate, L.; Roth, S.; Eke, A. C.

    2015-01-01

    Introduction. Silent spontaneous rupture of the uterus before term, with extrusion of an intact amniotic sac and delivery of a healthy neonate, with no maternal or neonatal morbidity or mortality is very rare. Very few cases have been reported in literature. Case Presentation. We report a case of silent spontaneous uterine rupture, found during a scheduled repeat cesarean section at 36 weeks of gestation. Patient had history of two prior classical cesarean sections. She underwent cesarean section, with delivery of a healthy male infant. She had a good postoperative recovery and was discharged on postoperative day 3. Conclusion. Silent spontaneous rupture of the uterus before term with extrusion of an intact amniotic sac is rare. A high index of suspicion and good imaging during pregnancy are important in making this diagnosis. PMID:26357580

  8. Spontaneous Rupture of Uterine Vein in Twin Pregnancy

    PubMed Central

    Doger, Emek; Cakiroglu, Yigit; Yildirim Kopuk, Sule; Akar, Bertan; Caliskan, Eray; Yucesoy, Gulseren

    2013-01-01

    Objective. Aim of our study is to present a case of a twin pregnancy following invitro fertilization cycle complicated with hemoperitoneum at third trimester. Case. A 26-year-old nulliparous pregnant woman at 32 weeks of gestation with twin pregnancy following invitro fertilization cycle complained of abdominal pain. After 48 hours of admission, laparotomy was performed with indications of aggravated abdominal pain and decreased hemoglobin levels. Utero-ovarian vein branch rupture was detected on the right posterior side of uterus and bleeding was stopped by suturing the vein. Etiopathogenesis of the present case still remains unclear. Conclusion. Spontaneous rupture of the uterine vessels during pregnancy is a rare complication and may lead to maternal and fetal morbidity and mortality. Diagnosis and treatment are based on the clinical symptoms of acute abdominal pain and laboratory tests of hypovolemic shock signs. PMID:24455353

  9. [Spontaneous uterine rupture in third trimester twin ivf pregnancy following myomectomy].

    PubMed

    Tsankova, M; Nikolov, A; Bosev, D; Pirnareva, E

    2012-01-01

    Uterine rupture is one of the most serious complications of pregnancy, causing maternal and perinatal death. An increased risk of uterine rupture is associated with uterine scars caused by previous cesarean section, myomectomy, hysteroscopic procedures and ART treatment. We report a case of 35-year-old nulliparous woman with a twin pregnancy who experienced a spontaneous uterine rupture at 30 weeks' gestation. She had a previous history of one opened myomectomy, two laporoscopic procedures for extrauterine pregnancy and myomectomy in the left uterine corn. Her pregnancy was established with in vitro fertilization 14 months after the laparoscopic myomectomy. The uterine rupture was heralded by a sudden onset of severe abdominal pain while she was having a routine exam. This case reinforces that pregnancy after myomectomy should be closely monitored with respect to uterine rupture.

  10. Spontaneous uterine rupture in the 35th week of gestation after laparoscopic adenomyomectomy.

    PubMed

    Nagao, Yukari; Osato, Kazuhiro; Kubo, Michiko; Kawamura, Takuya; Ikeda, Tomoaki; Yamawaki, Takaharu

    2016-01-01

    Uterine rupture rarely occurs during pregnancy, but it is a critical situation if so. It is already known that a history of uterine surgeries, such as cesarean section or myomectomy, is a risk factor for uterine rupture. Currently, the laparoscopic adenomyomectomy is a widely performed procedure, but associated risks have not been defined. We observed a case of spontaneous uterine rupture in a patient during the 35th week of gestation, after a laparoscopic adenomyomectomy. A 42-year-old, gravida 2, para 0 woman became pregnant after a laparoscopic adenomyomectomy and her pregnancy was conventional. At a scheduled date in the 35th week of gestation, after combined spinal epidural anesthesia and frequent uterine contractions, a weak pain suddenly ensued. After 13 minutes of uterine contractions, vaginal bleeding was evident. A cesarean section was performed, and the uterine rupture was found in the scar. After a laparoscopic adenomyomectomy, a pregnant uterus can easily rupture by rather weak and short uterine contractions, and is characterized by vaginal bleeding. When uterine bleeding is observed in pregnant women that have a history of adenomyomectomy, one should consider uterine rupture.

  11. Asymptomatic spontaneous complete uterine rupture in a term pregnancy after uterine packing during previous caesarean section: a case report.

    PubMed

    Zhang, J; Chen, S F; Luo, Y E

    2014-01-01

    Uterine rupture is a life-threatening obstetrical complication with significant neonatal and maternal morbidity. The authors report a 36-year-old woman with a history of previous caesarean section because of pre-eclampsia and antepartum haemorrhage at 31 gestational weeks during her first pregnancy. Postpartum haemorrhage occurred and the uterine cavity was packed with gauze for reducing blood loss. After two years, she underwent elective, repeat caesarean section at 38+1 gestational weeks with no abdominal pain or vaginal bleeding. During the operation, a six- to seven-cm-long defect was found in the lower uterine segment, with complete separation of the uterine scar and disruption of the visceral peritoneum. A live baby was delivered. The postoperative course was uneventful. Uterine dehiscence and rupture should be suspected in the presence of risk factors such as previous caesarean section, especially uterine packing involved. Spontaneous silent rupture can occur in women without any alarming symptoms.

  12. [Spontaneous uterine rupture of an unscarred uterus during labor: case report and review of the literature].

    PubMed

    Fatfouta, I; Villeroy de Galhau, S; Dietsch, J; Eicher, E; Perrin, D

    2008-04-01

    Uterine rupture during labor is a serious and uncommon obstetrical complication that can lead to severe prognosis for the mother and her child if not immediately diagnosed and treated. Most spontaneous uterine ruptures occur during labor in parturients with a scarred uterus and are much rarer on an unscarred uterus. We report the case of a uterine rupture on unscarred uterus to a 32 year-old woman after a labor induced by intravaginal prostaglandin and intravenous ocytocine injection. Our management is compared with the data from literature.

  13. Spontaneous rupture of uterus in midtrimester pregnancy due to increased uterine pressure with previous laparoscopic myomectomy.

    PubMed

    Kiseli, Mine; Artas, Hakan; Armagan, Figen; Dogan, Zeynep

    2013-10-01

    Uterine rupture is a life threatening condition for both the mother and her fetus. It may be seen in the second trimester usually after induction for pregnancy termination in a scarred uterus. Spontaneous rupture in the second trimester before labor is a very rare condition. Here, we report a case of uterine rupture at 23-week pregnancy due to elevated uterine pressure with a history of laparoscopic myomectomy one year before admission. She was symptomatic for diffuse abdominal pain and the ultrasonographic image was interpreted as amniotic band. Four days later, because of deterioration of the patient and fetal bradycardia urgent laparotomy was performed. Fundal rupture with fibrotic borders suggested that a chronic event was seen. Laparoscopic myomectomy has advantages over laparatomy but the possibility of uterine rupture in following pregnancies should not be underestimated. Therefore, repair of the myometrium should be carefully assessed.

  14. Spontaneous rupture of uterine varicose veins: a rare cause for obstetric shock.

    PubMed

    Lim, Pei Shan; Ng, Soon Pheng; Shafiee, Mohammad Nasir; Kampan, Nirmala; Jamil, Muhammad Abdul

    2014-06-01

    Spontaneous rupture of uterine surface varicose veins is rare but may result in serious complication of pregnancy, as it is associated with high perinatal and maternal mortality. We report a 24-year-old primigravida who presented with this rare condition mimicking placenta abruption, which was successfully managed. A review of reported cases was performed.

  15. Spontaneous Complete Uterine Rupture in a Nonlaboring, Early Third-trimester Uterus: Missed Diagnosis by Ultrasound.

    PubMed

    Dixon, Luke; Carlan, S J; O'Leary, T D; Perez, Jose

    2013-10-01

    Objective Describe potential consequences and remedy for not intermittently auscultating fetal heart tones during travel to the imaging department and misdiagnosing a ruptured uterus on ultrasound as a synechiae. Study Design Retrospective chart review of case. Results Spontaneous uterine rupture in pregnancy is a rare and catastrophic event. Fetal monitoring is an important component for diagnosis, but fetal heart auscultation is usually discontinued while the patient is receiving imaging. We present a ruptured uterus at 28 weeks with delayed diagnosis secondary to interrupted fetal heart tone auscultation and a misdiagnosis of a rupture as a synechiae resulting in a seriously compromised newborn at delivery. Conclusion Intermittent fetal heart tone auscultation is a possible method of monitoring when the patient is off continuous fetal monitoring.

  16. Spontaneous prelabor uterine rupture in a primigravida: a case report and review of the literature.

    PubMed

    Uccella, Stefano; Cromi, Antonella; Bogani, Giorgio; Zaffaroni, Eleonora; Ghezzi, Fabio

    2011-11-01

    A rare case of prelabor uterine rupture in a primigravida was reported. A woman with a history of uterine perforation during hysteroscopy became pregnant after donor oocyte in vitro fertilization. To provide more insight into the possible risk factors for prelabor uterine rupture in primigravidae, a literature review was performed.

  17. Early second trimester uterine scar rupture.

    PubMed

    Bharatnur, Sunanda; Hebbar, Shripad; Shyamala, G

    2013-12-10

    Spontaneous uterine scar rupture can be lethal in pregnant women. A spontaneous uterine scar rupture in the early mid-trimester is rare and difficult to diagnose. This is a case of a 30-year-old woman (G2P1L1) at 19 weeks of gestation and having undergone a previous caesarean section presented with acute abdomen in shock. Laparotomy revealed a uterine scar rupture, which was resutured after evacuation of products of conception. This case merits that the uterine rupture should be considered as a differential diagnosis in pregnant women presenting with acute abdomen. In this case, although there was uterine rupture in the second trimester and a complete placental separation, fetus was alive which is quite unusual in patients presenting with rupture uterus.

  18. [Bilateral uterine rupture of an unscarred gravid uterus before labor].

    PubMed

    Leroux, M; Coatleven, F; Faure, M; Horovitz, J

    2014-06-01

    We report a case of bilateral spontaneous uterine rupture of an unscarred uterus occured in a primigravida at 32 weeks to take care in our department after in utero transfert. Uterine rupture occurs mainly on scarred uterus during labor. This is an unfrequent but serious complication involving fetal-maternal prognosis in the absence of immediate care. We are conducting a review about spontaneous uterine rupture of unscarred uterus, before and during labor.

  19. UTERINE RUPTURE FOLLOWING MYOMECTOMY IN THIRD TRIMESTER.

    PubMed

    Djaković, Ivka; Rudman, Senka Sabolović; Kosec, Vesna

    2015-12-01

    Rupture of gravid uterus is surgical emergency causing maternal and fetal morbidity and mortality. The risk of uterine rupture is associated with uterine scars caused by previous cesarean section, myomectomy, hysteroscopic procedures, and curettage. We report a case of a 40-year-old woman in 31st week of gestation with spontaneous uterine rupture. It was her third pregnancy. She had two healthy children from previous pregnancies. Her symptoms were abdominal pain, vomiting and pain in the right shoulder lasting for 12 hours prior to admission. Ultrasound examination at admission revealed a dead fetus in the abdomen and free fluid in the abdominal cavity. She had previously undergone laparoscopic myomectomy. After myomectomy, she had one successful vaginal delivery. Every abdominal pain in pregnant woman with uterine scar should be carefully and promptly examined to exclude uterine rupture before further diagnostic procedures. This early time frame is essential for survival of the fetus and sometimes even of the mother. Uterine rupture represents indication for immediate cesarean section and it should be performed within 25 minutes of the first signs of uterine rupture. As shown in the case presented, one successful vaginal delivery after myomectomy is no guarantee for future pregnancies.

  20. Spontaneous uterine rupture in a primigravid woman in the early third trimester attributed to adenomyosis: a case report and review of the literature.

    PubMed

    Nikolaou, Marinos; Kourea, Helen P; Antonopoulos, Kostas; Geronatsiou, Katerina; Adonakis, George; Decavalas, George

    2013-03-01

    We report a rare case of spontaneous uterine rupture of an unscarred uterus caused by adenomyosis in the early third trimester. A 33-year-old primigravid woman was referred to our department because of severe acute abdominal pain and signs and symptoms of hemorrhagic shock. Ultrasound exanimation performed at admission revealed a living, intrauterine fetus of 28 weeks gestational age with reduced amniotic fluid and presence of free peritoneal fluid. The fetal heart rate was non-reassuring with variable decelerations and severe fetal bradycardia. Emergency cesarean section revealed massive hemoperitoneum and complete rupture in the uterine fundus. Subtotal peripartum hysterectomy with conservation of adnexae was performed. Histological examination revealed adenomyosis at the site of uterine rupture.

  1. Spontaneous uterine rupture at 14 weeks gestation during a pregnancy consecutive to an oocyte donation in a woman with Turner's syndrome.

    PubMed

    Masia, Florent; Zoric, Lana; Ripart-Neveu, Sylvie; Marès, Pierre; Ripart, Jacques

    2015-04-01

    We describe a spontaneous uterine rupture at 14 weeks gestation in a Turner patient. A 39 year-old patient was admitted for abdominal pain and hypotension at 14 weeks of pregnancy. The pregnancy had been obtained by oocyte donation and in vitro fertilization (IVF) because of Turner's syndrome. The abdominal ultrasound scan showed a normal pregnancy and a conserved foetal cardiac activity. It also showed a large amount of free fluid in the perihepatic space. Haemoglobin was 11.2 g/dL. After hemodynamic degradation, urgent laparoscopy showed an unrepairable uterine rupture with partial exteriorisation of the pregnancy, and placenta percreta. Urgent conversion to laparotomy allowed haemostatic hysterectomy. Uterine rupture during pregnancy obtained by oocyte donation in Turner's syndrome may be life threatening. The possibility of such a complication should be considered before oocyte donation for IVF in Turner's patients. Early spontaneous uterine rupture (second trimester) is a challenging diagnostic that should be evoked in case of non-specific abdominal pain in the presence of risk factors. PMID:25858617

  2. [Spontaneous rupture of the unscarred uterus during labor. Case report].

    PubMed

    Leung, F; Courtois, L; Aouar, Z; Bourtembourg, A; Eckman, A; Terzibachian, J J; Maillet, R; Riethmuller, D

    2009-04-01

    We report a case of spontaneous uterine rupture in a 19 year-old patient Gravida 1 para 2 with no past history of uterine surgery. The diagnosis of uterine rupture, evoked in the early post-partum in the presence of acute abdominal pain, collapsus and haemoperitoneum on ultrasonography, was confirmed by laparotomy. Treatment consisted in hysterorrhaphy. The etiopathogenesis, clinical and therapeutical aspects of spontaneous unscarred uterine ruptures are discussed throughout a literature review.

  3. Identifying risk factors for uterine rupture.

    PubMed

    Smith, Jennifer G; Mertz, Heather L; Merrill, David C

    2008-03-01

    Uterine rupture, whether in the setting of a prior uterine incision or in an unscarred uterus, is an obstetric emergency with potentially catastrophic consequences for both mother and child. Numerous studies have been published regarding various risk factors associated with uterine rupture. Despite the mounting data regarding both antepartum and intrapartum factors, it currently is impossible to predict in whom a uterine rupture will occur. This article reviews the data regarding these antepartum and intrapartum predictors for uterine rupture. The author hopes that the information presented in this article will help clinicians assess an individual's risk for uterine rupture.

  4. Spontaneous Iliac Vein Rupture

    PubMed Central

    Kim, Dae Hwan; Park, Hyung Sub; Lee, Taeseung

    2015-01-01

    Spontaneous iliac vein rupture (SIVR) is a rare entity, which usually occurs without a precipitating factor, but can be a life-threatening emergency often requiring an emergency operation. This is a case report of SIVR in a 62-year-old female who presented to the emergency room with left leg swelling. Workup with contrast-enhanced computed tomography revealed a left leg deep vein thrombosis with May-Thurner syndrome and a hematoma in the pelvic cavity without definite evidence of arterial bleeding. She was managed conservatively without surgical intervention, and also underwent inferior vena cava filter insertion and subsequent anticoagulation therapy for pulmonary thromboembolism. This case shows that SIVR can be successfully managed with close monitoring and conservative management, and anticoagulation may be safely applied despite the patient presenting with venous bleeding. PMID:26217647

  5. Postmyomectomic Uterine Rupture Despite Cesarean Section.

    PubMed

    Kacperczyk, Joanna; Bartnik, Paweł; Romejko-Wolniewicz, Ewa; Dobrowolska-Redo, Agnieszka

    2016-03-01

    Uterine fibroids (leiomyomas) are benign smooth muscle tumors of the uterus. Fibroids can develop anywhere within the muscular wall. Leiomyomas may be associated with infertility. Laparoscopic myomectomy is often used to remove symptomatic intramural or subserosal fibroids. Advantages of the procedure include short recovery time and minimal perioperative morbidity. At the same time, the multilayer suture technique is more complicated during laparoscopy. A rare but serious complication of laparoscopic myomectomies is uterine rupture. A brief review of the literature and a clinical example of a 33-year-old woman with history of infertility, laparoscopic myomectomies and uterine rupture followed by peripartum hemorrhage is presented. The treatment of leiomyomas is a challenge not only because of possible recurrence but also due to long-term consequences following successful myomectomy. Management of patients with uterine scars should include careful planning of the route of delivery, as the risk of rupture may be increased. PMID:26976991

  6. Rupture of uterine serosal hematoma: delayed complication of uterine perforation.

    PubMed

    Seol, H J; Ki, K D

    2015-01-01

    Uterine perforation, a major complication of dilatation and curettage (D&C), is typically recognized at the time of the procedure. Large defects in the uterine wall or injury to other intraabdominal organs can result in an acute abdomen requiring immediate surgical treatment. On the other hand, small perforations usually resolve on their own without any long-term consequences. Here, the authors report a case of delayed hemoperitoneum, ten days after the D&C evacuation of an early pregnancy. Initially, intramural pregnancy was the suspected etiology. However, histopathology suggested that the inciting event was the rupture of a serosal uterine hematoma, which likely resulted from an incomplete uterine perforation during D&C. The patient did well after undergoing an uneventful laparoscopy.

  7. Spontaneous rupture on irregular faults

    NASA Astrophysics Data System (ADS)

    Liu, C.

    2014-12-01

    It is now know (e.g. Robinson et al., 2006) that when ruptures propagate around bends, the rupture velocity decrease. In the extreme case, a large bend in the fault can stop the rupture. We develop a 2-D finite difference method to simulate spontaneous dynamic rupture on irregular faults. This method is based on a second order leap-frog finite difference scheme on a uniform mesh of triangles. A relaxation method is used to generate an irregular fault geometry-conforming mesh from the uniform mesh. Through this numerical coordinate mapping, the elastic wave equations are transformed and solved in a curvilinear coordinate system. Extensive numerical experiments using the linear slip-weakening law will be shown to demonstrate the effect of fault geometry on rupture properties. A long term goal is to simulate the strong ground motion near the vicinity of bends, jogs, etc.

  8. Spontaneous rupture of the ureter.

    PubMed

    Eken, Alper; Akbas, Tugana; Arpaci, Taner

    2015-02-01

    Spontaneous rupture of the ureter is a very rare condition and usually results from ureteral obstruction by a calculus. Only theoretical mechanisms have been proposed and no possible explanation has yet been reported in the literature. Intravenous contrast-enhanced computed tomography is the most informative study with high sensitivity. Treatment should be individualised, and depends on the state of the patient. Minimally invasive endourological procedures with double-J catheter placement and percutaneous drainage offer excellent results. Conservative management with analgesics and antibiotic coverage may be an alternative to surgery. Herein, we present a case of spontaneous rupture of the proximal ureter with no evidence of an underlying pathological condition.

  9. Maternal death after uterine rupture in an unscarred uterus: a case report.

    PubMed

    Dane, Banu; Dane, Cem

    2009-11-01

    Spontaneous uterine rupture is a life-threatening obstetrical emergency encountered infrequently in the Emergency Department. Emergency Physicians must consider this diagnosis when presented with a pregnant patient in shock with abdominal pain. We present the case of a multigravid woman who had a spontaneous uterine rupture after induction with oxytocin, followed by a discussion of uterine rupture with special emphasis on the unscarred uterus. After the delivery, the patient was treated with fundal pressure and oxytocin due to severe vaginal hemorrhage. Despite the lack of vaginal hemorrhage after 1 h, the condition of the patient worsened. Laparotomy and a hysterectomy were performed. A parametrial hematoma about 20 cm was detected. The patient died 30 min after the operation. The treatment for intrapartum uterine rupture includes fluid resuscitation and emergency laparotomy.

  10. The spontaneous prelabour rupture of anunscarred uterus at 34 weeks of pregnancy.

    PubMed

    Misra, Malabika; Roychowdhury, Ronita; Sarkar, Nayan Chandra; Koley, Murary Mohan

    2013-03-01

    Uterine rupture is an obstetric emergency needs immediate surgery and is associated with poor fetal & maternal outcome. Usually uterine rupture occurs at the lower segment (weakest part) if there is no history of uterine surgery. We hereby are reporting a case of spontaneous uterine rupture at fundus, at 34 weeks of gestation in a patient who has never had uterine surgery. Only uterine curettage was done once for missed abortion. In this case, diagnosis was delayed until the patient went into massive hemorrhagic shock; because, there was no history of previous uterine surgery. However, clinical picture of the ruptured uterus at the fundus suggests there was some weakness at the fundus. Thereafter, D & C operation was taken into account. Subtotal hysterectomy was done as the rupture was irreparable damage to the fundus. Her one month follow up was uneventful.

  11. Bladder rupture associated with uterine rupture at delivery.

    PubMed

    Yang, Bo

    2011-05-01

    This paper seeks to study the clinical presentation and emergency treatment of bladder rupture associated with uterine rupture at delivery. From June to December 2009, three cases of rupture of the uterus involving maternal bladder during labor at Revolutionary Hospital at Hodeidah, Yemen were reviewed. Intraoperatively, it appeared that the posterior wall of the bladder and the anterior wall of the uterus had ruptured; the laceration of the posterior bladder wall was closed in two layers. Of the patients who underwent the operations, one patient developed vesicovaginal fistula, which was repaired vaginally after 6 months, and the patient had a successful outcome. The others got uneventful recovery and there was no vesicovaginal fistula or hydronephrosis during follow-up. Uterine rupture and associated injury to the maternal bladder was rarely reported. It would be life threatening or would lead to long-term complications. Both urologists and obstetrician should keep bladder injuries in mind, as serious outcomes might occur during labor. Surgical treatment could be the preferred approach for this situation.

  12. Spontaneous bilateral quadriceps tendon rupture.

    PubMed

    Vigneswaran, N; Lee, K; Yegappan, M

    2007-11-01

    Spontaneous bilateral quadriceps tendon ruptures are uncommon. We present a 30-year-old man with end-stage renal failure, who sustained this injury, and subsequently had surgical repair of both tendons on separate occasions. He has since regained full range of movement of both knees.

  13. Uterine rupture at 26 weeks of pregnancy following laparoscopic salpingectomy with resection of the interstitial portion: a case report.

    PubMed

    Nishijima, Yoshihiro; Suzuki, Takahiro; Kashiwagi, Hirofumi; Narita, Atsuya; Kanno, Hidetoshi; Hayashi, Masaru; Shinoda, Mari; Noji, Chisato; Mitsuzuka, Kanako; Nishimura, Osamu; Ishimoto, Hitoshi

    2014-12-20

    Uterine rupture in pregnancy can occur in patients with a history of uterine surgery such as myomectomy and Cesarean section. Here, we report a case of spontaneous uterine rupture that occurred in the early third trimester in a pregnant woman who had previously undergone laparoscopic removal of the right fallopian tube and interstitial portion for treatment of interstitial pregnancy. The patient presented with sudden onset of abdominal pain at 26 weeks of gestation. Detailed ultrasonography and magnetic resonance imaging led to diagnosis of uterine rupture. In emergency laparotomy, the fetus was delivered by Cesarean section, the placenta and membranes were removed, and the uterus was preserved with closure of the rupture and wound. This case highlights the importance of close follow-up of a pregnant patient who has previously had a uterine incision. The case also raises the question of whether the prevalence of uterine rupture may increase as more patients are treated with laparoscopic surgery of the uterus.

  14. Uterine rupture in pregnancy: two case reports and review of literature.

    PubMed

    Pontis, A; Prasciolu, C; Litta, P; Angioni, S

    2016-01-01

    Rupture of a gravid uterus is an obstetric emergency. Risks factors include a scarred uterus but also spontaneous rupture of an un- scarred uterus during pregnancy is possible. The authors present two cases of a spontaneous complete uterine rupture during pregnancy. The first case had only a past history of dilatation and curettage for abortion; the second case had a past history of dilatation and curettage for abortion and a monolateral laparoscopic salpingectomy for ectopic pregnancy. They presented with abdominal pain and after ultrasound scan, uterine ruptures were diagnosed. These cases show that there should be a high index of suspicious of uterine rupture in a gravid woman with a history of curettage for the possible presence of misunderstood uterine scar and in women with a past history of salpingectomy with or without corneal resection. Appropriate counseling and close follow-up might help to avoid such obstetrical catastrophes. To provide more insight into the possible risk factors for prelabor uterine rupture in pregnancy, a literature review was performed.

  15. Spontaneous rupture of spleen in falciparum malaria.

    PubMed

    Vidyashankar, C; Basu, Arup; Kulkarni, A R; Choudhury, R K

    2003-01-01

    Spontaneous rupture of spleen is an extremely rare complication of falciparum malaria. We report a 3 1/2-year-old girl with splenic rupture who was managed successfully with splenectomy and antimalarials.

  16. Uterine rupture following termination of pregnancy in a scarred uterus.

    PubMed

    Bika, O; Huned, D; Jha, S; Selby, K

    2014-02-01

    We present a series of two cases complicated by uterine rupture following termination of pregnancy (TOP) in the 1st and 2nd trimesters using misoprostol in women with caesarean section scar. Current literature and practise have also been reviewed on ruptured uterus in women with caesarean section scar undergoing TOP using misoprostol; the diagnosis of adherent placenta in the 1st and 2nd trimesters in women with previous caesarean uterine scar; and likely implications of a ruptured uterus.

  17. [Uterine rupture in a patient with bicornuate uterus at 12 weeks of amenorrhea: about a case].

    PubMed

    Itchimouh, Sanaa; Khabtou, Karima; Mahdaoui, Sakher; Boufettal, Houssine; Samouh, Naima

    2016-01-01

    The incidence of uterine malformations affecting reproduction is difficult to assess. Their identification requires a specific assessment (hysterosalpingography, hysteroscopy, laparoscopy). Spontaneous fertility can be affected depending on the type of uterine abnormality. All these abnormalities can affect the evolution of pregnancy causing early and late miscarriage, ectopic pregnancy, threat of premature labour, premature labour, vascular pathologies during pregnancy and inadequate intra-uterine growth. Bicornuate uterus is the most common uterine malformation and represents about half of all uterine anomalies The occurrence of this type of pregnancy is associated with an increased risk of maternal mortality, but early diagnosis and proper monitoring can lead pregnancies to term on malformed uterus. Ultrasound screening should allow for a systematic identification of such cases in order to take the necessary preventive measures. We report a case of uterine rupture in a patient with unicervical bicornuate uterus at 12 weeks of amenorrhea.

  18. [Uterine rupture in a patient with bicornuate uterus at 12 weeks of amenorrhea: about a case].

    PubMed

    Itchimouh, Sanaa; Khabtou, Karima; Mahdaoui, Sakher; Boufettal, Houssine; Samouh, Naima

    2016-01-01

    The incidence of uterine malformations affecting reproduction is difficult to assess. Their identification requires a specific assessment (hysterosalpingography, hysteroscopy, laparoscopy). Spontaneous fertility can be affected depending on the type of uterine abnormality. All these abnormalities can affect the evolution of pregnancy causing early and late miscarriage, ectopic pregnancy, threat of premature labour, premature labour, vascular pathologies during pregnancy and inadequate intra-uterine growth. Bicornuate uterus is the most common uterine malformation and represents about half of all uterine anomalies The occurrence of this type of pregnancy is associated with an increased risk of maternal mortality, but early diagnosis and proper monitoring can lead pregnancies to term on malformed uterus. Ultrasound screening should allow for a systematic identification of such cases in order to take the necessary preventive measures. We report a case of uterine rupture in a patient with unicervical bicornuate uterus at 12 weeks of amenorrhea. PMID:27642490

  19. Uterine rupture at 10 weeks of gestation after laparoscopic myomectomy.

    PubMed

    Okada, Yoshiyuki; Hasegawa, Junichi; Mimura, Takashi; Arakaki, Tatsuya; Yoshikawa, Shinichiro; Yamashita, Yuka; Oba, Tomohiro; Nakamura, Masamitsu; Matsuoka, Ryu; Sekizawa, Akihiko

    2016-01-01

    The patient had a previous history of laparoscopic myomectomy. At 10 weeks of gestation, she visited our emergency center due to sudden abdominal pain. An ultrasound examination and MRI showed complete rupture of the uterine myometrium in the fundal wall and a floating gestation sac in Douglas' fossa with fluid. Emergency abdominal laparotomy was immediately performed due to the diagnosis of uterine rupture. During surgery, a small defect of the myometrium was found in the posterior fundal wall of the uterus. Two-layer suturing was performed at the perforation hole. The occasional occurrence of uterine rupture after surgery of the uterus even in the first trimester should be considered.

  20. Intrapartum uterine rupture with coincidental uterine adenomyosis in an African wild dog (Lycaon pictus).

    PubMed

    Newell-Fugate, Annie; Lane, Emily

    2009-12-01

    A 7-yr-old African wild dog (Lycaon pictus) multiparous bitch experienced severe dystocia and death one day after the onset of parturition. Necropsy revealed three placental attachments in the right uterine horn and one in the left. A full-thickness rupture of the right horn at the middle placental attachment and an autolysed fetus free in the abdomen were present. Death was attributed to hypovolemic and endotoxemic shock after uterine rupture. Myometrium adjacent to the rupture and in the left uterine horn was subdivided into irregular pseudolobules by fibrous connective tissue tracts containing small endometrial glandular acini suggestive of adenomyosis, which may have facilitated uterine rupture. This is the first reported case of dystocia-induced uterine rupture and of adenomyosis in a wild dog.

  1. Simultaneous and spontaneous bilateral quadriceps tendons rupture.

    PubMed

    Celik, Evrim Coşkun; Ozbaydar, Mehmet; Ofluoglu, Demet; Demircay, Emre

    2012-07-01

    Simultaneous and spontaneous bilateral quadriceps tendon rupture is an uncommon injury that is usually seen in association with multiple medical conditions and some medications. We report a case of simultaneous and spontaneous bilateral quadriceps tendon rupture that may be related to the long-term use of a statin.

  2. Spontaneous rupture of the abdominal aorta.

    PubMed Central

    Williams, T. G.

    1977-01-01

    Fatal spontaneous rupture of the lower abdominal aorta in a previously healthy 61-year-old woman is reported; the possibility that she had the Ehlers-Danlos syndrome is discussed. Images Fig. 1 PMID:870895

  3. Uterine sarcoma in a 14 year-old girl presenting with uterine rupture.

    PubMed

    Özcan, Jane; Dülger, Özlem; Küpelioğlu, Latif; Gönenç, Ali İhsan; Erşahin, Aynur

    2014-12-01

    Uterine sarcomas are rare in adolescents. Adenosarcomas are even more rare. Uterine rupture, as a presentation is a rare entity.•It is hard to diagnose sarcomas preoperatively. It is still hard even postoperatively due to variable morphologic features.•Experience of the gynecopathologists and oncologic surgeons is the hallmark of the treatment option.

  4. Combined uterine and urinary bladder rupture: an unusual complication of obstructed labor in a primigravida

    PubMed Central

    Takai, Idris Usman; Abubakar, Abdulkadir

    2016-01-01

    Background Combined uterine and urinary bladder rupture following prolonged obstructed labor is indeed a momentous uro-obstetric emergency. The urinary bladder involvement is distinctly rare in the absence of factors that predispose the bladder to be adherent to the lower uterine segment and is quite unusual in a primigravida. Objective To report a rare case of uterine rupture involving urinary bladder secondary to a prolonged obstructed labor in a primigravida from a low resource setting. Case A 17-year-old married unbooked primigravida who presented with a 3-day history of spontaneous onset of labor at term that was initially managed at home and later in a primary health care center where she had fundal pressure and oxytocin augmentation, respectively. The labor was complicated by combined uterine and urinary bladder rupture with sepsis. She was resuscitated and had exploratory laparotomy with uterine and urinary bladder repair. The postoperative period was uneventful and she was followed-up at the gynecology and family planning clinics. Conclusion There is a need for community reawakening on the inherent risks of teenage pregnancy, bad obstetric practices, and unsupervised pregnancy, labor, and delivery, particularly in the rural settings as in the index patient. A high index of suspicion and prompt appropriate intervention will reduce the sequel of morbidity and occasional mortality from this predicament. PMID:27499647

  5. Repair of uterine rupture in twin gestation after laparoscopic cornual resection.

    PubMed

    Liao, Chi-Yuan; Ding, Dah-Ching

    2009-01-01

    Spontaneous uterine rupture in the course of pregnancy is a rare event that usually occurs in a scarred uterus. The event occurs mostly during the intrapartum period and is potentially catastrophic for both mother and fetus. We report a case of 2-cm cornual rupture in a pregnant woman at 13 weeks twin gestation with previous history of cornual pregnancy successfully managed via laparoscopy. Sudden onset of abdominal pain and vaginal bleeding was noted first. Physical examination revealed stable vital signs, lower abdominal tenderness, and mild rebounding pain. Pelvic ultrasonography revealed twin pregnancy at 13 weeks with extrauterine saccular structure 6 cm in diameter located on the left fundus and contiguous with an intrauterine oligohydramnics twin. Exploratory laparotomy was promptly performed, and a small rupture about 2 cm in diameter was observed on the upper portion of the left fundus, the site of a previous laparoscopic cornual resection scar. A protruding amniotic sac of about 6 cm diameter and containing some part of the umbilical cord was seen. The uterine rupture site was repaired directly after aspiration of amniotic fluid from the protruding sac. After surgery, the patient received antibiotics, 17-OH-progesterone for potential rupture of membranes and prematurity. Tocolysis with Ritodrine for irregular uterine contractions was given at 22 weeks gestation. Steroids were given at 24 weeks gestation. The pregnancy ended with a successful delivery by cesarean section because of uncontrollable uterine contractions at 30 5/7 weeks gestation. In conclusion, although termination of pregnancy would normally be recommended when uterine rupture occurs, a different approach to management may now be accepted.

  6. Spontaneous rupture of the common bile duct.

    PubMed

    Kyzer, S; Bayer, I; Chaimoff, C

    1986-01-01

    Spontaneous rupture of the common bile duct in adults is very rare. The authors report only the 14th case in the Western literature. A 25-year-old woman had signs of peritonitis suggestive of a perforated appendix, but at operation the appendix appeared normal and a large amount of bile was found in the peritoneal cavity. A 2-mm tear was found on the anterior wall of the common bile duct. The patient recovered without complications after T-tube drainage and cholecystectomy. In this patient none of the factors thought to cause spontaneous rupture of the common bile duct were present, so the authors conclude that the case may be classified as idiopathic spontaneous rupture of the common bile duct. PMID:3940592

  7. Spontaneous Achilles tendon rupture in alkaptonuria

    PubMed Central

    Alajoulin, Omar A.; Alsbou, Mohammed S.; Ja’afreh, Somayya O.; Kalbouneh, Heba M.

    2015-01-01

    Alkaptonuria (AKU) is a rare inborn metabolic disease characterized by accumulation of homogentisic acid (HGA). Excretion of HGA in urine causes darkening of urine and its deposition in connective tissues causes dark pigmentation (ochronosis), early degeneration of articular cartilage, weakening of the tendons, and subsequent rupture. In this case report, we present a rare case of a patient presented with unilateral spontaneous rupture of Achilles tendon due to AKU. The patient developed most of the orthopedic manifestations of the disease earlier than typical presentations. Alkaptonuria patients should avoid strenuous exercises and foot straining especially in patients developing early orthopedic manifestations. PMID:26620992

  8. Spontaneous postpartum rupture of an intact uterus: a case report.

    PubMed

    Mavromatidis, George; Karavas, George; Margioula-Siarkou, Chrysoula; Petousis, Stamatios; Kalogiannidis, Ioannis; Mamopoulos, Apostolos; Rousso, David

    2015-01-01

    Rupture of uterus is an obstetrical complication characterized by a breach in the uterine wall and the overlying serosa. We report an unusual case of spontaneous rupture of an unscarred uterus in a 33-year-old woman, a day after her third successful vaginal delivery. A 33-year-old pregnant woman, gravid 3, para 3, was referred to our department at 39 gestational week because of rupture of membranes. Despite tocolysis administration, her pregnancy was delivered vaginally after 2 days, giving birth to a male neonate of 3,020 g with normal Apgar scores at first and fifth minute. Her uterus was intact and gynecological examination after delivery was normal without any potential signs or symptoms of pathology. However, the day following her labor, patient complained of left iliac fossa pain. Her blood tests revealed a CRP value at 27.6 mg/L, whereas the X-rays revealed an extensive impacted fecal mass in the colon. MRI revealed that the left lower myometrial part of the uterus was depicted abrupt, with simultaneous presence of hemorrhagic stuff. The decision of laparotomy was therefore made in order to further evaluate rupture of uterus and properly treat patient. And subtotal hysterectomy was performed. Postoperative follow-up period was not characterized by any complications and patient was finally discharged 4 days after hysterectomy.

  9. Spontaneous postpartum rupture of an intact uterus: a case report.

    PubMed

    Mavromatidis, George; Karavas, George; Margioula-Siarkou, Chrysoula; Petousis, Stamatios; Kalogiannidis, Ioannis; Mamopoulos, Apostolos; Rousso, David

    2015-01-01

    Rupture of uterus is an obstetrical complication characterized by a breach in the uterine wall and the overlying serosa. We report an unusual case of spontaneous rupture of an unscarred uterus in a 33-year-old woman, a day after her third successful vaginal delivery. A 33-year-old pregnant woman, gravid 3, para 3, was referred to our department at 39 gestational week because of rupture of membranes. Despite tocolysis administration, her pregnancy was delivered vaginally after 2 days, giving birth to a male neonate of 3,020 g with normal Apgar scores at first and fifth minute. Her uterus was intact and gynecological examination after delivery was normal without any potential signs or symptoms of pathology. However, the day following her labor, patient complained of left iliac fossa pain. Her blood tests revealed a CRP value at 27.6 mg/L, whereas the X-rays revealed an extensive impacted fecal mass in the colon. MRI revealed that the left lower myometrial part of the uterus was depicted abrupt, with simultaneous presence of hemorrhagic stuff. The decision of laparotomy was therefore made in order to further evaluate rupture of uterus and properly treat patient. And subtotal hysterectomy was performed. Postoperative follow-up period was not characterized by any complications and patient was finally discharged 4 days after hysterectomy. PMID:25368704

  10. [Uterine rupture superficial externum--a case report].

    PubMed

    Sikora-Szcześniak, Dobrosława

    2012-05-01

    The article presents a case of external superficial rupture of the uterus--along the left lateral margin--with ruptured posterior lamina of the broad uterine ligament. The complication developed in a 29-year-old patient--following delivery from breech fetal presentation with footling, in 41 hbd, 4th delivery. The patient had no history of any uterine operations, reported no injury to the uterus or inflammations of her sex organs. The symptoms of bleeding into the abdominal cavity and hypovolemic shock developed during early postpartum period. The operation was performed on an emergency basis: postpartum hysterectomy without adnexa was performed. Postoperative course was complicated, the patient developed superficial thrombophlebitis in the left leg. The patient and her healthy baby were released home on 24th day following the delivery and operation.

  11. Silent uterine rupture of scarred uterus--an unusual presentation as amniocele.

    PubMed

    Wali, Aisha Syed; Naru, Tahira Yasmeen

    2013-01-01

    Obstetricians should be aware of the possibility of silent rupture of scarred uterus. Ultrasound has an important role in the diagnosis of silent uterine rupture. A case of silent uterine rupture with foetal demise, that remained undiagnosed for many weeks, is described.

  12. Spontaneous rupture of unscarred uterus in a primigravida with preterm prelabour rupture of membranes.

    PubMed

    Mourad, Wael Sayed; Bersano, Debbra J; Greenspan, Peter B; Harper, Diane Medved

    2015-06-08

    Intrapartum uterine rupture is a true obstetrical emergency. Uterine rupture is associated with severe maternal and fetal morbidity and mortality. It is rare in the unscarred uterus of a primigravida. A 23-year-old primigravida with an unscarred uterus was admitted with preterm prelabour rupture of membranes at 36(+4) weeks of gestation. Abnormal fetal heart monitoring, associated with acute onset of severe abdominopelvic pain, developed on admission. Rupture occurred prior to onset of regular uterine contractions and in the absence of any interventional oxytocin. The neonate had evidence of severe acidosis despite emergency caesarean delivery. This case highlights the importance of maintaining a high index of suspicion for uterine rupture, even in the unlikely setting of a primigravida with an unscarred uterus.

  13. Reduction in the occurrence of uterine rupture in Central India.

    PubMed

    Chhabra, S; Bhagwat, N; Chakravorty, Anupama

    2002-01-01

    This study was carried out in the Department of Obstetrics and Gynaecology of the Mahatma Gandhi Institute of Medical Sciences, Sevagram in Central India. In the 12 years between 1989 and 2000 a total of 16 cases of ruptured uterus were managed, the incidence of rupture of the pregnant uterus being 0.62 per 1000 births. One-quarter of the cases occurred between 1983 and 1988. No teenager or elderly woman (over 40) or grandmultipara sustained a uterine rupture. Four women had a rupture of a previous scar. In five rupture had occurred in association with malpresentations, one was a case of hydrocephalus, two had a morbidly adherent placenta praevia and four had a normal presentation, with lack of progress in labour. Two of these 16 women had twins. One had come with a retained second twin with transverse lie and the other was a booked case with multiple problems, including a previous caesarean section, present twin pregnancy and placenta praevia accreta and she died. This was the only maternal death. Perinatal mortality was 77.77% compared to 5.88% maternal and 100% perinatal mortality in the cases reported previously between 83 and 88, from the same institution. Overall, there is some improvement in perinatal survival and one-quarter incidence of rupture of the pregnant uterus.

  14. Late onset hemorrhage caused by ruptured uterine artery pseudoaneurysm after robotic-assisted total hysterectomy.

    PubMed

    Gerardi, Melissa A; Díaz-Montes, Teresa P

    2011-12-01

    Robotic surgery has been used increasingly for the management of benign or malignant gynecologic conditions. Vaginal hemorrhage after hysterectomy is fairly uncommon. Uterine artery pseudoaneurysm is a rare phenomenon causing late onset hemorrhage that could be potentially life-threatening. This case describes the management of vaginal bleeding due to ruptured uterine artery pseudoaneurysm after robotic-assisted total hysterectomy. This is the first known reported case of a ruptured uterine artery pseudoaneurysm after a robotic-assisted hysterectomy. PMID:27628121

  15. Staircase sign: a newly described uterine contraction pattern seen in rupture of unscarred gravid uterus.

    PubMed

    Matsuo, Koji; Scanlon, Jennifer T; Atlas, Robert O; Kopelman, Jerome N

    2008-02-01

    Although extremely rare, rupture of an unscarred gravid uterus poses significant morbidity and mortality to both fetus and mother. In the past, loss of uterine contraction was thought to be characteristic of uterine rupture, while recent evidence shows that uterine contraction pattern is not associated with uterine rupture. We report two cases of rupture in the unscarred term uterus. Both patients were multiparous and denied any past medical complications, previous cesarean delivery or myomectomy. Uterine rupture occurred in the latent phase of labor at 1 cm dilation (Case 1) and during an intravenous oxytocin infusion after three doses of intravaginal misoprostol (Case 2). Case 2 required cesarean hysterectomy and blood transfusion. Case 1 was monitored with an external tocodynamometer, while Case 2 was monitored with an internal pressure transducer. External monitoring demonstrated the classic sign of complete loss of uterine tone. In contrast, internal monitoring demonstrated an increase in uterine resting tone. Both techniques revealed a stepwise gradual decrease in contraction amplitude followed by sudden onset of profound and prolonged fetal bradycardia (staircase sign). In cases of uterine rupture, differing baseline characteristics between contraction patterns were dependent on uterine monitoring technique. In both techniques a stepwise gradual decrease in contraction amplitude was followed by prolonged fetal bradycardia.

  16. Spontaneous rupture of a liver hemangioma. A case report.

    PubMed

    Guillén-Paredes, María Pilar; Martínez Fernández, Josefa; Morales González, Álvaro; Pardo-García, José Luis

    2016-07-01

    Spontaneous rupture of a liver hemangioma is a very uncommon disease, but extremely seriousness because it is associated to a 75% of mortality caused by hipovolemic shock. A case of an spontaneous rupture of liver hemangioma, which was previously unknow, is presented. PMID:27659104

  17. [Uterine rupture without preexisting caesarean section after perforation of the uterus during evacuation].

    PubMed

    Bønnelykke, Astrid; Jeppesen, Ulla; Munk, Anne Cathrine Hoffgaard

    2015-01-26

    Uterine rupture is a serious complication, associated with perinatal and maternal morbidity and mortality. This case report describes uterine rupture in a patient who did not have any previous caesarean section. The patient had acute abdominal pain, hypertonic uterus, blood in the amniotic fluid and abnormal cardiotocographic values. An abruption of the placenta was suspected, and an acute caesarean section was performed during which a rupture in fundus uteri was found. It was later experienced that the patient ten years earlier had suffered a uterine perforation during evacuation after a late abortion.

  18. Antepartum uterine rupture in a twin gestation presenting as an advanced extrauterine pregnancy in a patient with a previous lower segment Caesarean section.

    PubMed

    Ngene, Nnabuike C; Naidoo, Thinagrin D; Titus, Mokete; Moodley, Jagidesa; Craib, Shirley; Stutterheim, James

    2014-07-01

    We present a case of spontaneous antepartum uterine rupture through a previous lower segment Caesarean section (LSCS) scar with clinical features mimicking an advanced extrauterine pregnancy (AEUP) in a twin pregnancy at 28 weeks gestation. This report illustrates the need to consider a diagnosis of a ruptured uterus in any patient with a previous abdominal delivery who presents with mild abdominal tenderness and an ultrasonographic image suggestive of demised fetus in the intra-peritoneal cavity.

  19. Predicting uterine rupture in women undergoing trial of labor after prior cesarean delivery.

    PubMed

    Landon, Mark B

    2010-08-01

    Uterine rupture is the most serious complication for women undergoing trial of labor (TOL) after prior cesarean delivery. While rates of uterine rupture vary significantly according to a variety of clinically associated risk factors, the absolute risk for this complication ranges between 0.5 and 4 percent. Previous vaginal delivery and prior successful vaginal birth after cesarean delivery confer the lowest risk of rupture on women attempting TOL. In contrast, multiple prior cesareans, short interpregnancy interval, single layer uterine closure, prior preterm cesarean, labor induction and augmentation have all been suggested in some studies as factors which may increase the rate of uterine rupture. While considering these risk factors is important in counseling women regarding childbirth following cesarean delivery, the infrequency of uterine rupture coupled with relatively weak associations for most risk factors has prevented the development of an accurate prediction tool for uterine rupture. Preliminary studies suggest that sonographic evaluation of the uterine scar may hold some promise for identifying women at risk.

  20. Spontaneous rupture of the liver presenting as scrotal bruising.

    PubMed

    Vachharajani, A; Paes, B

    2001-05-01

    We describe a case of spontaneous rupture of the liver in a neonate, presenting with features consistent with testicular torsion. Ruptured liver has been well described in neonates following birth trauma, coagulation defects, and Group B Streptococcal infection. The etiology in our case remains undefined. PMID:11414525

  1. Spontaneous rupture of the spleen operated in gynecological unit mistaken for ruptured hemorrhagic ovarian cyst: total splenectomy

    PubMed Central

    Eko, Filbert Eko; Fouelifack, Florent Ymele; de Paul, Elanga Vincent

    2014-01-01

    Spontaneous splenic rupture is always neglected when consulting acute abdominal pains in gynecological emergencies. It constitutes about 1% of all splenic ruptures and can be managed by abstention, surgery or embolization. We present the case of a young lady who was diagnosed of spontaneous rupture during surgery that was mistaken for ruptured hemorrhagic ovarian cyst and finally treated by total splenectomy. The pre-operative work up was absolute for a rupturred hemorrhagic cyst and secondariy for a ruptured ectopic gestation. PMID:25918564

  2. Simultaneous uterine and urinary bladder rupture in an otherwise successful vaginal birth after cesarean delivery.

    PubMed

    Ho, Szu-Ying; Chang, Shuenn-Dhy; Liang, Ching-Chung

    2010-12-01

    Uterine rupture is the primary concern when a patient chooses a trial of labor after a cesarean section. Bladder rupture accompanied by uterine rupture should be taken into consideration if gross hematuria occurs. We report the case of a patient with uterine rupture during a trial of labor after cesarean delivery. She had a normal course of labor and no classic signs of uterine rupture. However, gross hematuria was noted after repair of the episiotomy. The patient began to complain of progressive abdominal pain, gross hematuria and oliguria. Cystoscopy revealed a direct communication between the bladder and the uterus. When opening the bladder peritoneum, rupture sites over the anterior uterus and posterior wall of the bladder were noted. Following primary repair of both wounds, a Foley catheter was left in place for 12 days. The patient had achieved a full recovery by the 2-year follow-up examination. Bladder injury and uterine rupture can occur at any time during labor. Gross hematuria immediately after delivery is the most common presentation. Cystoscopy is a good tool to identify the severity of bladder injury.

  3. Systematic review of the incidence and consequences of uterine rupture in women with previous caesarean section

    PubMed Central

    Guise, Jeanne-Marie; McDonagh, Marian S; Osterweil, Patricia; Nygren, Peggy; Chan, Benjamin K S; Helfand, Mark

    2004-01-01

    Objective To evaluate the incidence and consequences of uterine rupture in women who have had a delivery by caesarean section. Design Systematic review. Data sources Medline, HealthSTAR, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, National Centre for Reviews and Dissemination, reference lists, and national experts. Studies in all languages were eligible if published in full. Review methods Methodological quality was evaluated for each study by using criteria from the United States Preventive Services Task Force and the National Health Service Centre for Reviews and Dissemination. Uterine rupture was categorised as asymptomatic or symptomatic. Results We reviewed 568 full text articles to identify 71 potentially eligible studies, 21 of which were rated at least fair in quality. Compared with elective repeat caesarean delivery, trial of labour increased the risk of uterine rupture by 2.7 (95% confidence interval 0.73 to 4.73) per 1000 cases. No maternal deaths were related to rupture. For women attempting vaginal delivery, the additional risk of perinatal death from rupture of a uterine scar was 1.4 (0 to 9.8) per 10 000 and the additional risk of hysterectomy was 3.4 (0 to 12.6) per 10 000. The rates of asymptomatic uterine rupture in trial of labour and elective repeat caesarean did not differ significantly. Conclusions Although the literature on uterine rupture is imprecise and inconsistent, existing studies indicate that 370 (213 to 1370) elective caesarean deliveries would need to be performed to prevent one symptomatic uterine rupture. PMID:15231616

  4. Misdiagnosed Chest Pain: Spontaneous Esophageal Rupture

    PubMed Central

    Inci, Sinan; Gundogdu, Fuat; Gungor, Hasan; Arslan, Sakir; Turkyilmaz, Atila; Eroglu, Atila

    2013-01-01

    Chest pain is one of themost common complaints expressed by patients presenting to the emergency department, and any initial evaluation should always consider life-threatening causes. Esophageal rupture is a serious condition with a highmortality rate. If diagnosed, successful therapy depends on the size of the rupture and the time elapsed between rupture and diagnosis.We report on a 41-year-old woman who presented to the emergency department complaining of left-sided chest pain for two hours. PMID:27122690

  5. ABDOMINAL PREGNANCY IN A SERVAL (LEPTAILURUS SERVAL) SECONDARY TO UTERINE RUPTURE.

    PubMed

    Bryan, Laura K; Blue-McLendon, Alice; Hoffmann, Aline Rodrigues

    2015-06-01

    A 14-yr-old female serval (Leptailurus serval) died unexpectedly after 2 wk of inappetence and lethargy. Necropsy revealed a pyoabdomen with a full-term, well-developed fetus in the caudal abdomen covered by a mesenteric sac. The mesenteric sac communicated with a tear in the wall of the right uterine horn, supporting a diagnosis of secondary abdominal pregnancy. The uterine wall had evidence of adenomyosis at the rupture site with no evidence of pyometra. The fetus, supporting mesentery, and peritoneum were coated with mixed bacteria, which may have ascended through an open cervix to the site of uterine rupture. This is the first case of abdominal pregnancy related to uterine rupture reported in a large felid species.

  6. Lived experiences of women who developed uterine rupture following severe obstructed labor in Mulago hospital, Uganda

    PubMed Central

    2014-01-01

    Background Maternal mortality is a major public health challenge in Uganda. Whereas uterine rupture remains a major cause of maternal morbidity and mortality, there is limited research into what happens to women who survive such severe obstetric complications. Understanding their experiences might delineate strategies to support survivors. Methods This qualitative study used a phenomenological approach to explore lived experiences of women who developed uterine rupture following obstructed labor. In-depth interviews initially conducted during their hospitalization were repeated 3–6 months after the childbirth event to explore their health and meanings they attached to the traumatic events and their outcomes. Data were analyzed using thematic analysis. Results The resultant themes included barriers to access healthcare, multiple “losses” and enduring physical, psychosocial and economic consequences. Many women who develop uterine rupture fail to access critical care needed due to failure to recognise danger signs of obstructed labor, late decision making for accessing care, geographical barriers to health facilities, late or failure to diagnose obstructed labor at health facilities, and failure to promptly perform caesarean section. Secondly, the sequel of uterine rupture includes several losses (loss of lives, loss of fertility, loss of body image, poor quality of life and disrupted marital relationships). Thirdly, uterine rupture has grim economic consequences for the survivors (with financial loss and loss of income during and after the calamitous events). Conclusion Uterine rupture is associated with poor quality of care due to factors that operate at personal, household, family, community and society levels, and results in dire physical, psychosocial and financial consequences for survivors. There is need to improve access to and provision of emergency obstetric care in order to prevent uterine rupture consequent to obstructed labor. There is also

  7. Spontaneous retroperitoneal hemorrhage from a ruptured hypernephroma.

    PubMed

    Trivedi, R; Levy, M; Ibrahim, I; Bonacarti, A

    1979-01-01

    The clinical presentation and roentgenographic findings of renal cell carcinoma have been consistently variable. These patients can appear with flank pain mimicking ureteral colic, flank tumors, or symptomatic metastasis [1]. Systemic cardiac manifestations including cardiomegaly with congestive heart failure due to arteriovenous fistula formation have been reported [2] Roentgenographic findings may show the tumor to be either vascular or avascular. It may present as a spontaneous perforation of the pelvic ureteral system which is demonstrated by intravenous pyelography (3). In this article, we describe a case of hypernephroma in a cyst wall causing severe spontaneous hemorrhage in the retroperitoneal space resulting in a state of hypovolemic shock.

  8. Antepartum uterine rupture in previous caesarean sections presenting as advanced extrauterine pregnancies: lessons learnt.

    PubMed

    Ramphal, Surandhra R; Moodley, Jagidesa

    2009-03-01

    In present day obstetric practice, rupture of a previously scarred uterus should be uncommon. It occurs in <1% of previous caesarean sections and most cases occur during labour and have evidence of abnormal fetal heart rate patterns, vaginal bleeding and continuous abdominal pains. Clinicians are alert to these symptoms and signs, and therefore immediate action is taken to prevent further maternal morbidity and mortality. However, rupture of a previously scarred uterus may occur occasionally in the antepartum period. In such circumstances, the patients may be haemodynamically stable and present with loss of fetal movements and vague abdominal pains, and are treated expectantly for a period of time because an initial diagnosis of advanced extra-uterine pregnancy is made. We present a series of 7 cases, all of whom had one or more previous caesarean sections, were haemodynamically stable and were being managed expectantly, to illustrate the fact that ruptured uterus should be strongly considered in the differential diagnosis, even when the clinical signs and sonography are suggestive of an advanced extra-uterine pregnancy. The lessons in these cases fall into the following categories: 1. Ruptured uteri can occur in non-labouring women with previous lower segment caesarean sections. 2. Absence of signs of peritonism is possibly due to the fact that the pregnancy is extruded through the uterine rupture with the amniotic sac being intact and there is little or no bleeding into the abdominal cavity or vaginally. 3. Imaging techniques should focus on the size of the uterus, as an enlarged uterus in the background of an advanced extra-uterine pregnancy in a previously scarred uterus is highly suggestive of uterine rupture. Clinicians must strongly consider ruptured uteri in non labouring women with previous caesarean sections even when imaging modalities suggest an advanced extrauterine pregnancy. This will lead to earlier surgical treatment and appropriate information

  9. Spontaneous rupture of the spleen associated with Legionella pneumonia

    PubMed Central

    Casanova-Roman, Manuel; Casas, Javier; Sanchez-Porto, Antonio; Nacle, Belen

    2010-01-01

    Spontaneous rupture of the spleen associated with Legionella pneumonia is a rare and life-threatening complication; only three cases have been reported to date. The authors describe a case of a 47-year-old man who presented with pneumonia and abdominal pain. He underwent a splenectomy, and was successfully treated with clarithromycin and levofloxacin. PMID:21886641

  10. Spontaneous common iliac vein rupture: a case report

    PubMed Central

    DePass, Ian E.

    1998-01-01

    A 68-year-old woman, admitted because of acute lower quadrant abdominal pain but no history of trauma, underwent laparotomy for a suspected ruptured aortic aneurysm. Exploration revealed a 20-mm longitudinal tear in the left iliac vein. The vein was repaired primarily. Her postoperative course was complicated by deep vein thrombosis. Spontaneous rupture of the iliac vein without trauma is rare. but occurs predominantly in healthy white women between the ages of 40 and 80 years. Various causative mechanisms have been described: inflammation of the vessel wall secondary to thrombophlebitis, proximal obstruction of the iliac vein and spontaneous rupture without obstruction or thrombosis. In many cases an increase in intra-abdominal pressure is noted. PMID:9854541

  11. Spontaneous rupture of the left renal collecting system during pregnancy.

    PubMed

    Lo, K L; Ng, C F; Wong, W S

    2007-10-01

    Spontaneous rupture of a normal renal collecting system during pregnancy is uncommon and all reported cases have occurred in right kidneys. We report a case of spontaneous rupture of the left renal collecting system during pregnancy. A 33-year-old pregnant woman presented with left loin and lower abdominal pain, and signs of preterm labour, at 32 weeks' gestation. An emergency caesarean section was performed for foetal distress but the left loin pain did not subside after delivery. Ultrasonography and a computed tomogram showed a left perinephric collection and urine extravasation, compatible with rupture of the renal collecting system. A percutaneous nephrostomy was inserted and the symptoms subsided. A summary of the literature discussing management of this clinical situation is provided.

  12. Transcatheter Arterial Embolization for Spontaneous Rupture of the Omental Artery

    SciTech Connect

    Matsumoto, Tomohiro; Yamagami, Takuji; Morishita, Hiroyuki; Iida, Shigeharu; Tazoe, Jun; Asai, Shunsuke; Masui, Koji; Ikeda, Jun; Nagata, Akihiro; Sato, Osamu; Nishimura, Tsunehiko

    2011-02-15

    We encountered a rare case of spontaneous rupture of the omental artery. A 25-year-old man without any episode of abdominal trauma or bleeding disorders came to the emergency unit with left upper abdominal pain. Hematoma with extravasation of the greater omentum and a hemoperitoneum was confirmed on abdominal contrast-enhanced computed tomography. Bleeding from the omental artery was suspected based on these findings. Transcatheter arterial embolization was successfully performed after extravasation of the omental artery, which arises from the left gastroepiploic artery, was confirmed on arteriography. Partial ometectomy was performed 10 days after transcatheter arterial embolization, revealing that the hematoma measured 10 cm in diameter in the greater omentum. Pathological examination showed rupture of the branch of an omental artery without abnormal findings, such as an aneurysm or neoplasm. Thus, we diagnosed him with spontaneous rupture of the omental artery. The patient recovered and was discharged from the hospital 10 days after the surgery, with a favorable postoperative course.

  13. [Uterine scar after caeserean section- predicting the risk of uterine rupture and decision on the way of delivery].

    PubMed

    Tzankova, M; Nikolov, A; Pirnareva, E

    2014-01-01

    The Cesarean section rate in University Maternity Hospital 'Maichin dom' is 46 to 48%. The rate of repeated Cesarean section is also increasing. However there is an increasing number of women wishing to deliver vaginally after having had a Cesarean section for their first baby. On the other hand, with postponing pregnancy, increasing number of woman nowadays experience surgeries on their uterus prior to giving birth. With regards to the above-mentioned, pregnancy in scarred uterus is a common thing. Examining the uterine scar gives valuable information for the risk of uterine rupture during pregnancy and the decision making on the safest way of delivery. The current article shows ultrasound pics of uterine scar in pregnant and non-pregnant uterus. Gives recommendations for the timing of the US examination and the reference range for thickness of the uterine scar (residual myometrial thickness) in the view of the risk of rupture and the safest way of delivery. All this information is based on the most recent clinical trials.

  14. Expectant management of a herniated amniotic sac presenting as silent uterine rupture: a case report and literature review.

    PubMed

    Iemura, Asako; Kondoh, Eiji; Kawasaki, Kaoru; Fujita, Kohei; Ueda, Akihiko; Mogami, Haruta; Baba, Tsukasa; Konishi, Ikuo

    2015-01-01

    Foetal membranes bulging into the abdominal cavity is a unique initial manifestation of silent or complete uterine rupture during pregnancy. Since silent uterine rupture has potential risk for complete uterine rupture, which leads to acute life-threatening complications for both the mother and baby, it is difficult to determine whether to manage expectantly or surgically, including repair of the uterine wall or termination of the pregnancy, especially in the early second trimester. We present here a case of a herniated amniotic sac with overstretched uterine wall of the fundus presenting as silent uterine rupture, which was incidentally detected on routine ultrasonography at 18 weeks' gestation in a 38-year-old primigravida with a history of myomectomy for diffuse uterine leiomyomatosis. Magnetic resonance imaging examination revealed that the myometrium thickness was fully maintained at the site of the foetal membranes ballooning. The pregnancy was therefore managed expectantly and continued to successful delivery at 30 weeks' gestation. The precise assessment of the uterine wall may be essential to manage a herniated amniotic sac presenting as silent uterine rupture and to optimise the outcome of the pregnancy. We review all cases of a herniated amniotic sac out of focally overstretched uterine wall before 34 weeks' gestation.

  15. Spontaneous ureteral rupture diagnosis and treatment.

    PubMed

    Pampana, E; Altobelli, S; Morini, M; Ricci, A; D'Onofrio, S; Simonetti, G

    2013-01-01

    Rupture of the urinary collecting system associated with perinephric or retroperitoneal extravasation of the urine is an unusual condition and it is commonly associated with renal obstructing disease. Perforation could occur at any level from the calix to the bladder but it is usually seen at the fornices and upper ureter. It may lead to several serious consequences including urinoma, abscess formation, urosepsis, infection, and subsequent irreversible renal impairment. We report a case of a 69-year-old woman who presented at the emergency department of our institution with severe abdominal pain. Due to symptomatology worsening, complete laboratory evaluation was performed and the patient underwent abdominal contrast enhanced computed tomography (CT) evaluation which showed contrast agent extravasation outside the excretory system without any evidence of renal calculi at basal acquisition. It was decided to perform a double-J stent placement which was followed by complete healing of the ureter and its removal was performed 8 weeks later. Diagnosis and therapeutic approaches are discussed. PMID:24455381

  16. Spontaneous Liver Rupture After Treatment With Drug-Eluting Beads

    SciTech Connect

    Ritter, C. O.; Wartenberg, M.; Mottok, A.; Steger, U.; Goltz, J. P.; Hahn, D.; Kickuth, R.

    2012-02-15

    Spontaneous rupture of hepatocellular carcinoma (HCC) after transcatheter arterial chemoembolization (TACE) is a rare and life-threatening complication. Pathophysiologic mechanisms are not yet fully known; it is suggested that rupture is preceded by reactive tissue edema and intratumerous bleeding, leading to a rapid expansion of tumour mass with risk of extrahepatic bleeding in the case of subcapsular localisation. This case report discusses a sudden, unexpected lethal complication in a 74 year-old male patient treated with TACE using DC Bead loaded with doxorubicin (DEBDOX) in a progressive multifocal HCC.

  17. Spontaneous Heterotopic Triplet Pregnancy With Tubal Rupture

    PubMed Central

    Danso, Dennis

    2014-01-01

    The recent increase in heterotopic pregnancies has been largely attributed to the increased use of assisted reproduction technologies. We report the rare case of a multiparous woman with a spontaneous conception resulting in a triplet heterotopic pregnancy: a twin intrauterine pregnancy and a single right tubal ectopic pregnancy. Heterotopic pregnancy is a rare and potentially life-threatening condition in which simultaneous gestations occur at 2 or more implantation sites. It is infrequent in natural conception cycles, occurring in 1:30 000 pregnancies. However, the prevalence is rising with the increased use of assisted reproduction techniques to that of 1:100 to 1:500 in these patient subgroups, highlighting the need to incorporate it into a clinician’s diagnostic algorithm. PMID:26425603

  18. A case of uterine rupture diagnosed based on routine focused assessment with sonography for obstetrics.

    PubMed

    Tauchi, Maiko; Hasegawa, Junichi; Oba, Tomohiro; Arakaki, Tatsuya; Takita, Hiroko; Nakamura, Masamitsu; Sekizawa, Akihiko

    2016-01-01

    The patient was a 38-year-old primigravida woman with a previous history of myomectomy via laparotomy. At 30 weeks of gestation, she visited our emergency center because of sudden severe abdominal pain. Routine focused assessment with sonography for obstetrics (FASO) indicated no echo-free space at Douglas' pouch or between the spleen and kidney; however, echo-free spaces were visualized around the intestinal tract and at Morrison's pouch. Therefore, a diagnosis of hemoperitoneum due to uterine rupture was suspected, and emergency cesarean section was planned. During surgery, a small defect of the myometrium was found on the posterior to fundal uterine wall, with bleeding from the defect. We believe that routine FASO is useful for detecting emergency conditions, including uterine rupture during pregnancy and postpartum. When a pregnant woman complains of abdominal pain, an assessment with FASO is strongly recommended in the daily clinical setting.

  19. Monochorionic twin delivery after conservative surgical treatment of a patient with severe diffuse uterine adenomyosis without uterine rupture

    PubMed Central

    Kwack, Jae Young; Jeon, Su-Bun; Kim, Keuna; Lee, Soo-Jeong

    2016-01-01

    A 31-year-old nulliparous woman with severe diffuse uterine adenomyosis, which replaced nearly the whole uterine myometrium, visited our hospital due to severe dysmenorrhea, menorrhagia, and a desire to have a baby. The patient had a history of two spontaneous abortions. Laparotomic adenomyomectomy with transient occlusion of uterine arteries (TOUA) was performed safely and the patient tried in vitro fertilization and achieved a intrauterine twin pregnancy after recovery time of the operation. At 31+6 weeks of gestation, a male neonate baby weighing 1,620 g and a male neonate baby weighing 1,480 g were born by transverse lower segment cesarean delivery. There was no complication after the operation. The babies were discharged after receiving routine neonatal intensive care for neonatal respiratory distress syndrome. Adenomyomectomy with TOUA technique would be an option for conservative surgical treatment in patients with severe diffuse whole uterine adenomyosis. This is the first report of twin pregnancy after diffuse whole uterine adenomyomectomy with TOUA. PMID:27462599

  20. Monochorionic twin delivery after conservative surgical treatment of a patient with severe diffuse uterine adenomyosis without uterine rupture.

    PubMed

    Kwack, Jae Young; Jeon, Su-Bun; Kim, Keuna; Lee, Soo-Jeong; Kwon, Yong Soon

    2016-07-01

    A 31-year-old nulliparous woman with severe diffuse uterine adenomyosis, which replaced nearly the whole uterine myometrium, visited our hospital due to severe dysmenorrhea, menorrhagia, and a desire to have a baby. The patient had a history of two spontaneous abortions. Laparotomic adenomyomectomy with transient occlusion of uterine arteries (TOUA) was performed safely and the patient tried in vitro fertilization and achieved a intrauterine twin pregnancy after recovery time of the operation. At 31+6 weeks of gestation, a male neonate baby weighing 1,620 g and a male neonate baby weighing 1,480 g were born by transverse lower segment cesarean delivery. There was no complication after the operation. The babies were discharged after receiving routine neonatal intensive care for neonatal respiratory distress syndrome. Adenomyomectomy with TOUA technique would be an option for conservative surgical treatment in patients with severe diffuse whole uterine adenomyosis. This is the first report of twin pregnancy after diffuse whole uterine adenomyomectomy with TOUA. PMID:27462599

  1. Spontaneous rupture: a rare complication of hepatic hemangiomas.

    PubMed

    De Beul, P; Roels, P; Heirwegh, G; Janssen, A; Claikens, B

    2014-01-01

    Hepatic lesions are one of the possible visceral causes of spontaneous hemoperitoneum. Hepatic hemangiomas are congenital vascular malformations and are the most common benign tumours of the liver. Most cases are asymptomatic. Although they seldom rupture, it is important to diagnose them as their global mortality rate is high. An accurate diagnosis of a hemangioma as cause of a hemoperitoneum would result in correct clinical decision making and treatment. PMID:25597208

  2. Spontaneous splenic rupture during Pringle maneuver in liver surgery.

    PubMed

    van Buijtenen, Jesse M; Lamme, Bas; Hesselink, Erik J

    2010-06-27

    During liver resection clamping of the hepato-duodenal ligament (the Pringle maneuver) is performed to reduce intraoperative blood-loss. During this maneuver acute portal hypertension may lead to spontaneous splenic rupture requiring rapid splenectomy in order to control blood loss. We present 2 case of patients with hemorrhage from the spleen during clamping for liver surgery. A review of the literature with an emphasis on the pathophysiology of splenic hemorrhage is presented. PMID:21161004

  3. Fatal uterine rupture during oxytocin-augmented, saline-induced abortion.

    PubMed

    Grimes, D A; Cates, W; Petitti, D B; Pakter, J

    1978-03-01

    In light of the knowledge of the association between oxytocin administration and uterine rupture in late pregnancy, supraphysiologic doses of intravenous oxytocin are used by physicians to augment second trimester saline-induced abortions. According to the Center for Disease Control, this practice causing uterine rupturing is not unique to higher parities and can be fatal if not recognized. 2 case studies are reported. The 1st case, a 23-year-old woman (gravida 3, para 2), underwent saline instilled elective abortion at 18 menstrual weeks' gestation. Following removal of 200 cc of clear amniotic fluid from the uterus, an equal volume of 20% saline was instilled. 2 hours later, intravenous oxytocin was begun and an additional 400 mg of oxytocin was administered in the next 32 hours. 35 hours after instillation the patient had a thready pulse and blood pressure of 88/60, followed by stupor and cardiopulmonary arrest. After resuscitation a laparotomy disclosed an anterior paramedian laceration of the uterus. A hysterectomy was performed, the subsequent course was complicated, and the patient died on the 5th hospital day. In Case 2 a 29-year-old obese women (gravida 4, para 3) had an elective saline-instilled abortion at 20 menstrual weeks' gestation. After saline instillation the patient received intravenous oxytocin in the following amounts: 1) 60 mg; 2) 40 mg, with mild bleeding noted, and 3) 60 mg, followed by profuse vaginal bleeding. The fetus and the placenta were removed, and no detection of uterine rupture was made. The patient was transferred to another hospital, and died 5 hours later following multiple cardiopulmonary arrests. Rupture of the gravida uterus is defined as disruption of the uterine wall, occurring predominantly in the lower uterine segment. Uterine rupture and rupture during a term birth are probably analogous. The death-to-case rate for saline-induced abortions in the U.S. from 1972 to 1975 is .08 deaths/100,000, however, this rate would be

  4. Spontaneous Rupture of Hepatic Metastasis from Pancreatic Adenocarcinoma.

    PubMed

    Rahul, Anil; Robin, Fernandes; Adarsh, Hiremath

    2016-01-01

    A 58-year-old man with advanced-stage pancreatic adenocarcinoma presented with fatigue and dyspnea. Examination revealed tachycardia (102 b/min) with mild tenderness in right upper quadrant. His hemoglobin (Hb) was 7.9 g/dL (10 days prior to presentation 12.2 g/dL), International normalized ratio (INR), platelet count was normal, and the stool guaiac test was negative. On admission, abdominal computed tomography (CT) scan showed hepatic metastatic lesion with a rupture and hemoperitoneum communicating to the subdiaphragmatic space. This rapid progression of anemia along with presenting symptoms and CT imaging were attributed to diagnosis of spontaneous rupture of liver metastasis from pancreatic adenocarcinoma. Patient received blood transfusion and hemoglobin was monitored in successive intervals. His general condition and anemia improved with conservative management and he was discharged in 3 days. Repeated CT after 4 months showed resolving hemoperitoneum and stable hemoglobin levels. The patient deceased 9 months after being diagnosed. A literature search revealed limited data regarding the incidence and management of spontaneous rupture of metastatic lesion secondary to pancreatic adenocarcinoma which has been managed conservatively and thus we are reporting our experience. PMID:27597912

  5. Spontaneous Rupture of Hepatic Metastasis from Pancreatic Adenocarcinoma

    PubMed Central

    Robin, Fernandes; Adarsh, Hiremath

    2016-01-01

    A 58-year-old man with advanced-stage pancreatic adenocarcinoma presented with fatigue and dyspnea. Examination revealed tachycardia (102 b/min) with mild tenderness in right upper quadrant. His hemoglobin (Hb) was 7.9 g/dL (10 days prior to presentation 12.2 g/dL), International normalized ratio (INR), platelet count was normal, and the stool guaiac test was negative. On admission, abdominal computed tomography (CT) scan showed hepatic metastatic lesion with a rupture and hemoperitoneum communicating to the subdiaphragmatic space. This rapid progression of anemia along with presenting symptoms and CT imaging were attributed to diagnosis of spontaneous rupture of liver metastasis from pancreatic adenocarcinoma. Patient received blood transfusion and hemoglobin was monitored in successive intervals. His general condition and anemia improved with conservative management and he was discharged in 3 days. Repeated CT after 4 months showed resolving hemoperitoneum and stable hemoglobin levels. The patient deceased 9 months after being diagnosed. A literature search revealed limited data regarding the incidence and management of spontaneous rupture of metastatic lesion secondary to pancreatic adenocarcinoma which has been managed conservatively and thus we are reporting our experience. PMID:27597912

  6. Recurrence of Uterine Rupture in a Pseudo-Unicornuate Uterus at 17 Weeks of Amenorrhea: Case Report and Literature Review

    PubMed Central

    Errarhay, S; Mahmoud, S; Bouchikhi, C; Châara, H; Bouguern, H; Melhouf, MA; Banani, A

    2009-01-01

    Pregnancy in a rudimentary horn is a very rare condition. It is responsible for several complications. Prognosis is reserved because the natural evolution generally leads to a cataclysmic uterine rupture at the beginning of the second trimester. Classically, the treatment after foetal extraction consists of ablation of the rudimentary horn and associated fallopian tube. We report the obstetric outcome of a patient with history of rudimentary uterine horn rupture, the treatment of which was ablation of the rudimentary horn. PMID:21483504

  7. Recurrence of uterine rupture in a pseudo-unicornuate uterus at 17 weeks of amenorrhea: case report and literature review.

    PubMed

    Errarhay, S; Mahmoud, S; Bouchikhi, C; Châara, H; Bouguern, H; Melhouf, Ma; Banani, A

    2009-01-01

    Pregnancy in a rudimentary horn is a very rare condition. It is responsible for several complications. Prognosis is reserved because the natural evolution generally leads to a cataclysmic uterine rupture at the beginning of the second trimester. Classically, the treatment after foetal extraction consists of ablation of the rudimentary horn and associated fallopian tube. We report the obstetric outcome of a patient with history of rudimentary uterine horn rupture, the treatment of which was ablation of the rudimentary horn. PMID:21483504

  8. Spontaneous expulsion of decidualized pseudopolyps in pregnant women with uterine malformation.

    PubMed

    Gangemi, O; Petrone, M; Crivelli, F

    1987-01-01

    Two cases concerning expulsion of decidualized polyps in early pregnancy associated with uterine malformation are described. The authors discuss the differential diagnosis between the expulsion of cervical polyps during pregnancy and the ectopic pregnancy associated with polyposis. They suggest that a spontaneous expulsion of polyps or pseudopolyps during early pregnancy may be a sign of the presence of uterine malformation.

  9. Spontaneous Splenic Rupture in Vascular Ehlers-Danlos Syndrome.

    PubMed

    Batagini, Nayara Cioffi; Gornik, Heather; Kirksey, Lee

    2015-01-01

    Vascular Ehlers-Danlos Syndrome (VEDS) is a rare autosomal dominant collagen vascular disorder. Different from other Ehler-Danlos Syndrome subtypes, VEDS has poor prognosis due to severe fragility of connective tissues and association with life-threatening vascular and gastrointestinal complications. Spontaneous splenic rupture is a rare but hazardous complication related to this syndrome. To date, only 2 cases have been reported in the literature. Here we present another case of this uncommon complication, occurring in a 54-year-old woman in clinical follow-up for VEDS who presented with sudden onset of abdominal pain and hypotension.

  10. Spontaneous Splenic Rupture in Vascular Ehlers-Danlos Syndrome.

    PubMed

    Batagini, Nayara Cioffi; Gornik, Heather; Kirksey, Lee

    2015-01-01

    Vascular Ehlers-Danlos Syndrome (VEDS) is a rare autosomal dominant collagen vascular disorder. Different from other Ehler-Danlos Syndrome subtypes, VEDS has poor prognosis due to severe fragility of connective tissues and association with life-threatening vascular and gastrointestinal complications. Spontaneous splenic rupture is a rare but hazardous complication related to this syndrome. To date, only 2 cases have been reported in the literature. Here we present another case of this uncommon complication, occurring in a 54-year-old woman in clinical follow-up for VEDS who presented with sudden onset of abdominal pain and hypotension. PMID:26323967

  11. Can Intrapartum Cardiotocography Predict Uterine Rupture among Women with Prior Caesarean Delivery?: A Population Based Case-Control Study

    PubMed Central

    Andersen, Malene M.; Thisted, Dorthe L. A.; Amer-Wåhlin, Isis; Krebs, Lone

    2016-01-01

    Objective To compare cardiotocographic abnormalities recorded during labour in women with prior caesarean delivery (CD) and complete uterine rupture with those recorded in controls with prior CD without uterine rupture. Study Design Women with complete uterine rupture during labour between 1997 and 2008 were identified in the Danish Medical Birth Registry (n = 181). Cases were validated by review of medical records and 53 cases with prior CD, trial of labour, available cardiotocogram (CTG) and complete uterine rupture were included and compared with 43 controls with prior CD, trial of labour and available CTG. The CTG tracings were assessed by 19 independent experts divided into groups of three different experts for each tracing. The assessors were blinded to group, outcome and clinical data. They analyzed occurrence of defined abnormalities and classified the traces as normal, suspicious, pathological or pre-terminal according to international guidelines (FIGO). Results A pathological CTG during the first stage of labour was present in 77% of cases and in 53% of the controls (OR 2.58 [CI: 0.96–6.94] P = 0.066). Fetal tachycardia was more frequent in cases with uterine rupture (OR 2.50 [CI: 1.0–6.26] P = 0.053). Significantly more cases showed more than 10 severe variable decelerations compared with controls (OR 22 [CI: 1.54–314.2] P = 0.022). Uterine tachysystole was not correlated with the presence of uterine rupture. Conclusion A pathological cardiotocogram should lead to particular attention on threatening uterine rupture but cannot be considered a strong predictor as it is common in all women with trial of labour after caesarean delivery. PMID:26872018

  12. Spontaneous Ruptured Uterus in an Adolescent With Polycystic Ovarian Syndrome and Endometrial Hyperplasia.

    PubMed

    Baquing, Mary Anne; Brotherton, Joy

    2015-01-01

    Uterine diverticula and rudimentary horns are rare forms of uterine anomalies that occur during embryogenesis. They can communicate with the endometrial cavity and may have the potential to develop pathology. This case report presents an obese, anovulatory adolescent with polycystic ovarian syndrome who was admitted with acute abdominal pain and found to have radiological findings that were concerning for a ruptured mass contiguous with the uterine cavity, which was likely a uterine horn or diverticulum. Further evaluation revealed simple hyperplasia without atypia on endometrial sampling, supporting the surgical resection and subsequent medical management of this young patient.

  13. MR appearance of bilateral, spontaneous patellar tendon rupture in systemic lupus erythematosus.

    PubMed

    Gould, E S; Taylor, S; Naidich, J B; Furie, R; Lane, L

    1987-01-01

    Bilateral spontaneous patellar tendon rupture is an unusual complication in patients with systemic lupus erythematosus. The ability of magnetic resonance to detect these tendon abnormalities is demonstrated.

  14. Spontaneous bilateral kidney rupture during autologous stem cell transplantation in a patient affected by amyloidosis

    PubMed Central

    Ferrannini, Michele; Vischini, Gisella; De Angelis, Gottardo; Giannakakis, Konstantinos; Arcese, William

    2011-01-01

    Kidney spontaneous rupture is not a recognized complication neither for amyloidosis nor of autologous stem cell transplantation (ASCT). A 46-year-old white woman, affected by nephrotic syndrome, was diagnosed as AL amyloidosis by renal biopsy. We report the singular case of a bilateral spontaneous kidney rupture during ASCT for AL with renal rescue. PMID:25984105

  15. Spontaneous Healing of the Ruptured Anterior Cruciate Ligament

    PubMed Central

    Roe, Justin; Salmon, Lucy; Waller, Alison; Linklater, James; Pinczewski, Leo

    2016-01-01

    Objectives: It is widely believed that ACL tears are incapable of healing. However, there are anecdotal experiences of the healed ACL and sporadic case reports and series documenting either clinical or radiographic evidence of healed ACL tears. A truly healed ACL would demonstrate a clinically stable knee on Lachman and pivot shift testing, normal return to function and MRI and/or arthroscopic documentation of a continuous ligament. This is in contrast to “copers” who have an ACL deficient knee but lack instability either because of good neuromuscular control or non-participation in activities which are heavily ACL dependent. In this prospective series we report on the presentation and 5 year follow-up of patients with both clinical and radiographically healed ACLs. Methods: 19 patients who presented between July 2007 and April 2010 within 6 weeks of injury with clinical laxity and MRI confirmed ACL rupture. Patients subsequently demonstrated clinical knee stability at 8-12 weeks after pre-habilitation to obtain a pain free mobile joint. Prospective data was collected on these patients with MRI at 12 months, IKDC clinical and subjective scores, KT1000 instrumental laxity testing and Lysholm knee score at 12, 24 and 60 months. Results: At one year follow-up MRI 18/19 patients demonstrated a healed ACL with normal signal, normal trajectory and continuity of fibres. Remainder 1 patient demonstrated bridging of ACL tear with scar tissue and abnormal trajectory of fibers. 5 of 19 patients re-ruptured within 5 years of follow-up. At 5 years follow-up, intact healed ACL patients had a mean IKDC score of 88, mean Lysholm score of 92 and mean KT1000 score of 1.7 mm. 100% reported regular participation in strenuous sport. Conclusion: Although rare, spontaneous healing of the ACL is possible. The mechanism by which this occurs in unknown. It is recommended that reassessment of knee stability should be performed in the non-acute phase after an appropriate prehabilitation

  16. Emergency operation of a patient with spontaneous rupture and massive hemorrhage of pleural solitary fibrous tumor.

    PubMed

    Shao, Feng; Yang, Rusong; Pan, Yanqing

    2014-10-01

    Solitary fibrous tumor (SFT) is a rare pleural disease with asymptomatic clinical course. We report a case of a patient with spontaneous rupture and massive hemorrhage of pleural SFT, which was treated by emergency operation.

  17. Pseudoaneurysm After Spontaneous Rupture of Renal Angiomyolipoma in Tuberous Sclerosis: Successful Treatment with Percutaneous Thrombin Injection

    SciTech Connect

    Corso, Rocco Carrafiello, Gianpaolo; Rampoldi, Antonio; Leni, Davide; Ticca, Cristiana; Vercelli, Ruggero; Vanzulli, Angelo

    2005-04-15

    We report a case of a large perinephric pseudoaneurysm due to spontaneous rupture of renal angiomyolipoma, occluded by percutaneous thrombin injection under ultrasound guidance in a young woman affected by tuberous sclerosis.

  18. Role of laparoscopy as a minimally invasive procedure in treatment of ruptured uterine scar during second-trimester induction of abortion.

    PubMed

    Zheng, Yanmei; Jiang, Qiaoying; Lv, Ya-Er; Liu, Feng; Yang, Liwei

    2016-04-01

    Uterine rupture is an uncommon complication following termination of pregnancy and is usually accompanied by severe lower abdominal pain and shock caused by intra-abdominal hemorrhage. Laparotomy should be carried out promptly in order to repair the uterus or even to resect the uterus. Here we present a case of uterine rupture of a scarred uterus, which occurred during a second-trimester induced abortion. The patient was successfully treated by laparoscopy with the help of laparoscopic ultrasound. This case suggests an alternative, effective approach to the diagnosis and treatment of uterine rupture. PMID:26695381

  19. Osteotendinous repair of bilateral spontaneous quadriceps tendon ruptures with the Krackow technique in two patients with chronic renal failure.

    PubMed

    Kara, Adnan; Sari, Seçkin; Şeker, Ali; Öztürk, Irfan

    2013-01-01

    Although unilateral traumatic quadriceps tendon rupture is a relatively frequent pathology, bilateral non-traumatic spontaneous ruptures are uncommon and are usually associated with chronic renal failure, hyperparathyroidism, gout, and systemic lupus erythematosus. This paper aimed to discuss two patients with chronic renal failure treated with the Krackow suture technique for spontaneous bilateral quadriceps tendon rupture.

  20. Spontaneous Rupture of Kidney Due to Posterior Urethral Valve–Diagnostic Difficulties

    PubMed Central

    Kiliś-Pstrusińska, Katarzyna; Pukajło-Marczyk, Agnieszka; Patkowski, Dariusz; Zalewska-Dorobisz, Urszula; Zwolińska, Danuta

    2013-01-01

    Background Spontaneous kidney rupture could develop in the course of posterior urethral valve (PUV), the most common cause of outflow urinary tract obstruction in male infants. However, urinary extravasation is a rare complication among this group of children. Case Presentation Our case report presents diagnostic difficulties connected with spontaneous kidney rupture due to PUV in a 6 week-old infant. Due to not equivocal images, thundery course of disease and rapid deterioration in the infant's condition, the patient required an urgent laparatomy. Conclusion This case showed that the investigation of renal abnormalities during early neonatal period, is very important specifically in PUV that can lead to kidney rupture. PMID:23795264

  1. Nationwide population-based cohort study of uterine rupture in Belgium: results from the Belgian Obstetric Surveillance System

    PubMed Central

    Vandenberghe, G; De Blaere, M; Van Leeuw, V; Roelens, K; Englert, Y; Hanssens, M; Verstraelen, H

    2016-01-01

    Objectives We aimed to assess the prevalence of uterine rupture in Belgium and to evaluate risk factors, management and outcomes for mother and child. Design Nationwide population-based prospective cohort study. Setting Emergency obstetric care. Participation of 97% of maternity units covering 98.6% of the deliveries in Belgium. Participants All women with uterine rupture in Belgium between January 2012 and December 2013. 8 women were excluded because data collection forms were not returned. Results Data on 90 cases of confirmed uterine rupture were obtained, of which 73 had a previous Caesarean section (CS), representing an estimated prevalence of 3.6 (95% CI 2.9 to 4.4) per 10 000 deliveries overall and of 27 (95% CI 21 to 33) and 0.7 (95% CI 0.4 to 1.2) per 10 000 deliveries in women with and without previous CS, respectively. Rupture occurred during trial of labour after caesarean section (TOLAC) in 57 women (81.4%, 95% CI 68% to 88%), with a high rate of augmented (38.5%) and induced (29.8%) labour. All patients who underwent induction of labour had an unfavourable cervix at start of induction (Bishop Score ≤7 in 100%). Other uterine surgery was reported in the history of 22 cases (24%, 95% CI 17% to 34%), including 1 case of myomectomy, 3 cases of salpingectomy and 2 cases of hysteroscopic resection of a uterine septum. 14 cases ruptured in the absence of labour (15.6%, 95% CI 9.5% to 24.7%). No mothers died; 8 required hysterectomy (8.9%, 95% CI 4.6% to 16.6%). There were 10 perinatal deaths (perinatal mortality rate 117/1000 births, 95% CI 60 to 203) and perinatal asphyxia was observed in 29 infants (34.5%, 95% CI 25.2% to 45.1%). Conclusions The prevalence of uterine rupture in Belgium is similar to that in other Western countries. There is scope for improvement through the implementation of nationally adopted guidelines on TOLAC, to prevent use of unsafe procedures, and thereby reduce avoidable morbidity and mortality. PMID:27188805

  2. Peritoneal lavage with distilled water during liver resection in patients with spontaneously ruptured hepatocellular carcinomas.

    PubMed

    Lin, Chien-Hua; Hsieh, Huan-Fa; Yu, Jyh-Cherng; Chen, Teng-Wei; Yu, Chih-Yung; Hsieh, Chung-Bao

    2006-09-01

    Spontaneously rupture of hepatocellular carcinoma is a life threatening and worse prognosis. Not only the lower rate of resection and hemodynamic unstable, but also the hepatic failure and recurrence. Distilled water irrigation had been applied in several cancer surgeries including colon, stomach, breast, ovary, and bladder; thus had good results in lowering the tumor spreading. We applied distilled water peritoneal lavage after liver resection in patients with spontaneous rupture of hepatocellular carcinoma to define the influence of prognosis. Thirteen patients with spontaneous ruptured hepatocellular carcinoma underwent distilled water peritoneal lavage after curative liver resection (Group A). Nineteen patients with spontaneous ruptured hepatocellular carcinoma did not undergo distilled water peritoneal lavage after curative liver resection (Group B). There were 11 patients of tumor recurrence in Group B; 2 in Group A. The mean disease-free time of Group B was 2.05 +/- 0.74 years; for Group A it was 3.59 +/- 0.60 (P = 0.045). Peritoneal lavage in this series resulted in significantly better survival time for the patients in Group A (P = 0.0158). That implies distilled water peritoneal lavage during liver resection would retard the tumor recurrence and further improve the survival rate in patients with spontaneously ruptured hepatocellular carcinoma. PMID:16900516

  3. Life-threatening spontaneous kidney rupture in a rare case with systemic lupus erythematosus: Prompt diagnosis with computed tomography.

    PubMed

    Ufuk, Furkan; Herek, Duygu

    2016-01-01

    Nontraumatic, spontaneous parenchymal kidney rupture is a rare clinical entity that may cause extensive hemorrhage, hypovolemic shock, and death. Spontaneous nontraumatic kidney rupture is extremely rare in systemic lupus erythematosus (SLE) patients. Because of the high morbidity and mortality rates, an immediate establishment of the diagnosis and treatment are necessary. We present the case of a 30-year-old female with spontaneous parenchymal rupture of the right kidney who had renal failure due to SLE and presented with atraumatic sudden right flank pain during hemodialysis treatment. To our knowledge, this case is the second report of SLE manifesting as spontaneous kidney rupture in the literature.

  4. Spontaneous rupture of hepatic artery aneurysm associated with polyarteritis nodosa.

    PubMed

    Parent, Brodie A; Cho, Sung W; Buck, David G; Nalesnik, Michael A; Gamblin, T Clark

    2010-12-01

    Polyarteritis nodosa (PAN) is a vasculitis, which often involves small and medium sized visceral arteries. This condition may result in multifocal aneurismal formation and end-organ damage. Uncommonly, PAN may present with rupture of hepatic artery aneurysms. Here, we report a rare case of a ruptured intrahepatic aneurysm associated with PAN. A 79-year-old woman presenting with abdominal pain had CT scan of the abdomen, which revealed hematoma in the right hepatic lobe. Visceral angiogram confirmed pseudo-aneurysm of a right hepatic arterial branch, and this was managed with endovascular coil embolization. The diagnosis of PAN was made and corticosteroid therapy was initiated. We also performed a literature review to define this condition's demographics, clinical presentations, and appropriate management. The review revealed 17 published cases of ruptured PAN-related intrahepatic aneurysms. We conclude that unexplained findings of visceral arterial aneurysms should prompt investigations for vasculitis as the etiology.

  5. Spontaneous patellar tendon rupture in a case followed up for diagnosis of systemic lupus erythematosus

    PubMed Central

    Albayrak, İlknur; Küçük, Adem; Arslan, Şevket; Özbek, Orhan

    2014-01-01

    Spontaneous patellar tendon rupture is a rare condition that usually occurs secondary to conditions, such as rheumatoid arthritis, systemic lupus erythematosus (SLE), and use of steroids and fluoroquinolones. This paper presents a full-thickness patellar tendon rupture detected with magnetic resonance imaging, which was performed due to pain and swelling that started spontaneously on the front side of the left knee without a history of any trauma, of a 35-year-old male patient who had been followed up for a diagnosis of SLE for approximately 4 months and who had started taking methylprednisolone 4 mg/day 4 months prior, used it for 1 month, and then stopped using it. In patients who are followed up for a diagnosis of SLE, it should be kept in mind that there is a risk of developing a spontaneous tendon rupture secondary to chronic inflammation and use of corticosteroids.

  6. Spontaneous rupture and hemorrhage of adrenal pseudocyst presenting with acute abdomen and shock.

    PubMed

    Mahmodlou, Rahim; Valizadeh, Neda

    2011-12-01

    Adrenal gland pseudocysts are not common conditions, and most of them are nonfunctional and asymptomatic. However, large pseudocysts may causes abdominal discomfort and have compressive effects on adjacent organs. They may rupture spontaneously or after trauma, and lead to retroperitoneal hemorrhage and surgical emergency. Herein, we report a case of 21-year-old female who presented with acute abdomen and hemorrhagic shock due to spontaneous rupture of adrenal pseudocyst. She was treated successfully by open surgery, removal of adrenal pseudocyst and unilateral adrenalectomy.

  7. Tianeptine's effects on spontaneous and Ca2+-induced uterine smooth muscle contraction.

    PubMed

    Oreščanin-Dušić, Zorana; Miljević, C D; Slavić, M; Nikolić-Kokić, A; Paskulin, R; Blagojević, D; Lečić-Toševski, D; Spasić, M B

    2012-06-01

    Tianeptine is a novel anti-depressant with an efficacy equivalent to that of classical anti-depressants. Additional beneficial effects include neuroprotection, anti-stress and anti-ulcer properties whose molecular mechanisms are still not completely understood but may involve changes in the anti-oxidant defence system. Herein, we have studied the effects of tianeptine on both contractile activity of isolated rat uteri and components of the endogenous anti-oxidative defence system. Tianeptine-induced dose-dependent inhibition of both spontaneous and Ca2+-induced contraction of uterine smooth muscle. The effect was more pronounced in the latter. Tianeptine treatment increased glutathione peroxidase (GSH-Px) and catalase (CAT) activities in spontaneous and Ca2+-stimulated uteri. A significant decrease in glutathione-reductase (GR) activity in both spontaneous and Ca2+-induced uterine contractions after tianeptine treatment indicated a reduction in reduced glutathione and consequently a shift toward a more oxidised state in the treated uteri. In spontaneously contracting uteri, tianeptine caused a decrease in copper-zinc SOD (CuZnSOD) activity. Tianeptine's anti-depressant effects may be accomplished by triggering a cascade of cellular adaptations including inhibition of smooth muscle contractility and an adequate anti-oxidative protection response. PMID:22849838

  8. Exposure to light at night accelerates aging and spontaneous uterine carcinogenesis in female 129/Sv mice

    PubMed Central

    Popovich, Irina G.; Zabezhinski, Mark A.; Panchenko, Andrei V.; Piskunova, Tatiana S.; Semenchenko, Anna V.; Tyndyk, Maragriata L.; Yurova, Maria N.; Anisimov, Vladimir N.

    2013-01-01

    The effect of the constant illumination on the development of spontaneous tumors in female 129/Sv mice was investigated. Forty-six female 129/Sv mice starting from the age of 2 mo were kept under standard light/dark regimen [12 h light (70 lx):12hr dark; LD, control group], and 46 of 129/Sv mice were kept under constant illumination (24 h a day, 2,500 lx, LL) from the age of 5 mo until to natural death. The exposure to the LL regimen significantly accelerated body weight gain, increased body temperature as well as acceleration of age-related disturbances in estrous function, followed by significant acceleration of the development of the spontaneous uterine tumors in female 129/Sv mice. Total tumor incidence as well as a total number of total or malignant tumors was similar in LL and LD group (p > 0.05). The mice from the LL groups survived less than those from the LD group (χ2 = 8.5; p = 0.00351, log-rank test). According to the estimated parameters of the Cox’s regression model, constant light regimen increased the relative risk of death in female mice compared with the control (LD) group (p = 0.0041). The data demonstrate in the first time that the exposure to constant illumination was followed by the acceleration of aging and spontaneous uterine tumorigenesis in female 129/Sv mice. PMID:23656779

  9. Historia morbi atrocis--2 new cases of spontaneous rupture of the esophagus (Boerhaave syndrome).

    PubMed

    Tagan, D; Boesch, C; Baur, A; Berger, J P

    1990-11-24

    We report the case of two patients hospitalized within a few weeks of each other and both presenting with spontaneous rupture of the esophagus whose evolution proved fatal. We take the opportunity of drawing attention to this rare and challenging disease, which is often diagnosed too late.

  10. Spontaneous rupture of the urinary bladder (SRUB); A case report and review of literature

    PubMed Central

    Sawalmeh, Haitham; Al-Ozaibi, Labib; Hussein, Ahmed; Al-Badri, Faisal

    2015-01-01

    Introduction Spontaneous urinary bladder rupture is a rare urological emergency. It is usually secondary to an underlying pathology and it is an uncommon complication of urosepsis. We report a case of spontaneous urinary bladder rupture as a complication of urosepsis in a 67 year old male patient, who was admitted as a case of left diabetic foot and urinary tract infection. Case presentation A 67 year old male patient with a long standing indwelling urinary catheter and chronic cystitis developed acute peritonitis. Intraoperative finding was ruptured urinary bladder. Discussion A few cases of spontaneous urinary bladder rupture due to infection were found in literature. The majority of the patients present with diffuse abdominal pain, and tenderness due to chemical peritonitis. In the majority of cases the bladder perforation was diagnosed intra-operative. Conclusion A diagnosis of spontaneous perforation of the bladder should be considered in patients presenting with an acute abdomen. The general surgeon is more likely than the urologist to encounter such patients in the first instance. There should be a high index of suspicion in patients with an acute abdomen and have associated urinary bladder condition. PMID:26451645

  11. Spontaneous rupture of the kidney in the patients with synchronous renal hemangioma and nephrogenic hypertension

    PubMed Central

    Memmedoğlu, Akif; Musayev, Jamal

    2015-01-01

    Most renal neoplasms in adults are epithelial in origin and mesenchymal tumors are rarely encountered. Vascular tumors and tumor-like lesions account for a very small subset. Hemangioma of the kidney is a rarely seen benign vascular neoplasm that probably arises from angioblastic cells. Its general sign is macroscopic hematuria with or without pain. Preoperative diagnosis is difficult or impossible. Previously, spontaneous rupture of the kidney caused by renal hemangioma was not reported in the English literature. In this study, two cases with a history of nephrogenic hypertension who presented with spontaneous renal rupture are presented. There wasn’t any trauma history in the background of our patients. A long-standing nephrogenic hypertension was present in both patients. Patients underwent radical nephrectomy due to rupture of the renal tumor. In histopathological examination, capillary hemangioma was detected in the renal medulla in both cases. Patients didn’t need antihypertensive therapy during the postoperative period. PMID:26623154

  12. The role of cellular coupling in the spontaneous generation of electrical activity in uterine tissue.

    PubMed

    Xu, Jinshan; Menon, Shakti N; Singh, Rajeev; Garnier, Nicolas B; Sinha, Sitabhra; Pumir, Alain

    2015-01-01

    The spontaneous emergence of contraction-inducing electrical activity in the uterus at the beginning of labor remains poorly understood, partly due to the seemingly contradictory observation that isolated uterine cells are not spontaneously active. It is known, however, that the expression of gap junctions increases dramatically in the approach to parturition, by more than one order of magnitude, which results in a significant increase in inter-cellular electrical coupling. In this paper, we build upon previous studies of the activity of electrically excitable smooth muscle cells (myocytes) and investigate the mechanism through which the coupling of these cells to electrically passive cells results in the generation of spontaneous activity in the uterus. Using a recently developed, realistic model of uterine muscle cell dynamics, we investigate a system consisting of a myocyte coupled to passive cells. We then extend our analysis to a simple two-dimensional lattice model of the tissue, with each myocyte being coupled to its neighbors, as well as to a random number of passive cells. We observe that different dynamical regimes can be observed over a range of gap junction conductances: at low coupling strength, corresponding to values measured long before delivery, the activity is confined to cell clusters, while the activity for high coupling, compatible with values measured shortly before delivery, may spread across the entire tissue. Additionally, we find that the system supports the spontaneous generation of spiral wave activity. Our results are both qualitatively and quantitatively consistent with observations from in vitro experiments. In particular, we demonstrate that the increase in inter-cellular electrical coupling observed experimentally strongly facilitates the appearance of spontaneous action potentials that may eventually lead to parturition. PMID:25793276

  13. The clinical effect of tendon repair for tendon spontaneous rupture after corticosteroid injection in hands

    PubMed Central

    Lu, Hui; Yang, Hu; Shen, Hui; Ye, Ganmin; Lin, Xiang-Jin

    2016-01-01

    Abstract Corticosteroid injections for hand tendinitis can lead to a rare significant complication of tendon spontaneous rupture. However, only sporadic cases were reported in the literature before. This study was designed to gauge the clinical effect of tendon repair in patients of tendon spontaneous rupture after corticosteroid injection and analyze our experience. This was a retrospective observational study of 13 patients (8 women and 5 men) operated between July 2011 and December 2015 for tendon spontaneous rupture after corticosteroid injection. Demographic data, clinical features, imaging data, and surgical treatments were carefully reviewed. The average age was 52.308 ± 15.381 years (range 29–71). The average injection times were 2.538 ± 1.664 times (range 1–6). The average rupture time (after last injection) was 10.923 ± 9.500 weeks (range 3–32). Nine patients were treated by tendon suture (69% of cases), and 4 patients were treated by tendon grafting (31% of cases). All patients received follow-up in our outpatient clinic. The sites of the tendon rupture (15 tendons of 13 patients had involved) include extensor pollicis longus (6 tendons, 40% of cases), extensor digiti quinti and extensor digiti minimi (4 tendons, 27% of cases), ring finger of extensor digitorum communis (3 tendons, 20% of cases), and middle finger of extensor digitorum communis (2 tendons, 13% of cases). Two patients who had tendon adhesion (15% of cases) were treated by tendon release. One patient who had tendon rerupture (8% of cases) was treated by tendon grafting. No patient had complications of infections, vascular, or nerve injury. Tendon spontaneous rupture is a serious complication after corticosteroid injection for tendinitis. Rigid standard of corticosteroid injection is very important. Magnetic resonance imaging was contributory to preoperative assess tendon defect and can be used to monitor healing quality of tendons during the follow-up. PMID:27741145

  14. Spontaneous intraperitoneal rupture of a postpartum rectus sheath haematoma.

    PubMed

    Elmoghrabi, Adel; Mohamed, Mohamed; McCann, Michael; Sachwani-Daswani, Gul

    2016-01-01

    A 35-year-old woman presented to the emergency department (ED) with acute severe abdominal pain at 4 days postpartum. CT of the abdomen revealed a type II rectus sheath haematoma for which she was initially treated conservatively and discharged. A few hours later, she returned to the ED with a picture suggestive of peritonitis. Exploratory laparoscopy was performed and revealed haemoperitoneum and a ruptured area on the posterior rectus sheath. Approximately 2 L of blood was aspirated. Haemostatic control was achieved and closed suction drains secured in position. The patient was discharged in stable condition on postadmission day 6. She continued to follow-up on an outpatient basis and was doing well 3 months postoperatively. PMID:26961567

  15. Spontaneous and simultaneous bilateral rupture of the quadriceps tendon. A case report.

    PubMed

    Alpantaki, Kaliopi; Papadokostakis, George; Katonis, Pavlos; Hadjpavlou, Alexander

    2004-02-01

    Simultaneous bilateral rupture of the quadriceps tendon has rarely been reported; it generally occurs in association with chronic metabolic disorders, such as chronic renal failure, obesity, diabetes mellitus and secondary hyperparathyroidism. The case presented here was in an 85-year-old man with no known risk factors, who sustained simultaneous and spontaneous rupture of both quadriceps tendons. The patient suffered from spinal stenosis and degenerative changes in the knee menisci. These findings suggest that instability of the knee due to meniscal damage, and quadriceps weakness as a result of spinal stenosis, may have played a significant role in the pathogenesis of this injury.

  16. Yttrium-90 microsphere radioembolotherapy in a patient with spontaneously ruptured hepatocellular carcinoma.

    PubMed

    Winokur, Ronald S; Talenfeld, Adam D; Mozley, P David; Madoff, David C

    2016-01-01

    Spontaneous rupture of hepatocellular carcinoma (HCC) is a potentially fatal presentation of the disease. Although many options for treatment exist, Yttrium-90 transcatheter arterial radioembolization has not previously been reported. We report a case of a 92-year-old woman found to have a ruptured HCC treated with radioembolization that showed no viable tumor and no extrahepatic disease at 2 years. While further studies are warranted, this patient's clinical course may suggest that radioembolization may be an additional palliative treatment option in these patients.

  17. Spontaneous rupture of the extensor pollicis brevis tendon in a baseball pitcher: a case report.

    PubMed

    Fujimoto, Takuya; Tanase, Yoshihiro; Oribe, Takashi; Watanabe, Yasushi

    2009-01-01

    A 15-year-old pitcher on a boys' Little League baseball team suffered spontaneous rupture of the extensor pollicis brevis (EPB) tendon. Since the EPB tendon was, at surgery, found hypoplastic and non-functional, transfer of the extensor indicis proprius (EIP) tendon was carried out. After a 6-month period of rehabilitation and follow-up, the patient was able to resume playing baseball. Although rupture of the EPB is rare, transfer of the EIP tendon is one of the treatments of choice for such injuries.

  18. Progression of spontaneous in-plane shear faults from sub-Rayleigh to compressional wave rupture speeds

    NASA Astrophysics Data System (ADS)

    Liu, Chao; Bizzarri, Andrea; Das, Shamita

    2014-11-01

    We investigate numerically the passage of spontaneous, dynamic in-plane shear ruptures from initiation to their final rupture speed, using very fine grids. By carrying out more than 120 simulations, we identify two different mechanisms controlling supershear transition. For relatively weaker faults, the rupture speed always passes smoothly and continuously through the range of speeds between the Rayleigh and shear wave speeds (the formerly considered forbidden zone of rupture speeds). This, however, occurs in a very short time, before the ruptures reach the compressional wave speed. The very short time spent in this range of speeds may explain why a jump over these speeds was seen in some earlier numerical and experimental studies and confirms that this speed range is an unstable range, as predicted analytically for steady state, singular cracks. On the other hand, for relatively stronger faults, we find that a daughter rupture is initiated by the main (mother) rupture, ahead of it. The mother rupture continues to propagate at sub-Rayleigh speed and eventually merges with the daughter rupture, whose speed jumps over the Rayleigh to shear wave speed range. We find that this daughter rupture is essentially a "pseudorupture," in that the two sides of the fault are already separated, but the rupture has negligible slip and slip velocity. After the mother rupture merges with it, the slip, the slip velocity, and the rupture speed become dominated by those of the mother rupture. The results are independent of grid sizes and of methods used to nucleate the initial rupture.

  19. [Sudden death caused by the spontaneous rupture of the right ventricle in a woman with chronic Chagas disease].

    PubMed

    Tostes Júnior, S; Lopes, E R; Chapadeiro, E

    1990-01-01

    We report a case of sudden death from hemopericardium consequent to spontaneous rupture of the right ventricle in a 49-year-old chronic chagasic woman. To our knowledge, this is the third reported case of spontaneous cardiac rupture with chagasic cardiomyopathy. In our case we believe that the thinning of the anterior right ventricular wall, its large ray curvature and the increased ventricular pressure were factors favoring the rupture. There was no infarction and the chronic cardiopathy was significant. It caused the thinning of the rupture region through chronic myocarditis.

  20. Biliscrotum and Retroperitoneal Biloma: Spontaneous Rupture of the Biliary System presenting as an Incarcerated Inguinal Hernia

    PubMed Central

    Brady, RRW; McAteer, E; Weir, CD

    2006-01-01

    Spontaneous rupture of the biliary system is a well documented condition in infants1 but is rare in adults.2 We report the case of a 73-year-old gentleman who presented with clinical signs and symptoms mimicking that of a strangulated right inguinal hernia. At emergency operation the scrotum was found to contain bile. Following radiological imaging and exploratory surgery, a large retroperitoneal biloma was found. We discuss the clinical signs associated with biliscrotum and retroperitoneal biloma and describe our operative management of this patient. We review the previously reported cases of these rare clinical entities. We found that our case exhibited similarities in terms of the age of presentation and presence of distal common bile duct stones. This is, to our knowledge, the only reported case of a patient presenting with biliscrotum secondary to the assumed spontaneous rupture of the common bile duct and development of a retroperitoneal biloma. PMID:16457410

  1. Primary amyloidosis with spontaneous splenic rupture, cholestasis, and liver failure treated with emergency liver transplantation.

    PubMed

    Sandberg-Gertzén, H; Ericzon, B G; Blomberg, B

    1998-11-01

    A 61-yr-old man with cholestatic jaundice soon after presentation had an emergency operation because of spontaneous rupture of the spleen. This was found to be caused by primary systemic amyloidosis. After the splenectomy, the patient deteriorated with liver failure and was successfully treated with liver transplantation. Osteopenic fractures of the thoracic columna developed after transplantation. Except for this, the patient is well 18 months after transplantation.

  2. [A Case of Adrenergic Crisis Caused by Spontaneous Rupture of Cystic Pheochromocytoma].

    PubMed

    Miura, Kenji; Kanno, Toru; Nakamae, Keichiro; Kubota, Masashi; Nishiyama, Ryuichi; Okada, Takashi; Higashi, Yoshihito; Yamada, Hitoshi

    2015-11-01

    Pheochromocytoma crisis is a life-threatening situation. Herein we report a case of catecholamineinduced crisis caused by the rupture of cystic pheochromocytoma. A 76-year-old man with hypertension was referred to our hospital because of a cystic tumor in the retroperitoneal space adjacent to the aorta, which was suspicious of pheochromocytoma. Two days after admission, lower abdominal pain suddenly appeared, followed by hypertension with systolic pressure of 260 mmHg. Computed tomography revealed that the cystic tumor was ruptured spontaneously, leading to diagnosis of pheochromocytoma crisis. His blood pressure was successfully managed by medical treatment and he could recover from crisis. After adequate medical preparation by an α-adrenergic blocker, the tumor was successfully removed by laparoscopy, though the adhesion around the tumor was severe. To our knowledge adrenergic crisis caused by spontaneous rupture of cystic pheochromocytoma is rare, but we have to keep in mind that cystic pheochromocytoma can cause life-threatening crisis by the release of catecholamine due to rupture.

  3. Spontaneous and simultaneous bilateral rupture of the quadriceps tendon in a patient with osteogenesis imperfecta: a case report.

    PubMed

    Figueroa, David; Calvo, Rafael; Vaisman, Alex

    2006-03-01

    Bilateral rupture of the quadriceps tendon is an uncommon and serious injury that usually occurs in middle aged to elderly patients. It is frequently associated with chronic metabolic disorders like diabetes, hyperparathyroidism, gout, chronic renal failure or the chronic use of steroids. We report a case of spontaneous bilateral rupture of the quadriceps tendon in a patient with osteogenesis imperfecta.

  4. Progression of Spontaneous in-Plane Shear Faults from Sub-Rayleigh up to Compressional Wave Rupture Speeds

    NASA Astrophysics Data System (ADS)

    Das, S.; Liu, C.; Bizzarri, A.

    2014-12-01

    We investigate numerically the passage of spontaneous, dynamic in-plane shear ruptures from initiation to their final rupture speed, using very fine grids, by carrying out more than 120 simulations. We identify two different mechanisms controlling supershear transition. For weaker faults, the rupture speed always passes continuously through the range of speeds between the Rayleigh and shear wave speeds (forbidden zone of rupture speeds for steady-state ruptures). This, however, occurs in a very short time, before the ruptures reach the compressional wave speed. The very short time spent in this range of speeds may explain why a jump over these speeds was seen in some earlier numerical and experimental studies, and confirms that this speed range is an unstable range, as predicted analytically for steady-state singular cracks and numerically for steady-state non-singular cracks. On the other hand, for stronger faults, we find that a daughter rupture is initiated by the main (mother) rupture, ahead of it. The mother rupture continues to propagate at sub-Rayleigh speed and eventually merges with the daughter rupture, but its speed jumps over the Rayleigh to shear wave speed range. We find that this daughter rupture is essentially a "pseudo-rupture", in that the two sides of the fault are already separated, but the rupture has negligible slip and slip velocity. After the mother rupture merges with it, the slip, the slip velocity and the rupture speed become dominated by those of the mother rupture. The results are independent of grid sizes and of methods used to nucleate the initial rupture.

  5. [Rupture of non-communicating rudimentary pregnant uterine horn in a pseudo-unicornuate uterus at 23 weeks of amenorrhea. Case report].

    PubMed

    Fuchs, F; Guillot, E; Cordier, A-G; Chis, C; Raynal, P; Panel, P

    2008-04-01

    Pregnancy in the rudimentary horn of a unicornuate uterus is an extremely rare form of ectopic gestation associated with a high risk of uterine rupture. We report the case of a pregnancy developed in a non communicating rudimentary horn of a unicornuate uterus complicated by horn rupture at 23 weeks of amenorrhea showing as an acute abdominal pain and massive hemoperitoneum. This patient's uterine abnormality was known before, as this woman has delivered two years before at term a healthy boy by cesarean section. This past pregnancy was located in the normal horn and the non communicating rudimentary horn seemed at this time normal. This uterine malformation is presented with its gynecological and obstetrical entailments as well as methods that could prevent such outcome.

  6. Spontaneous Rupture of an Ovarian Artery Aneurysm: A Rare Postpartum Complication.

    PubMed

    Enakpene, Christopher A; Stern, Toni; Barzallo Salazar, Marco J; Mukherjee, Pradip

    2016-01-01

    Background. Spontaneous rupture of an ovarian artery aneurysm is a rare but usually life-threatening event. It is most often associated with pregnancy or fibroids. Our case followed a normal vaginal delivery and then a delayed presentation with features similar to other less life-threatening postpartum conditions. The diagnosis could have been missed but for the meticulous and timely interventions which avoided catastrophic outcome. Case. This is a case of a multiparous woman with rupture of a left ovarian artery aneurysm, causing massive retroperitoneal hemorrhage and hematoma that required a combination of arterial embolization, percutaneous CT scan guided drainage, and surgical evacuation of the hematoma. Conclusion. Spontaneous rupture of ovarian artery should be considered as one of the differential diagnoses in the immediate postpartum period especially when the clinical symptoms do not correlate with the amount of blood loss. A high index of suspicion, prompt diagnosis, intervention, and a multidisciplinary approach in the management were the elements of a successful outcome in this case. PMID:27034862

  7. Uterine Rupture in Pregnancy following Fall from a Motorcycle: A Horrid Accident in Pregnancy—A Case Report and Review of the Literature

    PubMed Central

    Sisay Woldeyes, Wondimagegnehu; Amenu, Demisew; Segni, Hailemariam

    2015-01-01

    Uterine rupture is one of the most catastrophic complications during pregnancy. It is a rare complication in developed countries but a frequent cause of maternal and perinatal morbidity and mortality in Africa. Uterine rupture occurs in 1.6% of patients suffering blunt abdominal trauma. Here we report a unique case of complete fundal rupture of the unscarred uterus following fall from motorcycle in 39-week-pregnant mother who was managed with total abdominal hysterectomy and left salpingo-oophorectomy and survived, though fetus died before intervention. We also reviewed similar cases reported from different parts of Africa. This is a preventable complication had the woman been properly instructed on transportation safety during her antenatal care visits. PMID:26576307

  8. Spontaneous rupture of the spleen in type IV Ehlers-Danlos syndrome: report of a case.

    PubMed

    Privitera, Antonio; Milkhu, Chaz; Datta, Vivek; Sayegh, Mazim; Cohen, Richard; Windsor, Alastair

    2009-01-01

    The vascular type of Ehlers-Danlos syndrome, type IV, is associated with severe complications, including arterial rupture and visceral perforation. However, to our knowledge, there has been only one previous report of splenic rupture caused by a spontaneous hemorrhage in type IV Ehlers-Danlos syndrome. We report another case of this uncommon complication, occurring in a 35-year-old woman who presented after the sudden onset of acute abdominal pain. Patients should be stabilized quickly in the intensive care unit and the most timesaving surgical techniques used. Moreover, tissues must be handled with great care intraoperatively in view of their extreme fragility. Despite prompt and appropriate treatment, the prognosis is often dismal. PMID:19132469

  9. Spontaneous subarachnoid hemorrhage due to ruptured cavernous internal carotid artery aneurysm after medical prolactinoma treatment.

    PubMed

    Khalsa, Siri Sahib; Hollon, Todd C; Shastri, Ravi; Trobe, Jonathan D; Gemmete, Joseph J; Pandey, Aditya S

    2016-01-01

    Aneurysms of the cavernous segment of the internal carotid artery (ICA) are believed to have a low risk of subarachnoid haemorrhage (SAH), given the confines of the dural rings and the anterior clinoid process. The risk may be greater when the bony and dural protection has been eroded. We report a case of spontaneous SAH from rupture of a cavernous ICA aneurysm in a patient whose large prolactinoma had markedly decreased in size as the result of cabergoline treatment. After passing a balloon test occlusion, the patient underwent successful endovascular vessel deconstruction. This case suggests that an eroding skull base lesion may distort normal anterior cranial base anatomy and allow communication between the cavernous ICA and subarachnoid space. The potential for SAH due to cavernous ICA aneurysm rupture should be recognised in patients with previous pituitary or other skull base lesions adjacent to the cavernous sinus. PMID:27277584

  10. Rapid recovery from spontaneous and simultaneous bilateral quadriceps tendon rupture in an active, healthy individual.

    PubMed

    Gaheer, Rajinder Singh; Hawkins, Amanda

    2010-07-13

    Bilateral spontaneous quadriceps rupture is an uncommon injury that is usually seen in association with multiple medical conditions and is frequently misdiagnosed. It is rarely seen in healthy, active individuals. This article presents a case of bilateral simultaneous and spontaneous rupture of the quadriceps tendon in a healthy, athletic, active and highly motivated patient with rapid recovery from injury and return to full sport activity within a relatively short period of time. A 65-year-old healthy man felt both knees give way while walking down stairs at home and collapsed, unable to bear weight. He was fit and well, not on any medications and basic laboratory screening was within normal limits. He was an active sportsman, horse rider, swimmer, and long-distance cyclist, and had completed a half marathon 1 month before his injury. He was diagnosed with bilateral quadriceps tendon ruptures. An ultrasound of both knees confirmed the diagnosis of full-thickness rupture. Surgical repair of both quadriceps tendons was performed 3 days after the injury. Bilateral locking brace in 10 degrees of flexion was used to immobilize both knees and protect the repair for 6 weeks. The patient remained nonweight bearing for 2 weeks, then gradual weight bearing was commenced, with full weight bearing at 6 weeks. Intensive isometric quadriceps exercises were started on the second postoperative day. Immobilization of both knees was maintained for 6 weeks, after which full active range of motion (ROM) was initiated. At 16 weeks after the injury he had bilateral ROM from 0 degrees to 120 degrees flexion, with no extension lag. He was horse riding, playing golf, swimming, and walking distances up to 2 miles at that time.

  11. May-Thurner syndrome presenting as spontaneous left iliac vein rupture.

    PubMed

    Hosn, Maen Aboul; Katragunta, Neelima; Kresowik, Timothy; Sharp, William John

    2016-10-01

    Spontaneous iliac vein rupture resulting in a retroperitoneal hematoma is extremely rare and can present as a life-threatening emergency. There is often a delay in diagnosis with no established treatment recommendations. We report the case of a 39-year-old woman who presented with hypovolemic shock, a large left retroperitoneal hematoma, and left lower extremity phlegmasia in the setting of a previously asymptomatic May-Thurner syndrome. She was successfully treated with a combined open and endovascular approach. We also reviewed the literature on the evolution of diagnosis and treatment of this rare condition and present our recommendations for management. PMID:27639003

  12. May-Thurner syndrome presenting as spontaneous left iliac vein rupture.

    PubMed

    Hosn, Maen Aboul; Katragunta, Neelima; Kresowik, Timothy; Sharp, William John

    2016-10-01

    Spontaneous iliac vein rupture resulting in a retroperitoneal hematoma is extremely rare and can present as a life-threatening emergency. There is often a delay in diagnosis with no established treatment recommendations. We report the case of a 39-year-old woman who presented with hypovolemic shock, a large left retroperitoneal hematoma, and left lower extremity phlegmasia in the setting of a previously asymptomatic May-Thurner syndrome. She was successfully treated with a combined open and endovascular approach. We also reviewed the literature on the evolution of diagnosis and treatment of this rare condition and present our recommendations for management.

  13. [Peritonitis caused by spontaneous rupture of pyonephrosis in pregnancy. Report of a case].

    PubMed

    Rabii, R; Rais, H; Sarf, I; Joual, A; Aboutaieb, R; Bennani, S; el Mrini, M; Benjelloun, S; Hamoudi, D; Idali, B; Harti, A; Barrou, L

    1999-01-01

    Peritonitis after spontaneous rupture of pyonephrosis into the peritoneal cavity is a rare complication, usually diagnosed intraoperatively. We report a case of a woman presenting with left lumbar pain and fever during pregnancy. On admission, ultrasonography showed a pregnancy with fetal activity for 16 weeks, and pyonephrosis in the left kidney, but on a normal right kidney. After antibiotic therapy and upper urinary, tract stenting renal drainage revealed purulent urine, fever persisted with acute abdomen. Clinical and radiological assessment showed features of acute peritonitis with pyonephrosis. Treatment consisted of laparotomy with nephrectomy and abdominal lavage and drainage. The postoperative complication was septic shock requiring resuscitation and artificial ventilation and prolonged convalescence.

  14. Gelatin sponge microparticles for the treatment of the spontaneous rupture of hepatocellular carcinoma hemorrhage

    PubMed Central

    Wu, Pu Zhao; Zhou, Jun; Zhang, Yue Wei

    2016-01-01

    Spontaneous rupture of hepatocellular carcinoma hemorrhage is life-threatening. The aim of the present study was to retrospectively analyze the effect of gelatin sponge microparticles (GSMs) of various diameters on the treatment of spontaneous rupture of hepatocellular carcinoma hemorrhage. GSMs serve as embolization agents by transcatheter arterial chemoembolization (TACE), and the current study analyzed their safety and efficacy. Data from a total of 13 cases of spontaneous rupture of hepatocellular carcinoma hemorrhage, who were treated with GSM-TACE at the Affiliated Zhongshan Hospital of Dalian University (Dalian, China) between August 2010 and June 2014, were collected. Post-operative complications were classified according to the National Cancer Institute Common Terminology Criteria. Review computed tomography was conducted 1, 3 and 6 months after GSM-TACE treatment in order to determine the occurrence of re-bleeding; the tumor response was evaluated based on the Modified Response Evaluation Criteria In Solid Tumors and the expression levels of α-feroprotein. The patients were followed-up for 1–6 months (average, 5.15±1.67 months). Following GSM-TACE treatment, 13 cases reached successful hemostasis without technical complications. The survival rates 1, 3 and 6 months after treatment were 76.9 (10/13), 61.5 (8/13) and 53.8% (7/13), respectively; the objective response rates were 61.6, 53.9 and 38.5%, respectively. The primary post-operative complications were pain (100%), nausea and vomiting (69.2%), and fever (53.8%). Among the 13 patients, 2 cases underwent surgical excision 10 and 30 days after GSM-TACE, and 1 case experienced re-bleeding 3 months after treatment, after which the patient received a second treatment with TACE and successful achieved hemostasis. In conclusion, GSM-TACE of various diameters is a safe and effective method in the treatment of spontaneous rupture of hepatocellular carcinoma hemorrhage. GSM-TACE is able to achieve immediate

  15. Spontaneous rupture of aneurysms of the ovarian artery at times remote from pregnancy.

    PubMed

    Kodaira, Yuzo; Iwamura, Taro; Hoshino, Hiroki; Takahashi, Ken; Kawahigashi, Yutaka; Matsumoto, Koshi

    2014-01-01

    Spontaneous rupture of an aneurysm of the ovarian artery is usually considered a rare complication of pregnancy and the puerperium. However, we observed this emergent condition in a 51-year-old postmenopausal woman. We report here our experiences and consider lessons about diagnosis and management that can be drawn from this case and 5 other published cases in multiparous middle-aged women. These lessons include application of contrast-enhanced computed tomography to focus emergent care, surgical intervention, and association with systemic inflammatory response syndrome. We also consider how the cases might shed new light on the pathogenesis and evolution of this condition.

  16. Gelatin sponge microparticles for the treatment of the spontaneous rupture of hepatocellular carcinoma hemorrhage

    PubMed Central

    Wu, Pu Zhao; Zhou, Jun; Zhang, Yue Wei

    2016-01-01

    Spontaneous rupture of hepatocellular carcinoma hemorrhage is life-threatening. The aim of the present study was to retrospectively analyze the effect of gelatin sponge microparticles (GSMs) of various diameters on the treatment of spontaneous rupture of hepatocellular carcinoma hemorrhage. GSMs serve as embolization agents by transcatheter arterial chemoembolization (TACE), and the current study analyzed their safety and efficacy. Data from a total of 13 cases of spontaneous rupture of hepatocellular carcinoma hemorrhage, who were treated with GSM-TACE at the Affiliated Zhongshan Hospital of Dalian University (Dalian, China) between August 2010 and June 2014, were collected. Post-operative complications were classified according to the National Cancer Institute Common Terminology Criteria. Review computed tomography was conducted 1, 3 and 6 months after GSM-TACE treatment in order to determine the occurrence of re-bleeding; the tumor response was evaluated based on the Modified Response Evaluation Criteria In Solid Tumors and the expression levels of α-feroprotein. The patients were followed-up for 1–6 months (average, 5.15±1.67 months). Following GSM-TACE treatment, 13 cases reached successful hemostasis without technical complications. The survival rates 1, 3 and 6 months after treatment were 76.9 (10/13), 61.5 (8/13) and 53.8% (7/13), respectively; the objective response rates were 61.6, 53.9 and 38.5%, respectively. The primary post-operative complications were pain (100%), nausea and vomiting (69.2%), and fever (53.8%). Among the 13 patients, 2 cases underwent surgical excision 10 and 30 days after GSM-TACE, and 1 case experienced re-bleeding 3 months after treatment, after which the patient received a second treatment with TACE and successful achieved hemostasis. In conclusion, GSM-TACE of various diameters is a safe and effective method in the treatment of spontaneous rupture of hepatocellular carcinoma hemorrhage. GSM-TACE is able to achieve immediate

  17. [Life threatening postpartal haemorrhage after rupture of the vagina, uterine cervix, caesarean section or hysterectomy].

    PubMed

    Kozovski, I; Radoinova, D

    2010-01-01

    The authors discuss 10 cases--seven after vaginal and cervical rupture, 2 after Caesarean section and 1 after hysterectomy. Six of them died--5 after rupture of the vagina and cervix and one after Caesarean section. The lethal issue was avoidable in all cases because it was a result of untimely done or not done at all hysterectomy and other interventions, e.g., ligation of the hypogastric arteries, as well as of faulty surgical performance. Basic principles of surgical behavior in such cases are postulated.

  18. Uterine preservation in placenta percreta complicated by unscarred uterine rupture at second trimester in a patient with repeated molar pregnancies: a case report and brief review of the literature.

    PubMed

    Ozdemir, A; Ertas, I E; Gungorduk, K; Kaya, C; Solmaz, U; Yildirim, G

    2014-01-01

    Placenta-percreta causing uterine rupture in unscarred uterus is a rare obstetric surgical emergency that can cause maternal and perinatal morbidity and mortality. A 25-year-old woman presented with abdominal pain for four days. Previously, she had undergone two suction curettages for complete hydatiform moles. Ultrasound revealed a non-viable fetus with an estimated gestational age of 21 weeks and free fluid and coagulum in the abdominal cavity. An emergency laparotomy was performed because of the acute abdomen. At exploration, the placenta had invaded the entire thickness of the myometrium and the non-viable fetus was in the abdominal cavity. The uterus was closed with a double-layer of interrupted sutures and uterine-sparing surgery was performed. The patient was discharged on postoperative day seven. The authors present a case of placenta-percreta in an unscarred uterus complicated with uterine rupture during the second-trimester that was managed successfully with uterine repair. They also review the literature briefly and discuss similar cases managed conservatively in the second-trimester.

  19. Characterization of the transcriptome of chorioamniotic membranes at the site of rupture in spontaneous labor at term

    PubMed Central

    Nhan-Chang, Chia-Ling; Romero, Roberto; Tarca, Adi L.; Mittal, Pooja; Kusanovic, Juan Pedro; Erez, Offer; Mazaki-Tovi, Shali; Chaiworapongsa, Tinnakorn; Hotra, John; Than, Nandor Gabor; Kim, Jung-Sun; Hassan, Sonia S.; Kim, Chong Jai

    2013-01-01

    OBJECTIVE The purpose of this study was to compare the transcriptome between the site of membrane rupture and the chorioamniotic membranes away from the site of rupture. STUDY DESIGN The transcriptome of amnion and chorion (n =20 each) from and distal to the site of rupture from women with spontaneous labor and vaginal delivery at term after spontaneous rupture of membranes was profiled with Illumina HumanHT-12 microarrays. Selected genes were validated with the use of quantitative reverse transcription–polymerase chain reaction. RESULTS Six hundred seventy-seven genes were differentially expressed in the chorion between the rupture and nonrupture sites (false discovery rate <0.1; fold change >1.5). Quantitative reverse transcription–polymerase chain reaction confirmed the differential expression in 10 of 14 genes. Enriched biological processes included anatomic structure development, cell adhesion and signal transduction. Extracellular matrix–receptor interaction was the most impacted signaling pathway. CONCLUSION The transcriptome of fetal membranes after spontaneous rupture of membranes in term labor is characterized by region-and tissue-specific differential expression of genes that are involved in signature pathways, which include extracellular matrix–receptor interactions. PMID:20452490

  20. [Embolization of a ruptured pseudo-aneurysm of the uterine artery at 26weeks of gestation: Materno-fetal consequences; a case-report].

    PubMed

    Maignien, C; Marcellin, L; Anselem, O; Silvera, S; Dousset, B; Grangé, G; Goffinet, F

    2015-09-01

    Rupture of a uterine artery pseudo-aneurysm during pregnancy is a rare condition with potential life-threatening complications, and management should take into account the fetal impact of the therapeutic choice. We report the case of a 2cm left uterine artery pseudo-aneurysm revealed by pelvic pain, in a 30-year-old pregnant woman at 26(+0)weeks of gestation (WG). Diagnosis was suspected at ultrasound scan, and confirmed with Magnetic Resonance angiography that showed signs of pre-rupture. An emergency selective embolization attempted in utero allowed the complete exclusion of the aneurysmal sac. The patient gave birth one month later to a girl at 31(+1)WG, initially managed by neonatologists, who is currently in good health.

  1. [Spontaneous rupture of utero-ovarian vessels in postpartal period: a case report and review of the literature].

    PubMed

    Ziereisen, V; Bellens, B; Gérard, C; Baeyens, L

    2003-02-01

    Spontaneous rupture of utero-ovarian veins occurring during pregnancy or the peripartal period is generally considered to be a medical curiosity (approximately 100 reported cases) rarely mentioned in obstetric textbooks. It is nevertheless a dramatic cause of maternal and /or fetal mortality. The available statistics are the following: 60% of the cases are directly related to labor and 50% occur in primiparas; when the rupture is associated with labor, mortality is 40%. Occurring outside of labor, mortality rate is approximatively 10%. The perinatal mortality remains high at 30%; in 75% of the cases, the broad ligament is the site of rupture (in many cases, the site of rupture is not found, at laparotomy or autopsy). We report the case of a patient who developed ovarian vein rupture on the 3rd postpartum day.

  2. Rupture of internal pudendal artery aneurysm following spontaneous vaginal delivery: An uncommon cause of post-partum bleeding.

    PubMed

    Martingano, Daniel; Martingano, Francis X; Ruggiero-DeCarlo, Rosemary

    2016-09-01

    Pregnancy-related rupture of an arterial aneurysm is an unusual occurrence associated with increased risk of morbidity and mortality. Various pregnancy-related physiologic changes appear to make pregnancy a high-risk situation for rupture of either preexisting arterial aneurysms or those that develop throughout the course of pregnancy. Splenic artery aneurysms are the most common (60%), followed by hepatic (20%), superior mesenteric (5.9%), celiac (4%), ovarian, uterine, and renal (<2%) artery. Even rarer are aneurysms involving the internal iliac artery and its branches, to which there is only one published case report. In this report, we present a case of a 34-year-old pregnant gravida1 para0 who, following a normal vaginal delivery, had a severe rupture of the right internal pudendal artery and subsequently developed a massive hematoma which ultimately required embolization treatment. PMID:27630752

  3. Sudden death due to spontaneous acute dissection of the left subclavian artery with rupture during postpartum period: a case report.

    PubMed

    Barbesier, Marie; Duncanson, Emily R; Mackey-Bojack, Shannon M; Roe, Susan J; Thomas, Lindsey C

    2013-03-01

    Subclavian artery dissection is usually associated with coexisting aortic disease. Isolated and spontaneous acute subclavian artery dissection is uncommon and rarely reported. In addition, no case of left subclavian artery dissection during pregnancy and early puerperium has been described. We report the autopsy case of a 24-year-old female who died suddenly 3 days after delivery due to a spontaneous left subclavian artery dissection with rupture.

  4. Spontaneous rupture on natural fractures and seismic radiation during hydraulic fracturing treatments

    NASA Astrophysics Data System (ADS)

    Duan, Benchun

    2016-07-01

    We extend spontaneous rupture models in earthquake source studies to analyze fluid injection problems. We perform these analyses on a 2-D fracture network model with a propagating hydraulic fracture (HF) and three sets of natural fractures (NFs). We find that it is difficult for NFs that are either parallel or perpendicular to the HF to slip because of little resolved shear stress on them in the prestress field. Shear failure of optimally oriented NFs depends on frictional parameters, such as the critical slip distance in slip-weakening laws. Slip of NFs near the tips of the HF may affect HF opening. Nonsmooth fracture opening generates isolated spiky seismic signals, while unstable frictional slip radiates strong and continuous seismic signals with long-duration coda waves. These results suggest microseismicity may be primarily generated by unstable frictional slip on NFs with some contribution from nonsmooth opening motions on HFs and/or NFs.

  5. Successful n-butyl cyanoacrylate embolization of a spontaneous rupture of the internal mammary artery in a patient with myelodysplastic syndrome: report of a case.

    PubMed

    Muradi, Akhmadu; Yamaguchi, Masato; Sakamoto, Noriaki; Okada, Takuya; Idoguchi, Koji; Sugimoto, Koji

    2014-03-01

    Hemomediastinum and hemothorax due to spontaneous internal mammary artery (IMA) rupture is extremely rare, and can be a life-threatening condition. We herein present, to the best of our knowledge, the first case of spontaneous IMA rupture complicating myelodysplastic syndrome, and the first case that was successfully treated by emergency trans-arterial embolization using n-butyl cyanoacrylate.

  6. Acute Spontaneous Subdural Hematoma due to Rupture of a Tiny Cortical Arteriovenous Malformation.

    PubMed

    Choi, Hyuk Jin; Lee, Jae Il; Nam, Kyoung Hyup; Ko, Jun Kyeung

    2015-12-01

    Acute subdural hematoma (SDH) of arterial origin is rare, especially SDH associated with an arteriovenous malformation (AVM) is extremely rare. The authors report a case of acute spontaneous SDH due to rupture of a tiny cortical AVM. A 51-year-old male presented with sudden onset headache and mentality deterioration without a history of trauma. Brain CT revealed a large volume acute SDH compressing the right cerebral hemisphere with subfalcine and tentorial herniation. Emergency decompressive craniectomy was performed to remove the hematoma and during surgery a small (5 mm sized) conglomerated aciniform mass with two surrounding enlarged vessels was identified on the parietal cortex. After warm saline irrigation of the mass, active bleeding developed from a one of the vessel. The bleeding was stopped by coagulation and the vessels were removed. Histopathological examination confirmed the lesion as an AVM. We concluded that a small cortical AVM existed at this area, and that the cortical AVM had caused the acute SDH. Follow up conventional angiography confirmed the absence of remnant AVM or any other vascular abnormality. This report demonstrates rupture of a cortical AVM is worth considering when a patient presents with non-traumatic SDH without intracerebral hemorrhage or subarachnoid hemorrhage. PMID:26819690

  7. Testing Friction Laws by Comparing Simulation Results With Experiments of Spontaneous Dynamic Rupture

    NASA Astrophysics Data System (ADS)

    Lu, X.; Lapusta, N.; Rosakis, A. J.

    2005-12-01

    Friction laws are typically introduced either based on theoretic ideas or by fitting laboratory experiments that reproduce only a small subset of possible behaviors. Hence it is important to validate the resulting laws by modeling experiments that produce spontaneous frictional behavior. Here we simulate experiments of spontaneous rupture transition from sub-Rayleigh to supershear done by Xia et al. (Science, 2004). In the experiments, two thin Homalite plates are pressed together along an inclined interface. Compressive load P is applied to the edges of the plates and the rupture is triggered by an explosion of a small wire. Xia et al. (2004) link the transition in their experiments to the Burridge-Andrews mechanism (Andrews, JGR, 1976) which involves initiation of a daughter crack in front of the main rupture. Xia et al. have measured transition lengths for different values of the load P and compared their results with numerical simulations of Andrews who used linear slip-weakening friction. They conclude that to obtain a good fit they need to assume that the critical slip of the slip-weakening law scales as P-1/2, as proposed by Ohnaka (JGR, 2003). Hence our first goal is to verify whether the dependence of the critical slip on the compressive load P is indeed necessary for a good fit to experimental measurements. To test that, we conducted simulations of the experiments by using boundary integral methodology in its spectral formulation (Perrin et al., 1995; Geubelle and Rice, 1995). We approximately model the wire explosion by temporary normal stress decrease in the region of the interface comparable to the size of the exploding wire. The simulations show good agreement of the transition length with the experimental results for different values of the load P, even though we keep the critical slip constant. Hence the dependence of the critical slip on P is not necessary to fit the experimental measurements. The inconsistency between Andrews' numerical results

  8. 3D Spontaneous Rupture Models of Large Earthquakes on the Hayward Fault, California

    NASA Astrophysics Data System (ADS)

    Barall, M.; Harris, R. A.; Simpson, R. W.

    2008-12-01

    We are constructing 3D spontaneous rupture computer simulations of large earthquakes on the Hayward and central Calaveras faults. The Hayward fault has a geologic history of producing many large earthquakes (Lienkaemper and Williams, 2007), with its most recent large event a M6.8 earthquake in 1868. Future large earthquakes on the Hayward fault are not only possible, but probable (WGCEP, 2008). Our numerical simulation efforts use information about the complex 3D fault geometry of the Hayward and Calaveras faults and information about the geology and physical properties of the rocks that surround the Hayward and Calaveras faults (Graymer et al., 2005). Initial stresses on the fault surface are inferred from geodetic observations (Schmidt et al., 2005), seismological studies (Hardebeck and Aron, 2008), and from rate-and- state simulations of the interseismic interval (Stuart et al., 2008). In addition, friction properties on the fault surface are inferred from laboratory measurements of adjacent rock types (Morrow et al., 2008). We incorporate these details into forward 3D computer simulations of dynamic rupture propagation, using the FaultMod finite-element code (Barall, 2008). The 3D fault geometry is constructed using a mesh-morphing technique, which starts with a vertical planar fault and then distorts the entire mesh to produce the desired fault geometry. We also employ a grid-doubling technique to create a variable-resolution mesh, with the smallest elements located in a thin layer surrounding the fault surface, which provides the higher resolution needed to model the frictional behavior of the fault. Our goals are to constrain estimates of the lateral and depth extent of future large Hayward earthquakes, and to explore how the behavior of large earthquakes may be affected by interseismic stress accumulation and aseismic slip.

  9. Bilingual aphasia due to spontaneous acute subdural haematoma from a ruptured intracranial infectious aneurysm.

    PubMed

    Vajramani, Girish V; Akrawi, Hawar; McCarthy, Rosaleen A; Gray, William P

    2008-09-01

    We report a case of spontaneous subdural haematoma due to ruptured intracranial infectious aneurysm, presenting with bilingual aphasia and illustrating differential language recovery. A 62-year-old right-handed bilingual gentleman, with a diagnosis of infective endocarditis, developed headache and became expressively aphasic in the English language. Three days later he was receptively and expressively aphasic in both English and Arabic. Cranial MRI scans showed a left-sided acute subdural haematoma with mass effect and midline shift. Contrast CT brain scans showed an enhancing speck adjacent to the clot and cerebral angiogram confirmed a distal middle cerebral artery aneurysm. He underwent image-guided craniotomy, evacuation of the subdural haematoma and excision of the aneurysm. Histopathological examination was consistent with an infectious intracranial aneurysm. Postoperatively his aphasia did not improve immediately. He had widened pulse pressure due to severe aortic regurgitation, confirmed on echocardiography. He underwent aortic valve replacement and mitral valve repair, following which his aphasia recovered gradually. Initially the recovery of his language was limited to Arabic. About a week later he recovered his English language as well. At 3-year follow-up he is doing well and has no neurological deficits. His aphasia has recovered completely. The present case is unique because of (a) presence of pure subdural haematoma, and (b) the differential susceptibility and recovery of native (L1) and acquired language (L2) in presence of a common pathology. The neurology of language in a bilingual is analysed and possible mechanisms discussed.

  10. Spontaneous rupture of a splenic hydatid cyst with anaphylaxis in a patient with multi-organ hydatid disease.

    PubMed

    Constantin, V; Popa, F; Socea, B; Carâp, A; Bălălău, C; Motofei, I; Banu, P; Costea, D

    2014-01-01

    Hidatid cysts of the spleen are a rare occurrence, the spleen being the third most common organ for the development of Echinococcus Granulosus. Splenic hydatid cysts are commonly part of multi-organ hydatid disease. Diagnosis is often established when investigating a splenomegaly or by chance during an unrelated consult. It can also be diagnosed after rupture, be it following trauma (the most common occurrence)or spontaneous. Splenic hydatid cyst rupture requires immediate action and is a life-threatening condition. It results, most often, in splenectomy. We present the case of a patient with multi-organ hydatid disease that presented with a ruptured splenic cyst and developed anaphylaxis. The case was resolved by splenectomy and recovered well. PMID:24956347

  11. Mixed cryoglobulinemia-associated Sjögren’s syndrome leading to spontaneous rupture of the kidney: a case report

    PubMed Central

    Haddiya, Intissar; Hamzaoui, Hakim; Alhamany, Zitouna; Berkchi, Fatime-zohra; Rhou, Hakima; Benamar, Loubna; Ouzeddoun, Naima; Bayahia, Rabea

    2016-01-01

    Background Spontaneous rupture of the kidney is uncommon and is mainly caused by renal tumors. Only a few cases are caused by vasculitis. We report here the first case of spontaneous rupture of kidney resulting from mixed cryoglobulinemia. Case presentation A 44-year-old man presented with sudden onset of fever, acute pulmonary edema, left flank abdominal pain unassociated with trauma, and rapidly progressive renal failure requiring dialysis. Computed tomography of the abdomen revealed a large perirenal hematoma of the left kidney. During conservative surgery, the patient underwent renal biopsy that showed renal vasculitis and membranoproliferative glomerulonephritis with intracapillary microthrombi. Tests were positive for mixed cryoglobulinemia caused by Sjögren’s syndrome. The patient was better after immunosuppressive therapy, with the disappearance of clinical symptoms and the recovery of baseline renal function. Conclusion We report on this case and discuss a possible link between spontaneous rupture of kidney and mixed cryoglobulinemia-associated Sjögren’s syndrome. PMID:27042145

  12. Epidemiology of spontaneous premature rupture of membranes: factors in pre-term births.

    PubMed Central

    Miller, H. C.; Jekel, J. F.

    1989-01-01

    The frequency of spontaneous premature rupture of membranes (PROM) was determined in the pregnancies of 1,848 white mothers and their singleton infants, born at the University of Kansas Medical Center between April 1975 and April 1978. The frequency of PROM increased significantly from a low of 34/707 (4.8 percent) among low-risk mothers, to 40/444 (9.0 percent) among mothers smoking one to 60 cigarettes a day, to 21/204 (10.3 percent) among mothers with multiple adverse maternal practices, and to 12/46 (26 percent) among mothers with selected complications of their pregnancies. The proportion of low birth weight (LBW) (less than 2,500 g) pre-term infants born to PROM mothers increased among the risk factor groups in a similar manner, from a low of 2/34 (6 percent) in low-risk pregnancies to 8/40 (20 percent) among mothers smoking one to 60 cigarettes a day, to 7/21 (33 percent) among mothers with multiple adverse practices, and to 7/12 (58 percent) among mothers with selected complications of pregnancy. The increased incidence of low birth weight pre-term infants born to mothers with PROM was associated with evidence of growth retardation among full-term infants in the high-risk groups. This finding was manifested by reductions in mean birth weights of full-term infants born to high-risk mothers but not observed in full-term infants born to low-risk mothers. The attained growth at birth of low birth weight pre-term infants could not be determined, because appropriate birth weight standards for pre-term infants born to mothers with low-risk pregnancies are not available. These results suggest that growth retardation in fetuses increased the probability of the mothers having PROM prior to the onset of labor, and, if PROM did occur, of having a premature delivery. We hypothesize that the tensile strength of the amnion and chorion is diminished by the same conditions that retard fetal growth, and that this reduction in strength of the fetal membranes contributes to

  13. Histopathological and Immunohistochemical Characterization of Spontaneously Occurring Uterine Deciduomas in Young Adult Rats

    PubMed Central

    Yoshizawa, Katsuhiko; Emoto, Yuko; Kinoshita, Yuichi; Kimura, Ayako; Uehara, Norihisa; Yuri, Takashi; Shikata, Nobuaki; Tsubura, Airo

    2013-01-01

    Uterine deciduomas were found in two female virgin rats, a 15-week-old Lewis rat and a 7-week-old Sprague-Dawley rat. The firm white nodules were located at the base of unilateral uterine horns and were approximately 6 mm and 4 mm in diameter. Histopathologically, the nodules were composed of three areas, each with a distinct type of proliferating cells: large epithelioid decidual cells with round nuclei, prominent nucleoli and abundant eosinophilic cytoplasm (antimesometrial region); compact spindle-shaped cells with oval nuclei and vacuolar cytoplasm (transitional region); and pleomorphic and spiny cells with round to oval nuclei and compact eosinophilic cytoplasm (mesometrial region). These cells proliferated in sheet-like arrangements and transformed into the other types of cells located in surrounding regions. Immunohistochemically, proliferating cells in all regions were strongly positive for proliferating cell nuclear antigen. The proliferating cells were positive for vimentin, and large decidual cells were positive for common acute lymphoblastic leukemia antigen 10, a marker of uterine interstitial cells. Large decidual cells were positive for α-smooth muscle actin and desmin, suggesting differentiation into muscular cells. Progesterone receptor was expressed in all cell types; however, estrogen receptor α was not expressed in the antimesometrial region. These extremely rare tumor-like nodules represent nonneoplastic lesions referred as decidual reactions of endometrial interstitial cells, and their biological behavior is that of a space-occupying benign tumor in young rats. Our cases might provide information as a historical control in toxicity and pharmacological studies in rats. PMID:23723570

  14. Chimney and periscope technique for emergent treatment of spontaneous aortic rupture.

    PubMed

    Trellopoulos, George; Georgakarakos, Efstratios; Pelekas, Dimitrios; Papachristodoulou, Athanasia; Argyriou, Christos; Georgiadis, George S

    2014-07-01

    Aortic rupture comprises a potentially fatal condition necessitating emergent treatment. Endovascular sealing of the rupture site is often combined with the use of chimney- and periscope stent placement to preserve perfusion of aortic branches. We present a case of successful endovascular management of contained aortic rupture in a 78-year-old patient. The left brachial access facilitated stenting of the celiac and superior mesenteric arteries, whereas the left femoral route served stenting of the renal artery. One-month follow-up confirmed complete sealing, stent patency, and absence of endograft migration. The combined periscope and chimney technique is feasible and effective in the emergency setting. PMID:24517987

  15. Spontaneous Rupture of Hepatocellular Carcinoma Supplied by the Right Renal Capsular Artery Treated by Transcatheter Arterial Embolization

    SciTech Connect

    Kodama, Yoshihisa; Shimizu, Tadashi; Endo, Hideho; Hige, Shuhei; Kamishima, Tamotsu; Holland, George A.; Miyamoto, Noriyuki; Miyasaka, Kazuo

    2002-03-15

    We present a case of spontaneous rupture of hepatocellular carcinoma (HCC) with poor liver function which was treated by transcatheter arterial embolization (TAE). The patient's bilirubin value was 3.8 mg/dL. The tumor was fed by the right renal capsular artery according to selective arteriography. It was subsequently treated by TAE. With successful TAE, no hepatic failure was related to the treatment. We believe that if tumors are fed only by extrahepatic collateral vessels, TAE may be an effective treatment even in patients with poor liver function.

  16. Bilateral Spontaneous Midsubstance Patellar Tendon Rupture after Bilateral Total Knee Arthroplasty

    PubMed Central

    Rajani, Amyn; Dash, Kumar Kaushik; Mahajan, Neetin P; Kumar, Ritesh

    2016-01-01

    Introduction: Patellar tendon rupture can occur due to multiple causes ranging from inflammatory pathologies to episodes of trauma. Extensor mechanism rupture is a rare complication of total knee arthroplasty (TKA). In most of these cases, the failure occurs as avulsion of patellar tendon from tibial tuberosity. We report a rare case with bilateral mid-substance patellar tendon rupture one month after bilateral total knee arthroplasty. Case Presentation: A 69-year-old male was operated for bilateral grade 4 osteoarthritis. On day 30 post-operative, he sustained bilateral patellar tendon rupture while getting up from toilet. He had a history of multiple steroid injections in the knee, which could have affected the tendon. The other etiologies could be inherent weakness of tendon due to diabetes and old age and micro-trauma/stretch associated with sudden correction of previous deformity by TKA. The management in our case was done by primary repair along with augmentation by autologous semitendinosus graft and suture anchor. Conclusion: The operating surgeon must be aware of the possibility of patellar tendon rupture following total knee arthroplasty. This will help the surgeon in early recognition and preparedness to handle such complications, should they arise. Surgeons may consider advising caution to both patient and rehabilitation team in cases with old age, chronic diabetes mellitus, and with a history of steroid injections. PMID:27703942

  17. Extra-uterine twin pregnancy: case report of spontaneous bilateral tubal ectopic pregnancy

    PubMed Central

    Amine, Ben Haj Hassine; Haythem, Siala

    2015-01-01

    Spontaneous bilateral ectopic pregnancy is the rarest form of ectopic pregnancy. Bilateral tubal pregnancies in the absence of preceding induction of ovulation are a rare occurrence, with an estimated incidence of 1 in 725 to 1 in 1580 ectopicpregnancies. They are usually diagnosed at the time of surgery. We report a case of spontaneous bilateral tubal pregnancies diagnosed intraoperatively. A 33-year-old patient was admitted after light vaginal bleeding, 35 days after her last menstruation. A bilateral salpingectomy was performed without complication and the pathology report confirmed the diagnosis. This is an unusual case of early diagnosis. The diagnosis of bilateral tubal pregnancy is usually madeintraoperatively. This underscores the importance ofidentifying and closely examining both tubes at the time ofsurgery, even in the presence of significant adhesive disease. PMID:26309468

  18. [Three cases of spontaneous pneumothorax by ruptured paravertebral gourd-shaped bullae].

    PubMed

    Takata, Masahiko; Miyamoto, Yoshifumi

    2014-04-01

    We reported 3 elderly patients with right pneumothorax caused by ruptured paravertebral gourdshaped bullae. Two patients showed the characteristic symptom of air leakage of this type of pneumothorax, which decreased in the supine position, but increased in the sitting position. Chest computed tomography imaging showed bullae spreading in the space of the azygoesophageal recess. All patients underwent video-assisted thoracic surgery (VATS), and 2 patients underwent mini-thoracotomy because of adhesion and pyothorax. Ruptured bullae with stalks were found at the mediastinal sides of their right lower lobes in all patients. Bullectomy using an endoscopic stapler or ligation at the bulla root was performed easily and safely. The right pneumothorax caused by ruptured paravertebral gourd-shaped bulla was considered to be a good indication for the VATS due to the unique shape of the bulla, which has a stalk at its root. PMID:24917167

  19. A grid-doubling finite-element technique for calculating dynamic three-dimensional spontaneous rupture on an earthquake fault

    USGS Publications Warehouse

    Barall, M.

    2009-01-01

    We present a new finite-element technique for calculating dynamic 3-D spontaneous rupture on an earthquake fault, which can reduce the required computational resources by a factor of six or more, without loss of accuracy. The grid-doubling technique employs small cells in a thin layer surrounding the fault. The remainder of the modelling volume is filled with larger cells, typically two or four times as large as the small cells. In the resulting non-conforming mesh, an interpolation method is used to join the thin layer of smaller cells to the volume of larger cells. Grid-doubling is effective because spontaneous rupture calculations typically require higher spatial resolution on and near the fault than elsewhere in the model volume. The technique can be applied to non-planar faults by morphing, or smoothly distorting, the entire mesh to produce the desired 3-D fault geometry. Using our FaultMod finite-element software, we have tested grid-doubling with both slip-weakening and rate-and-state friction laws, by running the SCEC/ USGS 3-D dynamic rupture benchmark problems. We have also applied it to a model of the Hayward fault, Northern California, which uses realistic fault geometry and rock properties. FaultMod implements fault slip using common nodes, which represent motion common to both sides of the fault, and differential nodes, which represent motion of one side of the fault relative to the other side. We describe how to modify the traction-at-split-nodes method to work with common and differential nodes, using an implicit time stepping algorithm. ?? Journal compilation ?? 2009 RAS.

  20. Bilateral spontaneous patellar tendon rupture in the absence of concomitant systemic disease or steroid use.

    PubMed

    Greenbaum, B; Perry, J; Lee, J

    1994-11-01

    A case of bilateral patellar tendon rupture in an otherwise healthy 41-year-old man is presented. This is the 15th case reported in the literature. The mechanism of injury is attributed to a flexion moment coupled with a contraction of the quadriceps muscle in nearly all reported cases. Surgical repair produces excellent results. PMID:7854842

  1. Retroperitoneal Haematom due to Spontaneous Rupture and Haemorrhage of Adrenal Cyst Presenting with Grey Turner's Sign.

    PubMed

    Sonmez, Bedriye Muge; Yilmaz, Fevzi; Özkan, Fevzi Bircan; Ongar, Murat; Özturk, Derya; Cesur, Fatma

    2015-07-01

    Spontaneous retroperitoneal haemorrhage is a rare entity and a potentially life-threatening condition. A 41-year-old woman presented to our emergency department with left flank pain and dysuria. Her physical examination disclosed left abdominal and costovertebral angle tenderness, left flank ecchymosis (Grey Turner sign). Abdominal computerised tomography revealed spontaneous retroperitoneal haemorrhage. She was discharged after 10 days with recommendation of urology follow-up.

  2. Spontaneous Rupture of an Unscarred Uterus Diagnosed Postpartum: A Case Report.

    PubMed

    Haakman, Olga; Ambrose, Devon; Katopodis, Christina; Altman, Alon D

    2015-11-01

    Contexte : La rupture utérine est une fissure affectant la pleine épaisseur de la paroi utérine qui entraîne la formation d’une anomalie dans cette dernière. Bien que la présence de cicatrices utérines (particulièrement celles qui sont attribuables à la césarienne) en constitue le facteur de risque majeur, une rupture utérine peut également se manifester dans le cas d’un utérus exempt de cicatrices. Il a été démontré qu’une telle rupture utérine, quoique rare, donnait lieu à des complications aggravées. Cas : Une femme de 31 ans, gravida 6 para 6, sans antécédents d’incision ou de manipulation utérine en est venue à connaître des saignements importants pendant la période postpartum. Une rupture utérine présentant une extension rétropéritonéale a été constatée et la mise en œuvre d’une prise en charge chirurgicale s’est avérée nécessaire. Conclusion : Le diagnostic précoce d’une rupture utérine suivi de la mise en œuvre rapide de soins de soutien et chirurgicaux pourrait améliorer le pronostic de façon significative. Il est impératif d’envisager la possibilité d’une rupture utérine chez toute patiente obstétricale présentant une instabilité hémodynamique ou une hémorragie, peu importe si des facteurs de risque (y compris la présence préalable d’une cicatrice utérine) sont présents ou non.

  3. Impact of spontaneous tumor rupture on prognosis of patients with T4 hepatocellular carcinoma

    PubMed Central

    Chan, Wen‐Hui; Hung, Chien‐Fu; Pan, Kuang‐Tse; Lui, Kar‐Wai; Huang, Yu‐Ting; Lin, Shen‐Yen; Lin, Yang‐Yu; Wu, Tsung‐Han

    2016-01-01

    Background and objectives Compare the outcomes of three groups of patients with T4 hepatocellular carcinoma (HCC): tumor rupture with shock (RS group), tumor rupture without shock (R group), and no tumor rupture (NR group). Materials and Methods We retrospectively reviewed 221 patients with T4 HCC from 2010 to 2012. The clinical background and prognosis were analyzed. Results Overall in‐hospital mortality rate was 18.1%; overall median survival time was 4 months. The NR group were more likely to have multiple and infiltrative tumors (P < 0.001). Relative to the NR group, the R + RS group had better survival rates at 6 months (49.2% vs. 32.2%), 1 year (35.3% vs. 21.0%), 3 years (22.5% vs. 11.0%), and 5 years (17.7% vs. 5.5%) (P = 0.010). Patients in the RS group had a higher in‐hospital mortality rate, but significantly better long‐term survival than the NR and R group (P < 0.001). Multivariate analysis indicated that Child‐Pugh class B or C, presence of portal venous thrombosis, and absence of shock were significantly associated with poor survival. Conclusion Patients with tumor rupture and shock had worse in‐hospital survival. However, patients without decompensated liver cirrhosis and portal venous thrombosis, and eligible for curative treatment had favorable long‐term outcome. J. Surg. Oncol. 2016;113:789–795. © 2016 The Authors. Journal of Surgical Oncology Published by Wiley Periodicals, Inc. PMID:27062288

  4. Spontaneous Intra-Abdominal Hemorrhage Due to Rupture of Jejunal Artery Aneurysm in Behcet Disease

    PubMed Central

    Wu, Xiao-yan; Wei, Jiang-peng; Zhao, Xiu-yuan; Wang, Yue; Wu, Huan-huan; Shi, Tao; Liu, Tong; Liu, Gang

    2015-01-01

    Abstract Rupture of jejunal artery aneurysm is a very rare event resulting in life-threatening hemorrhage in Behcet disease (BD). We report a case of ruptured jejunal artery aneurysm in a 35-year-old patient with BD. The patient had a 1-year history of intermittent abdominal pain caused by superior mesenteric artery aneurysm with thrombosis. Anticoagulation treatment showed a good response. Past surgical history included stenting for aortic pseudoaneurysm. On admission, the patient underwent an urgent operation due to sudden hemorrhagic shock. Resection was performed for jejunal artery aneurysm and partial ischemia of intestine. The patient was diagnosed with BD, based on a history of recurrent oral and skin lesions over the past 6 years. Treatment with anti-inflammatory medications showed a good response during the 8-month follow-up. An increased awareness of BD and its vascular complications is essential. Aneurysms in BD involving jejunal artery are rare, neglected and require proper management to prevent rupture and death. To our knowledge, this is the first reported case of jejunal artery aneurysm caused by BD. PMID:26559278

  5. Quantification of Ground Motion Reductions by Fault Zone Plasticity with 3D Spontaneous Rupture Simulations

    NASA Astrophysics Data System (ADS)

    Roten, D.; Olsen, K. B.; Cui, Y.; Day, S. M.

    2015-12-01

    We explore the effects of fault zone nonlinearity on peak ground velocities (PGVs) by simulating a suite of surface rupturing earthquakes in a visco-plastic medium. Our simulations, performed with the AWP-ODC 3D finite difference code, cover magnitudes from 6.5 to 8.0, with several realizations of the stochastic stress drop for a given magnitude. We test three different models of rock strength, with friction angles and cohesions based on criteria which are frequently applied to fractured rock masses in civil engineering and mining. We use a minimum shear-wave velocity of 500 m/s and a maximum frequency of 1 Hz. In rupture scenarios with average stress drop (~3.5 MPa), plastic yielding reduces near-fault PGVs by 15 to 30% in pre-fractured, low-strength rock, but less than 1% in massive, high quality rock. These reductions are almost insensitive to the scenario earthquake magnitude. In the case of high stress drop (~7 MPa), however, plasticity reduces near-fault PGVs by 38 to 45% in rocks of low strength and by 5 to 15% in rocks of high strength. Because plasticity reduces slip rates and static slip near the surface, these effects can partially be captured by defining a shallow velocity-strengthening layer. We also perform a dynamic nonlinear simulation of a high stress drop M 7.8 earthquake rupturing the southern San Andreas fault along 250 km from Indio to Lake Hughes. With respect to the viscoelastic solution (a), nonlinearity in the fault damage zone and in near-surface deposits would reduce long-period (> 1 s) peak ground velocities in the Los Angeles basin by 15-50% (b), depending on the strength of crustal rocks and shallow sediments. These simulation results suggest that nonlinear effects may be relevant even at long periods, especially for earthquakes with high stress drop.

  6. Ehlers-Danlos syndrome associated with fatal spontaneous vascular rupture in a dog.

    PubMed

    Uri, M; Verin, R; Ressel, L; Buckley, L; McEwan, N

    2015-01-01

    A 7-month-old male cross breed dog was presented with hyperextensible skin and atrophic scarring. A diagnosis of Ehlers-Danlos syndrome was made based on clinical signs, histopathology and electron microscopy. Two weeks after presentation, the dog died suddenly. Post-mortem examination revealed haemothorax and rupture of the left subclavian artery. Histological findings, including Goldner's modified Masson's trichrome staining and transmission electron microscopy of the subclavian artery, revealed abnormalities in the structure and arrangement of collagen fibrils, suggesting that the defective collagen formation extended to the vasculature. To the authors' knowledge, this is the first report of Ehlers-Danlos syndrome with vascular involvement in animals.

  7. [Secondary peritonitis due to rupture of pyometra in cervical cancer].

    PubMed

    Zeferino Toquero, Moisé; Bañuelos Flores, Joel

    2005-11-01

    Only 8 cases of spontaneous uterine rupture in untreated cervical cancer have been reported in the literature. We present the case of a 52-year-old female, who was admitted to the emergency room due to hypovolemic shock and signs of peritonitis. A 6x4x4 cm cervical tumor was detected at physical exam. At laparotomy 2000 mL of purulent material were found and a 1-cm perforation in the posterior portion of the uterine segment was identified. A subtotal hysterectomy was performed. The patient received antibiotic and support at Intensive Care Unit. Finally, the patient presented ascendant flaccid paralysis and died due to bronchoaspiration. Spontaneous pyometra rupture in untreated cervical cancer is a rare condition and must be considered in postmenopausal women with cervical tumors and peritonitis signs.

  8. Rupture of the retrocorporeal artery: a rare cause of spontaneous spinal epidural haematoma.

    PubMed

    Guédon, Alexis; Clarençon, Frédéric; Law-Ye, Bruno; Sourour, Nader; Gabrieli, Joseph; Rojas, Patricia; Chiras, Jacques; Peyre, Matthieu; Di Maria, Federico

    2016-06-01

    A 22-year-old man presented with a sudden backache and paraplegia (ASIA = B). Magnetic resonance imaging showed an anterior pan-spinal epidural haematoma. Digital subtraction angiography was performed and ruled out an underlying vascular malformation but showed an active contrast media leakage into the T-4 ventral epidural space with a pattern of pseudo-aneurysm. A rupture of a T-4 retrocorporeal artery was considered as the aetiology, possibly caused by a haemorrhagic sub-adventitial dissection. Treatment consisted in the embolisation of both the pseudo-aneurysm and the parent artery with liquid acrylic glue, followed by neurosurgical decompression in emergency. The patient had totally recovered (ASIA = E) by the 10-month clinical follow-up.

  9. 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

  10. Granulomatous reaction in hepatic inflammatory angiomyolipoma after chemoembolization and spontaneous rupture

    PubMed Central

    Kai, Keita; Miyosh, Atsushi; Aishima, Shinichi; Wakiyama, Kota; Nakashita, Shunya; Iwane, Shinji; Azama, Shinya; Irie, Hiroyuki; Noshiro, Hirokazu

    2015-01-01

    A 77-year-old Japanese woman was transported to a nearby hospital due to sudden abdominal pain and transient loss of consciousness. Abdominal computed tomography (CT) suggested hemoperitoneum and hepatic nodule. She was conservatively treated. Contrast-enhanced CT two months later revealed an increased mass size, and the enhancement pattern suggested the possibility of hepatocellular carcinoma (HCC). Under a clinical diagnosis of HCC, transcatheter arterial chemoembolization (TACE) was performed. A subsequent imaging study revealed that most of the lipiodol used for the embolization was washed out. Therefore, surgical resection was performed. Histologically, the nodule contained numerous inflammatory cells including small lymphocytes, plasma cells and macrophages. Notably, epithelioid granulomatous features with multinucleated giant cells were observed in both the nodule and background liver. Some of the multinucleated giant cells contained oil lipid. Among the infiltrating inflammatory cells, spindle-shaped, histiocytoid or myoid tumor cells with eosinophilic cytoplasm were found. The tumor cells were positive for Melan A and HMB45. The nodule contained many IgG4-positive plasma cells; these were counted and found to number 72.6 cells/HPF (range: 61-80). The calculated IgG4:IgG ratio was 33.2%. The nodule was finally diagnosed as previously ruptured inflammatory angiomyolipoma modified by granulomatous reaction after TACE. PMID:26327777

  11. Rupture of the uterus in Malawi and Tanzania.

    PubMed

    Armon, P J

    1977-09-01

    This paper describes the presenting features and possible etiology of 115 cases of rupture of the uterus occurring in Malawi and Tanzania. The series included 62 spontaneous ruptures, 24 traumatic ruptures, and 29 scar ruptures. The rupture was complete in 100 cases but the peritoneum was intact in 15. 72 cases involved obstructed labor and 29 occurred in women with previous cesarean sections. Only 22% of subjects were grand multiparae (7 or more pregnancies), and the average parity was 4.5. Classical symptoms and signs either did not occur or were late in appearing in most cases, and none of the women complained of a tearing or bursting sensation. 23 of the cases died during treatment. Sterilization is recommended in cases where the initial rupture extends into or is primarily situated in the upper segment of the uterus due to the probability of recurrence. Delays in reaching medical care and a lack of medical facilities contribute to the incidence of uterine rupture in developing countries. Careful screening for at-riskmothers and use of partograms to diagnose cephalopelvic disproportion during labor would diminish the occurrence of this complication, however. Also recommended is avoidance of unnecessary cesarean section procedures and extreme caution in the management of patients with uterine scars. The limitation of family size and improvements in maternal haalth education are further important preventive measures.

  12. Spontaneous healing and complete disappearance of a ruptured posterior inferior cerebellar artery dissecting aneurysm.

    PubMed

    Su, Tsung-Ming; Cheng, Ching-Hsiao; Chen, Wu-Fu; Hsu, Shih-Wei

    2014-05-01

    A 7-month-old baby presented with a 4-day history of drowsiness and vomiting after a falling accident. Magnetic resonance imaging demonstrated diffuse subarachnoid hemorrhage, intraventricular hemorrhage, and variable stages of subdural hematoma in bilateral occipital and left temporal subdural spaces. A partially thrombosed aneurysm was noted in the right craniocervical junction. Ophthalmological examination revealed bilateral retinal petechial hemorrhages. Conventional cerebral angiography revealed a dissecting aneurysm in the right posterior inferior cerebellar artery (PICA). Endovascular embolization was suggested, but the family refused. After conservative treatment, follow-up MRI revealed that the PICA aneurysm had remodeled and ultimately disappeared completely at the 10th month. This case illustrates the relatively plastic nature of intracranial aneurysms in pediatric patients. More studies are necessary to clarify the natural history of spontaneously thrombosed aneurysms to assist in their overall management.

  13. Role of Tumor Necrosis Factor-α and Natural Killer Cells in Uterine Artery Function and Pregnancy Outcome in the Stroke-Prone Spontaneously Hypertensive Rat

    PubMed Central

    Nosalski, Ryszard; Morgan, Hannah; Beattie, Elisabeth; Guzik, Tomasz J.; Graham, Delyth; Delles, Christian

    2016-01-01

    Women with chronic hypertension are at increased risk of maternal and fetal morbidity and mortality. We have previously characterized the stroke-prone spontaneously hypertensive rat (SHRSP) as a model of deficient uterine artery function and adverse pregnancy outcome compared with the control Wistar–Kyoto. The activation of the immune system plays a role in hypertension and adverse pregnancy outcome. Therefore, we investigated the role of tumor necrosis factor-α in the SHRSP phenotype in an intervention study using etanercept (0.8 mg/kg SC) at gestational days 0, 6, 12, and 18 in pregnant SHRSP compared with vehicle-treated controls (n=6). Etanercept treatment significantly lowered systolic blood pressure after gestational day 12 and increased litter size in SHRSP. At gestational day 18, etanercept improved the function of uterine arteries from pregnant SHRSP normalizing the contractile response and increasing endothelium-dependent relaxation, resulting in increased pregnancy-dependent diastolic blood flow in the uterine arteries. We identified that the source of excess tumor necrosis factor-α in the SHRSP was a pregnancy-dependent increase in peripheral and placental CD3– CD161+ natural killer cells. Etanercept treatment also had effects on placental CD161+ cells by reducing the expression of CD161 receptor, which was associated with a decrease in cytotoxic granzyme B expression. Etanercept treatment improves maternal blood pressure, pregnancy outcome, and uterine artery function in SHRSP by antagonizing signaling from excess tumor necrosis factor-α production and the reduction of granzyme B expression in CD161+ natural killer cells in SHRSP. PMID:27733586

  14. Risk Factors and Epidemiology of Coccidioidomycosis Demonstrated by a Case of Spontaneous Pulmonary Rupture of Cavitary Coccidioidomycosis

    PubMed Central

    Yau, Amy A.

    2016-01-01

    A 31-year-old Hispanic male with no medical history was admitted for fevers, pleurisy, and cough after recent oral surgery and completing demolition and construction work in Juarez, Mexico. Imaging showed a 4.4 cm cavitary lesion and bilateral tree-in-bud opacities. Initial suspicion of bacterial infection confirmed with clinical improvement on culture specific antibiotics, but after discharge he returned with progression of symptoms and new dyspnea. Radiograph showed a pyopneumothorax. Chest computed tomography after thoracostomy showed worsening infiltrates and another cavitary lesion. Symptoms persisted despite addition of broad spectrum antibiotics. Surgical repair for persistent air leak was required. Weeks after discharge, cultures and serologies returned positive for Coccidioidomycosis immitis. Coccidioides species cause up to 30% of community-acquired pneumonia and incidental cavitary lesions in endemic regions. Symptoms are nonspecific yet usually involve fatigue, cough, and pleurisy. Most hosts have spontaneous resolution; however, certain demographics such as Hispanics and diabetics, later diagnosed in our patient, have higher morbidity. As seen with our patient, cavitary rupture and bronchopleural fistulas are rare occurring in 2.6% of cavitary lesions. High suspicion based on symptoms and host demographics is important to assist in early diagnosis and treatment to avoid and treat this common pathogen's presentations. PMID:26904326

  15. Spontaneous rupture of an aneurysm of the right subclavian artery as a first presentation of Ehlers Danlos syndrome in a 15-year old boy.

    PubMed

    Verbert, A; Verbist, J; Peeters, P; Deferm, H; Haenen, L

    2013-01-01

    We report a case of a spontaneous rupture of a right subclavian aneurysm in a 15 year-old patient. This ruptured aneurysm was successfully treated in an endovascular manner by placing a covered stent-graft in the right subclavian artery via right brachial access. Subsequent work-up by skin biopsy and fibroblast culture and by DNA-screening revealed the diagnosis of Ehlers Danlos type IV. Meanwhile, the patient developed twice a spontaneous pneumothorax, treated with thoracoscopic pleurodesis. This article provides a clear overview of the clinical and genetic characteristics of a case of Ehlers Danlos type IV and illustrates the importance of avoiding surgery in patients with connective tissue disease because of the high risk of perioperative complications.

  16. An artificial stress asperity for initialization of spontaneous rupture propagation - a parametric study of a dynamic model with linear slip-weakening friction

    NASA Astrophysics Data System (ADS)

    Galis, M.; Pelties, C.; Kristek, J.; Moczo, P.

    2012-04-01

    Artificial procedures are used to initiate spontaneous rupture on faults with the linear slip-weakening (LSW) friction law. Probably the most frequent technique is the stress asperity. It is important to minimize effects of the artificial initialization on the phase of the spontaneous rupture propagation. The effects may strongly depend on the geometry and size of the asperity, spatial distribution of the stress in and around the asperity, and a maximum stress-overshoot value. A square initialization zone with the stress discontinuously falling down at the asperity border to the level of the initial stress has been frequently applied (e.g., in the SCEC verification exercise). Galis et al. (2010) and Bizzarri (2010) independently introduced the elliptical asperity with a smooth spatial stress distribution in and around the asperity. In both papers the width of smoothing/tapering zone was only ad-hoc defined. Numerical simulations indicate that the ADER-DG method can account for a discontinuous-stress initialization more accurately than the FE method. Considering the ADER-DG solution a reference we performed numerical simulations in order to define the width of the smoothing/tapering zone to be used in the FE and FD-FE hybrid methods for spontaneous rupture propagation. We considered different sizes of initialization zone, different shapes of the initialization zone (square, circle, ellipse), different spatial distributions of stress (smooth, discontinuous), and different stress-overshoot values to investigate conditions of the spontaneous rupture propagation. We compare our numerical results with the 2D and 3D estimates by Andrews (1976a,b), Day (1982), Campillo & Ionescu (1997), Favreau at al. (1999) and Uenishi & Rice (2003, 2004). Results of our study may help modelers to better setup the initialization zone in order to avoid, e.g., a too large initialization zone and reduce numerical artifacts.

  17. Unusual complication of a urinary stone in a child: spontaneous rupture of the renal pelvis with the migration of calculus into the retroperitoneum.

    PubMed

    Taşkınlar, Hakan; Yiğit, Doğakan; Avlan, Dinçer; Naycı, Ali

    2016-03-01

    Spontaneous perforation of the renal pelvis and extravasation of urine into the perinephric space is an extremely rare condition in childhood. It is mostly related to underlying congenital urinary tract abnormalities and caused by urolithiasis or infection in the setting of urinary obstruction. Here, we report a case of an 18-month-old female patient with rupture of the renal pelvis by an extruded kidney stone and its management. PMID:27011883

  18. [Comparative study of 2 series of cases of uterine rupture collected at the Averroès Hospital in Casablanca from 1979 to 1981 and from 1984 to 1986].

    PubMed

    Zhiri, M A; Aderdour, M; Zaher, N

    1989-01-01

    There were 156 uterine ruptures collected out of 34,807 deliveries in the gynaecological and obstetrical department of the University Hospital of Averroes in Casablanca. This is a rate of 1 per 223 deliveries. The factors that predispose to this complication are low socio-economic status of the patients, multiparity and, above all, a scarred uterus. Surgical abnormalities of the pelvis and dystocia due to malpresentations and above all inappropriate manoeuvres which continue to be practised are all responsible for the condition. The rupture usually occurs in the lower segment. When the lesions are extensive the cervix and the bladder are most often damaged. Treatment should be as conservative as possible to maintain the woman's fertility but at the same time doing whatever is necessary for her. PMID:2656837

  19. [Premature rupture of membranes and chorioamnionitis].

    PubMed

    Lopez Garcia, R

    1988-01-01

    Despite advances in perinatal medicine in the past decade, the diagnosis and treatment of premature rupture of membranes remain controversial. Premature rupture occurs in 2.7-7.0% of pregnancies and most cases occur spontaneously without apparent cause. The disparity in reported rates of premature rupture is due to differences in the definition and diagnostic criteria for premature rupture and lack of comparability in the populations studied. Mexico's National Institute of Perinatology has adopted the definition of the American COllege of Gynecology and Obstetrics which views premature rupture as that occurring before regular uterine contractions that produce cervical dilation. 8.8% of its patients have premature rupture according to this definition. 20% of cases occur before the 36th week of pregnancy. Treatment of rupture occurring before 37 weeks must balance the threat of amniotic infection with the dangers of premature birth. Infections appear more common in low income patient populations. Chorioamnionitis is a serious complication of pregnancy and is the main argument against conservative treatment of premature rupture. The rate of maternal infection is directly related to the time elapsing between rupture of the membranes and birth. The rate increases after the 1st 24 hours and is at least 10 times higher after 72 hours. But recent studies suggest that there is no considerable increase in infection if vaginal explorations are avoided and careful techniques are used in treating the patient. Those who advise conservative treatment believe that prenatal outcomes are better because respiratory disease syndrome due to prematurity is avoided. Conservative management requires a white cell count at least every 24 hours and measurement of pulse, maternal temperature, and fetal heart rate ideally every 4 hours. Perinatal mortality rates due to premature rupture of membranes range from 2.5-50%. The principal causes are respiratory disease syndrome, infection, asphyxia

  20. Reconstructive Treatment of Ruptured Intracranial Spontaneous Vertebral Artery Dissection Aneurysms: Long-Term Results and Predictors of Unfavorable Outcomes

    PubMed Central

    Huang, Qing-Hai; Xu, Yi; Hong, Bo; Li, Qiang; Liu, Jian-Min; Zhao, Wen-Yuan; Deng, Ben-Qiang

    2013-01-01

    Introduction Few studies focused on predictors of unfavorable outcomes (modified Rankin Scale, 2–6) after reconstructive treatment of the ruptured intracranial spontaneous vertebral artery dissection aneurysms (ris-VADAs), which was evaluated based on 57 reconstructed lesions in this study. Methods Results of 57 consecutive patients (M:F = 29∶28; median age, 48 years; range, 27 to 69 years) harboring 57 ris-VADAs, which were treated with coils combined with single stent(n = 32), double overlapping stents (n = 16), and triple overlapping stents (n = 9) between October 2000 to March 2011, were retrospectively reviewed and analyzed. Results The available (n = 54) mean durations of angiographic and clinical follow-ups were 27 months (range, 12 to 78) and 62 months (range, 12 to 132), respectively. The involvement of PICA (p = 0.004), size of lesions (p = 0.000), quantity of stent (p = 0.001), and coil type (p = 0.002) affected the immediate obliteration grade, which was only risk factor for angiographic recurrences (p = 0.031). Although the post-treatment outcomes did not differ between single stent and multiple stents (p = 0.434), 5 angiographic recurrences, 1 rebleeding and 1 suspected rebleeding, all occurred in partial obliteration after single-stent-assisted coiling. Progressive thrombosis and in-stent obliteration were not detected on follow-up angiograms. Older age (odds ratio [OR] = 1.090; 95% confidence interval [CI], 1.004–1.184; p = 0.040) and unfavorable Hunt-Hess scale (OR = 4.289; 95%CI, 1.232–14.933; p = 0.022) were independent predictors of unfavorable outcomes in the reconstructed ris-VADAs. Conclusions Immediate obliteration grade was only risk factor for angiographic recurrence after reconstructive treatment. Unfavorable Hunt-Hess grade and older age were independent predictors of unfavorable outcomes in ris-VADAs. PMID:23840616

  1. Spontaneous Rupture of Superficial Femoral Artery Repaired with Endovascular Stent-Grafting with use of Rendez-Vous Technique, Followed by Delayed Infection

    SciTech Connect

    Fanelli, Fabrizio Cannavale, Alessandro; Gazzetti, Marianna; Fantozzi, Cristiano; Taurino, Maurizio; Speziale, Francesco

    2013-02-15

    This is the case of a 72-year-old man with lower limb ischemia due to spontaneous rupture of nonaneurysmal superficial femoral artery that developed into thigh hematoma. After failure of a Fogarty revascularization, an emergency endovascular procedure was performed to restore the arterial continuity. A rendezvous procedure was performed with a double femoral and popliteal approach and two covered stent-grafts were deployed. Patient's clinical conditions immediately improved, but 4 months later the stent-grafts were surgically removed for infection and exteriorization. A femoropopliteal bypass was performed. After 1 year follow-up, the patient is in good clinical condition.

  2. Spontaneous ruptured dissection of the right common iliac artery in a patient with classic Ehlers-Danlos syndrome phenotype.

    PubMed

    Gaines, Rick; Tinkle, Brad T; Halandras, Pegge M; Al-Nouri, Omar; Crisostomo, Paul; Cho, Jae S

    2015-04-01

    Unlike vascular Ehlers-Danlos syndrome (EDS), classic EDS is rarely associated with vascular manifestation. We report the case of a 39-year-old man who presented with acute abdominal pain. At the time of presentation, the patient was in hypovolemic shock, and computed tomography angiogram demonstrated common iliac artery dissection with rupture. He underwent an attempted endovascular repair that was converted to an open repair of a ruptured right common iliac artery dissection. Subsequent genetic testing revealed a substitution of arginine for cysteine in type I collagen, COL1A1 exon 14 c.934C>T mutation, consistent with a rare variant of classic EDS. PMID:25597651

  3. Spontaneous ruptured dissection of the right common iliac artery in a patient with classic Ehlers-Danlos syndrome phenotype.

    PubMed

    Gaines, Rick; Tinkle, Brad T; Halandras, Pegge M; Al-Nouri, Omar; Crisostomo, Paul; Cho, Jae S

    2015-04-01

    Unlike vascular Ehlers-Danlos syndrome (EDS), classic EDS is rarely associated with vascular manifestation. We report the case of a 39-year-old man who presented with acute abdominal pain. At the time of presentation, the patient was in hypovolemic shock, and computed tomography angiogram demonstrated common iliac artery dissection with rupture. He underwent an attempted endovascular repair that was converted to an open repair of a ruptured right common iliac artery dissection. Subsequent genetic testing revealed a substitution of arginine for cysteine in type I collagen, COL1A1 exon 14 c.934C>T mutation, consistent with a rare variant of classic EDS.

  4. Uterine prolapse in a primigravid woman

    PubMed Central

    Kim, Jeong Ok; Jang, Shin A; Yun, Nae Ri; Lee, Sang-Hun; Hwang, Sung Ook

    2016-01-01

    Uterine prolapse during pregnancy is an uncommon condition. It can cause preterm labor, spontaneous abortion, fetal demise, maternal urinary complication, maternal sepsis and death. We report the case of uterine prolapse in a 32-year-old healthy primigravid woman. She had no risk factors associated with uterine prolapse. She was conservatively treated, resulting in a successful vaginal delivery. This report is a very rare case of uterine prolapse in a young healthy primigravid woman, resulting in a successful vaginal delivery. PMID:27200317

  5. Spontaneous rupture of atrioventricular valve tensor apparatus as late manifestation of anti-Ro/SSA antibody-mediated cardiac disease.

    PubMed

    Cuneo, Bettina F; Fruitman, Deborah; Benson, D Woodrow; Ngan, Bo-Yee; Liske, Michael R; Wahren-Herlineus, Marie; Ho, S Yen; Jaeggi, Edgar

    2011-03-01

    Atrioventricular (AV) block and endocardial fibroelastosis associated with dilated cardiomyopathy are the most common clinical manifestations of anti-Ro/SSA-mediated fetal cardiac disease. Valvar dysfunction has not been a prominent feature of this disease; however, recent anecdotal cases have suggested an association between rupture of the AV valve tensor apparatus and maternal anti-Ro/SSA antibodies. In the present study, we have described the clinical and laboratory findings and reviewed the published data for infants of anti-Ro/SSA-positive pregnancies with AV valve insufficiency due to chordal rupture from the papillary muscles. The histopathologic features of the papillary muscle and ventricular free wall and septum biopsy specimens were examined and compared to the sections of AV leaflets from 6 autopsied fetuses with anti-Ro/SSA-mediated complete AV block without chordal disruption. Specific epitopes to the p200 region of Ro52, and Ro60 antibodies were evaluated in cases with chordal rupture. Severe AV valve insufficiency was detected prenatally (as early as 34 weeks of gestation) or postnatally (as late as 182 days) after areas of patchy echogenicity were noted in the papillary muscle at 19 to 22 weeks of gestation. Postnatally, urgent valve surgery was performed in 5 of 6 patients; 1 of 6 patients died preoperatively. All patients tested positive for Ro52. Valve leaflet tissue from the autopsy specimens was normal. The ventricular free wall and septum biopsy specimens from a patient with chordal rupture showed normal tissue; however, the papillary muscle biopsy specimens demonstrated severe atrophy with near total replacement of myocytes by fibrosis and dystrophic calcifications, and negative immunochemistry findings. In conclusion, these findings have defined an underappreciated complication of fetal antibody-mediated cardiac inflammation.

  6. Spontaneous Splenic Rupture Following Intravenous Thrombolysis with Alteplase Applied as Stroke Therapy – Case Report and Review of Literature

    PubMed Central

    Aleksic-Shihabi, Anka; Jadrijevic, Eni; Milekic, Nina; Bulicic, Ana Repic; Titlic, Marina; Suljic, Enra

    2016-01-01

    Introduction: Stroke is a medical emergency in neurology, and is one of the leading causes of death nowadays. At a recent time, a therapeutic method used in adequate conditions is thrombolysis, a treatment of an emerging clot in the brain vascular system by alteplase. The application of alteplase also has a high risk of life threatening conditions. Case report: This is a brief report of a case with thrombolysis complication which manifested as a spleen rupture. PMID:26980937

  7. Spontaneous retroperitoneal hemorrhage presenting as hemoperitoneum secondary to renal cyst rupture in a peritoneal dialysis patient with acquired cystic kidney disease.

    PubMed

    Biyik, Z; Solak, Y; Gaipov, A; Ozbek, O; Esen, H; Turk, S

    2015-01-01

    Spontaneous retroperitoneal hemorrhage (SRH) is a rare and potentially fatal condition. Acquired cystic kidney disease (ACKD) may cause SRH in hemodialysis patients. However, presentation of retroperitoneal hematoma as hemoperitoneum in peritoneal dialysis (PD) patients is exceedingly rare. We report a 44-year-old male PD patient who presented with hemoperitoneum secondary to retroperitoneal hematoma. The reason of SRH was rupture of the cysts of ACKD. The patient underwent unilateral nephrectomy with subsequent disappearance of hemoperitoneum. The importance of this case lies in the fact that the patients who have been receiving dialysis for a long time should be under surveillance in terms of ACKD development and potential associated complications such as cyst hemorrhage and malignancy.

  8. Spontaneous retroperitoneal hemorrhage presenting as hemoperitoneum secondary to renal cyst rupture in a peritoneal dialysis patient with acquired cystic kidney disease

    PubMed Central

    Biyik, Z.; Solak, Y.; Gaipov, A.; Ozbek, O.; Esen, H.; Turk, S.

    2015-01-01

    Spontaneous retroperitoneal hemorrhage (SRH) is a rare and potentially fatal condition. Acquired cystic kidney disease (ACKD) may cause SRH in hemodialysis patients. However, presentation of retroperitoneal hematoma as hemoperitoneum in peritoneal dialysis (PD) patients is exceedingly rare. We report a 44-year-old male PD patient who presented with hemoperitoneum secondary to retroperitoneal hematoma. The reason of SRH was rupture of the cysts of ACKD. The patient underwent unilateral nephrectomy with subsequent disappearance of hemoperitoneum. The importance of this case lies in the fact that the patients who have been receiving dialysis for a long time should be under surveillance in terms of ACKD development and potential associated complications such as cyst hemorrhage and malignancy. PMID:26199480

  9. Spontaneous Rupture of the Hepatic Artery in a Patient with Type 1 Neurofibromatosis Treated by Embolization: A Case Report

    SciTech Connect

    Rao, V. Day, C.P.; Manimaran, N.; Hurlow, R.A.; Orme, R.

    2007-02-15

    We report the case of a 48-year-old man with neurofibromatosis presenting with sudden-onset abdominal pain, profound hypotension, and a drop in hemoglobin. CT scan demonstrated a massive hematoma within the right lobe of the liver with rupture into the peritoneal cavity. Angiography demonstrated diffuse abnormalities of the hepatic circulation with fusifom, ectatic, and stenotic segments. Acute extravasation from a peripheral branch of the right hepatic artery was identified and successfully embolized with subsequent hemodynamic stabilization of the patient. To the best of our knowledge this is the first case report of this kind in a patient with type I neurofibromatosis.

  10. Spontaneous rupture and hemorrhage of myxopapillary ependymoma of the filum terminale: a case report and literature review.

    PubMed

    Tonogai, Ichiro; Sakai, Toshinori; Tezuka, Fumitake; Goda, Yuichiro; Takata, Yoichiro; Higashino, Kosaku; Sairyo, Koichi

    2014-01-01

    We present a rare case of acute onset cauda equina syndrome caused by a ruptured myxopapillary ependymoma with accompanying hemorrhage. A 26-year-old healthy woman developed muscle weakness and sensory disturbances in her bilateral lower extremities. Magnetic resonance imaging showed a huge mass from the L1 body to the L2-3 disc level. She was able to ambulate with crutches after the tumor was successfully removed. To prevent recurrence, she received whole brain and spinal cord radiation. No sing of recurrence were detected at the 8 month follow up. PMID:25264068

  11. Flexor Carpi Radialis to Palmaris Longus Tendon Transfer for Spontaneous Rupture of the Flexor Carpi Radialis Tendon-A Review of an Uncommon Finding and Surgical Technique for Operative Correction.

    PubMed

    Shearin, Jonathan Winkworth; Walters, Brian; Yang, S Steven

    2016-10-01

    Spontaneous ruptures of the flexor carpi radialis tendon (FCR) are rare and associated with systemic inflammatory diseases, localized tendinopathy related to scaphotrapezial-trapezoidal arthritis, or chronic immunosuppression from corticosteroids. While most cases do not require operative intervention, some patients develop weakness, impaired range of motion, and persistent pain. Previously reported surgical options include synovectomy, tendon stump resection, and osteophyte removal. We describe a surgical technique for patients with persistent symptomatology following FCR rupture in which the FCR is transposed end-to-side to the palmaris longus tendon. Three cases using this technique are presented with follow-up of 4-9 months that were collected at Lenox Hill Hospital. All three patients did well regarding specific outcome measures: grip strength, range of motion, and functional activity. FCR transfer to palmaris is an alternative to other surgical options for the spontaneous rupture of the FCR tendon in patients who remain symptomatic despite a course of non-operative therapy. PMID:27595965

  12. Acute abdomen and hemorrhagic shock caused by spontaneous rupture of renal cyst in autosomal dominant polycystic kidney disease.

    PubMed

    Yaman, İsmail; Sağlam, İsmet; Kurt, Kamile

    2013-01-01

    Autosomal dominant polycystic kidney disease is an important cause of end stage renal failure. Rarely, these patients may present with hemorrhagic shock caused by rupture of the renal cyst. The aim of this study was to report a rare case of a patient who arrived at the emergency department with autosomal dominant polycystic kidney disease presenting with acute abdominal pain and hemorrhagic shock. A 58-year-old male with chronic renal failure was admitted to the emergency department with acute abdominal pain and hemorrhagic shock. The patient was admitted to the Department of Surgery with diagnosis of acute abdomen and perirenal hematoma. Although the patient was on conservative treatment, his symptoms did not improve and the patient was operated emergently. During exploration, there was bleeding from the right polycystic kidney, which was 30×20 cm in dimension. The patient underwent nephrectomy and drainage of the hematoma, and was discharged on the fifth postoperative day without any problems. Bleeding due to rupture of a cyst in autosomal dominant polycystic kidney disease occurs rarely but it may be life threatening. Although conservative methods are often preferable in treatment, surgery can be life saving for patients in whom the clinical situation does not improve.

  13. Spontaneous intra-uterine growth restriction modulates the endocrine status and the developmental expression of genes in porcine fetal and neonatal adipose tissue.

    PubMed

    Gondret, Florence; Père, Marie-Christine; Tacher, Sandrine; Daré, Sophie; Trefeu, Christine; Le Huërou-Luron, Isabelle; Louveau, Isabelle

    2013-12-01

    Low birth weight is correlated with low adiposity at birth, a phenotype that influences neonatal survival and later adiposity. A better understanding of events affecting the fetal adipose tissue development and its functionality around birth is thus needed. This study was undertaken to examine the impact of spontaneous intra-uterine growth restriction (IUGR) on circulating concentrations of hormones and nutrients together with the developmental expression patterns of various genes in subcutaneous adipose tissue of pig fetus during the last third of pregnancy and just after birth. At 71 and 112 days post-conception and 2 days postnatal, pairs of same-sex piglets were chosen within litters to have either a medium (MBW) or a low (LBW) weight (n=6 pairs at each stage). The results indicate that IUGR counteracts the temporal fall of DLK1 gene expression in developing adipose tissue across gestation. It also attenuates the time-dependent increase in expression levels of many genes promoting adipocyte differentiation (PPARG, CEBPA) and lipogenesis (LPL, SREBF1, FASN, FABP4). Opposite responses to IUGR were observed for the IGF system, so that IGF1 mRNA levels were lower (P<0.001) but IGF2 mRNA levels were greater in adipose tissue of LBW piglets compared with MBW piglets. The plasma insulin concentration and the mRNA levels of insulin receptor (INSR) and insulin-responsive glucose transporter (GLUT4) in adipose tissue were also greater in LBW piglets at day 2 postnatal. The data indicate that IUGR delays the normal ontogeny of adipose tissue across gestation and affects the insulin and IGF axes around birth.

  14. Ductus arteriosus aneurysm with community-acquired methicillin-resistant Staphylococcus aureus infection and spontaneous rupture: a potentially fatal quandary.

    PubMed

    Stewart, Audra; Dyamenahalli, Umesh; Greenberg, S Bruce; Drummond-Webb, Jonathan

    2006-06-01

    We present the case of a 6-month-old previously healthy girl who presented with high fever, labored breathing, and an enlarged cardiac silhouette on her chest radiograph. Comprehensive evaluation discovered a ductus arteriosus aneurysm and pericardial effusion with methicillin-resistant Staphylococcus aureus bacteremia. Despite pericardiocentesis and appropriate intravenous antibiotics, there was rapid enlargement of the aneurysm and accumulation of echogenic material within the ductus arteriosus aneurysm. Infected aneurysm rupture was identified during emergency surgery. This infant also had vocal cord paresis, a likely complication of the surgery. The clinical course, diagnosis, and treatment of this patient are discussed. Infection of a ductus arteriosus or an infected ductal arteriosus aneurysm is a rare and potentially fatal clinical entity. In the era of increasing community-acquired methicillin-resistant S aureus infections, this is a diagnosis that requires a high index of suspicion.

  15. Uterine factors.

    PubMed

    Jaslow, Carolyn R

    2014-03-01

    Uterine anomalies are one of the most common parental causes of recurrent pregnancy loss, occurring in about 19% of patients. Congenital uterine anomalies are most likely caused by HOX gene mutations, although the mechanism is probably polygenic. There are no known environmental causes other than estrogenic endocrine disruptors such as diethylstilbestrol. Acquired uterine anomalies may result from uterine trauma (adhesions) or benign growths of the myometrium (fibroids) or endometrium (polyps). Although randomized controlled trials are lacking, surgical treatment is recommended for repair of uterine septa, and for removal of severe adhesions and submucosal fibroids, especially if no other causes are identified.

  16. Uterine surgery by operative hysteroscopy.

    PubMed

    Bacskó, G

    1997-02-01

    Uterine anomalies are found in 10-15% of women with repeated pregnancy loss. Uterine malformations and benign tumors are common causes of abortions, premature labour and abnormal fetal presentation in some cases. One-third of patients with habitual abortion have a septated or subseptated uterus, and two-thirds of pregnancies in women with duplicated uterus progress to term. Müllerian fusion defects and submucous fibroid may cause poor implantation or ineffective maternal blood supply to the placental site of the developing pregnancy. When these abnormalities were evaluated in infertile patients or in habitual abortions, traditionally the abdominal correction (Jones, Strassman, Tompkins etc.) were used traditionally. These procedures require incision of abdominal and uterine walls in general anesthesia with relative long hospitalization and recovery. The new endoscopic procedure; hysteroscopy is used not only to evaluate the type and size of Müllerian fusion defects but also to treat this malformation. The uterine septum is transsectable, via this elegant method, without injury of abdominal wall and healthy uterine wall musculature. After a traditional abdominal metroplasty there is no other-choice other than the cesarean section to prevent rupture of the uterus, but after hysteroscopic septotomy the vaginal delivery is possible and the uterine rupture rarity.

  17. Silent rupture of an unscarred uterus at third-trimester abortion correlated with an unrecognized perforation.

    PubMed

    Li, Zhengyu; Yao, Qiang; Min, Wenjiao; Xing, Aiyun

    2012-01-01

    Silent uterine rupture in an unscarred uterus during pregnancy is rare. We present a case of silent uterine rupture in an unscarred uterus at third-trimester abortion by use of mifepristone and misoprostol in a patient who had a history of intrauterine procedures. The absence of clinical symptoms suggests that this uterine rupture resulted from an unrecognized perforation in a previous intrauterine manipulation. Routine sonographic follow-up examinations and careful clinical observations are especially recommended for women with previous intrauterine manipulations.

  18. Uterine Fibroids

    MedlinePlus

    Uterine fibroids are the most common benign tumors in women of childbearing age. Fibroids are made of muscle cells and other tissues ... of the uterus, or womb. The cause of fibroids is unknown. Risk factors include being African American ...

  19. Uterine Fibroids

    MedlinePlus

    ... it? How is it diagnosed? What are the treatments for it? Other FAQs NICHD Research Information Clinical Trials Resources and Publications Uterine Fibroids: Condition Information Skip sharing on social media links ...

  20. Uterine Cancer

    MedlinePlus

    ... is pregnant. There are different types of uterine cancer. The most common type starts in the endometrium, the lining of the uterus. This type of cancer is sometimes called endometrial cancer. The symptoms of ...

  1. Giant uterine artery pseudoaneurysm after a missed miscarriage termination in a cesarean scar pregnancy

    PubMed Central

    2014-01-01

    Background Uterine artery pseudoaneurysms are dangerous and can lead to severe hemorrhage. We report an uncommon cause of a giant pseudoaneurysm in a missed miscarriage in a woman with a cesarean scar pregnancy. Case presentation The patient was a 25-year-old Chinese woman with a missed miscarriage in a cesarean scar pregnancy. Curettage was performed under ultrasound monitoring. A uterine artery pseudoaneurysm measuring 71 × 44 × 39 mm was detected the next day by Doppler ultrasonography. While waiting for admittance to an advanced institution to undergo embolization treatment, the pseudoaneurysm ruptured spontaneously. The subsequent severe hemorrhage necessitated hysterectomy. Conclusion A delay in diagnosis of uterine artery pseudoaneurysms may result from a long period between the curettage and follow-up examination. Ultrasound and Doppler ultrasonography should be performed repeatedly at short intervals to rule out them, especially in cesarean scar pregnancies. For a giant uterine artery pseudoaneurysm, interventional embolization might be the first treatment choice. If time allows, intra-operative ligation of the feeding vessels should be attempted before any decision to perform a hysterectomy is made. However, hysterectomy remains a possibility when severe bleeding occurs. PMID:25070087

  2. Uterine factors and infertility.

    PubMed

    Sanders, Barry

    2006-03-01

    A literature review was performed to explore the available information regarding the association of uterine factors--intrauterine adhesions, uterine septa, uterine myomas and endometrial polyps--with infertility and reproductive loss. The literature was reviewed also to ascertain evidence that treatment of these abnormalities improves fertility. A MEDLINE search was performed to identify the relevant publications in the English-language literature. There is minimal published evidence to demonstrate that intrauterine adhesions lead to infertility or pregnancy loss, but the literature does contain several observational series that demonstrate successful fertility, with term pregnancy rates ranging from 32% to 87% following hysteroscopic division of intrauterine adhesions. The evidence supporting a direct link between a septate uterus and reproductive loss/infertility is derived from the results of metroplasty. Several case series demonstrated a reduction in the spontaneous abortion rate, from 91% to 17%, on average, after hysteroscopic metroplasty. Furthermore, following metroplasty, the mean pregnancy rate in previously infertile patients is 47%. Little has been written regarding the association of endometrial polyps and infertility. One study did demonstrate a pregnancy rate of 78% after hysteroscopic polypectomy as compared to 42% in infertile patients with normal endometrial cavities. The literature that associates myomas with infertility/reproductive loss is more extensive but quite controversial. Evidence from the in vitro fertilization literature suggests that only those myomas that distort the endometrial cavity impair fertility. Pregnancy rates approximating 50% are achieved with myomectomy by laparotomy, laparoscopy or hysteroscopy.

  3. Quadriceps Tendon Rupture due to Postepileptic Convulsion

    PubMed Central

    Erkut, Adem; Guvercin, Yilmaz; Sahin, Rifat; Keskin, Davut

    2014-01-01

    We present a case of quadriceps tendon (QT) rupture. QT ruptures can occur in all ages. The cause is mostly traumatic in origin. Spontaneous ruptures that are thought to result from predisposing conditions are rare. Post-convulsion QT ruptures lacking traumas in their history can be overlooked in clinical examinations. This should be born in mind by the attending physician, as early diagnosis and treatment of the condition can lead to satisfactory outcomes. PMID:24944977

  4. Vascular type Ehlers-Danlos Syndrome with fatal spontaneous rupture of a right common iliac artery dissection: case report and review of literature

    PubMed Central

    Abayazeed, Aly; Hayman, Emily; Moghadamfalahi, Mana; Cain, Darren

    2014-01-01

    Vascular Ehlers-Danlos Syndrome (previously Ehlers-Danlos IV) is a rare autosomal dominant collagen vascular disorder caused by a 2q31 COL3A1 gene mutation encoding pro-alpha1 chain of type III collagen (in contrast to classic Ehlers-Danlos, caused by a COL5A1 mutation). The vascular type accounts for less than 4% of all Ehlers-Danlos cases and usually has a poor prognosis due to life threatening vascular ruptures and difficult, frequently unsuccessful surgical and vascular interventions. In 70% of cases, vascular rupture or dissection, gastrointestinal perforation, or organ rupture is a presenting sign. We present a case of genetically proven vascular Ehlers-Danlos with fatal recurrent retroperitoneal hemorrhages secondary to a ruptured right common iliac artery dissection in a 30-year-old male. This case highlights the need to suspect collagen vascular disorders when a young adult presents with unexplained retroperitoneal hemorrhage, even without family history of such diseases. PMID:24967021

  5. Vascular type Ehlers-Danlos Syndrome with fatal spontaneous rupture of a right common iliac artery dissection: case report and review of literature.

    PubMed

    Abayazeed, Aly; Hayman, Emily; Moghadamfalahi, Mana; Cain, Darren

    2014-02-01

    Vascular Ehlers-Danlos Syndrome (previously Ehlers-Danlos IV) is a rare autosomal dominant collagen vascular disorder caused by a 2q31 COL3A1 gene mutation encoding pro-alpha1 chain of type III collagen (in contrast to classic Ehlers-Danlos, caused by a COL5A1 mutation). The vascular type accounts for less than 4% of all Ehlers-Danlos cases and usually has a poor prognosis due to life threatening vascular ruptures and difficult, frequently unsuccessful surgical and vascular interventions. In 70% of cases, vascular rupture or dissection, gastrointestinal perforation, or organ rupture is a presenting sign. We present a case of genetically proven vascular Ehlers-Danlos with fatal recurrent retroperitoneal hemorrhages secondary to a ruptured right common iliac artery dissection in a 30-year-old male. This case highlights the need to suspect collagen vascular disorders when a young adult presents with unexplained retroperitoneal hemorrhage, even without family history of such diseases.

  6. Vascular type Ehlers-Danlos Syndrome with fatal spontaneous rupture of a right common iliac artery dissection: case report and review of literature.

    PubMed

    Abayazeed, Aly; Hayman, Emily; Moghadamfalahi, Mana; Cain, Darren

    2014-02-01

    Vascular Ehlers-Danlos Syndrome (previously Ehlers-Danlos IV) is a rare autosomal dominant collagen vascular disorder caused by a 2q31 COL3A1 gene mutation encoding pro-alpha1 chain of type III collagen (in contrast to classic Ehlers-Danlos, caused by a COL5A1 mutation). The vascular type accounts for less than 4% of all Ehlers-Danlos cases and usually has a poor prognosis due to life threatening vascular ruptures and difficult, frequently unsuccessful surgical and vascular interventions. In 70% of cases, vascular rupture or dissection, gastrointestinal perforation, or organ rupture is a presenting sign. We present a case of genetically proven vascular Ehlers-Danlos with fatal recurrent retroperitoneal hemorrhages secondary to a ruptured right common iliac artery dissection in a 30-year-old male. This case highlights the need to suspect collagen vascular disorders when a young adult presents with unexplained retroperitoneal hemorrhage, even without family history of such diseases. PMID:24967021

  7. Resistance of a vaccinia virus A34R deletion mutant to spontaneous rupture of the outer membrane of progeny virions on the surface of infected cells

    SciTech Connect

    Husain, Matloob; Weisberg, Andrea S.; Moss, Bernard

    2007-09-30

    The extracellular form of vaccinia virus is referred to as an enveloped virion (EV) because it contains an additional lipoprotein membrane surrounding the infectious mature virion (MV) that must be discarded prior to cell fusion and entry. Most EVs adhere to the surface of the parent cell and mediate spread of the infection to adjacent cells. Here we show that some attached EVs have ruptured envelopes. Rupture was detected by fluorescence microscopy of unfixed and unpermeabilized cells using antibodies to the F13 and L1 proteins, which line the inner side of the EV membrane and the outer side of the MV membrane, respectively. The presence of ruptured EV membranes was confirmed by immunogold transmission electron microscopy. EVs with broken membranes were present on several cell lines examined including one deficient in glycosaminoglycans, which are thought to play a role in breakage of the EV membrane prior to fusion of the MV. No correlation was found between EVs with ruptured membranes and actin tail formation. Studies with several mutant viruses indicated that EV membranes lacking the A34 protein were unbroken. This result was consistent with other properties of A34R deletion mutants including resistance of the EV membrane to polyanions, small plaque formation and low infectivity that can be increased by disruption of the EV membrane by freezing and thawing.

  8. Endovascular stent-graft repair of spontaneous aorto-caval fistula secondary to a ruptured abdominal aortic aneurysm: An emergency management of hostile anatomy

    PubMed Central

    Liu, Mingyuan; Wang, Haofu

    2016-01-01

    Objectives: Although endovascular aneurysm repair of aorto-caval fistula offers a safe and efficient approach compared to traditional open repair, endovascular techniques for the treatment of aorto-caval fistula with ruptured abdominal aortic aneurysms in emergency circumstance are not well established. This study aims to evaluate the effect of endovascular repair of aorto-caval fistula of a patient with ruptured abdominal aortic aneurysm and hostile anatomy. Methods: we report a case of an aorto-caval fistula endovascular repaired in a 78-year-old male using a hybrid stent-graft technique. Results: The patient had an uneventful recovery and CTA follow up showed no sign of ACF or any endoleak. Conclusion: This case highlights ACF might be managed by composite endograft implantation with careful and solid sealing of anchoring zones on the two sides. PMID:27489717

  9. Rupture of bicornuate uterus

    PubMed Central

    Jayaprakash, Sheela; Muralidhar, Lakshmidevi; G, Sampathkumar; Sexsena, Rajivkumar

    2011-01-01

    A primigravida aged 20 years was referred to Vydehi Institute of Medical Sciences with diagnosis of 30 weeks of period of gestation with eclampsia and failure to respond to induction with misoprostol and she was on Pritchard regimen for the treatment of eclampsia and there was no response to induction of labour and emergency ultrasound was taken and it showed an extrauterine gestation of 30 weeks gestation with fetal demise and free fluid in peritoneum. A tentative diagnosis of secondary abdominal pregnancy with eclampsia was made and she was taken for emergency laprotomy. Intra operative findings showed haemoperitoneum, fetus with placenta and membranes in the peritoneal cavity, there was bicornuate uterus and right horn was ruptured from the fundus to about 8 cm down in the posterior aspect and ruptured part was sutured in two layers. After securing perfect haemostasis, abdomen was closed. This paper illustrates a case report of uterine anomaly with 30 weeks period of gestation and eclampsia and rupture following induction with prostaglandins. PMID:22675095

  10. Rupture of bicornuate uterus.

    PubMed

    Jayaprakash, Sheela; Muralidhar, Lakshmidevi; Sampathkumar, G; Sexsena, Rajivkumar

    2011-01-01

    A primigravida aged 20 years was referred to Vydehi Institute of Medical Sciences with diagnosis of 30 weeks of period of gestation with eclampsia and failure to respond to induction with misoprostol and she was on Pritchard regimen for the treatment of eclampsia and there was no response to induction of labour and emergency ultrasound was taken and it showed an extrauterine gestation of 30 weeks gestation with fetal demise and free fluid in peritoneum. A tentative diagnosis of secondary abdominal pregnancy with eclampsia was made and she was taken for emergency laprotomy. Intra operative findings showed haemoperitoneum, fetus with placenta and membranes in the peritoneal cavity, there was bicornuate uterus and right horn was ruptured from the fundus to about 8 cm down in the posterior aspect and ruptured part was sutured in two layers. After securing perfect haemostasis, abdomen was closed. This paper illustrates a case report of uterine anomaly with 30 weeks period of gestation and eclampsia and rupture following induction with prostaglandins. PMID:22675095

  11. Rupture of bicornuate uterus.

    PubMed

    Jayaprakash, Sheela; Muralidhar, Lakshmidevi; Sampathkumar, G; Sexsena, Rajivkumar

    2011-10-28

    A primigravida aged 20 years was referred to Vydehi Institute of Medical Sciences with diagnosis of 30 weeks of period of gestation with eclampsia and failure to respond to induction with misoprostol and she was on Pritchard regimen for the treatment of eclampsia and there was no response to induction of labour and emergency ultrasound was taken and it showed an extrauterine gestation of 30 weeks gestation with fetal demise and free fluid in peritoneum. A tentative diagnosis of secondary abdominal pregnancy with eclampsia was made and she was taken for emergency laprotomy. Intra operative findings showed haemoperitoneum, fetus with placenta and membranes in the peritoneal cavity, there was bicornuate uterus and right horn was ruptured from the fundus to about 8 cm down in the posterior aspect and ruptured part was sutured in two layers. After securing perfect haemostasis, abdomen was closed. This paper illustrates a case report of uterine anomaly with 30 weeks period of gestation and eclampsia and rupture following induction with prostaglandins.

  12. Cesarean Hysterectomy and Uterine-Preserving Alternatives.

    PubMed

    Huls, Christopher Kevin

    2016-09-01

    Hysterectomy at the time of an obstetric delivery or postpartum is an uncommon time to perform one of the most common gynecologic procedures. Hysterectomy associated with pregnancy is often unplanned and undesired. Postpartum complications associated with the need for hysterectomy carry significant risks, which pose challenges for mother-infant bonding and can signify an unexpected end to fertility. The most common indication for hysterectomy is postpartum hemorrhage. Postpartum hemorrhage is caused by uterine atony, genital tract laceration, uterine rupture, invasive placentation, infection, or coagulopathy. Multidisciplinary teams improve outcomes and are capable of managing complex medical and surgical complications that occur postpartum. PMID:27521882

  13. Rupture disc

    DOEpatents

    Newton, Robert G.

    1977-01-01

    The intermediate heat transport system for a sodium-cooled fast breeder reactor includes a device for rapidly draining the sodium therefrom should a sodium-water reaction occur within the system. This device includes a rupturable member in a drain line in the system and means for cutting a large opening therein and for positively removing the sheared-out portion from the opening cut in the rupturable member. According to the preferred embodiment of the invention the rupturable member includes a solid head seated in the end of the drain line having a rim extending peripherally therearound, the rim being clamped against the end of the drain line by a clamp ring having an interior shearing edge, the bottom of the rupturable member being convex and extending into the drain line. Means are provided to draw the rupturable member away from the drain line against the shearing edge to clear the drain line for outflow of sodium therethrough.

  14. Pregnancy outcome and uterine fibroids.

    PubMed

    Parazzini, Fabio; Tozzi, Luca; Bianchi, Stefano

    2016-07-01

    Myomas are observed in about 3-12% of pregnant women. Uterine fibroids may affect the outcome of pregnancy. The presence of myomas - in particular of myomas that distort the uterine cavity and larger intramural myomas - has been associated with infertility. In the case of pregnancy, it has been linked to an increased risk of spontaneous abortion, fetal malpresentation, placenta previa, preterm birth, cesarean section, and peripartum hemorrhage. Although fibroids may negatively affect pregnancy outcome, the impact of their treatment, particularly in quantitative terms, is unclear. Hysteroscopic myomectomy is the treatment of choice for submucous fibroids. The comparative efficacy of laparoscopic, laparotomic, or new modalities of treatment of intramural fibroids is not known. Up to date the choice and modalities of treatment of submucous fibroids should not be based on sound evidence but on clinical concerns and the skill of each center. PMID:26723475

  15. Pregnancy outcome and uterine fibroids.

    PubMed

    Parazzini, Fabio; Tozzi, Luca; Bianchi, Stefano

    2016-07-01

    Myomas are observed in about 3-12% of pregnant women. Uterine fibroids may affect the outcome of pregnancy. The presence of myomas - in particular of myomas that distort the uterine cavity and larger intramural myomas - has been associated with infertility. In the case of pregnancy, it has been linked to an increased risk of spontaneous abortion, fetal malpresentation, placenta previa, preterm birth, cesarean section, and peripartum hemorrhage. Although fibroids may negatively affect pregnancy outcome, the impact of their treatment, particularly in quantitative terms, is unclear. Hysteroscopic myomectomy is the treatment of choice for submucous fibroids. The comparative efficacy of laparoscopic, laparotomic, or new modalities of treatment of intramural fibroids is not known. Up to date the choice and modalities of treatment of submucous fibroids should not be based on sound evidence but on clinical concerns and the skill of each center.

  16. Carcinome épidermoïde de l'urètre masculin révélé par une rupture spontanée de l'urètre.

    PubMed

    Ghorbel, Jilani; Hafsia, Ghassen; Derouiche, Amine; Jrad, Anis; Chebil, Mohamed

    2011-06-01

    RéSUMé: Le carcinome épidermoïde de l'urètre masculin est une tumeur rare, les tumeurs de l'urètre tous types confondus représentant moins de 1 % des tumeurs de l'appareil urinaire. Le pronostic reste défavorable malgré un traitement chirurgical énergique. La radiochimiothérapie semble être un traitement prometteur, mais son rôle doit être défini par d'autres études.Nous rapportons un cas rare de carcinome épidermoïde de l'urètre bulbo-membraneux découvert à un stade localement avancé après observation d'une rupture urétrale transtumorale chez un homme âgé de 70 ans. Le patient a été traité, après drainage vésical, par une irradiation externe associée à une chimiothérapie par cisplatine, et est décédé après progression de la maladie sur un an.La rupture spontanée de l'urètre transtumorale est un mode de découverte exceptionnel témoignant d'une évolution locale défavorable, ce qui rend ces tumeurs difficilement opérables. Cependant, l'espoir actuel réside dans des protocoles thérapeutiques associant radiothérapie et chimiothérapie.

  17. Uterine fibroids.

    PubMed

    Stewart, Elizabeth A; Laughlin-Tommaso, Shannon K; Catherino, William H; Lalitkumar, Sujata; Gupta, Devashana; Vollenhoven, Beverley

    2016-01-01

    Uterine fibroids (also known as leiomyomas or myomas) are common clonal neoplasms of the uterus. Fibroids have both smooth muscle and fibroblast components, in addition to a substantial amount of fibrous extracellular matrix, which all contribute to the pathogenetic process. Fibroids are extremely heterogeneous in their pathophysiology, size, location and clinical symptomatology. They are also a part of a range of disease in which some variants have facets of malignant behaviour but overall are benign. Risk for fibroids is associated with race; black women have a higher risk of developing fibroids earlier in life than their white counterparts and also develop more-severe forms of the disease. Clinically, fibroids account for one-third to half of all hysterectomies and are associated with substantial morbidity and health care costs for women of reproductive age. Indeed, current treatments are primarily surgical and interventional; approximately three-quarters of all fibroid treatments are hysterectomies. However, clinical innovations are emerging in the use of progesterone receptor modulators as a medical therapy. New information is rapidly accumulating about the genetic subgroups that lead to fibroid formation, which might aid further understanding of the clinical heterogeneity of this disease and lead to individualized treatments. This information is a crucial development given the current lack of high-quality evidence on which to base therapeutic decisions. PMID:27335259

  18. Ruptured tubal molar pregnancy.

    PubMed

    Yakasai, I A; Adamu, N; Galadanchi, H S

    2012-01-01

    Molar pregnancies in most instances develop within the uterine cavity, but may occur at any site. Ectopic molar pregnancy is a rare event. The objective of this study was to present a case of ruptured tubal molar gestation, discuss its clinical features and ways to improve diagnostic accuracy. A 35-year-old woman presented with features suggestive of ruptured tubal ectopic pregnancy. There was neither any evidence at the time of presentation to suspect a molar gestation, nor β human chorionic gonadotrophin (βhCG) hormone estimation was done, but only a clearview pregnancy test was carried out. She had total left salpingectomy and histological evaluation of the specimen revealed complete hydatidiform mole. The hCG level normalized within 3 weeks of follow-up. Clinical features of ectopic molar pregnancy may be indistinguishable from non-molar ectopic pregnancy. We recommend βhCG estimation as well as histological examination of the surgical specimen for all patients coming with features suggestive of ectopic pregnancy. PMID:23238205

  19. Hysteroscopic Transcervical Resection of Uterine Septum

    PubMed Central

    Shi, Xiaoyan; Hua, Xiangdong; Gu, Xiaoyan; Yang, Dazhen

    2013-01-01

    Objective: To explore the method of diagnosis for uterine septum and the clinical effect of hysteroscopic transcervical resection of the septum. Methods: One-hundred ninety cases of patients with uterine septum who were diagnosed and treated at our hospital during 2007–2011 were selected, and their general information, perioperative status, postoperative recovery treatment, and postoperative pregnancy rates were statistically analyzed. Results: All 190 patients were cured with one surgery, with an average hysteroscopic operating time of 22.60 ± 10.67 minutes and intraoperative blood loss of 15.74 ± 9.64 mL. There were no complications such as uterine perforation, water intoxication, infection, or heavy bleeding. Among the 115 patients that we followed up, 86 became pregnant and delivered infants, 81 of which were born at term and 5 that were born premature. Conclusion: The combination of hysteroscopy and laparoscopy is still the most reliable method for the diagnosis of uterine septum. With a shorter operative time, less blood loss, a significantly increased postoperative pregnancy rate and live birth rate, and a significantly lower spontaneous abortion rate, transcervical resection of the septum was the preferred method for the treatment of uterine septum, and surgical instruments and skills were critical to the prognosis of uterine septum. PMID:24398191

  20. Anatomic uterine defects.

    PubMed

    Patton, P E

    1994-09-01

    Congenital or acquired uterine defects remain important considerations in the investigation of recurrent pregnancy loss. When repeated first or second trimester losses, preterm delivery, or abnormal fetal presentations are documented, the suspicion of a structural uterine abnormality should be high. The diagnosis of uterine defects is no longer elusive. The combination of radiologic imaging techniques, hysteroscopy, and laparoscopy enables an accurate diagnosis in nearly every case. The optimal treatment for uterine malformations is still a matter of considerable controversy. Therefore, when a uterine defect is diagnosed, tough clinical decisions must be made. When alternate causes of pregnancy loss are excluded, pregnancy potential will depend primarily on the specific type of uterine anomaly that is detected. It is important to recognize that not all uterine defects are amenable to therapy, but in carefully selected patients, reparative surgery may be rewarding.

  1. Management of Bleeding Uterine Arteriovenous Malformation with Bilateral Uterine Artery Embolization

    PubMed Central

    Kim, Taehwan; Kim, Jinoo; Yoon, Hyun-Ki; Ko, Gi-Young; Gwon, Dong-Il; Yang, Heechul; Sung, Kyu-Bo

    2014-01-01

    Purpose To evaluate the technical feasibility and clinical outcome of bilateral uterine artery embolization (UAE) as a first-line therapeutic option for bleeding uterine arteriovenous malformation (AVM). Materials and Methods Between 2002 and 2012, 19 patients were diagnosed with acquired uterine AVM clinically and through imaging studies. The clinical characteristics, angiographic features, technical success rate of embolization, procedure-related complications, imaging, and clinical follow-up data were assessed. Clinical success was defined as immediate symptomatic resolution with disappearance of vascular abnormality on subsequent imaging studies. Results A total of 20 bilateral UAE, with or without embolization of extra-uterine feeders, were performed as the first-line treatment. Technical and clinical success rate was 90.0% (18/20) and 89.5% (17/19), respectively. Embolization was incomplete in two patients who had residual extra-uterine fine feeders to the AVM or a procedure-related complication (ruptured uterine artery); the former showed slow regression of the vascular malformation during the observation period, while the latter underwent a successful second bilateral UAE. Immediate clinical success was achieved in the remaining 17 patients after a single session and no recurrence of bleeding was found. Recovery to normal menstrual cycle was seen in all 17 patients with clinical success within one or two months, two of whom subsequently had uneventful intrauterine pregnancies carried to term. Conclusion Bilateral UAE is a safe and effective first-line therapeutic option for the management of bleeding uterine AVMs. However, incomplete embolization due to unembolizable feeders or difficult access into the uterine artery may lead to suboptimal treatment. PMID:24532505

  2. Imaging diagnosis of congenital uterine malformation.

    PubMed

    Pui, Margaret H

    2004-10-01

    Congenital anomaly of the female reproductive system is associated with higher rate of infertility, spontaneous abortion, intrauterine growth retardation, premature birth and postpartum bleed. Because of the variable clinical pictures of obstruction of menstrual flow in adolescence to hypomenorrhea, vaginal discharge, dyspareunia, and fertility problems in adult life, early and accurate diagnosis is difficult. Complete uterine and vaginal septum can be easily confused with uterus didelphys. Management of these two müllerian duct anomalies is different. With improved treatment methods for complete relief of symptoms and prevention of further sequelae, comprehensive evaluation is important to identify the underlying problem and formulate appropriate therapeutic plan. The embryology, classification, and clinical presentation of uterine malformation, advantages and limitations of diagnostic methods including hysterosalpingogram, ultrasound, magnetic resonance imaging, laparoscopy, and hysteroscopy are discussed. The imaging features of different types of uterine anomalies are illustrated.

  3. Does Method of Placental Removal or Site of Uterine Incision Repair Alter Endometritis After Cesarean Delivery?

    PubMed Central

    Dodson, Mark K.; Harris, Robert L.; Floyd, Randall C.; Martin, James N.; Morrison, John C.

    1993-01-01

    Objective: his investigation was undertaken to evaluate the relationship between postcesarean endometritis and (1) method of placental removal and (2) site for uterine repair. Methods: This prospective, randomized study included 120 patients who underwent primary or repeat abdominal delivery for arrest of progress in labor, fetal distress, or breech presentation. Parturients were divided into four groups: I—spontaneous placental detachment, in situ uterine repair; II—spontaneous placental detachment, exteriorized uterine repair; III—manual placental removal, in situ uterine repair; and IV—manual placental removal, exteriorized uterine repair. Prophylactic antibiotics were not used. Results: Endometritis was significantly increased in the manual removal/exteriorized uterine repair group versus all the other groups including the spontaneous removal in situ (group I, P = 0.012), the spontaneous removal/exteriorized repair group (group II, P = 0.034), and the manual removal/in situ repair group (group III, P = 0.043). Comparison of group IV (manual removal/ exteriorized repair) with the combined groups I, II, and III (spontaneous removal/in situ repair, spontaneous removal/exteriorized repair, and manual removal/in situ repair) was significantly different (P = 0.005). Prior to delivery, use of an internal monitoring system, skill of the operating surgeon, and type of anesthesia were similar among groups. Conclusions: The findings of this investigation suggest that; when other known causes of infectious morbidity are constant, manual placental remvol in association with exteriorization for uterine repair significantly increases postcesarean endometritis. PMID:18476211

  4. Uterine pathology and infertility.

    PubMed

    Flamigni, C; Gianaroli, L; Ferraretti, A P; Jasonni, V M; Melega, C; Possati, G

    1985-01-01

    The authors describe the factors influencing implantation with reference to uterine pathology; the role that it plays both in the case of failure of implantation and in the case of repeated abortions is discussed and the techniques of treatment in the presence of uterine pathology affecting fertility are listed.

  5. Uterine artery embolization

    MedlinePlus

    ... the procedure. UAE is less invasive than surgical treatments for uterine fibroids. Many women may return more quickly to activities ... SC, Spies JB, Worthington-Kirsch R, et al. Uterine artery embolization for ... from the FIBROID registry. Obstet Gynecol . 2008; 111:22-33. Munro ...

  6. Spontaneous delivery through a cervical tear without cervical os dilatation.

    PubMed

    Djokovic, Dusan; Costa, Cristina; Martins, Ana; Abushad, Shadi

    2015-01-01

    Spontaneous delivery through a cervical tear, provoked by prostaglandin-induced uterine contractions, was described in a G2P0 woman with a history of cervical dilatation and uterine curettage. This rare complication with potentially serious maternal-fetal consequences can be predicted by an aberrant cervical response to prostaglandins in parturients with previous cervical interventions. PMID:25678963

  7. Spontaneous delivery through a cervical tear without cervical os dilatation

    PubMed Central

    Djokovic, Dusan; Costa, Cristina; Martins, Ana; Abushad, Shadi

    2015-01-01

    Key Clinical Message Spontaneous delivery through a cervical tear, provoked by prostaglandin-induced uterine contractions, was described in a G2P0 woman with a history of cervical dilatation and uterine curettage. This rare complication with potentially serious maternal–fetal consequences can be predicted by an aberrant cervical response to prostaglandins in parturients with previous cervical interventions. PMID:25678963

  8. Uterine fibroids: current perspectives

    PubMed Central

    Khan, Aamir T; Shehmar, Manjeet; Gupta, Janesh K

    2014-01-01

    Uterine fibroids are a major cause of morbidity in women of a reproductive age (and sometimes even after menopause). There are several factors that are attributed to underlie the development and incidence of these common tumors, but this further corroborates their relatively unknown etiology. The most likely presentation of fibroids is by their effect on the woman’s menstrual cycle or pelvic pressure symptoms. Leiomyosarcoma is a very rare entity that should be suspected in postmenopausal women with fibroid growth (and no concurrent hormone replacement therapy). The gold standard diagnostic modality for uterine fibroids appears to be gray-scale ultrasonography, with magnetic resonance imaging being a close second option in complex clinical circumstances. The management of uterine fibroids can be approached medically, surgically, and even by minimal access techniques. The recent introduction of selective progesterone receptor modulators (SPRMs) and aromatase inhibitors has added more armamentarium to the medical options of treatment. Uterine artery embolization (UAE) has now been well-recognized as a uterine-sparing (fertility-preserving) method of treating fibroids. More recently, the introduction of ultrasound waves (MRgFUS) or radiofrequency (VizAblate™ and Acessa™) for uterine fibroid ablation has added to the options of minimal access treatment. More definite surgery in the form of myomectomy or hysterectomy can be performed via the minimal access or open route methods. Our article seeks to review the already established information on uterine fibroids with added emphasis on contemporary knowledge. PMID:24511243

  9. Abnormal uterine bleeding.

    PubMed

    Jennings, J C

    1995-11-01

    Physicians who care for female patients cannot avoid the frequent complaint of abnormal uterine bleeding. Knowledge of the disorders that cause this problem can prevent serious consequences in many patients and improve the quality of life for many others. The availability of noninvasive and minimally invasive diagnostic studies and minimally invasive surgical treatment has revolutionized management of abnormal uterine bleeding. Similar to any other disorder, the extent to which a physician manages abnormal uterine bleeding depends on his or her own level of comfort. When limitations of either diagnostic or therapeutic capability are encountered, consultation and referral should be used to the best interest of patients.

  10. Abnormal Uterine Bleeding

    MedlinePlus

    ... Abnormal uterine bleeding is any bleeding from the uterus (through your vagina) other than your normal monthly ... or fibroids (small and large growths) in the uterus can also cause bleeding. Rarely, a thyroid problem, ...

  11. Puerperal uterine inversion managed by the uterine balloon tamponade

    PubMed Central

    Thiam, Mariétou; Niang, Mouhamadou Mansour; Gueye, Lamine; Sarr, Fatou Rachel; Dieme, Marie Edouard Faye; Cisse, Mamadou Lamine

    2015-01-01

    The uterine inversion is a rare and severe puerperal complication. Uncontrolled cord traction and uterine expression are the common causes described. We report a case of uterine inversion stage III caused by poor management of the third stage of labor. It was about a 20 years old primigravida referred in our unit for postpartum hemorrhage due to uterine atony. After manual reduction of the uterus, the use of intra uterine balloon tamponade helped to stop the hemorrhage. The uterine inversion is a rare complication that may cause maternel death. The diagnosis is clinical and its management must be immediate to avoid maternal complications. PMID:26977239

  12. Concomitant Vesicouterine Rupture with Avulsion of Ureter: A Rare Complication of Vaginal Birth after Cesarean Section

    PubMed Central

    Thiek, J Lalnunnem; Sialo, Stephen; Ahanthem, Santa Singh

    2016-01-01

    Uterine rupture is the most serious and life threatening complication and occurs in 0.7-0.9% of vaginal birth after lower segment caesarean section. Cases of bladder rupture along with uterine rupture have been rarely reported and avulsion of ureter, required ureteric implantation is even rarer. This case report describe a very rare case of vesicouterine rupture with avulsion of ureter following vacuum assisted delivery in a grandmulti with previous lower segment cesarean section (LSCS). Haematuria is the most common presentation of bladder rupture. Antenatal counseling regarding this entity is recommended if woman opted for vaginal birth after cesarean section. Intrapartum and postpartum high index of suspicion are important in clinching the diagnosis. PMID:27134952

  13. Spontaneous Right Hemothorax in the Elderly

    PubMed Central

    Sebai, Asma; Gharsalli, Houda; Zribi, Hazem; Neji, Henda; Maâlej, Sonia; Douik El Gharbi, Leila

    2016-01-01

    Rupture of thoracic aortic aneurysm is a life threatening condition. Rupture in the right pleural cavity is extremely rare. We report the case of an 80-year-old man with a spontaneous right hemothorax. Diagnosis was made by computed tomography (CT) scan. He was managed with chest tube and stabilization. The patient died before any surgical intervention. We report this case to emphasize that rupture of aortic aneurysm should be considered in the evaluation of spontaneous hemothorax even if it is right-sided particularly in the elderly. Emergent therapy is necessary to prevent mortality. PMID:27403181

  14. General Information About Uterine Sarcoma

    MedlinePlus

    ... Research Uterine Sarcoma Treatment (PDQ®)–Patient Version General Information About Uterine Sarcoma Go to Health Professional Version ... the PDQ Adult Treatment Editorial Board . Clinical Trial Information A clinical trial is a study to answer ...

  15. How Are Uterine Fibroids Diagnosed?

    MedlinePlus

    ... Clinical Trials Resources and Publications How are uterine fibroids diagnosed? Skip sharing on social media links Share ... probably won’t know that you have uterine fibroids. Sometimes, health care providers find fibroids during a ...

  16. Uterine fibroid embolization

    PubMed Central

    Raikhlin, Antony; Baerlocher, Mark Otto; Asch, Murray R.

    2007-01-01

    OBJECTIVE To review evidence supporting the use of uterine fibroid embolization (UFE) as an alternative to hysterectomy and myomectomy for managing uterine fibroids. QUALITY OF EVIDENCE MEDLINE was searched using the MeSH terms embolization, therapeutic; leiomyoma; treatment outcome; pregnancy; and clinical trials. Most published studies on use of UFE for management of uterine fibroids provide level II evidence. MAIN MESSAGE For 71% to 92% of patients, UFE is effective at alleviating fibroid-related symptoms. After UFE, fibroids are reduced in size by 42% to 83%. Patients’ satisfaction with the procedure is high (>90%), and UFE is safe and has a low rate of major complications (1.25%). When compared with hysterectomy, UFE is associated with fewer major complications, shorterhospital stays, and faster recovery. Although successful pregnancy following UFE is possible, there is insufficient evidence to advocate use of UFE over myomectomy for management of uterine fibroids in women wishing to preserve fertility. CONCLUSION For treatment of symptomatic uterine fibroids, UFE is a safe and effective nonsurgical alternative to hysterectomy and myomectomy. PMID:17872642

  17. Risk of Occult Uterine Sarcoma in Presumed Uterine Fibroids.

    PubMed

    Cui, Rosa R; Wright, Jason D

    2016-03-01

    Symptomatic fibroids are a common indication for hysterectomy or myomectomy. Although rare, unexpected gynecologic malignancies in presumed fibroids have been documented. In cases where tissue retrieval is performed through morcellation, there is increasing concern that intra-abdominal dispersion of occult uterine malignancies may lead to peritoneal dissemination and worse outcomes. We examined the available literature to determine the prevalence of all uterine cancers in women undergoing hysterectomy or myomectomy for benign uterine disease, with attention to the risk of morcellating occult uterine sarcomas. We also reviewed the available tools for preoperative discrimination between benign and malignant uterine disease. PMID:26645385

  18. A Rare Case of Bilateral Patellar Tendon Ruptures: A Case Report and Literature Review

    PubMed Central

    Tarazi, Nadim; O'loughlin, Padhraig; Amin, Amin; Keogh, Peter

    2016-01-01

    Bilateral patellar tendon ruptures are rare. The majority of case reports describing bilateral patellar tendon ruptures have occurred in patients with predisposing factors to tendinopathy. We describe a case of bilateral patellar tendon rupture sustained following minimal trauma by a patient with no systemic disease or history of steroid use. Due to the rarity of this injury, clinical suspicion is low. It is reported that 38% of patellar tendon ruptures are misdiagnosed initially. Therefore careful history taking and physical examination is integral in ensuring a diagnosis is achieved for early primary repair. We discuss the aetiology of spontaneous tendon rupture and report a literature review of bilateral patellar tendon ruptures. PMID:27200200

  19. Gemcitabine Hydrochloride and Docetaxel With or Without Bevacizumab in Treating Patients With Advanced or Recurrent Uterine Leiomyosarcoma

    ClinicalTrials.gov

    2015-11-11

    Recurrent Uterine Corpus Sarcoma; Stage IIIA Uterine Sarcoma; Stage IIIB Uterine Sarcoma; Stage IIIC Uterine Sarcoma; Stage IVA Uterine Sarcoma; Stage IVB Uterine Sarcoma; Uterine Corpus Leiomyosarcoma

  20. Ruptured ectopic pregnancy in rudimentary horn of the uterus.

    PubMed

    Tufail, Amber; Hashmi, Haleema A

    2007-02-01

    Rudimentary horn is one of the rarest congenital uterine anomalies and consists of a relatively normal appearing uterus on one side with a rudimentary horn on the other side. It is difficult to diagnose before surgery and hazardous to maternal life as rupture of pregnant horn result in severe hemoperitoneum. Case of rudimentary horn pregnancy is reported in a lady with history of habitual abortion and signs and symptoms of acute adnexal pathology. Exploratory laparotomy revealed ruptured rudimentary horn pregnancy. Excision of accessory horn was done.

  1. Clinical practice. Uterine fibroids.

    PubMed

    Stewart, Elizabeth A

    2015-04-23

    A 47-year-old black woman has heavy menstrual bleeding and iron-deficiency anemia.She reports nocturia and urinary frequency. A colonoscopy is negative. Ultrasonography shows a modestly enlarged uterus with three uterine fibroids. She is not planning to become pregnant. How should this case be evaluated and managed? PMID:25901428

  2. Clinical practice. Uterine fibroids.

    PubMed

    Stewart, Elizabeth A

    2015-04-23

    A 47-year-old black woman has heavy menstrual bleeding and iron-deficiency anemia.She reports nocturia and urinary frequency. A colonoscopy is negative. Ultrasonography shows a modestly enlarged uterus with three uterine fibroids. She is not planning to become pregnant. How should this case be evaluated and managed?

  3. Glass rupture disk

    DOEpatents

    Glass, S. Jill; Nicolaysen, Scott D.; Beauchamp, Edwin K.

    2002-01-01

    A frangible rupture disk and mounting apparatus for use in blocking fluid flow, generally in a fluid conducting conduit such as a well casing, a well tubing string or other conduits within subterranean boreholes. The disk can also be utilized in above-surface pipes or tanks where temporary and controllable fluid blockage is required. The frangible rupture disk is made from a pre-stressed glass with controllable rupture properties wherein the strength distribution has a standard deviation less than approximately 5% from the mean strength. The frangible rupture disk has controllable operating pressures and rupture pressures.

  4. MR imaging findings of uterine pyomyoma: radiologic-pathologic correlation.

    PubMed

    Ono, Hiromi; Kanematsu, Masayuki; Kato, Hiroki; Toyoki, Hiroshi; Hayasaki, Yoh; Furui, Tatsuro; Morishige, Ken-ichirou; Hatano, Yuichiro

    2014-08-01

    A 69-year-old postmenopausal female with a spontaneously occurring uterine pyomyoma was described with emphasis on the MR imaging findings. On unenhanced T1- and T2-weighted MR images, a huge mottled mass suspected to contain blood products, necrotic tissue, or purulent or viscous fluid was demonstrated within anterior myometrial wall of uterine body. The mass was surrounded by a peripheral rim that was hyperintense on T1-weighted images and hypointense on T2-weighted images. On gadolinium-enhanced MR images, most of the mass was unenhanced, but the peripheral rim was equally enhanced with the surrounding myometrium. Pathological examination revealed an intramural uterine pyomyoma surrounded by fibrous capsules with abundant lymphocytes and neutrophils. Our findings indicate that pyomyoma should be considered when MR images demonstrate a myometrial cystic lesion accompanied by a peripheral rim. PMID:24615512

  5. Successful Treatment of Uterine Arteriovenous Malformation due to Uterine Trauma

    PubMed Central

    Ozdemir, Ozgur; Uysal, Aysel; Alparslan, Ahmet Sukru; Gurses, Cemil; Koroglu, Mert

    2016-01-01

    Uterine arteriovenous malformation (AVM) is defined as abnormal and nonfunctional connections between the uterine arteries and veins. Although the patients typically present with vaginal bleeding, some patients may experience life-threatening massive bleeding in some circumstances. The treatment of choice depends on the symptoms, age, desire for future fertility, and localization and size of the lesion; however, embolization of the uterine artery is the first choice in symptomatic AVM in patients at reproductive age with expectations of future fertility. We report a case of acquired AVM (after D/C) with an extensive lesion, which was successfully treated with bilateral uterine artery embolization (UAE).

  6. Successful Treatment of Uterine Arteriovenous Malformation due to Uterine Trauma

    PubMed Central

    Ozdemir, Ozgur; Uysal, Aysel; Alparslan, Ahmet Sukru; Gurses, Cemil; Koroglu, Mert

    2016-01-01

    Uterine arteriovenous malformation (AVM) is defined as abnormal and nonfunctional connections between the uterine arteries and veins. Although the patients typically present with vaginal bleeding, some patients may experience life-threatening massive bleeding in some circumstances. The treatment of choice depends on the symptoms, age, desire for future fertility, and localization and size of the lesion; however, embolization of the uterine artery is the first choice in symptomatic AVM in patients at reproductive age with expectations of future fertility. We report a case of acquired AVM (after D/C) with an extensive lesion, which was successfully treated with bilateral uterine artery embolization (UAE). PMID:27699074

  7. Spontaneous Heterotopic Pregnancy: Dual Case Report and Review of Literature

    PubMed Central

    Chadee, Annika; Kirby, Catherine; Chadwick, Ekaterina; Gottimukkala, Sri; Hamaoui, Abraham; Stankovich, Vasiliy; Hale, Theodore; Gilak, Hamid; Momtaz, Mohammad; Sasken, Harvey; Henderson, Cassandra E.

    2016-01-01

    Introduction. Heterotopic pregnancy is a rare complication usually seen in populations at risk for ectopic pregnancy or those undergoing fertility treatments. It is a potentially dangerous condition occurring in only 1 in 30,000 spontaneous pregnancies. With the advent of Assisted Reproduction Techniques (ART) and ovulation induction, the overall incidence of heterotopic pregnancy has risen to approximately 1 in 3,900 pregnancies. Other risk factors include a history of pelvic inflammatory disease (PID), tubal damage, pelvic surgery, uterine Mullerian abnormalities, and prior tubal surgery. Heterotopic pregnancy is a potentially fatal condition, rarely occurring in natural conception cycles. Most commonly, heterotopic pregnancy is diagnosed at the time of rupture when surgical management is required. Case. This paper represents two cases of heterotopic pregnancies as well as a literature review. Conclusion. Heterotopic pregnancy should be suspected in patients with an adnexal mass, even in the absence of risk factors. Clinicians must be alert to the fact that confirming an intrauterine pregnancy clinically or by ultrasound does not exclude the coexistence of an ectopic pregnancy. A high index of suspicion in women is needed for early and timely diagnosis, and management with laparotomy or laparoscopy can result in a favorable and successful obstetrical outcome. PMID:27413561

  8. Splenic rupture as a presenting feature of endocarditis.

    PubMed

    Winearls, James Roger; McGloughlin, Steven; Fraser, John F

    2009-04-01

    We describe the first case of infective endocarditis presenting with spontaneous splenic rupture. Our patient, a known intravenous drug user presented with hypovolaemic shock secondary to splenic rupture. The patient was resuscitated and underwent an emergency splenectomy. Subsequent clinical examination revealed a systolic murmur and a diagnosis of mitral valve infective endocarditis was made after echocardiography. Splenic tissue, blood cultures and mitral valve tissue all cultured Enterococcus faecalis. The patient had a successful mitral valve replacement and was discharged home after 44 days. To our knowledge this is the first reported case of enterococcal endocarditis presenting with splenic rupture. This case highlights the need to consider endocarditis in spontaneous splenic rupture particularly in those patients in a high risk group, such as IV drug users, especially if they lack a clear history of trauma. PMID:19217796

  9. [Bilateral rupture of the quadriceps tendon].

    PubMed

    Modrego, Francisco J; Molina, Juan

    2004-01-01

    Simultaneous, bilateral, and spontaneous rupture of the quadriceps tendon is a very rare injury. Individuals with this injury are usually predisposed by chronic renal disease with secondary hyperparathyroidism, gout, diabetes, and lupus erythematosus. Often, primary diagnostic confusion can lead to a delay in treatment. Two cases of a bilateral lesion of the quadriceps tendon, that were treated surgically using the technique of Scuderi, followed by an intense rehabilitation programme, are presented. Surgical treatment yields satisfactory results.

  10. Efficacy of Combined Laparoscopic and Hysteroscopic Repair of Post-Cesarean Section Uterine Diverticulum: A Retrospective Analysis

    PubMed Central

    Li, Cuilan; Tang, Shiyan; Gao, Xingcheng; Lin, Wanping; Han, Dong; Zhai, Jinguo; Mo, Xuetang; Zhou, Lee Jaden Gil Yu Kang

    2016-01-01

    Background. Diverticulum, one of the long-term sequelae of cesarean section, can cause abnormal uterine bleeding and increase the risk of uterine scar rupture. In this study, we aimed to evaluate the efficacy of combined laparoscopic and hysteroscopic repair, a newly occurring method, treating post-cesarean section uterine scar diverticulum. Methods. Data relating to 40 patients with post-cesarean section uterine diverticulum who underwent combined laparoscopic and hysteroscopic repair were retrospectively analyzed. Preoperative clinical manifestations, size of uterine defects, thickness of the lower uterine segment (LUS), and duration of menstruation were compared with follow-up findings at 1, 3, and 6 months after surgery. Results. The average preoperative length and width of uterine diverticula and thickness of the lower uterine segment were recorded and analyzed. The average durations of menstruations at 1, 3, and 6 months after surgery were significantly shorter than the preoperative one (p < 0.05), respectively. At 6 months after surgery, the overall success improvement rate of surgery was 90% (36/40). Three patients (3/40 = 7.5%) developed partial improvement, and 1/40 (2.5%) was lost to follow-up. Conclusions. Our findings showed that combined treatment with laparoscopy and hysteroscopy was an effective method for the repair of post-cesarean section uterine diverticulum. PMID:27066497

  11. Uterine Leiomyomas: An ENIGMA

    PubMed Central

    Geethamala, Kempula; Murthy, Venkataramappa Srinivasa; Vani, Bangalore Ramalingiah; Rao, Sudha

    2016-01-01

    Introduction: Leiomyomas are benign tumors composed of smooth muscle cells and varying amounts of fibrous connective tissue commonly encountered in women of reproductive age group. Leiomyomas need hormonal milieu for their growth and maintenance. Unopposed estrogenic stimulation manifests as leiomyomas undergoing secondary changes, endometrial proliferation or hyperplasia, and other associated pathological findings. Objective: To study and analyze various histopathological changes within uterine leiomyomas in hysterectomy specimens. And also, to analyze the associated endometrial and adnexal structures pathology. Materials and Methods: A 4 years retrospective study from June 2010 to June 2014 conducted in the Department of Pathology and Obstetrics and Gynecology, ESIC Medical College and PGIMSR, wherein 820 hysterectomy specimens clinically diagnosed as uterine leiomyomas were subjected to histopathological examination and relevant clinical data were analyzed. Results: Leiomyomas occurred mostly in women aged 31-50 years (90.23%). Menorrhagia (49.36%) and pain abdomen (30.6%) were the chief clinical manifestations. Endometrial patterns commonly seen were proliferative and hyperplastic endometrium together accounting for 73.4% and dual pathology with adenomyosis was 29.1%. Four cases of tubercular etiology and a single case of granulosa cell tumor of ovary was noted. Conclusion: Though hysterectomy is a routine procedure in the management of uterine leiomyomas, occasional cases of tumor or infective pathology may be missed. Therefore, histopathology is mandatory and conscientious quest must be done for confirmed diagnosis and ensuring optimal management. PMID:27134477

  12. Atraumatic splenic rupture after coagulopathy owing to a snakebite.

    PubMed

    Kang, Changwoo; Kim, Dong Hoon; Kim, Seong Chun; Kim, Dong Seob; Jeong, Chi-Young

    2014-09-01

    Among the many complications that may follow envenomation by some species of venomous snakes, coagulopathy is common and well known. However, hemoperitoneum induced by coagulopathy after a snakebite is rare. Atraumatic spontaneous splenic rupture is also an uncommon and life-threatening condition. Here, we report a case of presumptive envenomation by Gloydius spp. that resulted in atraumatic splenic rupture as a probable manifestation of coagulopathy, which has not been previously reported. PMID:24882658

  13. Uterine anomalies. A retrospective, matched-control study.

    PubMed

    Ben-Rafael, Z; Seidman, D S; Recabi, K; Bider, D; Mashiach, S

    1991-10-01

    The obstetric risk associated with congenital uterine malformations was studied in a group of 67 women who had undergone hysterosalpingography (HSG) during an eight-year period. HSG was performed to investigate primary (21% of the cases) and secondary (19%) infertility (group 1) or recurrent early fetal loss (60%) (group 2). The study group was compared with a random control group of 130 patients with HSG-proven normal uteri, matched for the presenting symptom. Prematurity and intrauterine fetal death were found to be significantly more common (P less than .05) for women in group 1 with uterine anomalies. The mean birth weight for preterm infants (less than 37 weeks) was significantly lower (P less than .01) for women with malformed uteri. The incidence of antepartum bleeding during pregnancy (P less than .01), breech presentation and cesarean section (P less than .001) was significantly higher for the study group. Premature rupture of the membranes was diagnosed more frequently (P less than .05) only in group 1. Patients with congenital uterine anomalies are a high-risk obstetric group. Primary infertility may be a more common presenting complaint in women with uterine anomalies than previously recognized.

  14. Attritional Rupture of the Little Finger Flexor Digitorum Profundus Tendon in the Carpal Tunnel in a Patient with Acromegaly.

    PubMed

    Lee, Munn Yi Tina; Jin, Yeo Chong

    2016-02-01

    Spontaneous rupture of flexor tendons within the carpal tunnel is rare in the absence of rheumatoid arthritis. Other predisposing conditions such as gout, infection, pisotriquetrial osteoarthritis, as well as hook of hamate fracture non-union, have previously been reported. However, tendon ruptures of the hand in the presence of acromegaly, as well as spontaneous ruptures within the carpal tunnel, have not been described in the literature. PMID:27454510

  15. Bilateral renal rupture in a patient on hemodialysis.

    PubMed

    Carlson, Chris C; Holsten, Steve J; Grandas, Oscar H

    2003-06-01

    This is a case presentation and discussion of a dialysis patient who presented to the surgical service with abdominal pain, hypotension, and tachycardia and in extremis who was found to have a contained retroperitoneal hematoma after rupture of his left kidney. Six months after an uneventful nephrectomy and postoperative recovery he again presented with hypotension and anemia and was found to have a contralateral retroperitoneal hematoma consistent with renal hemorrhage. After unsuccessful angioembolization, the patient underwent a right nephrectomy and recovered without sequelae. Bilateral spontaneous renal rupture is a rare event documented by only a few anecdotal reports in the literature and usually associated with acquired cystic kidney disease. Rupture of renal cysts is relatively common in renal cystic disease but usually presents as asymptomatic hematuria or flank pain. Trauma is the most common cause of renal rupture, but other causes of spontaneous renal rupture are rare and include polyarteritis nodosa and urothelial carcinoma. The diagnosis of acute abdominal pain in the dialysis patient is a challenging differential. While a rare complication the diagnosis of spontaneous renal rupture should not be excluded in a patient presenting with abdominal pain, hypotension, and anemia.

  16. Successful Delivery of Twin Pregnancy in Class U3b/C2/V1 Uterus by Bilateral Caesarean Section after Spontaneous Conception

    PubMed Central

    El-Masry, Yasmine; Ossman, Ahmed M. E.; El-Namoury, Mohammed; Sarsik, Sameh

    2015-01-01

    A case of a 19-year-old female with class U3b/C2/V1 uterus conceived a twin pregnancy with a fetus in each horn after spontaneous conception. She referred to our department with presentation of premature rupture of membranes, with a history of cesarean delivery of a single full term living fetus a year and a half before this delivery. Examination revealed two completely separate uterine horns with a fetus in each horn, two distinct externally rounded cervices, and a single vagina with a short nonobstructing vaginal septum in the upper part of the vagina. And as the appropriate mode of delivery is still unclear, each case should be managed as the condition requires, and in our case urgent bilateral caesarean sections were performed. PMID:26557398

  17. Malignant transformation of uterine leiomyoma

    PubMed Central

    Al Ansari, Afaf A.; Al Hail, Fatima A.; Abboud, Emad

    2012-01-01

    A rare case of malignant transformation of uterine leiomyoma is reported. A 54 year old lady, nulliparous and 2 years postmenopausal presented to gynecology clinic with a pelvi – abdominal mass and ultrasound scan suggestive of multiple uterine fibroid. Total abdominal hysterectomy performed. Histopathology report showed leiomyosarcomative changes from benign leiomyoma within the huge mass. PMID:25003044

  18. Spontaneous cervical and mediastinal emphysema.

    PubMed

    Parker, G S; Mosborg, D A; Foley, R W; Stiernberg, C M

    1990-09-01

    Subcutaneous cervical emphysema often appears as a result of surgery or trauma. However, when it occurs spontaneously, the patient may present with clinically impressive and dramatic features. The etiology is related to the rupture of terminal alveoli and dissection of air along the pulmonary vasculature. Exercise may contribute to the process by increases in intrathoracic pressure. Six cases of spontaneous cervical emphysema, all related to SCUBA diving training at a Naval facility, were recently seen at our institution. Proper management entails having a high index of suspicion for diagnosis, and then being able to identify potentially life-threatening complications.

  19. Patellar Tendon Rupture after Lateral Release without Predisposing Systemic Disease or Steroid Use

    PubMed Central

    De Giorgi, S.; Notarnicola, A.; Vicenti, G.; Moretti, B.

    2015-01-01

    Arthroscopic technique for lateral release is the most widely used procedure for the correction of recurrent dislocations of the patella. In the relevant literature, several complications of lateral release are described, but the spontaneous patellar tendon rupture has never been suggested as a possible complication of this surgical procedure. Patellar tendon rupture is a rather infrequent and often unilateral lesion. Nevertheless, in case of systemic diseases (LES, rheumatoid arthritis, and chronic renal insufficiency) that can weaken collagen structures, bilateral patellar tendon ruptures are described. We report a case of a 24-year-old girl with spontaneous rupture of patellar tendon who, at the age of 16, underwent an arthroscopic lateral release for recurrent dislocation of the patella. This is the first case of described spontaneous patellar tendon rupture that occurred some years after an arthroscopic lateral release. PMID:25960904

  20. Uterine Inversion; A case report.

    PubMed

    Bouchikhi, C; Saadi, H; Fakhir, B; Chaara, H; Bouguern, H; Banani, A; Melhouf, Ma

    2008-01-01

    The puerperal uterine inversion is a rare and severe complication occurring in the third stage of labour. The mechanisms are not completely known. However, extrinsic factors such as oxytocic arrests after a prolonged labour, umbilical cord traction or abdominal expression are pointed. Other intrinsic factors such as primiparity, uterine hypotonia, various placental localizations, fundic myoma or short umbilical cord were also reported. The diagnosis of the uterine inversion is mainly supported by clinical symptoms. It is based on three elements: haemorrhage, shock and a strong pelvic pain. The immediate treatment of the uterine inversion is required. It is based on a medical reanimation associated with firstly a manual reduction then surgical treatment using various techniques. We report an observation of a 25 years old grand multiparous patient with a subacute uterine inversion after delivery at home. PMID:21516244

  1. Uterine Inversion; A case report

    PubMed Central

    Bouchikhi, C; Saadi, H; Fakhir, B; Chaara, H; Bouguern, H; Banani, A; Melhouf, MA

    2008-01-01

    The puerperal uterine inversion is a rare and severe complication occurring in the third stage of labour. The mechanisms are not completely known. However, extrinsic factors such as oxytocic arrests after a prolonged labour, umbilical cord traction or abdominal expression are pointed. Other intrinsic factors such as primiparity, uterine hypotonia, various placental localizations, fundic myoma or short umbilical cord were also reported. The diagnosis of the uterine inversion is mainly supported by clinical symptoms. It is based on three elements: haemorrhage, shock and a strong pelvic pain. The immediate treatment of the uterine inversion is required. It is based on a medical reanimation associated with firstly a manual reduction then surgical treatment using various techniques. We report an observation of a 25 years old grand multiparous patient with a subacute uterine inversion after delivery at home. PMID:21516244

  2. Radiation Therapy, Paclitaxel, and Carboplatin in Treating Patients With Uterine Cancer

    ClinicalTrials.gov

    2015-01-16

    Stage IA Uterine Sarcoma; Stage IB Uterine Sarcoma; Stage IC Uterine Sarcoma; Stage IIA Uterine Sarcoma; Stage IIB Uterine Sarcoma; Stage IIIA Uterine Sarcoma; Stage IIIB Uterine Sarcoma; Stage IIIC Uterine Sarcoma; Stage IVA Uterine Sarcoma; Stage IVB Uterine Sarcoma; Uterine Carcinosarcoma

  3. Uterine Contraction Modeling and Simulation

    NASA Technical Reports Server (NTRS)

    Liu, Miao; Belfore, Lee A.; Shen, Yuzhong; Scerbo, Mark W.

    2010-01-01

    Building a training system for medical personnel to properly interpret fetal heart rate tracing requires developing accurate models that can relate various signal patterns to certain pathologies. In addition to modeling the fetal heart rate signal itself, the change of uterine pressure that bears strong relation to fetal heart rate and provides indications of maternal and fetal status should also be considered. In this work, we have developed a group of parametric models to simulate uterine contractions during labor and delivery. Through analysis of real patient records, we propose to model uterine contraction signals by three major components: regular contractions, impulsive noise caused by fetal movements, and low amplitude noise invoked by maternal breathing and measuring apparatus. The regular contractions are modeled by an asymmetric generalized Gaussian function and least squares estimation is used to compute the parameter values of the asymmetric generalized Gaussian function based on uterine contractions of real patients. Regular contractions are detected based on thresholding and derivative analysis of uterine contractions. Impulsive noise caused by fetal movements and low amplitude noise by maternal breathing and measuring apparatus are modeled by rational polynomial functions and Perlin noise, respectively. Experiment results show the synthesized uterine contractions can mimic the real uterine contractions realistically, demonstrating the effectiveness of the proposed algorithm.

  4. Successful Pregnancy after Treatment with Ulipristal Acetate for Uterine Fibroids

    PubMed Central

    Monleón, Javier; Galliano, Daniela; Pellicer, Antonio

    2014-01-01

    This case report presents a clinical pregnancy after ulipristal acetate (UA) to decrease uterine fibroid size. A 37-year-old patient, gravida 1, abortus 1, with uterine fibroids was treated with 5 mg of UA daily for 13 weeks starting eight months after a multiple laparotomic myomectomy. Fibroid shrinkage and restoration of the morphology of endometrial cavity were evaluated in order to allow a subsequent pregnancy. A decrease of the uterine fibroids and a normal morphology of the endometrial cavity were noted by transvaginal ultrasound after treatment. An endometrial biopsy excluded histologic endometrial changes. Three months after the end of UA the patient reported amenorrhea for 5 weeks and a clinical pregnancy was confirmed with transvaginal ultrasound. She underwent a subsequent uneventful pregnancy. Thus, the spontaneous pregnancy after UA to reduce fibroid size may support the potential clinical utility of this selective progesterone receptor modulator in the management of women with pregnancy desire and uterine fibroids after a prior myomectomy. Patients who refuse a new surgical procedure and/or those who are going to undergo assisted reproductive techniques would benefit from UA. It effectively shrinks fibroids, avoids risks of a new surgical procedure, and allows an immediate attempt at conception after the end of treatment. PMID:25143845

  5. LOX Tank Rupture

    NASA Technical Reports Server (NTRS)

    1986-01-01

    The bright luminous glow at the top is attributed to the rupture of the liquid oxygen tank just above the SRB/ET attachment. At this point, Challenger is completely engulfed in a firey flow of escaping liquid propellant.

  6. Achilles tendon rupture - aftercare

    MedlinePlus

    Heel cord tear; Calcaneal tendon rupture ... MRI scan to see what type of Achilles tendon tear you have. An MRI is a type ... partial tear means at least some of the tendon is still OK. A full tear means your ...

  7. Uterine leiomyoma cytogenetics.

    PubMed

    Nibert, M; Heim, S

    1990-05-01

    Uterine leiomyoma--a benign smooth muscle tumor--has recently been found to contain tumor-specific chromosome aberrations. Although only normal karyotypes were detected in 50 to 80% of cytogenetically investigated tumors, 104 leiomyomas with karyotypic aberrations have already been reported. At least four cytogenetically abnormal subgroups have been identified thus far, characterized by rearrangements of 6p, del(7)(q21.2q31.2), +12, and t(12;14)(q14-15;q23-24). The remaining abnormal tumors have had various nonrecurrent anomalies. Secondary karyotypic rearrangements, sometimes including ring chromosomes, have been found in one-third and reflect clonal evolution. Occasional leiomyomas have contained multiple numerical and structural rearrangements. Though benign, these cytogenetically grossly aberrant tumors often displayed more atypical histological features than are usually seen in leiomyoma. Multiple leiomyomas have been investigated from 69 patients, with detection of chromosome anomalies in at least two separate tumors from the same uterus in ten cases. In half of these patients unrelated aberrations were found in different leiomyomas from the same uterus. On other occasions the aberrations were identical, indicating that although some uterine leiomyomas originate independently, others may develop by intra-myometrial spreading from a common neoplastic clone. Some common features are discernible between the karyotypic pictures of uterine leiomyoma and angioleiomyoma; rearrangements of 6p, 13q, and 21q have been described in both tumor types. The cytogenetic similarities so far detected between leiomyoma and the malignant muscle tumors--leiomyosarcoma and rhabdomyosarcoma--are few and may be fortuitous. The cytogenetic profiles of leiomyoma and lipoma are strikingly similar; both tumor types have nonrandom rearrangements of 12q13-15, t(12;14) in leiomyoma and t(3;12) in lipoma, as well as variant rearrangements of the same 12q segment. Both also have cytogenetic

  8. Pharmacological characterization of KUR-1246, a selective uterine relaxant.

    PubMed

    Kobayashi, M; Takeda, K; Murata, S; Kojima, M; Akahane, M; Inoue, Y; Kitamura, K; Kawarabayashi, T

    2001-05-01

    The aim of the present study was to evaluate the efficacy and beta 2-adrenoceptor (AR) selectivity of KUR-1246, a new uterine relaxant. Inhibition of spontaneous or drug-induced uterine contractions by KUR-1246 was evaluated in pregnant rats and rabbits by an organ bath method or by a balloon method. The selectivity of KUR-1246 was assessed simultaneously in organs isolated from late-pregnant rats. The affinity of KUR-1246 for human beta 1-, beta 2-, and beta 3-ARs was determined using two radioligands. KUR-1246 suppressed both spontaneous and drug-induced contractions in isolated uteri, the rank order of potency being isoproterenol > KUR-1246 > terbutaline > ritodrine. ICI-118551 (selective beta 2-AR antagonist) competitively antagonized the KUR-1246-induced inhibition of spontaneous uterine contractions, but CGP-20712A (selective beta 1-AR antagonist) and SR-58894A (selective beta 3-AR antagonist) did not. All beta-AR agonists tested produced significant inhibition of spontaneous uterine contractions in vivo: ED(30) value for KUR-1246 was 0.13 microg/kg/min, a potency about 6 times and 400 times greater than that of terbutaline and ritodrine, respectively. In contrast, the positive chronotropic effect was minimal in KUR-1246-treated rats. KUR-1246 displaced radioligand binding to beta 1-, beta 2-, and beta 3-ARs, the pK(i) values being 5.75 +/- 0.03, 7.59 +/- 0.08, and 4.75 +/- 0.03 for beta 1-, beta 2-, and beta 3-ARs, respectively. For the selectivity of KUR-1246 for human beta 2-AR, we obtained values of 39.2 ([IC(50) for beta 1-AR]/[IC(50) for beta 2-AR]) and 198.2 ([IC(50) for beta 3-AR]/[IC(50) for beta 2-AR]), indicating an apparently higher affinity for human beta 2-AR than for other beta-AR subtypes. The present study clearly demonstrated that KUR-1246 is a more selective beta 2-AR agonist than the drugs presently used for relaxing uterine muscle.

  9. Fatal splenic rupture in Ehlers-Danlos syndrome.

    PubMed Central

    Harris, S. C.; Slater, D. N.; Austin, C. A.

    1985-01-01

    A fatal case of Ehlers-Danlos syndrome (Type IV) is described. Autopsy revealed splenic rupture that had resulted from spontaneous haemorrhage into the splenic parenchyma. This is a previously unrecorded complication of Ehlers-Danlos syndrome and should be considered in the differential diagnosis of chest and abdominal pain in patients with this condition. PMID:3983062

  10. Contemporary Diagnosis and Management of Preterm Premature Rupture of Membranes

    PubMed Central

    Caughey, Aaron B; Robinson, Julian N; Norwitz, Errol R

    2008-01-01

    Spontaneous rupture of membranes (ROM) is a normal component of labor and delivery. Premature ROM (PROM) refers to rupture of the fetal membranes prior to the onset of labor irrespective of gestational age. Once the membranes rupture, delivery is recommended when the risk of ascending infection outweighs the risk of prematurity. When PROM occurs at term, labor typically ensues spontaneously or is induced within 12 to 24 hours. The management of pregnancies complicated by preterm PROM (defined as PROM occurring prior to 37 weeks of gestation) is more challenging. Preterm PROM complicates 2% to 20% of all deliveries and is associated with 18% to 20% of perinatal deaths. Management options include admission to hospital, amniocentesis to exclude intra-amniotic infection, and administration of antenatal corticosteroids and broad-spectrum antibiotics, if indicated. This article reviews in detail the contemporary diagnosis and management of preterm PROM. PMID:18701929

  11. Rupture of the round window membrane.

    PubMed

    Taylor, P H; Bicknell, P G

    1976-01-01

    A case of sudden deafness due to rupture of the round window membrane is presented. Nineteen similar cases have previously been reported in the literature. In a review of these twenty patients, it is noted that a history of concurrent physical effort or barotrauma was present in eighteen. This supports the view that the injury is produced by pressure changes acting either along the cochlear aqueduct (the explosive route) or, directly on the middle ear structures (the implosive route). At operation, the rupture may be difficult to see, and a separate leak from the oval window may be present. The timing of any surgical intervention is important. The authors recommend that this should be deferred for one week after the onset of symptoms, as the fistula may heal spontaneously. If no definite improvement has occurred at the end of this time, then tympanotomy should be undertaken during the next week.

  12. Spontaneous Retroperitoneal Hemorrhage from Adrenal Artery Aneurysm

    SciTech Connect

    Gonzalez Valverde, F.M. Balsalobre, M.; Torregrosa, N.; Molto, M.; Gomez Ramos, M.J.; Vazquez Rojas, J.L.

    2007-04-15

    Spontaneous adrenal hemorrhage is a very rare but serious disorder of the adrenal gland that can require emergent treatment. We report on a 42-year-old man who underwent selective angiography for diagnosis and treatment of retroperitoneal hemorrhage from small adrenal artery aneurysm. This case gives further details about the value of transluminal artery embolization in the management of visceral aneurysm rupture.

  13. Spontaneous Fission

    DOE R&D Accomplishments Database

    Segre, Emilio

    1950-11-22

    The first attempt to discover spontaneous fission in uranium was made by [Willard] Libby, who, however, failed to detect it on account of the smallness of effect. In 1940, [K. A.] Petrzhak and [G. N.] Flerov, using more sensitive methods, discovered spontaneous fission in uranium and gave some rough estimates of the spontaneous fission decay constant of this substance. Subsequently, extensive experimental work on the subject has been performed by several investigators and will be quoted in the various sections. [N.] Bohr and [A.] Wheeler have given a theory of the effect based on the usual ideas of penetration of potential barriers. On this project spontaneous fission has been studied for the past several years in an effort to obtain a complete picture of the phenomenon. For this purpose the spontaneous fission decay constants {lambda} have been measured for separated isotopes of the heavy elements wherever possible. Moreover, the number {nu} of neutrons emitted per fission has been measured wherever feasible, and other characteristics of the spontaneous fission process have been studied. This report summarizes the spontaneous fission work done at Los Alamos up to January 1, 1945. A chronological record of the work is contained in the Los Alamos monthly reports.

  14. Etiology and pathophysiology of tendon ruptures in sports.

    PubMed

    Kannus, P; Natri, A

    1997-04-01

    Of all spontaneous tendon ruptures, complete Achilles tendon tears are most closely associated with sports activities (1-3). Schönbauer (3) reported that 75% of all ruptures of the Achilles tendon are related to sports. In Plecko & Passl (2) the number was 60%. In our material of 430 cases, the number of sports-related Achilles ruptures was very similar (62%), while only 2% of ruptures of other tendons were sports-related (P < 0.001) (1). Also, the majority of Achilles reruptures occurred in sports. The ruptures occurred most often in soccer (34%), track and field (16%) and basketball (14%). The distribution of Achilles ruptures according to different sports varies considerably from country to country, according to the national sport traditions. For example, in northern and middle Europe, soccer, tennis, track and field, indoor ball games, downhill skiing, and gymnastics are the most common; and in North America, football, basketball, baseball, tennis and downhill skiing dominate the statistics (1, 2, 4). In sports, some Achilles ruptures are not spontaneous or degeneration-induced but may occur as a consequence of the remarkably high forces that are involved in the performance (2). Ruptures in the high jump or triple jump are good examples. In such cases, failure in the neuromuscular protective mechanisms due to fatigue or disturbed co-ordination can frequently be found. The spontaneous complete rupture of the supraspinatus tendon of the rotator cuff does not occur very frequently in sports. Those sports that include high-energy throwing movements, such as American and Finnish baseball, American football, rugby and discuss and javelin throwing, may, however, produce this injury. Partial tears and inflammations of the rotator cuff complex are much more frequent in throwing sports. The complete rupture of the proximal long head of the biceps brachii tendon is rare among competitive and recreational athletes. In our material, under 2% of these ruptures were

  15. Biomechanical Rupture Risk Assessment

    PubMed Central

    2016-01-01

    Abdominal aortic aneurysm (AAA) rupture is a local event in the aneurysm wall that naturally demands tools to assess the risk for local wall rupture. Consequently, global parameters like the maximum diameter and its expansion over time can only give very rough risk indications; therefore, they frequently fail to predict individual risk for AAA rupture. In contrast, the Biomechanical Rupture Risk Assessment (BRRA) method investigates the wall’s risk for local rupture by quantitatively integrating many known AAA rupture risk factors like female sex, large relative expansion, intraluminal thrombus-related wall weakening, and high blood pressure. The BRRA method is almost 20 years old and has progressed considerably in recent years, it can now potentially enrich the diameter indication for AAA repair. The present paper reviews the current state of the BRRA method by summarizing its key underlying concepts (i.e., geometry modeling, biomechanical simulation, and result interpretation). Specifically, the validity of the underlying model assumptions is critically disused in relation to the intended simulation objective (i.e., a clinical AAA rupture risk assessment). Next, reported clinical BRRA validation studies are summarized, and their clinical relevance is reviewed. The BRRA method is a generic, biomechanics-based approach that provides several interfaces to incorporate information from different research disciplines. As an example, the final section of this review suggests integrating growth aspects to (potentially) further improve BRRA sensitivity and specificity. Despite the fact that no prospective validation studies are reported, a significant and still growing body of validation evidence suggests integrating the BRRA method into the clinical decision-making process (i.e., enriching diameter-based decision-making in AAA patient treatment).

  16. Pregnancy complications in women with uterine duplication abnormalities.

    PubMed

    Lewis, Amanda Demetri; Levine, Deborah

    2010-12-01

    Patients with duplication anomalies have a higher incidence of infertility, repeated first trimester spontaneous abortions, fetal intrauterine growth restriction, fetal malposition, preterm labor, and retained placenta. The role of imaging is not only to detect and diagnose müllerian anomalies but also to help distinguish surgically correctable forms of müllerian duct anomalies from nonsurgical forms. Imaging is also important to identify the location of the pregnancy, because ultrasound guidance may be needed after miscarriage or when pregnancies occur in an ectopic location. Attention to the position of the fetus within a normal-appearing uterus, with normal thickness surrounding myometrium, is important for recognizing an otherwise unsuspected uterine duplication abnormality. In this article, we review and illustrate the imaging features and complications of uterine duplication anomalies in pregnancy and identify potential mimics of duplication anomalies.

  17. Achilles Tendon Rupture

    PubMed Central

    Wertz, Jess; Galli, Melissa; Borchers, James R.

    2013-01-01

    Context: Achilles tendon (AT) rupture in athletes is increasing in incidence and accounts for one of the most devastating sports injuries because of the threat to alter or end a career. Despite the magnitude of this injury, reliable risk assessment has not been clearly defined, and prevention strategies have been limited. The purpose of this review is to identify potential intrinsic and extrinsic risk factors for AT rupture in aerial and ground athletes stated in the current literature. Evidence Acquisition: A MEDLINE search was conducted on AT rupture, or “injury” and “risk factors” and “athletes” from 1980 to 2011. Emphasis was placed on epidemiology, etiology, and review articles focusing on the risk for lower extremity injury in runners and gymnasts. Thirty articles were reviewed, and 22 were included in this assessment. Results: Aerial and ground athletes share many intrinsic risk factors for AT rupture, including overuse and degeneration of the tendon as well as anatomical variations that mechanically put an athlete at risk. Older athletes, athletes atypical in size for their sport, high tensile loads, leg dominance, and fatigue also may increase risk. Aerial athletes tend to have more extrinsic factors that play a role in this injury due to the varying landing surfaces from heights and technical maneuvers performed at various skill levels. Conclusion: Risk assessment for AT rupture in aerial and ground athletes is multivariable and difficult in terms of developing prevention strategies. Quantitative measures of individual risk factors may help identify major contributors to injury. PMID:24427410

  18. Current Evidence on Uterine Embolization for Fibroids

    PubMed Central

    Spies, James B.

    2013-01-01

    Strong evidence for both safety and effectiveness of uterine fibroid embolization has been generated since the procedure's introduction. This review will focus on the key articles representing the best evidence to summarize the outcomes from uterine embolization. This review will attempt to answer three important questions associated with uterine embolization. First, does uterine embolization relieve symptoms caused by uterine fibroids? Second, how well does the improvement in symptoms and quality of life after uterine embolization compare with standard surgical options for fibroids? Finally, how durable is the improvement in fibroid-related symptoms and quality of life after embolization? PMID:24436560

  19. Abnormal uterine bleeding.

    PubMed

    Whitaker, Lucy; Critchley, Hilary O D

    2016-07-01

    Abnormal uterine bleeding (AUB) is a common and debilitating condition with high direct and indirect costs. AUB frequently co-exists with fibroids, but the relationship between the two remains incompletely understood and in many women the identification of fibroids may be incidental to a menstrual bleeding complaint. A structured approach for establishing the cause using the Fédération International de Gynécologie et d'Obstétrique (FIGO) PALM-COEIN (Polyp, Adenomyosis, Leiomyoma, Malignancy (and hyperplasia), Coagulopathy, Ovulatory disorders, Endometrial, Iatrogenic and Not otherwise classified) classification system will facilitate accurate diagnosis and inform treatment options. Office hysteroscopy and increasing sophisticated imaging will assist provision of robust evidence for the underlying cause. Increased availability of medical options has expanded the choice for women and many will no longer need to recourse to potentially complicated surgery. Treatment must remain individualised and encompass the impact of pressure symptoms, desire for retention of fertility and contraceptive needs, as well as address the management of AUB in order to achieve improved quality of life. PMID:26803558

  20. Growth and subsequent disappearance of a ruptured small saccular intracranial aneurysm: A morphometric and flow-dynamic analysis.

    PubMed

    Peruvumba, Jayakumar Narayan; Paul, Divyan; Verghese, Renjan

    2016-10-01

    The growth of a ruptured small saccular aneurysm has rarely been documented. Also rare are reports of spontaneous thrombosis of ruptured small intracranial saccular aneurysms. However, there are no reported instances of ruptured small saccular aneurysms that have demonstrated an increase in size after rupture, subsequently thrombosed and disappeared from circulation. We report one such aneurysm in a patient who presented with subarachnoid hemorrhage from a ruptured small saccular aneurysm of the anterior communicating artery. The possible reasons for the initial growth and subsequent thrombosis of the aneurysm from morphometric and flow dynamic points of view are discussed. PMID:27470928

  1. [Uterine myomas in pregnancy, childbirth and puerperium].

    PubMed

    Sparić, Radmila

    2014-01-01

    Fibroids are the most common benign tumors of the genital organs of women in reproductive age. Achieving reproductive function later in life, with more frequent use of assisted reproductive technologies, leads to an increased number of pregnancies complicated with fibroids. Their size may change during pregnancy, but the changes are mostly individual. Most fibroids stop growing or decline during the puerperium. The effect of fibroids on pregnancy depends on their number, size and location. The mechanisms bringing about perinatal complications are not fully understood. Fibroids during pregnancy can cause many perinatal complications, such as bleeding in pregnancy, miscarriage, pain due to red degeneration, malpresentation, preterm labor, premature rupture of membranes, placental abruption and obstruction of delivery and are associated with higher incidence of cesarean section, operative vaginal delivery, uterine atony and postpartum hemorrhage. Postpartum hysterectomy in these women is also more likely than in general population. Postpartum infections are more common in patients with fibroids, and myomas may also cause retained placenta. The most common cause of neonatal morbidity is prematurity, due to pregnancy ending in an earlier gestational age. Monitoring of pregnancies complicated with fibroids is essentially indistinguishable from monitoring normal pregnancies. Therapy includes only bed rest and observation, symptomatic therapy in case of pain and intensive fetal surveillance, and surgery in the acute situations.

  2. Smoking habits and spontaneous abortion.

    PubMed

    Sandahl, B

    1989-04-01

    Smoking habits have been compared in three samples of pregnancies: (1) spontaneous abortions (n = 610); (2) induced abortions (n = 800); and (3) deliveries (n = 1337). The variables studied were, besides smoking habits, day of LMP, outcome of earlier pregnancies, maternal age, and, for the delivery sample, also diagnoses of mother and child, gestational length, sex, and birthweight. A statistical analysis of the association between smoking and the risk of having a spontaneous abortion was made. The comparisons were made with all types of intra-uterine pregnancies but spontaneous abortions, e.g., deliveries and induced abortions. The effects and consequences of that are discussed. The smoking rates according to pregnancy outcome differ among the samples. In the induced abortion sample 58% smoked compared with 50% in the spontaneous abortion sample and 44% in the delivery sample. The well-known effect of smoking on gestational length and birthweight was shown. No significant effect of smoking on the miscarriage risk was seen. The only trend was the opposite. Possible explanations for this are discussed.

  3. Investigation on the key parameters of slip weakening law in dynamic rupture simulations

    NASA Astrophysics Data System (ADS)

    Liu, Q.; Zhang, H.; Chen, X.

    2008-12-01

    How the crack propagates on the fault plane when an earthquake happens is a fundamental problem in earthquake studies. To understand the dynamics of a spontaneously propagating crack various constitutive laws for friction, e.g., slip weakening, slip rate weakening, effective temperature and rate-and-state laws, which define the relationship between the instantaneous stress and slip (or slip rate) on the fault have been widely used in various rupture simulations. One crucial aspect of the variety of rupture models is to to quantify how the main parameters characterizing a certain law affect the rupture process. We chose the slip weakening law and then massively computed a large suite of dynamic rupture simulations on a rectangular fault embedded in 3-D isotropic homogeneous medium. The simulations included hundreds of different sets of parameters varying Dc, the critical slip weakening distance and Te the initial stress. All are spatially constant except in a rectangular asperity, where the rupture is triggered. With the same parameter set we used several different discretizations to avoid the numerical effects. Computationally we use the boundary integral method. We have also given definitions of rupture status: non-growth rupture, growth rupture, subshear rupture and supershear rupture. With all of the simulations we construct a phase-diagram on which different rupture states locate in different parameter-set zones (phase boundary lines with errors less than 0.1%) We find that (1) In the areas with smaller Dc, phase boundary lines seems to fit the ones Madariaga (1998) predicted using non- dimensionalized parameter κ, but not for the whole phase line. (2) When Dc reaches a particular size, none of the ruptures will propagate regardless of the value of the initial stress on the fault. (3) Some transitional states may occur where a rupture propagates only 2-4 times the initial asperity size and then stops spontaneously.

  4. What Are the Symptoms of Uterine Fibroids?

    MedlinePlus

    ... and Publications What are the symptoms of uterine fibroids? Skip sharing on social media links Share this: Page Content ​Uterine fibroids can cause uncomfortable or sometimes painful symptoms, such ...

  5. Abnormal Uterine Bleeding (Beyond the Basics)

    MedlinePlus

    ... Approach to abnormal uterine bleeding in nonpregnant reproductive-age women Differential diagnosis of genital tract bleeding in women Postmenopausal uterine bleeding The following organizations also provide reliable health information. ● National Library of Medicine ( www.nlm.nih.gov/ ...

  6. Medical Treatment of Uterine Leiomyoma

    PubMed Central

    Sabry, Mohamed; Al-Hendy, Ayman

    2012-01-01

    Uterine leiomyomas (also called myomata or fibroids) are the most common gynecologic tumors in the United States. The prevalence of leiomyomas is at least 3 to 4 times higher among African American women than in white women. Pathologically, uterine leiomyomas are benign tumors that arise in any part of the uterus under the influence of local growth factors and sex hormones, such as estrogen and progesterone. These common tumors cause significant morbidity for women and they are considered to be the most common indication for hysterectomy in the world; they are also associated with a substantial economic impact on health care systems that amounts to approximately $2.2 billion/year in the United States alone. Uterine myomas cause several reproductive problems such as heavy or abnormal uterine bleeding, pelvic pressure, infertility, and several obstetrical complications including miscarriage and preterm labor. Surgery has traditionally been the gold standard for the treatment of uterine leiomyomas and has typically consisted of either hysterectomy or myomectomy. In recent years, a few clinical trials have evaluated the efficacy of orally administered medications for the management of leiomyoma-related symptoms. In the present review, we will discuss these promising medical treatments in further detail. PMID:22378865

  7. Medical treatment of uterine leiomyoma.

    PubMed

    Sabry, Mohamed; Al-Hendy, Ayman

    2012-04-01

    Uterine leiomyomas (also called myomata or fibroids) are the most common gynecologic tumors in the United States. The prevalence of leiomyomas is at least 3 to 4 times higher among African American women than in white women. Pathologically, uterine leiomyomas are benign tumors that arise in any part of the uterus under the influence of local growth factors and sex hormones, such as estrogen and progesterone. These common tumors cause significant morbidity for women and they are considered to be the most common indication for hysterectomy in the world; they are also associated with a substantial economic impact on health care systems that amounts to approximately $2.2 billion/year in the United States alone. Uterine myomas cause several reproductive problems such as heavy or abnormal uterine bleeding, pelvic pressure, infertility, and several obstetrical complications including miscarriage and preterm labor. Surgery has traditionally been the gold standard for the treatment of uterine leiomyomas and has typically consisted of either hysterectomy or myomectomy. In recent years, a few clinical trials have evaluated the efficacy of orally administered medications for the management of leiomyoma-related symptoms. In the present review, we will discuss these promising medical treatments in further detail.

  8. Premature rupture of membranes

    MedlinePlus

    ... the 37th week of pregnancy, it is called preterm premature rupture of membranes (PPROM). The earlier your water breaks, the more ... babies born early). If there is not a preterm unit where you deliver, you and your baby will be moved to a hospital that has one.

  9. [Stomach rupture while diving].

    PubMed

    Russi, E; Gäumann, N; Geroulanos, S; Bühlmann, A A

    1985-06-01

    A case of stomach rupture in a 47-year-old scuba diver is reported. Symptoms of gastrointestinal expansion during ascent are quite common and are caused by decompression of swallowed air. Gastric perforation is however rare, and needs to be promptly recognized and surgically repaired.

  10. Labyrinthine window rupture.

    PubMed

    Fraser, J G; Harborow, P C

    1975-01-01

    Some cases of sensorineural deafness are due to labyrinthine window rupture. Three cases have been presented to illustrate different aspects of diagnosis and managment of this condition. The indications for surgical intervention have been discussed. The importance of making the diagnosis is that operation can relieve vertigo and restore the hearing.

  11. Infertility and uterine fibroids.

    PubMed

    Zepiridis, Leonidas I; Grimbizis, Grigoris F; Tarlatzis, Basil C

    2016-07-01

    Uterine fibroids are the most common tumors in women and their prevalence is higher in patients with infertility. At present, they are classified according to their anatomical location, as no classification system includes additional parameters such as their size or number. There is a general agreement that submucosal fibroids negatively affect fertility, when compared to women without fibroids. Intramural fibroids above a certain size (>4 cm), even without cavity distortion, may also negatively influence fertility. However, the presence of subserosal myomas has little or no effect on fertility. Many possible theories have been proposed to explain how fibroids impair fertility: mechanisms involving alteration of local anatomical location, others involving functional changes of the myometrium and endometrium, and finally endocrine and paracrine molecular mechanisms. Nevertheless, any of the above mentioned mechanisms can cause reduced reproductive potential, thereby leading to impaired gamete transport, reduced ability for embryo implantation, and creation of a hostile environment. The published experience defines the best practice strategy, as not many large, well-designed, and properly powered studies are available. Myomectomy appears to have an effect in fertility improvement in certain cases. Excision of submucosal myomas seems to restore fertility with pregnancy rates after surgery similar to normal controls. Removal of intramural myomas affecting pregnancy outcome seems to be associated with higher pregnancy rates when compared to non-operated controls, although evidence is still nοt sufficient. Treatment of subserosal myomas of reasonable size is not necessary for fertility reasons. The results of endoscopic and open myomectomy are similar; thus, endoscopic treatment is the recommended approach due to its advantages in patient's postoperative course. PMID:26856931

  12. Uterine fibroids associated with infertility.

    PubMed

    Van Heertum, Kristin; Barmat, Larry

    2014-11-01

    In recent years, there has been an increasing focus on the contributory role of uterine fibroids to infertility. The prevalence of these tumors increases with age, which becomes significant as more women are delaying childbearing. Therefore, fibroids and infertility frequently occur together. Treatment varies with fibroid location and size. The various methods of treatment include open myomectomy, laparoscopic or robot-assisted myomectomy, medical treatment, uterine artery embolization and magnetic resonance guided focused ultrasound surgery. While there is a general consensus on the treatment of submucosal fibroids, the management of intramural fibroids in the infertility patient remains controversial. This paper aims to review and summarize the current literature in regards to the approach to uterine fibroids in the infertile patient. PMID:25482490

  13. Uterine fibroids associated with infertility.

    PubMed

    Van Heertum, Kristin; Barmat, Larry

    2014-11-01

    In recent years, there has been an increasing focus on the contributory role of uterine fibroids to infertility. The prevalence of these tumors increases with age, which becomes significant as more women are delaying childbearing. Therefore, fibroids and infertility frequently occur together. Treatment varies with fibroid location and size. The various methods of treatment include open myomectomy, laparoscopic or robot-assisted myomectomy, medical treatment, uterine artery embolization and magnetic resonance guided focused ultrasound surgery. While there is a general consensus on the treatment of submucosal fibroids, the management of intramural fibroids in the infertility patient remains controversial. This paper aims to review and summarize the current literature in regards to the approach to uterine fibroids in the infertile patient.

  14. Successful myomectomy in early pregnancy for a large asymptomatic uterine myoma: case report

    PubMed Central

    Jhalta, Pawan; Negi, Sonam Gialchhen; Sharma, Vikas

    2016-01-01

    The decision of myomectomy is not usually taken by OBG specialist for uterine fibroids during pregnancy because of its complications which may become hazardous at times. This is why it is generally delayed until after delivery. The current case was a large, asymptomatic subserous uterine myoma diagnosed during pregnancy by ultrasound and successfully managed by antepartum myomectomy retaining the fetus alive in utero at 13 -14 weeks gestation. At term, the patient had spontaneous vaginal delivery of 3 kg male child. This case demonstrates that myomectomy during pregnancy in special circumstances in selected cases to prevent forthcoming events adversely affecting mother and fetus can be considered. PMID:27800083

  15. Pulse-like and crack-like ruptures in experiments mimicking crustal earthquakes

    PubMed Central

    Lu, Xiao; Lapusta, Nadia; Rosakis, Ares J.

    2007-01-01

    Theoretical studies have shown that the issue of rupture modes has important implications for fault constitutive laws, stress conditions on faults, energy partition and heat generation during earthquakes, scaling laws, and spatiotemporal complexity of fault slip. Early theoretical models treated earthquakes as crack-like ruptures, but seismic inversions indicate that earthquake ruptures may propagate in a self-healing pulse-like mode. A number of explanations for the existence of slip pulses have been proposed and continue to be vigorously debated. This study presents experimental observations of spontaneous pulse-like ruptures in a homogeneous linear-elastic setting that mimics crustal earthquakes; reveals how different rupture modes are selected based on the level of fault prestress; demonstrates that both rupture modes can transition to supershear speeds; and advocates, based on comparison with theoretical studies, the importance of velocity-weakening friction for earthquake dynamics. PMID:18025479

  16. Pregnancy Following Uterine Artery Embolization with Polyvinyl Alcohol Particles for Patients with Uterine Fibroid or Adenomyosis

    SciTech Connect

    Kim, Man Deuk Kim, Nahk Keun; Kim, Hee Jin; Lee, Mee Hwa

    2005-06-15

    Purpose:To determine whether uterine fibroid embolization (UFE) with polyvinyl alcohol (PVA) particles affects fertility in women desiring future pregnancy.Methods:Of 288 patients managed with UFE with PVA particles for uterine myoma or adenomyosis between 1998 and 2001, 94 patients were enrolled in this study. The age range of participants was 20-40 years. The data were collected through review of medical records and telephone interviews. Mean duration of follow-up duration was 35 months (range 22-60 months). Patients using contraception and single women were excluded, and the chance of infertility caused by possible spousal infertility or other factors was disregarded. Contrast-enhanced magnetic resonance imaging was performed in all patients before and after UFE, and the size of PVA particles used was 255-700 {mu}m.Results:Among 94 patients who underwent UFE with PVA, 74 were on contraceptives, 6 had been single until the point of interview, and 8 were lost to follow-up. Of the remaining 6 patients who desired future pregnancy, 5 (83%) succeeded in becoming pregnant (1 patient became pregnant twice). Of a total of 8 pregnancies, 6 were planned pregnancies and 2 occurred after contraception failed. Five deliveries were vaginal, and 2 were by elective cesarean. Artificial abortion was performed in 1 case of unplanned pregnancy. There was 1 case of premature rupture of membrane (PROM) followed by preterm labor and delivery of an infant who was small-for-gestational-age. After UFE, mean volume reduction rates of the uterus and fibroid were 36.6% (range 0 to 62.6%) and 69.3% (range 36.3% to 93.3%), respectively.Conclusion:Although the absolute number of cases was small, UFE with PVA particles ultimately did not affect fertility in the women who underwent the procedure.

  17. Gemcitabine Hydrochloride, Docetaxel, and Radiation Therapy in Treating Patients With Uterine Sarcoma That Has Been Removed By Surgery

    ClinicalTrials.gov

    2015-01-16

    Stage IA Uterine Sarcoma; Stage IB Uterine Sarcoma; Stage IC Uterine Sarcoma; Stage IIA Uterine Sarcoma; Stage IIB Uterine Sarcoma; Stage IIIA Uterine Sarcoma; Stage IIIB Uterine Sarcoma; Stage IIIC Uterine Sarcoma; Stage IVA Uterine Sarcoma; Stage IVB Uterine Sarcoma; Uterine Corpus Leiomyosarcoma

  18. Spontaneous Recovery

    ERIC Educational Resources Information Center

    Rescorla, Robert A.

    2004-01-01

    Spontaneous recovery from extinction is one of the most basic phenomena of Pavlovian conditioning. Although it can be studied by using a variety of designs, some procedures are better than others for identifying the involvement of underlying learning processes. A wide range of different learning mechanisms has been suggested as being engaged by…

  19. Fan-structure waves in shear ruptures

    NASA Astrophysics Data System (ADS)

    Tarasov, Boris

    2016-04-01

    This presentation introduces a recently identified shear rupture mechanism providing a paradoxical feature of hard rocks - the possibility of shear rupture propagation through the highly confined intact rock mass at shear stress levels significantly less than frictional strength. According to the fan-mechanism the shear rupture propagation is associated with consecutive creation of small slabs in the fracture tip which, due to rotation caused by shear displacement of the fracture interfaces, form a fan-structure representing the fracture head. The fan-head combines such unique features as: extremely low shear resistance (below the frictional strength), self-sustaining stress intensification in the rupture tip (providing easy formation of new slabs), and self-unbalancing conditions in the fan-head (making the failure process inevitably spontaneous and violent). An important feature of the fan-mechanism is the fact that for the initial formation of the fan-structure an enhanced local shear stress is required, however, after completion of the fan-structure it can propagate as a dynamic wave through intact rock mass at shear stresses below the frictional strength. Paradoxically low shear strength of pristine rocks provided by the fan-mechanism determines the correspondingly low transient strength of the lithosphere, which favours generation of new earthquake faults in the intact rock mass adjoining pre-existing faults in preference to frictional stick-slip instability along these faults. The new approach reveals an alternative role of pre-existing faults in earthquake activity: they represent local stress concentrates in pristine rock adjoining the fault where special conditions for the fan-mechanism nucleation are created, while further dynamic propagation of the new fault (earthquake) occurs at low field stresses even below the frictional strength.

  20. Spontaneous Hemothorax in Neurofibromatosis Treated with Percutaneous Embolization

    SciTech Connect

    Arai, Kazunori; Sanada, Junichiro Kurozumi, Akiko; Watanabe, Toshio; Matsui, Osamu

    2007-06-15

    We evaluated the effectiveness of transcatheter arterial coil embolization therapy for the treatment of spontaneous hemothorax followed by aneurysm rupture in neurofibromatosis patients. Three patients were treated for massive hemothorax caused by arterial lesions associated with neurofibromatosis. Bleeding episodes were secondary to ascending cervical artery aneurysm and dissection of vertebral artery in 1 patient, and intercostal artery aneurysm with or without arteriovenous fistula in 2 patients. Patients were treated by transarterial coil embolization combined with chest drainage. In 1 patient, the ruptured ascending cervical artery aneurysm was well embolized but, shortly after the embolization, fatal hemorrhage induced by dissection of the vertebral artery occurred and the patient died. In the other 2 patients, the ruptured intercostal artery aneurysm was well embolized and they were successfully treated and discharged. Transcatheter arterial coil embolization therapy is an effective method for the treatment of spontaneous hemothorax followed by aneurysm rupture in neurofibromatosis patients.

  1. Premature rupture of membranes.

    PubMed Central

    Poma, P. A.

    1996-01-01

    The management of patients with premature rupture of membranes has changed markedly in the past several years. The basis for this is a combination of a better understanding of newborn physiology, improved neonatal care, refinements in antibiotic therapy, and the widespread use of maternal and fetal monitoring. The best outcome for both mother and infant undoubtedly reflects data based on a combination of factors, among which are gestational age survival, evidence of fetal distress, presence or absence of labor and sepsis, and of course, the cervical condition as it is related to labor-readiness. An important recent advance is the recognition that an active observation management program is associated with less morbidity and mortality than the classic management course of delivery within 12 hours of membrane rupture. The fact that preterm premature rupture of membranes tends to recur in subsequent pregnancies offers an opportunity for prevention. Moreover, advances in perinatal and neonatal care will continue to improve the outcomes of these women and their children. PMID:8583489

  2. Spontaneous ureteral rupture in a patient with systemic lupus erythematosus

    SciTech Connect

    Benson, C.H.; Pennebaker, J.B.; Harisdangkul, V.; Songcharoen, S.

    1983-08-01

    A patient with known systemic lupus erythematosus had fever and symptoms of a lower urinary tract infection. Bone scintigraphy showed left ureteral perforation and necrosis with no demonstrable nephrolithiasis. It is speculated that this episode was due to lupus vasculitis.

  3. A model for educational simulation of the evolution of uterine contractions during labor.

    PubMed

    Bastos, Luísa Ferreira; van Meurs, Willem; Ayres-de-Campos, Diogo

    2012-08-01

    Electronic fetal monitoring remains an important tool in labor ward settings, providing continuous information on fetal heart rate and maternal uterine contractions. A prompt detection of abnormalities in these signals is essential for the timely resolution of situations that may put both mother and fetus at risk. Uterine contraction signals provide information that is important to evaluate the onset and progress of labor, as well as the significance of certain fetal heart rate abnormalities. We present a model for educational simulation of the spontaneous evolution of uterine contractions during labor, which combines a previously published signal generator with literature-based pre-programmed scripts for educationally relevant scenarios. This model is an essential component of a high-fidelity simulator of intrapartum emergencies, aimed to improve the competency of healthcare providers. Real and simulated tracings were presented to three independent clinical experts who judged simulated signals to be indistinguishable or negligibly different from real tracings.

  4. Alterations in uterine contractility during the oviposition cycle in domestic hens.

    PubMed

    Saito, N; Koike, T I

    1992-07-01

    1. The potencies of several neurohypophysial hormones were examined at different times during the oviposition cycle in an in vitro fowl oxytocic assay. 2. Uterine tissues were removed 2 h before (-2h-OP), immediately after (0h-OP) and 5 h after (+5h-OP) spontaneous oviposition. In addition, uterine tissue was removed immediately after oviposition was induced, by administering prostaglandin E2 2 h before an expected oviposition (Induced-OP). 3. The rank order of oxytocic potencies for the peptides was arginine vasotocin = vasopressin greater than oxytocin greater than mesotocin. The sensitivity of the uterus to the hormones was 0h-OP = Induced-OP greater than -2h-OP = +5-OP. 4. These results suggest that uterine sensitivity to neurohypophysial hormones changes during the oviposition cycle in domestic fowls.

  5. Rupture of adductor longus tendon due to ciprofloxacin.

    PubMed

    Mouzopoulos, George; Stamatakos, Mihalis; Vasiliadis, George; Skandalakis, Panagiotis

    2005-12-01

    We present a rare case of spontaneous rupture of the adductor longus tendon induced by ciprofloxacin. A 35-year-old man was diagnosed with pneumonia and was recommended ciprofloxacin 500 mg iv twice a day for 7 days. Three days after receiving the initial dose, he developed discomfort in his left medial thigh, and pain and swelling in the same area followed ten days later. He consulted us when he noted a palpable mass on the medial side of his left thigh, and MRI study revealed adductor longus tendon rupture. There was no obvious underlying disease or other factor causing fragility of his adductor longus tendon. We review the pathophysiological mechanisms leading to fluoroquinolone-related tendon rupture as well as the risk factors and discuss proper management.

  6. Complicated malaria and a covert ruptured spleen: a case report.

    PubMed

    Waweru, Peter; Macleod, Jana; Gikonyo, Anthony

    2014-01-01

    Spontaneous splenic rupture in complicated malaria is an uncommon cause of hemoperitoneum in the tropics. The exact incidence of splenic rupture is unknown, largely due to under-reporting, but has been estimated at ∼2%. Its pathophysiology is linked to the formation of a subcapsular hematoma. Upon rupture, patients present with features of shock and peritonitis and in most cases (95%), computed tomography (CT) scan detects the splenic injury. Patients should be managed conservatively with splenectomy reserved for patients with shock and hemoperitoneum due to risk of post-splenectomy sepsis. We report the case of a 38-year-old man with severe malaria who presented with fever, chills and abdominal pains. A CT scan abdomen failed to reveal splenic parenchymal injury or any splenic extravasation of contrast. Conservative management was unsuccessful. Exploratory laparatomy confirmed the spleen as the site of bleeding necessitating a splenectomy. PMID:25395608

  7. Complicated malaria and a covert ruptured spleen: a case report.

    PubMed

    Waweru, Peter; Macleod, Jana; Gikonyo, Anthony

    2014-11-13

    Spontaneous splenic rupture in complicated malaria is an uncommon cause of hemoperitoneum in the tropics. The exact incidence of splenic rupture is unknown, largely due to under-reporting, but has been estimated at ∼2%. Its pathophysiology is linked to the formation of a subcapsular hematoma. Upon rupture, patients present with features of shock and peritonitis and in most cases (95%), computed tomography (CT) scan detects the splenic injury. Patients should be managed conservatively with splenectomy reserved for patients with shock and hemoperitoneum due to risk of post-splenectomy sepsis. We report the case of a 38-year-old man with severe malaria who presented with fever, chills and abdominal pains. A CT scan abdomen failed to reveal splenic parenchymal injury or any splenic extravasation of contrast. Conservative management was unsuccessful. Exploratory laparatomy confirmed the spleen as the site of bleeding necessitating a splenectomy.

  8. Successful Nonoperative Management of Spontaneous Splenic Hematoma and Hemoperitoneum due to CMV Infection

    PubMed Central

    Lianos, Georgios; Ignatiadou, Eleftheria; Bali, Christina; Harissis, Haralampos; Katsios, Christos

    2012-01-01

    Introduction. Spontaneous splenic hematoma or splenic rupture due to CMV infection in immunocompetent adults is rare and life-threatening. Case Report. Herein we report a rare case of spontaneous splenic hematoma and hemoperitoneum due to CMV infection in a 23-year-old Caucasian male in whom conservative management was successful. Conclusion. Spontaneous splenic hematoma and spontaneous splenic rupture are extremely rare conditions during primary CMV infection. Though rare, they must be always considered by the operating surgeon, because any misinterpretation may result in unfavorable outcomes. PMID:23227374

  9. Biological Roles of Uterine Glands in Pregnancy

    PubMed Central

    Spencer, Thomas E.

    2014-01-01

    All mammalian uteri contain glands in the endometrium that synthesize or transport and secrete substances essential for survival and development of the conceptus (embryo/fetus and associated extraembryonic membranes). This review summarizes information related to the biological roles of uterine glands and their secretions in blastocyst/conceptus survival and implantation, uterine receptivity, and stromal cell decidualization in humans and animal models. The infertility and recurrent pregnancy loss observed in the ovine uterine gland knockout (UGKO) model unequivocally supports a primary role for uterine glands and, by inference, their secretions present in uterine luminal fluid in survival and development of the conceptus. Further, studies with mutant and progesterone-induced UGKO mice found that uterine glands and their secretions are required for establishment of uterine receptivity and blastocyst implantation as well as stromal cell decidualization. Similarly in humans, uterine glands and their secretory products are likely critical regulators of blastocyst implantation, uterine receptivity, and conceptus growth and development during the first trimester. Circumstantial evidence suggests that deficient glandular activity may be a causative factor in pregnancy failure and complications in humans. Thus, an increased understanding of uterine gland biology is important for diagnosis, prevention and treatment of fertility and pregnancy problems in mammals. PMID:24959816

  10. Preterm Delivery in the Setting of Left Calyceal Rupture

    PubMed Central

    Hanson, Brent; Tabbarah, Rami

    2015-01-01

    Spontaneous rupture of the renal collecting system is a rare but serious complication of pregnancy. We report a case of nontraumatic left renal calyceal rupture in a pregnancy which ultimately progressed to preterm delivery. A 29-year-old primigravida with a remote history of urolithiasis presented with left flank pain, suprapubic pain, and signs of preterm labor at 33 weeks of gestation. The patient was believed to have urolithiasis, although initial renal ultrasound failed to demonstrate definitive calculi. After a temporary improvement in flank pain with medication, the patient experienced acute worsening of her left flank pain. Urology was consulted and further imaging was obtained. Magnetic resonance imaging (MRI) was consistent with bilateral hydronephrosis and rupture of the left renal calyx. Given the patient's worsening pain in the setting of left calyceal rupture, the urology team planned for placement of a left ureteral stent. However, before the patient could receive her stent, she progressed to active labor and delivered a viable female infant vaginally. Following delivery, the patient's flank pain resolved rapidly and spontaneously, so no surgical intervention was performed. A summary of the literature and the details of this specific clinical situation are provided. PMID:26483981

  11. Cell-Free Fetal DNA, Telomeres, and the Spontaneous Onset of Parturition.

    PubMed

    Phillippe, Mark

    2015-10-01

    Multiple previous reports have provided compelling support for the premise that spontaneous parturition is mediated by activation of inflammation-related signaling pathways leading to increased secretion of cytokines and chemokines, the influx of neutrophils and macrophages into the pregnant uterus, increased production of uterine activation proteins (eg, connexin-43, cyclo-oxygenase-2, oxytocin receptors, etc), activation of matrix metalloproteinases, and the release of uterotonins leading to cervical ripening, membrane rupture, and myometrial contractions. The missing link has been the fetal/placental signal that triggers these proinflammatory events in the absence of microbial invasion and intrauterine infection. This article reviews the biomedical literature regarding the increase in cell-free fetal DNA (cffDNA), which is released during apoptosis in the placenta and fetal membranes at term, the ability of apoptosis modified vertebrate DNA to stimulate toll-like receptor-9 (TLR9) leading to increased release of cytokines and chemokines, and the potential "fail-safe" role for the anti-inflammatory cytokine IL-10. This article also reviews the literature supporting the key role that telomere loss plays in regard to increasing the ability of vertebrate (including placental) DNA to stimulate TLR9, and in regard to signaling the onset of apoptosis in the placenta and fetal membranes, thereby providing a biologic clock that determines the length of gestation and the timing for the onset of parturition. In summary, this literature review provides a strong rationale for future research to test the hypothesis that telomere loss and increased cffDNA levels trigger the proinflammatory events leading to the spontaneous onset of parturition in mammals: the "cffDNA/telomere hypothesis."

  12. [Spontaneous heterotopic pregnancy and fetal survival].

    PubMed

    Luna Lugo, Gilberto; Rangel Ruiz, Irais; Gutiérrez Laiza, Nadia Saray; Martínez Guerrero, Misael Eleazar; Méndez Oceguera, José Raúl; Suárez López, Norma María Luisa

    2011-08-01

    The spontaneous heterotopic pregnancy is an unusual event. Generally the extrauterine product lost and the intrauterine present complications in different grade. The most common is the rupture and can be associated with hemodynamic unstable with risk for patient's life. The intrauterine pregnancy can be continuing to the end. We report the case of patient with spontaneous heterotopic pregnancy; the diagnosis was in the first trimester, with two products (intrauterine and in right fimbrius). The salpingectomy is doing with the extrauterine pregnancy and the patient has not complications trans or postoperative time and without complications for the intrauterine pregnancy, she continues with stricter control until to obtain a life product.

  13. Calcium-activated chloride channels anoctamin 1 and 2 promote murine uterine smooth muscle contractility

    PubMed Central

    Bernstein, Kyra; Vink, Joy Y; Fu, Xiao Wen; Wakita, Hiromi; Danielsson, Jennifer; Wapner, Ronald; Gallos, George

    2014-01-01

    Objective To determine the presence of calcium activated chloride channels anoctamin 1 and 2 in human and murine uterine smooth muscle and evaluate the physiologic role for these ion channels in murine myometrial contractility. Study Design We performed reverse transcription polymerase chain reaction to determine if anoctamin 1 and 2 are expressed in human and murine uterine tissue to validate the study of this protein in mouse models. Immunohistochemical staining of anoctamin 1 and 2 was then performed to determine protein expression in murine myometrial tissue. The function of anoctamin 1 and 2 in murine uterine tissue was evaluated using electrophysiological studies, organ bath, and calcium flux experiments. Results Anoctamin 1 and 2 are expressed in human and murine USM cells. Functional studies show that selective antagonism of these channels promotes relaxation of spontaneous murine uterine smooth muscle contractions. Blockade of anoctamin 1 and 2 inhibits both agonist-induced and spontaneous transient inward currents and abolishes G-protein coupled receptor (oxytocin) mediated elevations in intracellular calcium. Conclusion The calcium activated chloride channels ANO 1 and 2 are present in human and murine myometrial tissue and may provide novel potential therapeutic targets to achieve effective tocolysis. PMID:24928056

  14. Curettage after uterine artery embolization combined with methotrexate treatment for caesarean scar pregnancy

    PubMed Central

    Feng, Ying; Chen, Suwen; Li, Changdong; Zhang, Xiaofeng; Duan, Hua; Sooranna, Suren; Johnson, Mark R.; Li, Jian

    2016-01-01

    In the present study, we evaluated the diagnosis and management modalities of caesarean scar pregnancy (CSP). Thirty patients diagnosed with CSP were retrospectively studied between February, 2010 and February, 2012. Twenty-five patients were offered prophylactic uterine artery embolization (UAE) and methotrexate (MTX) prior to uterine suction curettage. Five cases were referred from other hospitals where the initial management with uterine suction curettage had resulted in uncontrollable massive haemorrhage, 4 of the cases had UAE and one proceeded immediately to hysterectomy. In the 25 patients treated with prophylactic UAE and MTX, 12 had laparoscopy-guided curettage and 13 had ultrasound-guided curettage without complication. The results showed that the 25 patients with CSP, who received prophylactic UAE and MTX prior to uterine curettage, recovered without complications. Five patients referred from other hospitals, where uterine curettage was the primary procedure, had severe complications including uncontrolled vaginal bleeding and uterine rupture. Four of the five patients were treated successfully with emergency UAE and the remaining patient underwent emergency hysterectomy as ultrasound examination detected significant haemorrhage between the uterus and the bladder. Of the 25 patients who received prophylactic UAE combined with MTX, there were no reports of irregular menstruation or serious adverse effects. Notably, the decrease in serum human chorionic gonadotropin (HCG) levels 3 days post-surgery was greater with ultrasound-guided curettage (84.3±5.5%) than with laparoscopy-guided curettage (76.3±10.2%). In summary, the data suggested that prophylactic UAE with MTX followed by ultrasound-guided curettage is the most effective therapeutic approach in CSP. PMID:27602071

  15. Curettage after uterine artery embolization combined with methotrexate treatment for caesarean scar pregnancy

    PubMed Central

    Feng, Ying; Chen, Suwen; Li, Changdong; Zhang, Xiaofeng; Duan, Hua; Sooranna, Suren; Johnson, Mark R.; Li, Jian

    2016-01-01

    In the present study, we evaluated the diagnosis and management modalities of caesarean scar pregnancy (CSP). Thirty patients diagnosed with CSP were retrospectively studied between February, 2010 and February, 2012. Twenty-five patients were offered prophylactic uterine artery embolization (UAE) and methotrexate (MTX) prior to uterine suction curettage. Five cases were referred from other hospitals where the initial management with uterine suction curettage had resulted in uncontrollable massive haemorrhage, 4 of the cases had UAE and one proceeded immediately to hysterectomy. In the 25 patients treated with prophylactic UAE and MTX, 12 had laparoscopy-guided curettage and 13 had ultrasound-guided curettage without complication. The results showed that the 25 patients with CSP, who received prophylactic UAE and MTX prior to uterine curettage, recovered without complications. Five patients referred from other hospitals, where uterine curettage was the primary procedure, had severe complications including uncontrolled vaginal bleeding and uterine rupture. Four of the five patients were treated successfully with emergency UAE and the remaining patient underwent emergency hysterectomy as ultrasound examination detected significant haemorrhage between the uterus and the bladder. Of the 25 patients who received prophylactic UAE combined with MTX, there were no reports of irregular menstruation or serious adverse effects. Notably, the decrease in serum human chorionic gonadotropin (HCG) levels 3 days post-surgery was greater with ultrasound-guided curettage (84.3±5.5%) than with laparoscopy-guided curettage (76.3±10.2%). In summary, the data suggested that prophylactic UAE with MTX followed by ultrasound-guided curettage is the most effective therapeutic approach in CSP.

  16. Slow rupture of frictional interfaces

    NASA Astrophysics Data System (ADS)

    Bar Sinai, Yohai; Brener, Efim A.; Bouchbinder, Eran

    2012-02-01

    The failure of frictional interfaces and the spatiotemporal structures that accompany it are central to a wide range of geophysical, physical and engineering systems. Recent geophysical and laboratory observations indicated that interfacial failure can be mediated by slow slip rupture phenomena which are distinct from ordinary, earthquake-like, fast rupture. These discoveries have influenced the way we think about frictional motion, yet the nature and properties of slow rupture are not completely understood. We show that slow rupture is an intrinsic and robust property of simple non-monotonic rate-and-state friction laws. It is associated with a new velocity scale cmin, determined by the friction law, below which steady state rupture cannot propagate. We further show that rupture can occur in a continuum of states, spanning a wide range of velocities from cmin to elastic wave-speeds, and predict different properties for slow rupture and ordinary fast rupture. Our results are qualitatively consistent with recent high-resolution laboratory experiments and may provide a theoretical framework for understanding slow rupture phenomena along frictional interfaces.

  17. The linear synchronization measures of uterine EMG signals: Evidence of synchronized action potentials during propagation.

    PubMed

    Domino, Malgorzata; Pawlinski, Bartosz; Gajewski, Zdzislaw

    2016-11-01

    Evaluation of synchronization between myoelectric signals can give new insights into the functioning of the complex system of porcine myometrium. We propose a model of uterine contractions according to the hypothesis of action potentials similarity which is possible to detect during propagation in the uterine wall. We introduce similarity measures based on the concept of synchronization as used in matching linear signals such as electromyographic (EMG) time series data. The aim was to present linear measures to assess synchronization between contractions in different topographic regions of the uterus. We use the cross-correlation function (ƒx,y[l], ƒy,z[l]) and the cross-coherence function (Cxy[ƒ], Cyz[ƒ]) to assess synchronization between three data series of a diestral uterine EMG bundles in porcine reproductive tract. Spontaneous uterine activity was recorded using telemetry method directly by three-channel transmitter and three silver bipolar needle electrodes sutured on different topographic regions of the reproductive tract in the sow. The results show the usefulness of the cross-coherence function in that synchronization between uterine horn and corpus uteri for multiple action potentials (bundles) could be observed. The EMG bundles synchronization may be used to investigate the direction and velocity of EMG signals propagation in porcine reproductive tract. PMID:27570104

  18. Uterine oxytocin gene expression. I. Induction during pseudopregnancy and the estrous cycle.

    PubMed

    Lefebvre, D L; Farookhi, R; Larcher, A; Neculcea, J; Zingg, H H

    1994-06-01

    We have recently demonstrated that the gene encoding the hypothalamic peptide oxytocin (OT) is highly expressed in the rat endometrial epithelium during the last 4 days of pregnancy. Here, we show that uterine OT gene expression is also induced during the proestrous phase of the estrous cycle and after induction of pseudopregnancy. In mature female rats, OT mRNA levels increased more than 10-fold between diestrus and proestrus and remained elevated at estrus. The levels attained at estrus corresponded to about 1/20th of the levels present at term. In immature rats rendered pseudopregnant by treatment with pregnant mare serum and hCG, uterine OT mRNA levels rose steadily and reached a maximum on day 14 of pseudopregnancy, corresponding to about 1/8th of the levels observed on day 21 of normal pregnancy. Oil-induced decidualization of the left uterine horn prolonged pseudopregnancy and maintained OT mRNA levels in both uterine horns until day 19 of pseudopregnancy. These changes were tissue specific, as hypothalamic OT mRNA levels remained essentially unaffected. The present findings demonstrate that either spontaneous or induced changes in endogenous steroid levels are capable of eliciting important changes in uterine, but not hypothalamic, OT gene expression.

  19. Spontaneous fission

    SciTech Connect

    Hoffman, D.C.

    1993-09-01

    The spontaneous fission (SF) of the heaviest actinides and the transactinides is of particular interest because of the dramatic changes in properties observed in the region of the heavy fermion isotopes and for still heavier elements. The existing experimental information on SF properties including half-life systematics, fragment kinetic-energy and mass-yield distributions, prompt neutron emission, and gamma emission will be reviewed. Possibility for extending studies of SF properties to other regions are considered and the potential for obtaining additional information about low-energy fission properties is discussed.

  20. Dynamic fault rupture constraints to high frequency radiation of crustal earthquakes: the role of rupture velocity and fmax

    NASA Astrophysics Data System (ADS)

    Pulido, N. E.; Dalguer, L. A.

    2004-12-01

    The study of high frequency (HF) radiation of large earthquakes have been traditionally investigated by using kinematic models of the source. Some of these studies locate the HF radiation near boundaries of large slip regions (Zeng et. al. 1993, Kakehi et. al. 1996, 1997; Nakahara 1999, 2002), while others locate the HF radiation overlapping regions of large slip (Hartzell et. al 1996). However, a major limitation of all these studies is the over-simplification of the physical parameters involved in the rupture process such as the assumption of a nearly constant rupture velocity across the fault plane. Simple dynamic crack models have theoretically demonstrated that local variations of the rupture velocity play a very important role in the radiation of high frequency from the source (Madariaga 1977, 1983). In the present study we investigate the high frequency radiation of the 2000 Tottori earthquake (Japan) in two steps: First we investigate the complexity in the fault rupture by performing a spontaneous rupture dynamic model of the Tottori earthquake in the low frequency range (.1 to 1Hz). The fault friction law parameters and stress drop of the dynamic model are constrained from results of a kinematic model of source. On the other hand the rupture velocity is allowed to vary spontaneously. In the second step we calculate the high frequencies from a semi-stochastic approach that considers the radiation from a heterogenous finite fault and a frequency-dependent subfault-site specific radiation pattern model (Pulido et. al. 2004). The forward calculation of the high-frequency ground motion (1 to 20Hz) at the target observation sites is constrained by the subfault rupture times from the above dynamic model. In order to optimise the agreement to observed high frequency ground motion we use a Genetic Algorithm approach to invert for the stress drop distribution, fmax, and the high frequency decay for frequencies above fmax, by comparing the observed and simulated RMS

  1. Pharmacological Treatment of Uterine Fibroids

    PubMed Central

    Moroni, RM; Vieira, CS; Ferriani, RA; Candido-dos-Reis, FJ; Brito, LGO

    2014-01-01

    Uterine fibroids (UF) are common, benign gynecologic tumors, affecting one in three to four women, with estimates of up to 80%, depending on the population studied. Their etiology is not well established, but it is under the influence of several risk factors, such as early menarche, nulliparity and family history. More than 50% of affected women are asymptomatic, but the lesions may be related to bothersome symptoms, such as abnormal uterine bleeding, pelvic pain and bloating or urinary symptoms. The treatment of UF is classically surgical; however, various medical options are available, providing symptom control while minimizing risks and complications. A large number of clinical trials have evaluated commonly used medical treatments and potentially effective new ones. Through a comprehensive literature search using PubMed, EMBASE, CENTRAL, Scopus and Google Scholar databases, through which we included 41 studies out of 7658 results, we thoroughly explored the different pharmacological options available for management of UF, their indications, advantages and disadvantages. PMID:25364587

  2. Innovative Oral Treatments of Uterine Leiomyoma

    PubMed Central

    Sabry, Mohamed; Al-Hendy, Ayman

    2012-01-01

    Uterine fibroids (leiomyoma), the benign tumors of the uterine wall, are very common cause of morbidity in reproductive age women usually in the form of excessive vaginal bleeding, chronic pelvic pain, miscarriage and infertility. These tumors are the leading indication for hysterectomy in the United States. Uterine fibroids are about 4 times higher in blacks compared to whites and constitute a major health disparity challenge. The estimated cost of uterine fibroids is up to $34.4 billion annually. Additionally, women who suffer from this disease and desire to maintain their future fertility have very limited treatment choices. Currently, there is no effective long-term medicinal treatment for uterine fibroids. While surgery has traditionally been the gold standard for the treatment of uterine fibroids, there is growing interest towards orally administered medications for the management of leiomyoma-related symptoms. In this paper, we will discuss these promising innovative oral medical treatments in detail. PMID:22518167

  3. GIANT INTRALIGAMENTARY UTERINE LEIOMYOMA AND ITS COMPLICATIONS.

    PubMed

    Cărăuleanu, A; Socolov, R; Lupaşcu, Ivona Anghelache; Rugină, V; Socolov, Demetra

    2016-01-01

    Uterine leiomyomas are benign tumors arising from uterine smooth muscle. Although their pathogenesis remains unclear, they are the most common tumor of the female reproductive tract, occurring in as many as half of women older than 35 years. Uterine leiomyomas represent the most common benign tumors of the female reproductive tract. Giant uterine leiomyomas are very rare and represents a great diagnosis and therapeutic challenge. Uterine leiomyoma is one of the most frequent types of tumours and it is diagnosed in 20-40% of the women of reproductive age. Until the age of 50, approximately 70% of the white women and less than 80% of the black women will have had at least one leiomyoma. The frequency of the emergence of uterine leiomyoma in black women is significantly higher than in white women. PMID:27125088

  4. Celiac artery disease and fatal rupture of a hepatic artery aneurysm in the Ehlers-Danlos syndrome.

    PubMed

    Nat, Amritpal; George, Tanya; Mak, Gregory; Sharma, Amit; Nat, Amitpal; Lebel, Robert

    2014-04-01

    Isolated visceral arteriopathies of the celiac and hepatic artery are rare. We present a case of a Caucasian man who presented with abdominal pain and was found to have a spontaneous celiac artery dissection. Genetic analysis revealed a mutation consistent with Ehlers-Danlos syndrome type IV. The patient died 2 months later from a spontaneous rupture of his hepatic artery. PMID:24688192

  5. GCIG Consensus Review: Uterine and Ovarian Leiomyosarcomas

    PubMed Central

    Hensley, Martee L.; Barrette, Brigitte A.; Baumann, Klaus; Gaffney, David; Hamilton, Anne L.; Kim, Jae-Weon; Maenpaa, Johanna U.; Pautier, Patricia; Siddiqui, Nadeem Ahmad; Westermann, Anneke M.; Ray-Coquard, Isabelle

    2016-01-01

    Objective The GCIG aimed to provide an overview of uterine and ovarian leiomyosarcoma management. Methods Published articles and author experience were used to draft management overview. The draft manuscript was circulated to international members of the GCIG for review and comment, and appropriate revisions were made. Results The approach to management of uterine and ovarian leiomyosarcoma management is reviewed. Conclusions Uterine and ovarian leiomyosarcomas are rare, aggressive cancers that require specialized expertise for optimal management. PMID:25341583

  6. Bilateral quadriceps tendon ruptures in a healthy, active duty soldier: case report and review of the literature.

    PubMed

    Johnson, Anthony E; Rose, Stephen D

    2006-12-01

    Unilateral quadriceps tendon ruptures are not uncommon. These injuries have been reported to occur spontaneously and after seemingly trivial trauma in elderly individuals, patients undergoing renal dialysis, and patients with metabolic derangements such as hyperparathyroidism. In young patients, unilateral quadriceps tendon ruptures have been reported as complications of burns, anabolic steroid abuse, and elective orthopedic surgery. Bilateral quadriceps tendon ruptures in young healthy patients are rare injuries. We present the case of a young, healthy, active duty soldier who sustained bilateral quadriceps tendon ruptures after a relatively minor trauma.

  7. Simultaneous rupture of the quadriceps tendon and contralateral patellar tendon in a patient with chronic renal failure.

    PubMed

    Muratli, Hasan Hilmi; Celebi, Levent; Hapa, Onur; Biçimoğlu, Ali

    2005-01-01

    Simultaneous quadriceps and patellar tendon rupture is rare. Mechanical factors and coexisting systemic and local factors are taken into consideration in the pathogenesis of these ruptures. In patients with some chronic systemic diseases, simultaneous rupture can occur spontaneously or with minor traumas. We present a case of simultaneous quadriceps and patellar tendon rupture in a 21-year-old man with chronic renal failure in this report. He was treated surgically by osseotendinous repair with suture anchors and supplemental cerclage wire fixation on both sides. He regained his normal knee joint functions 18 months after the operation.

  8. Nonsurgical Alternatives for Uterine Fibroids.

    PubMed

    Zupi, Errico; Centini, Gabriele; Sabbioni, Lorenzo; Lazzeri, Lucia; Argay, István Máté; Petraglia, Felice

    2016-07-01

    Uterine leiomyomata are the direct cause of a significant health-care burden for women, their families, and society as a whole. Because of the long experience with the mode of treatment, surgical myomectomy remains the gold standard for treating reproductive-age women; however, in the recent years, the wide evolution of less invasive approaches led to a change in the options used by the clinician to treat symptomatic fibroids. Minimally invasive procedures such as uterine artery embolization (UAE) are increasingly used to treat symptomatic fibroids. Other alternative treatments are becoming more diffuse, such as magnetic resonance-guided high-frequency focused ultrasound surgery (MRgFUS), cryomyolysis, vaginal occlusion, and laparoscopic closure of the uterine arteries. Both advantages and limitations of these techniques under development must be taken into account, but this wider range of choices is being increasingly considered for a tailored treatment. This article aims to enable health-care providers with the tools to provide the latest evidence-based care in the minimally invasive or noninvasive management of this common problem. PMID:26711881

  9. Microvessels Density in Uterine Leiomyosarcoma

    PubMed Central

    Bobiński, Marcin; Bednarek, Wiesława; Szumiło, Justyna; Cybulski, Marek; Polak, Grzegorz; Kotarski, Jan

    2015-01-01

    Uterine leiomyosarcomas (LMS) are rare tumors typically presenting rapid growth and unfavorable outcome. Nowadays the results of uterine LMS treatment do not meet expectations. Angiogenesis is one of processes investigated to be target for future treatment. The aim of the research was to assess microvessels density (MVD) in tumor samples collected from 50 patients with histological confirmed uterine leiomyosarcoma and to investigate statistical relations between MVD, patients survival, and FIGO stage of tumor. The assessment was carried out using immunohistochemistry methods with anti-CD34 antibody. No significant difference in MVD between FIGO stages was observed. Furthermore, contrary to many other malignancies, we found no significant relation between MVD and patients overall and 2-year survival. Results obtained in the study suggest that processes on vascular mimicry and mesenchymal to epithelial transition (MET) may play important role in development of LMS. No statistical relation between MVD and survival leads to conclusion that not only angiogenesis but other mechanisms as well should be taken into consideration in planning future research. PMID:26161403

  10. Perforation of Transverse Colon: A Catastrophic Complication of Uterine Artery Embolization for Fibroids

    SciTech Connect

    Acharya, Jyotsna Bancroft, Karen; Lay, James

    2012-12-15

    We report a case of a 43-year-old woman who underwent uterine artery embolization (UAE) for a symptomatic large fibroid uterus and had spontaneous perforation of the transverse colon 3 months after embolisation with near-fatal consequences. We believe this is the first reported case in the literature of this serious complication of UAE. We briefly review the literature on bowel complications after UAE and discuss lessons to be learned regarding patient selection and postprocedure follow-up.

  11. RBMK pressure tube rupture assessment

    SciTech Connect

    Schmitt, B.E.; Tsiklauri, G.V.

    1994-08-01

    The Russian RBMK reactor core design consists of multiple parallel pressure tube channels that contain Zr clad, UO{sub 2} fuel pin bundles. These parallel channels are contained within graphite moderator blocks which are, in turn, contained within a sealed core cavity. Current safety evaluation efforts of the RBMK reactors have been concentrating in the area of tube ruptures within the core cavity and, in particular, multiple tube ruptures that could threaten the reactor core integrity. Tube rupture events result in a pressurization of the reactor core cavity. The original design overpressure for the cavity region was based on a single tube rupture, resulting in considerable margin to the top plate lift pressure. The top plate lift pressure is 3.1 bar, and a single tube rupture would result in approximately 1.4 bar. RBMK plant specific cavity pressure relief designs provide for between three and in simultaneous tube ruptures before exceeding the top plate lift pressure. Thus, current safety evaluations have begun to examine the potential for multiple tube ruptures that could exceed the current cavity pressure relief designs. One such scenario being examined is a partial rupture in a group distribution header that results in stagnated (low) flow to up to 40 pressure tubes. The subsequent fuel heatup in these reduced flow tubes could result in multiple tube ruptures beyond the design relief capacity of the core cavity. This paper examines several key issues in evaluating this transient, including: (1) the effects of low flow, (2) the effects of axial peaking, and (3) the effects of radial peaking, all relative to the time to tube rupture. These issues each play a significant role in attempting to evaluate the likelihood and severity of multiple tube ruptures for a partial group distribution header break.

  12. Maternal uterine vascular remodeling during pregnancy.

    PubMed

    Osol, George; Mandala, Maurizio

    2009-02-01

    Sufficient uteroplacental blood flow is essential for normal pregnancy outcome and is accomplished by the coordinated growth and remodeling of the entire uterine circulation, as well as the creation of a new fetal vascular organ: the placenta. The process of remodeling involves a number of cellular processes, including hyperplasia and hypertrophy, rearrangement of existing elements, and changes in extracellular matrix. In this review, we provide information on uterine blood flow increases during pregnancy, the influence of placentation type on the distribution of uterine vascular resistance, consideration of the patterns, nature, and extent of maternal uterine vascular remodeling during pregnancy, and what is known about the underlying cellular mechanisms.

  13. Skeletal muscle metastasis from uterine leiomyosarcoma.

    PubMed

    O'Brien, J M; Brennan, D D; Taylor, D H; Holloway, D P; Hurson, B; O'Keane, J C; Eustace, S J

    2004-11-01

    A case of a 68-year-old woman who presented with a rapidly enlarging painful right thigh mass is presented. She had a known diagnosis of uterine leiomyosarcoma following a hysterectomy for dysfunctional uterine bleeding. She subsequently developed a single hepatic metastatic deposit that responded well to radiofrequency ablation. Whole-body MRI and MRA revealed a vascular mass in the sartorius muscle and a smaller adjacent mass in the gracilis muscle, proven to represent metastatic leiomyosarcoma of uterine origin. To our knowledge, metastatic uterine leiomyosarcoma to the skeletal muscle has not been described previously in the English medical literature.

  14. [A two-stage kidney rupture following an intrarenal kidney cystic lesion].

    PubMed

    Lungenschmid, D; Furtschegger, A; Kastlunger, W; Jenewein, K

    1991-11-01

    Five days after a blunt trauma with intrarenal rupture of a renal cyst, whereby temporarily a calyceal communication had formed, there was a spontaneous second rupture of the cyst with excessive retroperitoneal haemorrhage. Surgical treatment was necessary and could be accomplished without nephrectomy. Both an arterial bleeding at the bottom of the cyst and a several days' old renal infarction at the edge of the cyst seemed to be relevant for the two-stage rupture. The sonographic, urographic and surgical findings are reported.

  15. Uterine structural anomalies and arthrogryposis-death of an urban legend.

    PubMed

    Hall, Judith G

    2013-01-01

    In a review of 2,300 cases of arthrogryposis collected over the last 35 years, 33 cases of maternal uterine structural anomalies were identified (1.3%). These cases of arthrogryposis represent a very heterogeneous group of types of arthrogryposis. Over half of individuals affected with arthrogryposis demonstrated asymmetry and some responded to removal of constraint, 29 of the 33 cases of arthrogryposis whose mother had a uterine structural anomaly could be identified as having a specific recognizable type of arthrogryposis. Only two cases (0.08%) had primarily proximal contractures that returned to almost normal function within 1 year. Craniofacial asymmetry was the most striking finding in these two cases. A quarter of cases had ruptured membranes between 32 and 36 weeks and either oligohydramnios or prematurity. The pregnancy histories of the mothers with uterine structural anomalies were typical in having infertility, multiple miscarriages, and stillbirths. The finding of only two cases which are likely to have multiple congenital contractures on the basis of uterine constraint suggests that it is a very rare primary cause of arthrogryposis. PMID:23239599

  16. Medroxyprogesterone in Treating Patients With Endometrioid Adenocarcinoma of the Uterine Corpus

    ClinicalTrials.gov

    2016-03-17

    Endometrial Adenocarcinoma; Endometrial Adenosquamous Carcinoma; Endometrial Endometrioid Adenocarcinoma, Variant With Squamous Differentiation; Recurrent Uterine Corpus Carcinoma; Stage I Uterine Corpus Cancer; Stage II Uterine Corpus Cancer; Stage III Uterine Corpus Cancer; Stage IV Uterine Corpus Cancer

  17. Simultaneous bilateral quadriceps tendon rupture in patient with chronic renal failure.

    PubMed

    Lee, Yunseok; Kim, Byounggook; Chung, Ju-Hwan; Dan, Jinmyoung

    2011-12-01

    Simultaneous bilateral spontaneous rupture of the quadriceps tendon is a very rare condition and only a few cases have been reported in the literature. The etiology is not clear yet. But it occurs infrequently in patients with chronic metabolic disorders. A 30-year-old female patient with simultaneous bilateral spontaneous quadriceps tendon rupture visited our hospital. She had chronic renal failure and her parathyroid hormone level was elevated due to parathyroid adenoma. We report a surgical repair of both quadriceps tendons of a patient with chronic renal failure as well as management of hyperparathyroidism.

  18. Acute diaphragmatic rupture in a patient with Ehlers-Danlos syndrome.

    PubMed

    Levine, Michael; Adler, Jonathan

    2011-10-01

    Ehlers-Danlos syndrome (EDS) is a rare connective tissue disorder, usually characterized by the triad of hypermobility of the joints, hyperextensibility of the skin, and tissue fragility. Numerous gastrointestinal complications have been reported with this syndrome. However, spontaneous diaphragmatic rupture remains a very rare complication. We report a case of a 22-year-old woman with EDS who presented to the Emergency Department complaining of shortness of breath and left-sided chest pain. She was ultimately found to have a spontaneous diaphragmatic rupture after forceful emesis. PMID:18439794

  19. [Uterine artery embolization for myomas treatment].

    PubMed

    Kahn, Vanessa; Pelage, Jean-Pierre; Marret, Henri

    2013-01-01

    Myoma treatment by uterine artery embolisation (UAE) using non-spherical PVA particles or calibrated tris-acryl microspheres>500μm is effective in more than 90 % of cases in the short-term. In the long-term, menorrhagia, bulk-related symptoms and pelvic pain are significantly improved or eliminated in 75 % of cases at 5 to 7 years. At 6 months, uterine volume reduction and larger myoma volume reduction varies between 30 to 60 % and 50 to 80 % respectively. During hospital stay the complication rate is very low, less than 3 % mostly urinary infection and pain. Secondary hysterectomy for complication is less than 2 % at 3 months. Definitive amenorrhea is reported in less than 5 % of cases in women of more than 45-year of age. No significant impact of embolization on hormonal function has been reported in women less than 45 years with normal baseline function. UAE is not indicated for submucous myomas. Randomized studies comparing embolization to hysterectomy demonstrate that reinterventions are more frequently performed after embolization. Secondary hysterectomy is performed in 13 to 24 % of cases at 2 years and in up to 28 % of cases at 5 years. Hospital stay, duration of recovery and time off work are shorter after embolization compared to hysterectomy. Embolization is cheaper than hysterectomy at 12 and 24 months even taking into consideration the additional costs of imaging and reinterventions. UAE is a good alternative treatment in women with unique myoma of less than 10cm and multiple myomas around 15cm. This treatment should be proposed to women each time possible. Randomized studies comparing embolization to myomectomy demonstrate that in the short and mid-term there is no difference in terms of control of menorrhagia and bulk-related symptoms. Uterine volume reduction and quality of life were not different at 6 months. Periprocedural and 30-day complication rates are not different. At 6 months, the rate of complications is higher

  20. Primary Uterine Peripheral T-cell Lymphoma

    PubMed Central

    Gong, Jing; Dong, Aisheng; Wang, Yang; Zhang, Xuefeng; Yang, Panpan; Wang, Li; Jing, Wei

    2016-01-01

    Abstract Primary uterine non-Hodgkin's lymphoma is extremely rare accounting for <1% of all extranodal non-Hodgkin's lymphomas. Imaging findings of primary uterine lymphoma have rarely been reported before. We present magnetic resonance imaging (MRI) and fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/CT findings in a patient with primary uterine peripheral T-cell lymphoma. A 27-year-old female presented with intermittent fever with neutropenia for 7 months. MRI showed an ill-defined mass involved both the uterine corpus and cervix, resulting in diffuse enlargement of the uterus. This mass showed inhomogeneous hypointensity on unenhanced T1-weighted images, hyperintensity on diffusion-weighted imaging, relative hypointensity compared to the surrounding myometrium on T2-weighted images and lower enhancement than the surrounding myometrium on enhanced T1-weighted images. FDG PET/CT showed intense FDG uptake in the thickened wall of the uterine corpus and cervix with SUVmax of 26.9. There were multiple hypermetabolic lymph nodes in the pelvis and retroperitoneum. Uterine curettage and CT-guided biopsy of the uterine mass revealed peripheral T-cell lymphoma. Bone marrow biopsy revealed no evidence of lymphomatous involvement. The imaging and pathologic findings were consistent with primary uterine lymphoma. After 3 circles of chemotherapy, follow-up enhanced MRI showed decreased thickness of the uterine wall. Despite its rarity, primary uterine non-Hodgkin's lymphoma should be taken into consideration when a uterine tumor shows large size, relative hypointesity on both T2-weighted images and enhanced T1-weighted images compared to the surrounding myometrium, and intense FDG uptake on PET/CT. MRI may be helpful for describing the relationship between the tumor and adjacent structures. FDG PET/CT may be useful for tumor detection and staging. PMID:27124063

  1. Short-lived Supershear Rupture

    NASA Astrophysics Data System (ADS)

    Fukuyama, E.; Xu, S.; Yamashita, F.; Mizoguchi, K.; Takizawa, S.; Kawakata, H.

    2015-12-01

    Fukuyama and Olsen (2002) computed the supershear rupture initiation, propagation and termination process due to a passage of high stress drop area (called asperity) using a boundary integral equation method. They found that supershear rupture continued to propagate after the passage through high stress drop area but it died after a certain propagation distance, which depends on the elastic energy released at the high stress drop area. Here, we could reproduce a similar phenomenon in the laboratory. We conducted large-scale biaxial friction experiments using a pair of meter-scaled metagabbro rock specimens (VP=6.9km/s, VS=3.6km/s) at the National Research institute for Earth Science and Disaster Prevention (NIED). We observed several stick slip rupture events that initiated close to an asperity and immediately became supershear ruptures. But after propagating certain distance they died out and co-existing subshear ruptures became prominent. If we look into details, during the supershear rupture, we could see a sequence of rupture acceleration, its short rest and re-acceleration. This feature reminds us of a sequential breakage of small high stress patches as predicted by Fukuyama and Madariaga (2000). These observations might be interpreted under a concept of energy balance where the energy transmission from strain energy released by the asperity to fracture energy consumed at the crack tip was not instantaneously balanced in space. This could be related to the fact that earthquake rupture velocity is rather smooth reported from the finite fault analysis of large earthquakes with seismic waveforms. References Fukuyama, E. and R. Madariaga (2000) Dynamic propagation and interaction of a rupture front on a planar fault, PAGEOPH, 257, 1959-1979. Fukuyama, E. and K.B. Olsen (2002) A condition for super-shear rupture propagation in a heterogeneous stress field, PAGEOPH, 159, 2047-2056.

  2. Paclitaxel and Intraperitoneal Carboplatin Followed by Radiation Therapy in Treating Patients With Stage IIIC-IV Uterine Cancer

    ClinicalTrials.gov

    2015-02-10

    Endometrial Serous Adenocarcinoma; Stage IIIA Uterine Corpus Cancer; Stage IIIB Uterine Corpus Cancer; Stage IIIC1 Uterine Corpus Cancer; Stage IIIC2 Uterine Corpus Cancer; Stage IVA Uterine Corpus Cancer; Stage IVB Uterine Corpus Cancer

  3. Relaxin mediates uterine artery compliance during pregnancy and increases uterine blood flow

    PubMed Central

    Vodstrcil, Lenka A.; Tare, Marianne; Novak, Jacqueline; Dragomir, Nicoleta; Ramirez, Rolando J.; Wlodek, Mary E.; Conrad, Kirk P.; Parry, Laura J.

    2012-01-01

    Normal pregnancy involves dramatic remodeling of the uterine vasculature, with abnormal vascular adaptations contributing to pregnancy diseases such as preeclampsia. The peptide hormone relaxin is important for the renal and systemic hemodynamic adaptations to pregnancy, and has been shown to increase arterial compliance and outward hypertrophic remodeling. Therefore, we investigated the possibility that relaxin acts on its receptor, RXFP1, to mediate uterine artery compliance in late pregnancy and increase uterine blood flow velocity in rats. RXFP1 was predominantly localized to the tunica media vascular smooth muscle cells in the uterine artery, although receptors were also detected in endothelial cells. Highest expression of Rxfp1 in the uterine artery occurred in estrus and early pregnancy. Isolated uterine arteries from late pregnant rats treated with a monoclonal antibody against circulating relaxin (MCA1) had significantly increased vessel wall stiffness compared with controls, with no reduction in wall thickness. Chronic infusion of relaxin (4 μg/h, osmotic minipump) for 5 d in nonpregnant rats significantly increased uterine artery blood flow velocity. Overall, these data demonstrate a functional role for relaxin in mediating uterine artery compliance in pregnant rats, which may be necessary to maintain adequate uterine blood flow to the uterus and placenta.—Vodstrcil, L. A., Tare, M., Novak, J., Dragomir, N., Ramirez, R. J., Wlodek, M. E., Conrad, K. P., Parry, L. J. Relaxin mediates uterine artery compliance during pregnancy and increases uterine blood flow. PMID:22744867

  4. Uterine glands: biological roles in conceptus implantation, uterine receptivity, and decidualization

    PubMed Central

    Filant, Justyna; Spencer, Thomas E.

    2014-01-01

    All mammalian uteri contain glands in the endometrium that synthesize or transport and secrete substances essential for survival and development of the conceptus (embryo/fetus and associated extraembryonic membranes). This review summarizes information related to the biological roles of uterine glands and their secretions in uterine receptivity, blastocyst/conceptus survival and implantation, and stromal cell decidualization. Studies with the ovine uterine gland knockout (UGKO) model support a primary role for uterine glands and, by inference, their secretions present in uterine luminal fluid histrotroph for conceptus survival and development. In rodents, studies with mutant and progesterone-induced UGKO mice found that uterine glands and their secretions are unequivocally required for establishment of uterine receptivity and blastocyst implantation and also may influence blastocyst trophectoderm activation and stromal cell decidualization in the uterus. Similarly in humans, histotroph from uterine glands appears critical for blastocyst implantation, uterine receptivity, and conceptus nutrition during the first trimester and uterine glands likely have a role in stromal cell decidualization. An increased understanding of uterine gland biology is important for diagnosis, prevention and treatment of fertility problems, particularly infertility and recurrent pregnancy loss, in domestic animals and humans. PMID:25023676

  5. Coupling geodynamic earthquake cycles and dynamic ruptures

    NASA Astrophysics Data System (ADS)

    van Zelst, Iris; van Dinther, Ylona; Gabriel, Alice-Agnes; Heuret, Arnauld

    2016-04-01

    Studying the seismicity in a subduction zone and its effects on tsunamis requires diverse modelling methods that span spatial and temporal scales. Hundreds of years are necessary to build the stresses and strengths on a fault, while consequent earthquake rupture propagation is determined by both these initial fault conditions and the feedback of seismic waves over periods of seconds up to minutes. This dynamic rupture displaces the sea floor, thereby causing tsunamis. The aim of the ASCETE (Advanced Simulations of Coupled Earthquake and Tsunami Events) project is to study all these aspects and their interactions. Here, we present preliminary results of the first aspects in this modelling chain: the coupling of a seismo-thermo-mechanical (STM) code to the dynamic rupture model SeisSol. STM models of earthquake cycles have the advantage of solving multiple earthquake events in a self-consistent manner concerning stress, strength and geometry. However, the drawback of these models is that they often lack in spatial or temporal resolution and do not include wave propagation. In contrast, dynamic rupture models solve for frictional failure coupled to seismic wave propagation. We use the software package SeisSol (www.seissol.org) based on an ADER-DG discretization allowing high-order accuracy in space and time as well as flexible tetrahedral meshing. However, such simulations require assumptions on the initial fault stresses and strengths and its geometry, which are hard to constrain due to the lack of near-field observations and the complexity of coseismic conditions. By adapting the geometry as well as the stress and strength properties of the self-consistently developing non-finite fault zones from the geodynamic models as initial conditions for the dynamic rupture models, the advantages of both methods are exploited and modelling results may be compared. Our results show that a dynamic rupture can be triggered spontaneously and that the propagating rupture is

  6. Etiology of primary spontaneous pneumothorax.

    PubMed

    Lyra, Roberto de Menezes

    2016-01-01

    With the advent of HRCT, primary spontaneous pneumothorax has come to be better understood and managed, because its etiology can now be identified in most cases. Primary spontaneous pneumothorax is mainly caused by the rupture of a small subpleural emphysematous vesicle (designated a bleb) or of a subpleural paraseptal emphysematous lesion (designated a bulla). The aim of this pictorial essay was to improve the understanding of primary spontaneous pneumothorax and to propose a description of the major anatomical lesions found during surgery. RESUMO Com o advento da TCAR, o pneumotórax espontâneo primário passou a ser mais bem entendido e conduzido, pois sua etiologia pode ser atualmente identificada na maioria dos casos. O pneumotórax espontâneo primário tem como principal causa a rotura de uma pequena vesícula enfisematosa subpleural, denominada bleb ou de uma lesão enfisematosa parasseptal subpleural, denominada bulla. O objetivo deste ensaio pictórico foi melhorar o entendimento do pneumotórax espontâneo primário e propor uma descrição das principais lesões anatômicas encontradas durante a cirurgia. PMID:27383937

  7. The Fat-Fed Apolipoprotein E Knockout Mouse Brachiocephalic Artery in the Study of Atherosclerotic Plaque Rupture

    PubMed Central

    Bond, Andrew R.; Jackson, Christopher L.

    2011-01-01

    Atherosclerosis has been studied in animals for almost a century, yet the events leading up to the rupture of an atherosclerotic plaque (the underlying cause of the majority of fatal thrombosis formation) have only been studied in the past decade, due in part to the development of a mouse model of spontaneous plaque rupture. Apolipoprotein E knockout mice, when fed a high-fat diet, consistently develop lesions in the brachiocephalic artery that rupture at a known time point. It is therefore now possible to observe the development of lesions to elucidate the mechanisms behind the rupture of plaques. Critics argue that the model does not replicate the appearance of human atherosclerotic plaque ruptures. The purpose of this review is to highlight the reasons why we should be looking to the apolipoprotein E knockout mouse to further our understanding of plaque rupture. PMID:21076539

  8. Deceased Donor Uterine Transplantation: Innovation and Adaptation.

    PubMed

    Flyckt, Rebecca L; Farrell, Ruth M; Perni, Uma C; Tzakis, Andreas G; Falcone, Tommaso

    2016-10-01

    This commentary endeavors to share our practical experience in developing and implementing the first uterine transplant clinical trial in the United States. Uterine transplant is a promising novel treatment for uterine factor infertility. After reported successful live births after uterine transplant in Sweden, research teams around the world are either embarking on or are considering the development of uterine transplant protocols. Our observations on the applied rather than theoretical aspects of uterine transplantation research in human subjects are detailed in this article. Important among these considerations are composing a broad and experienced multidisciplinary team as well as performing adequate preclinical preparations, including ideally animal studies and practice organ procurements. Ethical preparation is tantamount to clinical preparation for the complexities inherent in uterine transplant, and our suggestions for updating the current ethical criteria for uterine transplant are outlined here. We also describe our perspectives on the strengths and weaknesses of living compared with deceased donor models. Finally, we describe how a strong program can recover and adapt in the face of setbacks to continue a path toward innovation. PMID:27607877

  9. Uterine prolapse in 2 dromedary camels.

    PubMed Central

    Gutierrez, C; Corbera, J A; Morales, I; Morales, M; Navarro, R

    2001-01-01

    Two cases of uterine prolapse in dromedary camels in a herd with concomitant cases of white muscle disease are described. Serum selenium and glutathione peroxidase in whole blood were investigated in both patients and showed statistical difference compared with a control group. Results suggest that selenium deficiency could promote uterine prolapse in dromedary camels. PMID:11665430

  10. Acute Renal Failure after Uterine Artery Embolization

    SciTech Connect

    Rastogi, Sachin; Wu, Yu-Hsin; Shlansky-Goldberg, Richard D.; Stavropoulos, S. William

    2004-09-15

    Renal failure is a potential complication of any endovascular procedure using iodinated contrast, including uterine artery embolization (UAE). In this report we present a case of acute renal failure (ARF) following UAE performed as a treatment for uterine fibroids. The likely causes of ARF in this patient are explored and the possible etiologies of renal failure in patients undergoing UAE are reviewed.

  11. Reducing maternal mortality from ruptured uterus--the Sokoto initiative.

    PubMed

    Ahmed, Y; Shehu, C E; Nwobodo, E I; Ekele, B A

    2004-06-01

    Uterine rupture is the most common cause of maternal mortality in our institution. Case fatality for the year 2001 was 47%. Health care including emergency obstetric care (EmOC) is not free, hence, delays in receiving care could occur in patients with limited resources. The objectives of the study were to promote access to emergency obstetric care through a loan scheme for indigent patients with ruptured uterus and determine the success or otherwise of the scheme. The scheme was initiated in January 2002, with the sum of thirty eight Thousand Naira (about 300 US dollars) by consultant obstetricians in the department. Funds were released to the patient only after assessment of her financial capability to enable her get emergency surgical packs. All that was required was a promise to pay back the loan before discharge. Following resuscitation, surgery was performed by one of the consultants. Eighteen cases of ruptured uterus have been managed. Treatment was initiated within 30 minutes of admission. Admission-laparotomy interval averaged 3.5 hours (+/-1.2). There were two maternal deaths, giving a case fatality of 11% (2/ 18). The case fatality from a previous study from the same centre was 38% (16/42). There was a significant difference in case fatality between the two studies (P<0.05; confidence limits are-0.328 and -0.211). Of the seventeen patients that benefited from the scheme, 16 repaid the loan before discharge (94% loan recovery). Only one patient defaulted with five thousand Naira (40 US dollars). A loan scheme for indigent patients with ruptured uterus that enabled them receive emergency obstetric care reduced case fatality. Loan recovery was good. In our quest to reduce maternal mortality in low-income countries without health insurance policies, there might be a need to extend similar initiative to other obstetric emergencies.

  12. Preoperative Uterine Artery Embolization (PUAE) Before Uterine Fibroid Myomectomy

    SciTech Connect

    Dumousset, E.; Chabrot, P.; Rabischong, B.; Mazet, N.; Nasser, S.; Darcha, C.; Garcier, J.M.; Mage, G.; Boyer, L.

    2008-05-15

    Purpose. To evaluate the potential of uterine artery embolization to minimize blood loss and facilitate easier removal of fibroids during subsequent myomectomy. Methods. This retrospective study included 22 patients (median age 37 years), of whom at least 15 wished to preserve their fertility. They presented with at least one fibroid (mean diameter 85.6 mm) and had undergone preoperative uterine artery embolization (PUAE) with resorbable gelatin sponge. Results. No complication or technical failure of embolization was identified. Myomectomies were performed during laparoscopy (12 cases) and laparotomy (9 cases). One hysterectomy was performed. The following were noted: easier dissection of fibroids (mean 5.6 per patient, range 1-30); mean intervention time 113 min (range 25-210 min); almost bloodless surgery, with a mean peroperative blood loss of 90 ml (range 0-806 ml); mean hemoglobin pretherapeutically 12.3 g/dl (range 5.9-15.2 g/dl) and post-therapeutically 10.3 g/dl (range 5.6-13.3 g/dl), with no blood transfusion needed. Patients were discharged on day 4 on average and the mean sick leave was 1 month. Conclusion. Preoperative embolization is associated with minimal intraoperative blood loss. It does not increase the complication rate or impair operative dissection, and improves the chances of performing conservative surgery.

  13. Congenital uterine anomalies affecting reproduction.

    PubMed

    Reichman, David E; Laufer, Marc R

    2010-04-01

    The following review seeks to summarise the current data regarding reproductive outcomes associated with congenital uterine anomalies. Such malformations originate from adverse embryologic events ranging from agenesis to lateral and vertical fusion defects. Associated renal anomalies are common both for the symmetric and asymmetric malformations. While fertility is minimally impacted upon by müllerian anomalies in most cases, such malformations have historically been associated with poor obstetric outcomes such as recurrent miscarriage, second trimester loss, preterm delivery, malpresentation and intrauterine foetal demise (IUFD). The following review delineates the existing literature regarding such outcomes and indicates therapies, where applicable, to optimise the care of such patients.

  14. Endocervicosis of the Uterine Cervix.

    PubMed

    Mobarki, Mousa; Karpathiou, Georgia; Forest, Fabien; Corsini, Thomas; Peoc'h, Michel

    2016-09-01

    Endocervicosis is considered a form of Mülleriosis affecting mainly the bladder and is comprised of endocervical-type glands and cysts. It has been rarely described in the uterine cervix where the extensive involvement of cervical and paracervical tissue poses the suspicion of malignancy, mostly minimal-deviation adenocarcinoma. We describe a case of cervical endocervicosis causing long-term symptoms leading to hysterectomy. We provide evidence that this pathology is associated with cesarean section similar with isthmocele. Its differential diagnosis is discussed. PMID:26825004

  15. Dynamic Rupture Segmentation Along The Nankai Trough, Southwest Japan

    NASA Astrophysics Data System (ADS)

    Hok, S.; Fukuyama, E.; Hashimoto, C.

    2010-12-01

    In southwest Japan, large devastating earthquakes (Mw>8) occurred along the Nankai subduction zone every 100-200 years (e.g. Ando, 1975, Tectonophys.; Ishibashi, 2004, Ann. Geophys.). Historical records revealed the segmented nature of the 600 km long seismogenic zone, producing Nankai and Tonankai earthquakes to occur separately or jointly at each cycle. The intersegment zone which separates Nankai and Tonankai source areas, near the Kii Peninsula, should have some special physical properties. In this study, we investigate the dynamic linkage of the coseismic slips on the Nankai and Tonankai segments, by modeling the spontaneous rupture propagation on the subduction interface. To conduct a reliable modeling, the parameters’ lateral variations along the place interface are introduced by combining several geophysical observation data sets. First, we use a large-scale 3D geometry for the plate interface, inferred from seismicity; we also integrate the slip deficit distribution (Hashimoto et al., 2009, SSJ meeting) obtained by inversion of GPS data, to constrain the distribution of stress drop on the interface. This distribution is not uniform, and explains the 1st order asperities of the subduction zone: Hyuga, Nankai, Tonankai and Tokai areas appear clearly as loaded regions. In addition, a constitutive friction law is required to link fault slip and stress release. We compiled regional geophysical information relevant to the segmentation, to infer the distribution of the frictional parameters at seismogenic depths. We focused on areas where the rupture is known to have stopped. The barriers seem to be related to upper plate structure (Wells et al. 2003, JGR, Rosenau and Oncken 2009, JGR). Uplifted areas show common characteristics: end of seismogenic segments, underplating in the wedge, and higher density of the upper old wedge (granitic intrusions). Following above review, we introduced 3 barrier regions delimiting 2 asperity regions (Nankai and Tonankai

  16. Spontaneous closure of macular hole following blunt trauma.

    PubMed

    Freitas-Neto, Clovis Arcoverde; Pigosso, Douglas; Pacheco, Katia Delalíbera; Pereira, Viviane Oliveira; Patel, Pranav; Freitas, Luiz Guilherme; Ávila, Marcos Pereira

    2016-01-01

    Ocular trauma can result in macular hole and it can lead to complete loss of central vision. We are reporting a case of traumatic macular hole associated with retinal hemorrhages and choroidal ruptures with spontaneous resolution and total vision recovery. PMID:27433039

  17. Insights into rupture processes of a laboratory-earthquake in dry and lubricated faults

    NASA Astrophysics Data System (ADS)

    Bayart, Elsa; Svetlizky, Ilya; Fineberg, Jay

    2016-04-01

    Our understanding of the dynamics of earthquakes requires us to understand the mechanisms of transition from static to sliding friction. The weakening of a fault is mediated by the propagation of rapid interfacial ruptures (earthquakes) that detach the solid contacts forming the frictional interface. By measuring the real contact area and strain fields near rough frictional interfaces, we have shown that these ruptures correspond to true shear cracks [1]. In particular, dynamic ruptures may spontaneously arrest at various locations along the interface. We show that a fracture-mechanics-based criterion can predict the location of the rupture arrest [2]. These results shed light on the selection of an earthquake's magnitude and arrest. Another interesting question is how interstitial fluids act to weaken a fault. By performing stick-slip experiments where the contacting surfaces are covered by a thin lubricating layer, we show that the established framework of fracture mechanics can also describe the measured strain fields when rupture of the interface takes place. A surprising result is that, although reducing the frictional strength of the interface (friction coefficient), lubricants actually significantly increase the fracture energy (amount of dissipated energy) during rupture. Thus surface lubrication, while strongly reducing the residual stresses in the wake of rupture propagation, actually toughens the contacting surfaces. [1] Svetlizky, I. & Fineberg, J. Classical shear cracks drive the onset of dry frictional motion. Nature 509, 205-208 (2014). [2] Bayart, E., Svetlizky, I. & Fineberg, J. Fracture mechanics determine the lengths of interface ruptures that mediate frictional motion. Nature Physics (2015).

  18. The effects of Ginseng Java root extract on uterine contractility in nonpregnant rats

    PubMed Central

    Sukwan, Catthareeya; Wray, Susan; Kupittayanant, Sajeera

    2014-01-01

    Abstract Ginseng Java or Talinum paniculatum (Jacq.) Geartn has long been used in herbal recipes because of its various therapeutic properties. Ginseng Java is believed to be beneficial to the female reproductive system by inducing lactation and restoring uterine functions after the postpartum period. There are, however, no scientific data on verifying the effects on the uterus to support its therapeutic relevance. Therefore, the purpose of this study was to investigate the effects of Ginseng Java root extract and its possible mechanism(s) of action on uterine contractility. Female virgin rats were humanely killed by CO2 asphyxia and uteri removed. Isometric force was measured in strips of longitudinal myometrium. The effects of Ginseng Java root extract at its IC50 concentration (0.23 mg/mL) on spontaneous, oxytocin‐induced (10 nmol/L), and depolarized (KCl 40 mmol/L) contraction were investigated. After establishing regular phasic contractions, the application of Java root extract significantly inhibited spontaneous uterine contractility (n =5). The extract also significantly inhibited the contraction induced by high KCl solution (n =5) and oxytocin (n =5). The extract also inhibited oxytocin‐induced contraction in the absence of external Ca entry (n =7) and the tonic force induced by oxytocin in the presence of high KCl solution. Taken together, the data demonstrate a potent and consistent ability of extract from Ginseng Java root to reduce myometrial contractility. The tocolytic effects were demonstrated on both spontaneous and agonist‐induced contractions. The fact that force was inhibited in depolarized conditions suggests that the possible mechanisms may be blockade of Ca influx via L‐type Ca channels. The data in Ca‐free solutions suggest that the extract also reduces IP3‐induced Ca release from the internal store. These tocolytic effects do not support the use of ginseng to help with postpartum contractility, but instead suggest it may be

  19. Uterine artery embolization as a treatment option for uterine myomas.

    PubMed

    Marshburn, Paul B; Matthews, Michelle L; Hurst, Bradley S

    2006-03-01

    Information is still being collected on the long-term clinical responses and appropriate patient selection for UAE. Prospective RCTs have not been performed to compare the clinical results from UAE with more conventional therapies for symptomatic uterine leiomyomata. At least three attempts at conducting such RCTs have been unsuccessful because of poor patient accrual that related to differing patient expectation and desires, clinical bias, insurance coverage, and the tendency that patients who have exhausted other treatment options may be disposed more favorably to less invasive treatments. Other comparative studies have serious limitations. For example, the retrospective study that compared outcomes after abdominal myomectomy with UAE suggested that patients who received UAE were more likely to require further invasive treatment by 3 years than were recipients of myomectomy. Lack of randomization introduced a selection bias because women in the group that underwent UAEwere older and were more likely to have had previous surgeries. A prospective study of "contemporaneous cohorts," which excluded patients who had sub-mucosal and pedunculated subserosal myomas, sought to compare quality of life measures and adverse events in patients who underwent UAE or hysterectomy. The investigators concluded that both treatments resulted in marked improvement in symptoms and quality of life scores, but complications were higher in the group that underwent hysterectomy over 1 year. In this study,however, a greater proportion of patients who underwent hysterectomy had improved pelvic pain scores. Furthermore, hysterectomy eliminates uterine bleeding and the risk for recurrence of myomas. Despite the lack of controlled studies that compared UAE with conventional surgery, and despite limited extended outcome data, UAE has gained rapid acceptance, primarily because the procedure preserves the uterus, is less invasive, and has less short-term morbidity than do most surgical options

  20. Uterine caliper and depth gauge

    DOEpatents

    King, Loyd L.; Wheeler, Robert G.; Fish, Thomas M.

    1977-01-01

    A uterine caliper and sound consisting of an elongated body having outwardly biased resilient caliper wings and a spring-loaded slidable cervical stop. A slide on the body is operatively connected to the wings by a monofilament and operates with respect to a first scale on the body as a width indicator. A rod extending longitudinally on the body is connected to the cervical stop and cooperates with a second scale on the body as a depth indicator. The instrument can be positioned to measure the distance from the outer cervical ostium to the fundus, as read on said second scale. The wings may be allowed to open by moving the slide, and when the wings engage the utero-tubal junctions, the width may be read on said first scale. By adjustment of the caliper wings the instrument may be retracted until the resistance of the inner ostium of the cervix is felt, enabling the length of the cervical canal to be read directly by the position of the longitudinal indicator rod with respect to said second scale. The instrument may be employed to measure the width of the uterine cavity at any position between the inner ostium of the cervix and the fundus.

  1. Achilles tendon rupture rehabilitation

    PubMed Central

    Kearney, R. S.; Parsons, N.; Underwood, M.; Costa, M. L.

    2015-01-01

    Objectives The evidence base to inform the management of Achilles tendon rupture is sparse. The objectives of this research were to establish what current practice is in the United Kingdom and explore clinicians’ views on proposed further research in this area. This study was registered with the ISRCTN (ISRCTN68273773) as part of a larger programme of research. Methods We report an online survey of current practice in the United Kingdom, approved by the British Orthopaedic Foot and Ankle Society and completed by 181 of its members. A total of ten of these respondents were invited for a subsequent one-to-one interview to explore clinician views on proposed further research in this area. Results The survey showed wide variations in practice, with patients being managed in plaster cast alone (13%), plaster cast followed by orthoses management (68%), and orthoses alone (19%). Within these categories, further variation existed regarding the individual rehabilitation facets, such as the length of time worn, the foot position within them and weight-bearing status. The subsequent interviews reflected this clinical uncertainty and the pressing need for definitive research. Conclusions The gap in evidence in this area has resulted in practice in the United Kingdom becoming varied and based on individual opinion. Future high-quality randomised trials on this subject are supported by the clinical community. Cite this article: Bone Joint Res 2015;4:65–9 PMID:25868938

  2. Blood vessel rupture by cavitation

    PubMed Central

    Chen, Hong; Brayman, Andrew A.; Bailey, Michael R.

    2011-01-01

    Cavitation is thought to be one mechanism for vessel rupture during shock wave lithotripsy treatment. However, just how cavitation induces vessel rupture remains unknown. In this work, a high-speed photomicrography system was set up to directly observe the dynamics of bubbles inside blood vessels in ex vivo rat mesenteries. Vascular rupture correlating to observed bubble dynamics were examined by imaging bubble extravasation and dye leakage. The high-speed images show that bubble expansion can cause vessel distention, and bubble collapse can lead to vessel invagination. Liquid jets were also observed to form. Our results suggest that all three mechanisms, vessel distention, invagination and liquid jets, can contribute to vessel rupture. PMID:20680255

  3. The ruptured PIP breast implant.

    PubMed

    Helyar, V; Burke, C; McWilliams, S

    2013-08-01

    Public concern erupted about the safety of Poly Implant Prothèse (PIP) breast implants when it was revealed in 2011 that they contained an inferior, unlicensed industrial-grade silicone associated with a high rate of rupture. There followed national guidance for UK clinicians, which led to a considerable increase in referrals of asymptomatic women for breast implant assessment. In this review we discuss possible approaches to screening the PIP cohort and the salient characteristics of a ruptured implant. PMID:23622796

  4. Uterine transplantation: a promising surrogate to surrogacy?

    PubMed

    Grynberg, Michael; Ayoubi, Jean-Marc; Bulletti, Carlo; Frydman, Rene; Fanchin, Renato

    2011-03-01

    Infertility due to the inability of the uterus to carry a pregnancy ranks among the most unresolved issues in reproductive medicine. It affects millions of women worldwide who have congenital or acquired uterine affections, often requiring hysterectomy, and potentially represents a considerable fraction of the general infertile population. Patients suffering from severe uterine infertility are currently compelled to go through gestational surrogacy or adoption; both approaches, unfortunately, deprive them of the maternal experience of pregnancy and birth. Uterine transplantation represents an outstanding, yet complex, perspective to alleviating definitive uterine infertility. In the past decades, a number of scientific experiments conducted both in animals and women, focusing on uterine transplantation, have led to promising results. Collectively, these findings undoubtedly constitute a sound basis to clinically apply uterine transplantation in the near future. This paper is, however, an overview not only of the extent and limitations of accumulated scientific knowledge on uterine transplantation, but also its ethical implications, in an effort to define the actual place of such an approach among the therapeutic arsenal for alleviating infertility. PMID:21401629

  5. The role of voltage-gated potassium channels in the regulation of mouse uterine contractility

    PubMed Central

    Smith, Ryan C; McClure, Marisa C; Smith, Margaret A; Abel, Peter W; Bradley, Michael E

    2007-01-01

    Background Uterine smooth muscle cells exhibit ionic currents that appear to be important in the control of uterine contractility, but how these currents might produce the changes in contractile activity seen in pregnant myometrium has not been established. There are conflicting reports concerning the role of voltage-gated potassium (Kv) channels and large-conductance, calcium-activated potassium (BK) channels in the regulation of uterine contractility. In this study we provide molecular and functional evidence for a role for Kv channels in the regulation of spontaneous contractile activity in mouse myometrium, and also demonstrate a change in Kv channel regulation of contractility in pregnant mouse myometrium. Methods Functional assays which evaluated the effects of channel blockers and various contractile agonists were accomplished by quantifying contractility of isolated uterine smooth muscle obtained from nonpregnant mice as well as mice at various stages of pregnancy. Expression of Kv channel proteins in isolated uterine smooth muscle was evaluated by Western blots. Results The Kv channel blocker 4-aminopyridine (4-AP) caused contractions in nonpregnant mouse myometrium (EC50 = 54 micromolar, maximal effect at 300 micromolar) but this effect disappeared in pregnant mice; similarly, the Kv4.2/Kv4.3 blocker phrixotoxin-2 caused contractions in nonpregnant, but not pregnant, myometrium. Contractile responses to 4-AP were not dependent upon nerves, as neither tetrodotoxin nor storage of tissues at room temperature significantly altered these responses, nor were responses dependent upon the presence of the endometrium. Spontaneous contractions and contractions in response to 4-AP did not appear to be mediated by BK, as the BK channel-selective blockers iberiotoxin, verruculogen, or tetraethylammonium failed to affect either spontaneous contractions or 4-AP-elicited responses. A number of different Kv channel alpha subunit proteins were found in isolated myometrium

  6. Kernohan's phenomenon associated with left ruptured occipital arteriovenous malformation.

    PubMed

    Fujimoto, A; Sato, H; Katayama, W; Nakai, K; Tsunoda, T; Kobayashi, E; Nose, T

    2004-05-01

    A 23-year-old woman presented with ipsilateral hemiparesia due to rupture of a left occipital arteriovenous malformation (AVM). Emergency decompression (the onset-operation interval was 46 minutes,) was carried out and the patient could leave the hospital upon recovery without neurological deficits. In general, Kernohan's phenomenon is caused by the gradual displacement of the cerebral peduncle against the tentorial edge caused by compression by the contralateral mass. This phenomenon is very rare among the cases with spontaneous intracranial hemorrhage and only three cases including the present one have been reported in the literature. In all cases the onset-operation intervals of were very short. Kernohan's phenomenon associated with a ruptured AVM is a rare condition and emergency decompression is required. PMID:15080971

  7. Relationship between vesicle size and steric hindrance influences vesicle rupture on solid supports.

    PubMed

    Jackman, Joshua A; Kim, Min Chul; Zhdanov, Vladimir P; Cho, Nam-Joon

    2016-01-28

    Phospholipid assemblies on solid supports mimic the cell membrane, and provide a platform to study membrane biology. Among the different types of model membranes, the planar bilayer is a two-dimensional lipid bilayer sheet that can be formed by the adsorption and spontaneous rupture of vesicles. The formation process is influenced by the interactions between vesicles and the solid support as well as between vesicles. On silicon oxide, which is a commonly used solid support, vesicles typically adsorb until reaching a critical coverage and then spontaneous rupture begins. Although it is generally understood that spontaneous rupture leads to planar bilayer formation, oversaturation of vesicles at the critical coverage can hinder the whole process due to a steric factor. To date, the role of this factor has been scrutinized only in relation to temperature, and the influence of additional parameters remains to be elucidated. In this work, we have investigated how vesicle size and corresponding steric constraints influence the kinetics of vesicle adsorption and rupture and, more specifically, how the state of adsorbed vesicles after fusion depends on the vesicle size. Using quartz crystal microbalance-dissipation (QCM-D) and fluorescence recovery after photobleaching (FRAP), we characterized the adsorption kinetics of vesicles onto silicon oxide and the lateral mobility of solid-supported lipid assemblies. While the vesicle adsorption kinetics were diffusion-limited up to the onset of vesicle rupture, the extent of rupture depended on vesicle size and it was observed that larger vesicles are more prone to steric effects than smaller vesicles. We discuss this finding in terms of the structural transformation from adsorbed vesicles to a planar bilayer, including how the interplay of thermodynamic, kinetic and steric factors can affect vesicle rupture on solid supports. PMID:26739602

  8. Relationship between vesicle size and steric hindrance influences vesicle rupture on solid supports.

    PubMed

    Jackman, Joshua A; Kim, Min Chul; Zhdanov, Vladimir P; Cho, Nam-Joon

    2016-01-28

    Phospholipid assemblies on solid supports mimic the cell membrane, and provide a platform to study membrane biology. Among the different types of model membranes, the planar bilayer is a two-dimensional lipid bilayer sheet that can be formed by the adsorption and spontaneous rupture of vesicles. The formation process is influenced by the interactions between vesicles and the solid support as well as between vesicles. On silicon oxide, which is a commonly used solid support, vesicles typically adsorb until reaching a critical coverage and then spontaneous rupture begins. Although it is generally understood that spontaneous rupture leads to planar bilayer formation, oversaturation of vesicles at the critical coverage can hinder the whole process due to a steric factor. To date, the role of this factor has been scrutinized only in relation to temperature, and the influence of additional parameters remains to be elucidated. In this work, we have investigated how vesicle size and corresponding steric constraints influence the kinetics of vesicle adsorption and rupture and, more specifically, how the state of adsorbed vesicles after fusion depends on the vesicle size. Using quartz crystal microbalance-dissipation (QCM-D) and fluorescence recovery after photobleaching (FRAP), we characterized the adsorption kinetics of vesicles onto silicon oxide and the lateral mobility of solid-supported lipid assemblies. While the vesicle adsorption kinetics were diffusion-limited up to the onset of vesicle rupture, the extent of rupture depended on vesicle size and it was observed that larger vesicles are more prone to steric effects than smaller vesicles. We discuss this finding in terms of the structural transformation from adsorbed vesicles to a planar bilayer, including how the interplay of thermodynamic, kinetic and steric factors can affect vesicle rupture on solid supports.

  9. Uncommon Complication of Uterine Artery Embolization: Expulsion of Infarcted Myoma and Uterine Sepsis.

    PubMed

    Martins, Juliana G; Gaudenti, Dawn; Crespo, Frank; Ganesh, Dervi; Verma, Usha

    2016-01-01

    Uterine leiomyomas are the most common benign tumors in young females and leading cause of hysterectomy. Uterine artery embolization is a safe option for women who wish to retain their uterus. Several complications have been reported including expulsion and sepsis. MRI is a useful pretreatment tool to predict results and outcomes. We report a case of a 44-year-old female with a history of uterine fibroids with the largest one being intracavitary. Patient underwent uterine artery embolization that was complicated by endomyometritis that failed antibiotics, leading to sepsis and hysterectomy. PMID:27073705

  10. Uncommon Complication of Uterine Artery Embolization: Expulsion of Infarcted Myoma and Uterine Sepsis

    PubMed Central

    Martins, Juliana G.; Gaudenti, Dawn; Crespo, Frank; Ganesh, Dervi; Verma, Usha

    2016-01-01

    Uterine leiomyomas are the most common benign tumors in young females and leading cause of hysterectomy. Uterine artery embolization is a safe option for women who wish to retain their uterus. Several complications have been reported including expulsion and sepsis. MRI is a useful pretreatment tool to predict results and outcomes. We report a case of a 44-year-old female with a history of uterine fibroids with the largest one being intracavitary. Patient underwent uterine artery embolization that was complicated by endomyometritis that failed antibiotics, leading to sepsis and hysterectomy. PMID:27073705

  11. Uterine Serous Adenocarcinoma in an Elderly Postmenopausal Woman: Clinically Misdiagnosed as Uterine Cervix Cancer

    PubMed Central

    Hong, Jeong-A; Lee, Hae-Hyeog; Chung, Soo-Ho; Heo, Gyeong-Eun; Jeon, Dong-Su; Kwak, Jeong Ja; Choi, Seung Do; Han, Eunkyung

    2015-01-01

    Uterine serous adenocarcinoma (USC) is rare and invasive cancer. This cancer is more often reported in the ovary, the fallopian tube, and the endometrium than uterine cervix. No matter where the tumor is located, the tumor exhibits similar histological characteristics. So when uterine cancer is proven to be serous adenocarcinoma, it is necessary to see if the tumor originated from ovary or endometrium and invaded the cervix. We report a case of a 73-year-old postmenopausal woman with USC arising near the internal os of endocervical canal, clinically misdiagnosed as uterine cervix cancer. PMID:26793684

  12. Ultrasound diagnosis of uterine myomas.

    PubMed

    Fascilla, Fabiana D; Cramarossa, Paola; Cannone, Rossella; Olivieri, Claudiana; Vimercati, Antonella; Exacoustos, Caterina

    2016-06-01

    Myomas represent a large part of benign gynecological pathology, widely spread in fertile female population. First step to diagnose fibroids is ultrasound (US) that can be 2-dimensional (2D), 3-dimensional (3D), Color Doppler (CD) and sonohysterography (SHG). This review develops according to MUSA's sonographic features (Morphological Uterus Sonographic Assessment). One of the main topic of interest for ultrasonographer today is endo/myometrial junctional zone (JZ), because it may be useful to discern a diagnosis of myoma and adenomyosis. Another important aspect of ultrasound is the analysis of vascularization in front of a uterine lesion. Indeed, vascular pattern can be used to make differential diagnosis between myoma-adenomyosis and leiomyosarcomas. Myomas should be described accurately according to sonographic guidelines. Sonographic features correlated with symptoms should guide an appropriate surgical or medical treatment. PMID:27014801

  13. Uterine leiomyosarcoma and pyometra in a dog.

    PubMed

    Tsioli, V G; Gouletsou, P G; Loukopoulos, P; Zavlaris, M; Galatos, A D

    2011-02-01

    A seven-year-old entire female, mixed-breed dog, weighing 19 kg, was presented with a 2-day history of abdominal distension, reduced appetite and general dullness. Abdominal palpation revealed a large mass. Radiography showed a large mass occupying the left mid-abdominal area and convoluted loops of tubular fluid opacity occupying the right mid-abdominal area. Ultrasonography revealed a large heterogeneous mass with an anechoic area and some hyperechoic foci, indicative of calcification, in the mid-abdominal area. Furthermore, hypoechoic areas were found in the middle and caudal abdominal area and were presumed to be the fluid-filled uterine horns. At laparotomy, a 10·5×14·5-cm firm mass was found in the uterine body, while the uterine horns were filled with a thick red-brownish exudate; ovariohysterectomy was subsequently performed. A diagnosis of uterine leiomyosarcoma associated with pyometra was established by histopathology and immunohistochemistry. PMID:21265853

  14. Role of Medical Management for Uterine Leiomyomas.

    PubMed

    Kashani, Banafsheh N; Centini, Gabriele; Morelli, Sara S; Weiss, Gerson; Petraglia, Felice

    2016-07-01

    Uterine leiomyomas, or fibroids, are the most common benign tumor in reproductive aged women. Affected women may remain asymptomatic or may report symptoms related to abnormal uterine bleeding, infertility, or pelvic pain and pressure. Depending on a patient's symptomatology and reproductive plans, treatment options include expectant management, medical management (hormonal and non-hormonal), or surgical management (myomectomy or hysterectomy). In those wishing to defer surgical management, non-hormonal therapies such as non-steroidal anti-inflammatory drugs and tranexamic acid have been shown to decrease menstrual blood loss. In patients with more symptomatic leiomyomas, hormonal therapies such as gonadotropin-releasing hormone agonists and selective progesterone receptor modulators are effective at reducing leiomyoma volume, uterine size, and menstrual blood loss. This manuscript will detail the available and emerging hormonal and non-hormonal treatments for symptomatic uterine leiomyomas. PMID:26796059

  15. Uterine torsion in pregnancy. Case Report.

    PubMed

    Vavrinkova, Blanka; Binder, Tomas

    2015-01-01

    This paper describes a case of uterine torsion not only around the long, but also the horizontal axis, diagnosed post-operatively. The patient was 28-years-old, II/I in the 34th week of her gravidity. She was admitted due to amniotic fluid leak. Due to unsuccessful delivery induction using prostaglandins, a caesarean section was indicated to end the gravidity. Uterine torsion 180° around the longitudinal axis and 90° around the transversal axis was diagnosed during the surgery. The uterine wound was treated in accordance with guidelines and the patient was dismissed in a good condition. Control hysteroscopy and laparoscopy done after a time interval showed problem-free healing of the wound in the posterior uterine wall.

  16. The Phenotype of Spontaneous Preterm Birth: Application of a Clinical Phenotyping Tool

    PubMed Central

    Manuck, Tracy A.; Esplin, M. Sean; Biggio, Joseph; Bukowski, Radek; Parry, Samuel; Zhang, Heping; Varner, Michael W.; Andrews, William; Saade, George; Sadovsky, Yoel; Reddy, Uma M.; Ilekis, John

    2015-01-01

    Objective Spontaneous preterm birth (SPTB) is a complex condition that is likely a final common pathway with multiple possible etiologies. We hypothesized that a comprehensive classification system could appropriately group women with similar STPB etiologies, and provide an explanation, at least in part, for the disparities in SPTB associated with race and gestational age at delivery. Study Design Planned analysis of a multicenter, prospective study of singleton SPTB. Women with SPTB < 34 weeks were included. We defined 9 potential SPTB phenotypes based on clinical data, including infection/inflammation, maternal stress, decidual hemorrhage, uterine distention, cervical insufficiency, placental dysfunction, premature rupture of the membranes, maternal comorbidities, and familial factors. Each woman was evaluated for each phenotype. Delivery gestational age was compared between those with and without each phenotype. Phenotype profiles were also compared between women with very early (20.0–27.9 weeks) SPTB vs. those with early SPTB (28.0–34.0 weeks), and between African-American and Caucasian women. Statistical analysis was by t-test and chi-square as appropriate. Results The phenotyping tool was applied to 1025 women with SPTB who delivered at a mean 30.0 (+/− 3.2) weeks gestation. Of these, 800 (78%) had ≥2 phenotypes. Only 43 (4.2%) had no phenotypes. The 281 women with early SPTB were more likely to have infection/inflammation, decidual hemorrhage, and cervical insufficiency phenotypes (all p≤0.001). African-American women had more maternal stress and cervical insufficiency but less decidual hemorrhage and placental dysfunction compared to Caucasian women (all p<0.05). Gestational age at delivery decreased as the number of phenotypes present increased. Conclusions Precise SPTB phenotyping classifies women with SPTB and identifies specific differences between very early and early SPTB and between African-Americans and Caucasians. PMID:25687564

  17. Quadriceps and patellar tendon rupture.

    PubMed

    Ramseier, L E; Werner, C M L; Heinzelmann, M

    2006-06-01

    Ruptures of the patellar and/or quadriceps tendon are rare injuries that require immediate repair to re-establish knee extensor continuity and to allow early motion. We evaluated 36 consecutive patients with quadriceps or patellar tendon rupture between 1993 and 2000. There were 37 primary ruptures, 3 reruptures, 21 quadriceps and 19 patellar tendon ruptures. Follow up examination (>24 months postoperatively) included the patient's history, assessment of risk factors, clinical examination of both knees, isometric muscle strength measurements and three specific knee scores, Hospital for Special Surgery Score, Knee Society Score and Turba Score, and a short form SF-36. We evaluated 29 patients (26 men) with 33 ruptures (16 patellar tendon, 17 quadriceps tendon). Seven patients were lost to follow up. We found no difference between the range of motion and muscle strength when the injured leg was compared to the non-injured leg. Risk factors did not influence the four scores, patient satisfaction, pain, muscle strength or range of motion. Multiple injured patients had a significant reduction in muscle strength and circumference, however patient satisfaction did not differ to the non-multiple injured patient group.

  18. In silico synchronization reveals regulators of nuclear ruptures in lamin A/C deficient model cells.

    PubMed

    Robijns, J; Molenberghs, F; Sieprath, T; Corne, T D J; Verschuuren, M; De Vos, W H

    2016-01-01

    The nuclear lamina is a critical regulator of nuclear structure and function. Nuclei from laminopathy patient cells experience repetitive disruptions of the nuclear envelope, causing transient intermingling of nuclear and cytoplasmic components. The exact causes and consequences of these events are not fully understood, but their stochastic occurrence complicates in-depth analyses. To resolve this, we have established a method that enables quantitative investigation of spontaneous nuclear ruptures, based on co-expression of a firmly bound nuclear reference marker and a fluorescent protein that shuttles between the nucleus and cytoplasm during ruptures. Minimally invasive imaging of both reporters, combined with automated tracking and in silico synchronization of individual rupture events, allowed extracting information on rupture frequency and recovery kinetics. Using this approach, we found that rupture frequency correlates inversely with lamin A/C levels, and can be reduced in genome-edited LMNA knockout cells by blocking actomyosin contractility or inhibiting the acetyl-transferase protein NAT10. Nuclear signal recovery followed a kinetic that is co-determined by the severity of the rupture event, and could be prolonged by knockdown of the ESCRT-III complex component CHMP4B. In conclusion, our approach reveals regulators of nuclear rupture induction and repair, which may have critical roles in disease development.

  19. In silico synchronization reveals regulators of nuclear ruptures in lamin A/C deficient model cells

    PubMed Central

    Robijns, J.; Molenberghs, F.; Sieprath, T.; Corne, T. D. J.; Verschuuren, M.; De Vos, W. H.

    2016-01-01

    The nuclear lamina is a critical regulator of nuclear structure and function. Nuclei from laminopathy patient cells experience repetitive disruptions of the nuclear envelope, causing transient intermingling of nuclear and cytoplasmic components. The exact causes and consequences of these events are not fully understood, but their stochastic occurrence complicates in-depth analyses. To resolve this, we have established a method that enables quantitative investigation of spontaneous nuclear ruptures, based on co-expression of a firmly bound nuclear reference marker and a fluorescent protein that shuttles between the nucleus and cytoplasm during ruptures. Minimally invasive imaging of both reporters, combined with automated tracking and in silico synchronization of individual rupture events, allowed extracting information on rupture frequency and recovery kinetics. Using this approach, we found that rupture frequency correlates inversely with lamin A/C levels, and can be reduced in genome-edited LMNA knockout cells by blocking actomyosin contractility or inhibiting the acetyl-transferase protein NAT10. Nuclear signal recovery followed a kinetic that is co-determined by the severity of the rupture event, and could be prolonged by knockdown of the ESCRT-III complex component CHMP4B. In conclusion, our approach reveals regulators of nuclear rupture induction and repair, which may have critical roles in disease development. PMID:27461848

  20. In silico synchronization reveals regulators of nuclear ruptures in lamin A/C deficient model cells

    NASA Astrophysics Data System (ADS)

    Robijns, J.; Molenberghs, F.; Sieprath, T.; Corne, T. D. J.; Verschuuren, M.; de Vos, W. H.

    2016-07-01

    The nuclear lamina is a critical regulator of nuclear structure and function. Nuclei from laminopathy patient cells experience repetitive disruptions of the nuclear envelope, causing transient intermingling of nuclear and cytoplasmic components. The exact causes and consequences of these events are not fully understood, but their stochastic occurrence complicates in-depth analyses. To resolve this, we have established a method that enables quantitative investigation of spontaneous nuclear ruptures, based on co-expression of a firmly bound nuclear reference marker and a fluorescent protein that shuttles between the nucleus and cytoplasm during ruptures. Minimally invasive imaging of both reporters, combined with automated tracking and in silico synchronization of individual rupture events, allowed extracting information on rupture frequency and recovery kinetics. Using this approach, we found that rupture frequency correlates inversely with lamin A/C levels, and can be reduced in genome-edited LMNA knockout cells by blocking actomyosin contractility or inhibiting the acetyl-transferase protein NAT10. Nuclear signal recovery followed a kinetic that is co-determined by the severity of the rupture event, and could be prolonged by knockdown of the ESCRT-III complex component CHMP4B. In conclusion, our approach reveals regulators of nuclear rupture induction and repair, which may have critical roles in disease development.

  1. Breaking of a single asperity: Rupture process and seismic radiation

    NASA Astrophysics Data System (ADS)

    Das, S.; Kostrov, B. V.

    1983-05-01

    The problem of spontaneous shear rupture of a single circular asperity on an infinite fault plane is studied. Initially, the fault plane is broken everywhere except at a circular asperity. An applied displacement at infinity results in a stress concentration along the bounding edge of the asperity. The frictional stress on the broken part of the fault plane is taken to be a constant. Once a point on the asperity breaks, the stress there drops to the same value as on the `main' fault surface. The rupture is started by relaxing the shear stress at a point on the asperity edge and is then allowed to propagate spontaneously, using a critical stress level fracture criterion. The rupture process is calculated numerically. It is found that for asperities of constant strength, the rupture first propagates around the edge of the asperity and then inward, a phenomenon best described by the well-known term of classic military maneuver: `the double encircling pincer movement.' In the appendix, the expressions for the far-field seismic radiation due to the rupture of such an asperity are derived. It is shown that the nth Cartesian component of the far-field displacement at (x, t) for P, SV, and SH waves, using the notation of Aki and Richards (1980), is given by un(x, t) = (Dni/4πρc2R)∫∫s0τi3{ξ, t - [(R - ξ · γ)/c]} dS(ξ). Thus the far-field pulses can be directly found from the stress drops on the fault plane. This formula is also true for `crack' or `dislocation' problems. The directivity function Dni for displacement for the asperity problem is found to be that for the double couple, modified by some factor. In particular, the fault plane is a nodal plane for SV waves. For the rupturing of asperities on a finite fault, these directivity functions are applicable only to the initial part of observed pulses at a receiver, provided the receiver is not located on the fault plane outside the broken part of the main crack edge, in which case it is inapplicable for all

  2. Spontaneous intrathyroidal hematoma causing airway obstruction

    PubMed Central

    Best, Corliss A.E.; Dhaliwal, Sandeep; Tam, Samantha; Low, T. Hubert; Hughes, Brian; Fung, Kevin; MacNeil, S. Danielle

    2016-01-01

    Abstract Introduction: Spontaneous thyroid hemorrhage is a rare occurrence that results in pain, discomfort, and occasionally compressive symptoms. Infrequently, extensive thyroid hemorrhage can result in a rapidly expanding hematoma resulting in airway compromise. This is a case of an otherwise healthy young woman, 3 months postpartum, with a slowly expanding spontaneous thyroid hemorrhage that measured at 7 × 5.5 × 5 cm by computed tomography. She ultimately required intubation to manage respiratory distress and subsequently a hemithyroidectomy for definitive treatment. The case presentation is followed by a literature review where known etiologies of thyroid hematoma including traumatic and nontraumatic causes, precipitating anticoagulation, and spontaneous rupture of branches of the external carotid artery are outlined. The potential links to pregnancy are explored. The roles of bedside thyroid ultrasound in the emergency department and lateral neck roentgenogram in diagnosis are explored. The importance of airway management and indications for conservative versus surgical treatments are discussed. Conclusions: This is a case of a spontaneous intrathyroidal hemorrhage, which progressed over days to ultimately cause airway compromise. It is imperative that physicians are educated on the appropriate detection and management of the potentially life-threatening spontaneous thyroid hematoma. PMID:27583841

  3. Potential Therapeutic Targets in Uterine Sarcomas

    PubMed Central

    Cuppens, Tine; Tuyaerts, Sandra; Amant, Frédéric

    2015-01-01

    Uterine sarcomas are rare tumors accounting for 3,4% of all uterine cancers. Even after radical hysterectomy, most patients relapse or present with distant metastases. The very limited clinical benefit of adjuvant cytotoxic treatments is reflected by high mortality rates, emphasizing the need for new treatment strategies. This review summarizes rising potential targets in four distinct subtypes of uterine sarcomas: leiomyosarcoma, low-grade and high-grade endometrial stromal sarcoma, and undifferentiated uterine sarcoma. Based on clinical reports, promising approaches for uterine leiomyosarcoma patients include inhibition of VEGF and mTOR signaling, preferably in combination with other targeted or cytotoxic compounds. Currently, the only targeted therapy approved in leiomyosarcoma patients is pazopanib, a multitargeted inhibitor blocking VEGFR, PDGFR, FGFR, and c-KIT. Additionally, preclinical evidence suggests effect of the inhibition of histone deacetylases, tyrosine kinase receptors, and the mitotic checkpoint protein aurora kinase A. In low-grade endometrial stromal sarcomas, antihormonal therapies including aromatase inhibitors and progestins have proven activity. Other potential targets are PDGFR, VEGFR, and histone deacetylases. In high-grade ESS that carry the YWHAE/FAM22A/B fusion gene, the generated 14-3-3 oncoprotein is a putative target, next to c-KIT and the Wnt pathway. The observation of heterogeneity within uterine sarcoma subtypes warrants a personalized treatment approach. PMID:26576131

  4. Uterine sarcomas: clinical presentation and MRI features

    PubMed Central

    Santos, Pedro; Cunha, Teresa Margarida

    2015-01-01

    Uterine sarcomas are a rare heterogeneous group of tumors of mesenchymal origin, accounting for approximately 8% of uterine malignancies. They comprise leiomyosarcoma, endometrial stromal sarcoma, undifferentiated endometrial sarcoma, and adenosarcoma. Compared with the more common endometrial carcinomas, uterine sarcomas behave more aggressively and are associated with a poorer prognosis. Due to their distinct clinical and biological behavior, the International Federation of Gynecology and Obstetrics introduced a new staging system for uterine sarcomas in 2009, categorizing uterine carcinosarcoma as a variant of endometrial carcinoma, rather than a pure sarcoma. Magnetic resonance imaging (MRI) has a developing role in the assessment of these malignancies. Features such as tumor localization, irregular or nodular margins, necrosis, rapid growth, intense contrast enhancement, and restriction at diffusion-weighted imaging can suggest the diagnosis and help differentiate from more common leiomyomas and endometrial carcinoma. MRI is therefore extremely useful in preoperative detection and staging and, consequently, in determination of appropriate management. This pictorial review aims to discuss the clinical features of uterine sarcomas, as well as their most common appearances and distinct characteristics in MRI. PMID:25347940

  5. Uterine disorders in 50 pet rabbits.

    PubMed

    Künzel, Frank; Grinninger, Petra; Shibly, Sarina; Hassan, Jasmin; Tichy, Alexander; Berghold, Petra; Fuchs-Baumgartinger, Andrea

    2015-01-01

    Although the incidence of uterine disorders in pet rabbits is high there are only a few retrospective studies and case reports on genital tract disease in female rabbits. Uterine disorders were assessed in 50 pet rabbits. In 31 pet rabbits with suspected clinical uterine disease, medical records were further reviewed regarding clinical signs, diagnostic workup, treatment as well as the outcome itself. Uterine adenocarcinoma (54%) was most frequently diagnosed, followed by endometrial hyperplasia (26%). Serosanguineous vaginal discharge was the predominant clinical sign observed by the rabbit owners. In approximately 50% of the rabbits with suspected uterine disorders, abdominal palpation revealed enlarged and/or irregular masses in the caudoventral abdomen indicating uterine lesions. Out of 23 rabbits undergoing ovariohysterectomy, four were either euthanized or died shortly after surgery because they were clinically unstable. Overall, 80% of the ovariohysterectomized animals were still alive 6 mo after surgery. In female pet rabbits that are not breeding, either ovariohysterectomy should be performed at an early age or routine checks including ultrasonography of the abdomen are recommended on a regular basis.

  6. Synergy and interactions among biological pathways leading to preterm premature rupture of membranes.

    PubMed

    Lannon, Sophia M R; Vanderhoeven, Jeroen P; Eschenbach, David A; Gravett, Michael G; Adams Waldorf, Kristina M

    2014-10-01

    Preterm premature rupture of membranes (PPROM) occurs in 1% to 2% of births. Impact of PPROM is greatest in low- and middle-income countries where prematurity-related deaths are most common. Recent investigations identify cytokine and matrix metalloproteinase activation, oxidative stress, and apoptosis as primary pathways to PPROM. These biological processes are initiated by heterogeneous etiologies including infection/inflammation, placental bleeding, uterine overdistention, and genetic polymorphisms. We hypothesize that pathways to PPROM overlap and act synergistically to weaken membranes. We focus our discussion on membrane composition and strength, pathways linking risk factors to membrane weakening, and future research directions to reduce the global burden of PPROM.

  7. Increased contraction frequency in rat uterine strips treated in vitro with o,p prime -DDT

    SciTech Connect

    Juberg, D.R.; Loch-Caruso, R. )

    1991-05-01

    Elevated levels of DDT and other organochlorine pesticides have been associated with spontaneous abortion and preterm birth in several species, including humans. Despite the prevalence of organochlorine pesticides in the environment, a mechanistic basis for this association has not been explored. Furthermore, while DDT has been associated with inhibition of calcium ATPases, altered gap junctional communication and electrophysiological changes, all of which could affect the excitation-contraction process characteristic of smooth muscle, direct effects of DDT on uterine smooth muscle have not been reported. This study was initiated to assess the direct effects of o,p{prime}-DDT (an estrogenic isomer present in the technical grade preparation) on pregnant rat uterine tissue.

  8. Dynamic Rupture Benchmarking of the ADER-DG Method

    NASA Astrophysics Data System (ADS)

    Pelties, C.; Gabriel, A.

    2012-12-01

    We will verify the arbitrary high-order derivative Discontinuous Galerkin (ADER-DG) method in various test cases of the 'SCEC/USGS Dynamic Earthquake Rupture Code Verification Exercise' benchmark suite (Harris et al. 2009). The ADER-DG scheme is able to solve the spontaneous rupture problem with high-order accuracy in space and time on three-dimensional unstructured tetrahedral meshes. Strong mesh coarsening or refinement at areas of interest can be applied to keep the computational costs feasible. Moreover, the method does not generate spurious high-frequency contributions in the slip rate spectra and therefore does not require any artificial damping as demonstrated in previous presentations and publications (Pelties et al. 2010 and 2012). We will show that the mentioned features hold also for more advanced setups as e.g. a branching fault system, heterogeneous background stresses and bimaterial faults. The advanced geometrical flexibility combined with an enhanced accuracy will make the ADER-DG method a useful tool to study earthquake dynamics on complex fault systems in realistic rheologies. References: Harris, R.A., M. Barall, R. Archuleta, B. Aagaard, J.-P. Ampuero, H. Bhat, V. Cruz-Atienza, L. Dalguer, P. Dawson, S. Day, B. Duan, E. Dunham, G. Ely, Y. Kaneko, Y. Kase, N. Lapusta, Y. Liu, S. Ma, D. Oglesby, K. Olsen, A. Pitarka, S. Song, and E. Templeton, The SCEC/USGS Dynamic Earthquake Rupture Code Verification Exercise, Seismological Research Letters, vol. 80, no. 1, pages 119-126, 2009 Pelties, C., J. de la Puente, and M. Kaeser, Dynamic Rupture Modeling in Three Dimensions on Unstructured Meshes Using a Discontinuous Galerkin Method, AGU 2010 Fall Meeting, abstract #S21C-2068 Pelties, C., J. de la Puente, J.-P. Ampuero, G. Brietzke, and M. Kaeser, Three-Dimensional Dynamic Rupture Simulation with a High-order Discontinuous Galerkin Method on Unstructured Tetrahedral Meshes, JGR. - Solid Earth, VOL. 117, B02309, 2012

  9. Dynamic Rupture Benchmarking of the ADER-DG Method

    NASA Astrophysics Data System (ADS)

    Gabriel, Alice; Pelties, Christian

    2013-04-01

    We will verify the arbitrary high-order derivative Discontinuous Galerkin (ADER-DG) method in various test cases of the 'SCEC/USGS Dynamic Earthquake Rupture Code Verification Exercise' benchmark suite (Harris et al. 2009). The ADER-DG scheme is able to solve the spontaneous rupture problem with high-order accuracy in space and time on three-dimensional unstructured tetrahedral meshes. Strong mesh coarsening or refinement at areas of interest can be applied to keep the computational costs feasible. Moreover, the method does not generate spurious high-frequency contributions in the slip rate spectra and therefore does not require any artificial damping as demonstrated in previous presentations and publications (Pelties et al. 2010 and 2012). We will show that the mentioned features hold also for more advanced setups as e.g. a branching fault system, heterogeneous background stresses and bimaterial faults. The advanced geometrical flexibility combined with an enhanced accuracy will make the ADER-DG method a useful tool to study earthquake dynamics on complex fault systems in realistic rheologies. References: Harris, R.A., M. Barall, R. Archuleta, B. Aagaard, J.-P. Ampuero, H. Bhat, V. Cruz-Atienza, L. Dalguer, P. Dawson, S. Day, B. Duan, E. Dunham, G. Ely, Y. Kaneko, Y. Kase, N. Lapusta, Y. Liu, S. Ma, D. Oglesby, K. Olsen, A. Pitarka, S. Song, and E. Templeton, The SCEC/USGS Dynamic Earthquake Rupture Code Verification Exercise, Seismological Research Letters, vol. 80, no. 1, pages 119-126, 2009 Pelties, C., J. de la Puente, and M. Kaeser, Dynamic Rupture Modeling in Three Dimensions on Unstructured Meshes Using a Discontinuous Galerkin Method, AGU 2010 Fall Meeting, abstract #S21C-2068 Pelties, C., J. de la Puente, J.-P. Ampuero, G. Brietzke, and M. Kaeser, Three-Dimensional Dynamic Rupture Simulation with a High-order Discontinuous Galerkin Method on Unstructured Tetrahedral Meshes, JGR. - Solid Earth, VOL. 117, B02309, 2012

  10. Self-Rupturing Hermetic Valve

    NASA Technical Reports Server (NTRS)

    Tucker, Curtis E., Jr.; Sherrit, Stewart

    2011-01-01

    For commercial, military, and aerospace applications, low-cost, small, reliable, and lightweight gas and liquid hermetically sealed valves with post initiation on/off capability are highly desirable for pressurized systems. Applications include remote fire suppression, single-use system-pressurization systems, spacecraft propellant systems, and in situ instruments. Current pyrotechnic- activated rupture disk hermetic valves were designed for physically larger systems and are heavy and integrate poorly with portable equipment, aircraft, and small spacecraft and instrument systems. Additionally, current pyrotechnically activated systems impart high g-force shock loads to surrounding components and structures, which increase the risk of damage and can require additional mitigation. The disclosed mechanism addresses the need for producing a hermetically sealed micro-isolation valve for low and high pressure for commercial, aerospace, and spacecraft applications. High-precision electrical discharge machining (EDM) parts allow for the machining of mated parts with gaps less than a thousandth of an inch. These high-precision parts are used to support against pressure and extrusion, a thin hermetically welded diaphragm. This diaphragm ruptures from a pressure differential when the support is removed and/or when the plunger is forced against the diaphragm. With the addition of conventional seals to the plunger and a two-way actuator, a derivative of this design would allow nonhermetic use as an on/off or metering valve after the initial rupturing of the hermetic sealing disk. In addition, in a single-use hermetically sealed isolation valve, the valve can be activated without the use of potential leak-inducing valve body penetrations. One implementation of this technology is a high-pressure, high-flow-rate rupture valve that is self-rupturing, which is advantageous for high-pressure applications such as gas isolation valves. Once initiated, this technology is self

  11. Enzymatically triggered rupture of polymersomes.

    PubMed

    Jang, Woo-Sik; Park, Seung Chul; Reed, Ellen H; Dooley, Kevin P; Wheeler, Samuel F; Lee, Daeyeon; Hammer, Daniel A

    2016-01-28

    Polymersomes are robust vesicles made from amphiphilic block co-polymers. Large populations of uniform giant polymersomes with defined, entrapped species can be made by templating of double-emulsions using microfluidics. In the present study, a series of two enzymatic reactions, one inside and the other outside of the polymersome, were designed to induce rupture of polymersomes. We measured how the kinetics of rupture were affected by altering enzyme concentration. These results suggest that protocells with entrapped enzymes can be engineered to secrete contents on cue.

  12. STAT3 accelerates uterine epithelial regeneration in a mouse model of decellularized uterine matrix transplantation

    PubMed Central

    Hiraoka, Takehiro; Saito-Fujita, Tomoko; Matsuo, Mitsunori; Egashira, Mahiro; Matsumoto, Leona; Haraguchi, Hirofumi; Dey, Sudhansu K.; Furukawa, Katsuko S.; Fujii, Tomoyuki; Osuga, Yutaka

    2016-01-01

    Although a close connection between uterine regeneration and successful pregnancy in both humans and mice has been consistently observed, its molecular basis remains unclear. We here established a mouse model of decellularized uterine matrix (DUM) transplantation. Resected mouse uteri were processed with SDS to make DUMs without any intact cells. DUMs were transplanted into the mouse uteri with artificially induced defects, and all the uterine layers were recovered at the DUM transplantation sites within a month. In the regenerated uteri, normal hormone responsiveness in early pregnancy was observed, suggesting the regeneration of functional uteri. Uterine epithelial cells rapidly migrated and formed a normal uterine epithelial layer within a week, indicating a robust epithelial-regenerating capacity. Stromal and myometrial regeneration occurred following epithelial regeneration. In ovariectomized mice, uterine regeneration of the DUM transplantation was similarly observed, suggesting that ovarian hormones are not essential for this regeneration process. Importantly, the regenerating epithelium around the DUM demonstrated heightened STAT3 phosphorylation and cell proliferation, which was suppressed in uteri of Stat3 conditional knockout mice. These data suggest a key role of STAT3 in the initial step of the uterine regeneration process. The DUM transplantation model is a powerful tool for uterine regeneration research. PMID:27358915

  13. Uterine distension differentially affects remodelling and distensibility of the uterine vasculature in non-pregnant rats.

    PubMed

    Osol, George; Barron, Carolyn; Mandalà, Maurizio

    2012-01-01

    During pregnancy the mammalian uterine circulation undergoes significant expansive remodelling necessary for normal pregnancy outcome. The underlying mechanisms are poorly defined. The goal of this study was to test the hypothesis that myometrial stretch actively stimulates uterine vascular remodelling by developing a new surgical approach to induce unilateral uterine distension in non-pregnant rats. Three weeks after surgery, which consisted of an infusion of medical-grade silicone into the uterine lumen, main and mesometrial uterine artery and vein length, diameter and distensibility were recorded. Radial artery diameter, distensibility and vascular smooth muscle mitotic rate (Ki67 staining) were also measured. Unilateral uterine distension resulted in significant increases in the length of main uterine artery and vein and mesometrial segments but had no effect on vessel diameter or distensibility. In contrast, there were significant increases in the diameter of the radial arteries associated with the distended uterus. These changes were accompanied by reduced arterial distensibility and increased vascular muscle hyperplasia. In summary, this is the first report to show that myometrial stretch is a sufficient stimulus to induce significant remodelling of uterine vessels in non-pregnant rats. Moreover, the results indicate differential regulation of these growth processes as a function of vessel size and type.

  14. Uterine sarcoma Part I-Uterine leiomyosarcoma: The Topic Advisory Group systematic review.

    PubMed

    Wen, Kuo-Chang; Horng, Huann-Cheng; Wang, Peng-Hui; Chen, Yi-Jen; Yen, Ming-Shyen; Ng, Heung-Tat

    2016-08-01

    Uterine sarcomas account for 3-7% of all uterine cancers. Because of their rarity, unknown etiology, and highly divergent genetic aberration, there is a lack of consensus on risk factors for occurrence and predictive poor outcomes as well as optimal therapeutic choices. Tumor types according to the World Health Organization classification include leiomyosarcoma, endometrial stroma sarcoma, and undifferentiated sarcoma. Staging is done using the 2014 Federation International Gynecology and Obstetrics and 2010 American Joint Committee on Cancer tumor, lymph node, and metastases systems. Tumor grade can be classified based on the French Federation of Cancer Centers Sarcoma Group system or the Broder's system that incorporates tumor differentiation, mitotic count, and tumor necrosis. This review is a series of articles discussing uterine sarcoma, and this is Part I, which focuses on one of the subtypes of uterine sarcomas-uterine leiomyosarcoma. The clinical characteristics, diagnosis, outcome, and recent advances are summarized in this article. PMID:27590365

  15. Uterine Artery Embolization to Treat Uterine Adenomyosis with or without Uterine Leiomyomata: Results of Symptom Control and Health-Related Quality of Life 40 Months after Treatment

    SciTech Connect

    Froeling, V. Scheurig-Muenkler, C. Hamm, B. Kroencke, T. J.

    2012-06-15

    Purpose: To evaluate the clinical outcome for uterine adenomyosis with or without uterine leiomyomata 40 months after uterine artery embolization (UAE). Methods: Forty women aged 39-56 years (median 46 years) with symptomatic uterine adenomyosis and magnetic resonance imaging findings of uterine adenomyosis with or without combined uterine leiomyomata underwent UAE. Self-perceived changes in clinical symptoms were assessed, and residual symptom severity and health-related quality of life (HRQOL) after UAE were evaluated. Clinical failure was defined as no symptomatic improvement or second invasive therapy after UAE. Results were stratified by the extent of uterine adenomyosis at baseline magnetic resonance imaging. Results: Patients were followed for a median of 40 months (range 5-102 months). UAE led to symptomatic control after UAE in 29 (72.5%) of 40 patients while 11 women underwent hysterectomy (n = 10) or dilatation and curettage (n = 1) for therapy failure. No significant difference between women with pure uterine adenoymosis and women with uterine adenomyosis combined with uterine leiomyomata was observed. Best results were shown for UAE in uterine adenomyosis with uterine leiomyomata predominance as opposed to predominant uterine adenomyosis with minor fibroid disease (clinical failure 0% vs. 31.5%, P = 0.058). Throughout the study group, HRQOL score values increased and symptom severity scores decreased after UAE. Least improvement was noted for women with pure adenomyosis. Conclusions: UAE is clinically effective in the long term in most women with uterine adenomyosis. Symptomatic control and HRQOL were highest in patients with combined disease of uterine adenomyosis but leiomyomata predominance.

  16. Kinetics of the multistep rupture of fibrin 'A-a' polymerization interactions measured using atomic force microscopy.

    PubMed

    Averett, Laurel E; Schoenfisch, Mark H; Akhremitchev, Boris B; Gorkun, Oleg V

    2009-11-18

    Fibrin, the structural scaffold of blood clots, spontaneously polymerizes through the formation of 'A-a' knob-hole bonds. When subjected to external force, the dissociation of this bond is accompanied by two to four abrupt changes in molecular dimension observable as rupture events in a force curve. Herein, the configuration, molecular extension, and kinetic parameters of each rupture event are examined. The increases in contour length indicate that the D region of fibrinogen can lengthen by approximately 50% of the length of a fibrin monomer before rupture of the 'A-a' interaction. The dependence of the dissociation rate on applied force was obtained using probability distributions of rupture forces collected at different pull-off velocities. These distributions were fit using a model in which the effects of the shape of the binding potential are used to quantify the kinetic parameters of forced dissociation. We found that the weak initial rupture (i.e., event 1) was not well approximated by these models. The ruptured bonds comprising the strongest ruptures, events 2 and 3, had kinetic parameters similar to those commonly found for the mechanical unfolding of globular proteins. The bonds ruptured in event 4 were well described by these analyses, but were more loosely bound than the bonds in events 2 and 3. We propose that the first event represents the rupture of an unknown interaction parallel to the 'A-a' bond, events 2 and 3 represent unfolding of structures in the D region of fibrinogen, and event 4 is the rupture of the 'A-a' knob-hole bond weakened by prior structural unfolding. Comparison of the activation energy obtained via force spectroscopy measurements with the thermodynamic free energy of 'A-a' bond dissociation indicates that the 'A-a' bond may be more resistant to rupture by applied force than to rupture by thermal dissociation.

  17. Coupling a geodynamic seismic cycling model to rupture dynamic simulations

    NASA Astrophysics Data System (ADS)

    Gabriel, Alice; van Dinther, Ylona

    2014-05-01

    The relevance and results of dynamic rupture scenarios are implicitly linked to the geometry and pre-existing stress and strength state on a fault. The absolute stresses stored along faults during interseismic periods, are largely unquantifiable. They are, however, pivotal in defining coseismic rupture styles, near-field ground motion, and macroscopic source properties (Gabriel et al., 2012). Obtaining these in a physically consistent manner requires seismic cycling models, which directly couple long-term deformation processes (over 1000 year periods), the self-consistent development of faults, and the resulting dynamic ruptures. One promising approach to study seismic cycling enables both the generation of spontaneous fault geometries and the development of thermo-mechanically consistent fault stresses. This seismo-thermo-mechanical model has been developed using a methodology similar to that employed to study long-term lithospheric deformation (van Dinther et al., 2013a,b, using I2ELVIS of Gerya and Yuen, 2007). We will innovatively include the absolute stress and strength values along physically consistent evolving non-finite fault zones (regions of strain accumulation) from the geodynamic model into dynamic rupture simulations as an initial condition. The dynamic rupture simulations will be performed using SeisSol, an arbitrary high-order derivative Discontinuous Galerkin (ADER-DG) scheme (Pelties et al., 2012). The dynamic rupture models are able to incorporate the large degree of fault geometry complexity arising in naturally evolving geodynamic models. We focus on subduction zone settings with and without a splay fault. Due to the novelty of the coupling, we first focus on methodological challenges, e.g. the synchronization of both methods regarding the nucleation of events, the localization of fault planes, and the incorporation of similar frictional constitutive relations. We then study the importance of physically consistent fault stress, strength, and

  18. Alterations in uterine hemodynamics caused by uterine fibroids and their impact on in vitro fertilization outcomes

    PubMed Central

    Moon, Jei-Won; Kim, Jun-Bum; Kim, Sung-Hoon; Chae, Hee-Dong; Kang, Byung-Moon

    2015-01-01

    Objective To investigate the impact of fibroids on the blood flow of the uterine and subendometrial arteries and in vitro fertilization (IVF) outcomes. Methods In this study, we analyzed 86 IVF/intracytoplasmic sperm injection (ICSI) cycles in which a gonadotropin-releasing hormone antagonist protocol was used for controlled ovarian stimulation between January 2008 and March 2009. The subjects comprised 86 infertile women with (fibroid group, n=43) or without (control group, n=43) uterine fibroids. Results Patient characteristics were similar between the fibroid and control groups. The IVF/ICSI outcomes in patients with fibroids were similar to those of patients in the control group. The resistance index (RI) and pulsatile index (PI) of the uterine and subendometrial arteries on the day of embryo transfer were also comparable between the two groups. IVF outcomes and uterine hemodynamics in patients with multiple (≥2) fibroids were similar to those of patients with a single fibroid. However, clinical pregnancy and implantation rates were significantly lower in patients with fibroids who experienced uterine cavity distortion than in patients with fibroids who had a normal uterine cavity (both p<0.05). The RI and PI of the subendometrial artery were significantly higher on the day of embryo transfer in patients with fibroids who experienced uterine cavity distortion than in patients with fibroids who had a normal uterine cavity (both p<0.05). Conclusion Fibroids which distorting the uterine cavity might impair the subendometrial artery blood flow clinical pregnancy rate and embryo implantation rate in infertile patients undergoing IVF. Otherwise, IVF outcomes were not influenced by the presence of uterine fibroids. PMID:26816875

  19. Relationship of uterine artery with ureter.

    PubMed

    Ara, Z G; Khalil, M; Rahman, M H; Mannan, S; Sultana, S Z; Rahman, M M; Ahmed, M S; Zaman, K S; Islam, M S

    2008-07-01

    The study was done to see the relationship of right and left uterine artery with corresponding ureter. Their distance from lateral border of uterus and site of crossing in relation to internal os in Bangladeshi female were observed. Sixty post mortem specimens containing uterus, uterine tube, ureter and surrounding structures were collected from cadavers of different age groups and fixed in 10% formol saline solution. Gross and fine dissections were carried out to study the relationship and distance of uterine artery where it crosses the corresponding ureter and the site of crossing in relation to internal os. In the present study our findings were compared with those of the standard text books. In this study, there were no variations regarding relations of right and left uterine artery with corresponding ureter. In all cases of all age groups, ureters were found to cross the uterine artery anteriorly on both sides. Site of crossing of uterine artery of both sides with ureter at the level of internal os was 50% in 2-12 years (Group A) 20.45% in 13-45 years (Group B) and 12.50% in 46-80 years (Group C) age group. Below the level of the os was found in remaining cases except one which crosses above the level of the os in group B. In this study mean distance of uterine artery where it crosses the ureter from lateral border of uterus was more on right side in all age groups, which was 1.67 cm, 2.30 cm and 2.11 cm in age Group A, B & C respectively. PMID:18626447

  20. Uterine adenosarcomas are mesenchymal neoplasms.

    PubMed

    Piscuoglio, Salvatore; Burke, Kathleen A; Ng, Charlotte K Y; Papanastasiou, Anastasios D; Geyer, Felipe C; Macedo, Gabriel S; Martelotto, Luciano G; de Bruijn, Ino; De Filippo, Maria R; Schultheis, Anne M; Ioris, Rafael A; Levine, Douglas A; Soslow, Robert A; Rubin, Brian P; Reis-Filho, Jorge S; Weigelt, Britta

    2016-02-01

    Uterine adenosarcomas (UAs) are biphasic lesions composed of a malignant mesenchymal (ie stromal) component and an epithelial component. UAs are generally low-grade and have a favourable prognosis, but may display sarcomatous overgrowth (SO), which is associated with a worse outcome. We hypothesized that, akin to breast fibroepithelial lesions, UAs are mesenchymal neoplasms in which clonal somatic genetic alterations are restricted to the mesenchymal component. To characterize the somatic genetic alterations in UAs and to test this hypothesis, we subjected 20 UAs to a combination of whole-exome (n = 6), targeted capture (n = 13) massively parallel sequencing (MPS) and/or RNA sequencing (n = 6). Only three genes, FGFR2, KMT2C and DICER1, were recurrently mutated, all in 2/19 cases; however, 26% (5/19) and 21% (4/19) of UAs harboured MDM2/CDK4/HMGA2 and TERT gene amplification, respectively, and two cases harboured fusion genes involving NCOA family members. Using a combination of laser-capture microdissection and in situ techniques, we demonstrated that the somatic genetic alterations detected by MPS were restricted to the mesenchymal component. Furthermore, mitochondrial DNA sequencing of microdissected samples revealed that epithelial and mesenchymal components of UAs were clonally unrelated. In conclusion, here we provide evidence that UAs are genetically heterogeneous lesions and mesenchymal neoplasms. PMID:26592504

  1. Self-healing slip pulses in dynamic rupture models due to velocity-dependent strength

    USGS Publications Warehouse

    Beeler, N.M.; Tullis, T.E.

    1996-01-01

    Seismological observations of short slip duration on faults (short rise time on seismograms) during earthquakes are not consistent with conventional crack models of dynamic rupture and fault slip. In these models, the leading edge of rupture stops only when a strong region is encountered, and slip at an interior point ceases only when waves from the stopped edge of slip propagate back to that point. In contrast, some seismological evidence suggests that the duration of slip is too short for waves to propagate from the nearest edge of the ruptured surface, perhaps even if the distance used is an asperity size instead of the entire rupture dimension. What controls slip duration, if not dimensions of the fault or of asperities? In this study, dynamic earthquake rupture and slip are represented by a propagating shear crack. For all propagating shear cracks, slip velocity is highest near the rupture front, and at a small distance behind the rupture front, the slip velocity decreases. As pointed out by Heaton (1990), if the crack obeys a negative slip-rate-dependent strength relation, the lower slip velocity behind the rupture front will lead to strengthening that further reduces the velocity, and under certain circumstances, healing of slip can occur. The boundary element method of Hamano (1974) is used in a program adapted from Andrews (1985) for numerical simulations of mode II rupture with two different velocity-dependent strength functions. For the first function, after a slip-weakening displacement, the crack follows an exponential velocity-weakening relation. The characteristic velocity V0 of the exponential determines the magnitude of the velocity-dependence at dynamic velocities. The velocity-dependence at high velocity is essentially zero when V0 is small and the resulting slip velocity distribution is similar to slip weakening. If V0 is larger, rupture propagation initially resembles slip-weakening, but spontaneous healing occurs behind the rupture front. The

  2. [Role of embolization in the management of uterine fibroids].

    PubMed

    Kahn, V; Fohlen, A; Pelage, J-P

    2011-12-01

    demonstrate that in the short- and mid-term there is no difference in terms of control of menorrhagia and bulk-related symptoms. Uterine volume reduction and quality of life were not different at 6 months. Periprocedural and 30-day complication rates are not different. At 6 months, the rate of complications is higher after myomectomy. Reinterventions are more frequent after embolization compared to myomectomy. Hospital stay, duration of recovery and time off work are shorter after embolization compared to myomectomy. Embolization should be considered with caution in pregnancy-seeking women since there is still a lack of good quality data available in the specific group of patients. FSH level is more frequently elevated after embolization compared to myomectomy. Pregnancy rate and term pregnancy rate are higher after myomectomy compared to embolization. Spontaneous abortion is more frequent after embolization than after myomectomy. There is no difference between embolization and myomectomy for the rates of pre-term delivery, cesarean section, post-partum hemorrhage, pre-eclampsia or intra-uterine growth retardation. Embolization performed before myomectomy (preoperative or combined procedures) can be discussed for an individual patient but there is not enough data to support its routine use.

  3. Spontaneous intra-hepatic haemorrhage in a patient with fever of unknown origin.

    PubMed

    Leung, Vincent K S; Lam, Clement Y W; Chan, C C; Ng, W L; Loke, Tony K L; Luk, I Sc; Chau, T N; Wu, Arthur H W; Fong, W N; Lam, S H

    2007-08-01

    Polyarteritis nodosa is a systemic necrotising vasculitis that affects the small- and medium-sized arteries. Multifocal aneurysmal formation in the renal, hepatic, and mesenteric vasculature is a hallmark of this condition, and spontaneous aneurysmal rupture may occur, resulting in life-threatening haemorrhage. We describe a 42-year-old man who initially presented with fever of unknown origin. A diagnosis could not be reached at that time despite extensive investigations. The fever subsided spontaneously after 8 weeks, and the patient remained well for 6 years until he was admitted again for evaluation of fever. During his hospital stay, he developed a spontaneous massive intra-hepatic haemorrhage resulting in hepatic rupture and a haemoperitoneum. The bleeding was controlled at emergency laparotomy. An abdominal angiography demonstrated multiple microaneurysms in the hepatic and mesenteric arterial vasculature. The clinical findings suggested polyarteritis nodosa, and the source of bleeding was probably a ruptured intra-hepatic artery aneurysm.

  4. Centrally-Rupturing Squib-Closure Disks

    NASA Technical Reports Server (NTRS)

    Richter, R.

    1986-01-01

    Rupture-disk design makes squib action more predictable. In new design, center of rupture disk contains cruciform indentation in which thickness reduced to about 0.5 mil (0.013 mm). Reduces strength of center of rupture disk in same manner as that of pull tabs on beverage cans; therefore, disk will fail predictably in center.

  5. 46 CFR 64.61 - Rupture disc.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 2 2011-10-01 2011-10-01 false Rupture disc. 64.61 Section 64.61 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING MARINE PORTABLE TANKS AND CARGO HANDLING SYSTEMS Pressure Relief Devices and Vacuum Relief Devices for MPTs § 64.61 Rupture disc. If a rupture...

  6. 46 CFR 64.61 - Rupture disc.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 46 Shipping 2 2014-10-01 2014-10-01 false Rupture disc. 64.61 Section 64.61 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING MARINE PORTABLE TANKS AND CARGO HANDLING SYSTEMS Pressure Relief Devices and Vacuum Relief Devices for MPTs § 64.61 Rupture disc. If a rupture...

  7. 46 CFR 64.61 - Rupture disc.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 46 Shipping 2 2013-10-01 2013-10-01 false Rupture disc. 64.61 Section 64.61 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING MARINE PORTABLE TANKS AND CARGO HANDLING SYSTEMS Pressure Relief Devices and Vacuum Relief Devices for MPTs § 64.61 Rupture disc. If a rupture...

  8. 46 CFR 64.61 - Rupture disc.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 2 2010-10-01 2010-10-01 false Rupture disc. 64.61 Section 64.61 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING MARINE PORTABLE TANKS AND CARGO HANDLING SYSTEMS Pressure Relief Devices and Vacuum Relief Devices for MPTs § 64.61 Rupture disc. If a rupture...

  9. 46 CFR 64.61 - Rupture disc.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 2 2012-10-01 2012-10-01 false Rupture disc. 64.61 Section 64.61 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) MARINE ENGINEERING MARINE PORTABLE TANKS AND CARGO HANDLING SYSTEMS Pressure Relief Devices and Vacuum Relief Devices for MPTs § 64.61 Rupture disc. If a rupture...

  10. Recurrent spontaneous abortion--aetiological factors and subsequent reproductive performance in 76 couples.

    PubMed

    van Iddekinge, B; Hofmeyr, G J

    1991-09-01

    A diagnostic screening programme identified a possible aetiological factor in 32 of 76 couples (42%) evaluated for recurrent spontaneous abortion (three or more consecutive abortions). The abnormalities most commonly observed were endocervical infections (18%), cervical incompetence (11%) and uterine abnormality (9%). Hypothyroidism was present in 3 women and chromosomal abnormality in 2. None were positive for lupus anticoagulant. Treatment of uterine abnormality and cervical incompetence was associated with 75% and 86% success rates, respectively, whereas treatment of infective causes resulted in a 44% successful pregnancy rate, much the same as the 42% rate that occurred in women who had not been thus treated.

  11. What's New in Uterine Sarcoma Research and Treatment?

    MedlinePlus

    ... Next Topic Additional resources for uterine sarcoma What`s new in uterine sarcoma research and treatment? Molecular pathology ... the chromosomes leads to the formation of a new gene, called JAZF1/JJAZ. This gene may help ...

  12. Gene Tied to Breast Cancer Raises Uterine Cancer Risk Too

    MedlinePlus

    ... news/fullstory_159652.html Gene Tied to Breast Cancer Raises Uterine Cancer Risk Too Women with BRCA1 may want to ... increased risk for a deadly form of uterine cancer, a new study finds. The BRCA1 gene mutation ...

  13. Use of nitroglycerin for uterine relaxation.

    PubMed

    Smith, G N; Brien, J F

    1998-09-01

    Data from human and experimental animal research indicate that nitric oxide (NO), a novel messenger, formed during the nitric oxide synthase-catalyzed oxidation of L-arginine to L-citrulline, is involved in maintaining normal uterine tone during gestation. There are demonstrated and potential benefits of manipulating the L-arginine-NO system during pregnancy. Several recent case reports and case series have described the effective use of nitroglycerin (GTN), a NO donor compound, antenatally, intrapartum, and postpartum for acute uterine relaxation. Therapeutic indications for GTN range from facilitating external cephalic version, difficult vaginal or cesarean section delivery, and manual exploration of the uterus, to its use as a tocolytic. The intravenous regimen of GTN required to obtain the desired degree of uterine relaxation is extremely variable; intravenous bolus doses of 50 micrograms to 500 micrograms GTN with up to three repeated injections of 50 micrograms to 250 micrograms have been reported. Other methods of GTN administration include transdermal patches and sublingual spray. GTN, when used in low doses, may provide safe and effective uterine relaxation with no clinically apparent fetal or maternal adverse effects. However, clinical trials with use of objective methods of evaluating uterine tone and comparing GTN to other tocolytic agents are required before widespread use in advocated.

  14. Subarachnoid hemorrhage caused by a ruptured anterior spinal artery aneurysm.

    PubMed

    Karakama, Jun; Nakagawa, Kazuhiko; Maehara, Taketoshi; Ohno, Kikuo

    2010-01-01

    A 51-year-old man presented with an extremely rare case of intracranial subarachnoid hemorrhage caused by rupture of an anterior spinal artery aneurysm manifesting as disturbance of consciousness following sudden onset of neck pain and numbness of the extremities. Cranial computed tomography revealed subarachnoid hemorrhage, mainly in the posterior fossa. Cerebral angiography studies on admission and on the 4th day demonstrated no definite abnormality as a bleeding source. A ventricular catheter was inserted to treat the acute hydrocephalus, and conservative management was continued during the acute period. Third angiography on the 18th day demonstrated an anterior spinal artery aneurysm at the C1 level which was considered to be the bleeding site. After conservative treatment, the patient was discharged without neurological deficits. Fourth angiography on the 108 th day disclosed spontaneous disappearance of the aneurysm, which was confirmed by the fifth angiography on the 269 th day. If subarachnoid hemorrhage of unknown etiology is encountered, spinal artery aneurysm should be considered as the bleeding source. Despite the controversy concerning the treatment strategy, ruptured spinal artery aneurysms can be treated conservatively because of the possibility of spontaneous regression. Follow-up angiography is required to evaluate the natural course of the lesion.

  15. Enhanced Uterine Contractility and Stillbirth in Mice Lacking G Protein-Coupled Receptor Kinase 6 (GRK6): Implications for Oxytocin Receptor Desensitization.

    PubMed

    Grotegut, Chad A; Mao, Lan; Pierce, Stephanie L; Swamy, Geeta K; Heine, R Phillips; Murtha, Amy P

    2016-04-01

    Oxytocin is a potent uterotonic agent and is used clinically for induction and augmentation of labor, as well as for prevention and treatment of postpartum hemorrhage. Oxytocin increases uterine contractility by activating the oxytocin receptor (OXTR), a member of the G protein-coupled receptor family, which is prone to molecular desensitization. After oxytocin binding, the OXTR is phosphorylated by a member of the G protein-coupled receptor kinase (GRK) family, which allows for recruitment of β-arrestin, receptor internalization, and desensitization. According to previous in vitro analyses, desensitization of calcium signaling by the OXTR is mediated by GRK6. The objective of this study was to determine the role of GRK6 in mediating uterine contractility. Here, we demonstrate that uterine GRK6 levels increase in pregnancy and using a telemetry device to measure changes in uterine contractility in live mice during labor, show that mice lacking GRK6 produce a phenotype of enhanced uterine contractility during both spontaneous and oxytocin-induced labor compared with wild-type or GRK5 knockout mice. In addition, the observed enhanced contractility was associated with high rates of term stillbirth. Lastly, using a heterologous in vitro model, we show that β-arrestin recruitment to the OXTR, which is necessary for homologous OXTR desensitization, is dependent on GRK6. Our findings suggest that GRK6-mediated OXTR desensitization in labor is necessary for normal uterine contractile patterns and optimal fetal outcome. PMID:26886170

  16. Uterine torsion and cesarean section in llamas and alpacas.

    PubMed

    Anderson, David E

    2009-07-01

    Dystocia occurs infrequently in llamas and alpacas. Uterine torsion is one of the more common causes of dystocia that requires veterinary care. Cesarean section may be required to resolve dystocia or uterine torsion. Correction of uterine torsion is most often successful without laparotomy. Laparotomy and cesarean section can be performed successfully in llamas and alpacas in field settings. This article discusses the indications, techniques, and expected outcomes of uterine torsion and cesarean section when performed in llamas or alpacas.

  17. Clinical efficiency investigation of laparoscopic uterine artery occlusion combined with myomectomy for uterine fibroids.

    PubMed

    Yin, Xiang-Hua; Gao, Ling-Ling; Gu, Yang; Song, Jing-Zhe; Gao, Jing; Ji, Xiao-Ping

    2014-01-01

    To investigate the effectiveness of laparoscopic uterine artery occlusion combined with myomectomy for uterine fibroids. From August 2008 to August 2009, forty-eight women with uterine fibroids desiring to preserve their uteri underwent laparoscopic myomectomy. Among them, 18 women received laparoscopic uterine artery occlusion before uterine myomectomy while the others received laparoscopic myomectomy only. All of the 48 cases with uterine fibroids underwent laparoscopic myomectomy successfully, and no patient developed Intraoperative or postoperative complications. The average operation time was (105.6±27.6) min, and the average surgical blood loss was (87.52±18.35) ml. Blocking uterine artery before laparoscopic myomectomy is valuable and feasible for the management of women with symptomatic fibroids. Adopting this method can obtain pleasing therapeutic effect. The method can reduce blood loss thus make the surgical field clean and clear, and it can reduce the operating time and recurrence rate. It can also reduce electro-coagulation on the surgical surface and therefore cause less tissue necrosis and lower incidence of complications. PMID:24995096

  18. Clinical efficiency investigation of laparoscopic uterine artery occlusion combined with myomectomy for uterine fibroids.

    PubMed

    Yin, Xiang-Hua; Gao, Ling-Ling; Gu, Yang; Song, Jing-Zhe; Gao, Jing; Ji, Xiao-Ping

    2014-01-01

    To investigate the effectiveness of laparoscopic uterine artery occlusion combined with myomectomy for uterine fibroids. From August 2008 to August 2009, forty-eight women with uterine fibroids desiring to preserve their uteri underwent laparoscopic myomectomy. Among them, 18 women received laparoscopic uterine artery occlusion before uterine myomectomy while the others received laparoscopic myomectomy only. All of the 48 cases with uterine fibroids underwent laparoscopic myomectomy successfully, and no patient developed Intraoperative or postoperative complications. The average operation time was (105.6±27.6) min, and the average surgical blood loss was (87.52±18.35) ml. Blocking uterine artery before laparoscopic myomectomy is valuable and feasible for the management of women with symptomatic fibroids. Adopting this method can obtain pleasing therapeutic effect. The method can reduce blood loss thus make the surgical field clean and clear, and it can reduce the operating time and recurrence rate. It can also reduce electro-coagulation on the surgical surface and therefore cause less tissue necrosis and lower incidence of complications.

  19. Clinical efficiency investigation of laparoscopic uterine artery occlusion combined with myomectomy for uterine fibroids

    PubMed Central

    Yin, Xiang-Hua; Gao, Ling-Ling; Gu, Yang; Song, Jing-Zhe; Gao, Jing; Ji, Xiao-Ping

    2014-01-01

    To investigate the effectiveness of laparoscopic uterine artery occlusion combined with myomectomy for uterine fibroids. From August 2008 to August 2009, forty-eight women with uterine fibroids desiring to preserve their uteri underwent laparoscopic myomectomy. Among them, 18 women received laparoscopic uterine artery occlusion before uterine myomectomy while the others received laparoscopic myomectomy only. All of the 48 cases with uterine fibroids underwent laparoscopic myomectomy successfully, and no patient developed Intraoperative or postoperative complications. The average operation time was (105.6±27.6) min, and the average surgical blood loss was (87.52±18.35) ml. Blocking uterine artery before laparoscopic myomectomy is valuable and feasible for the management of women with symptomatic fibroids. Adopting this method can obtain pleasing therapeutic effect. The method can reduce blood loss thus make the surgical field clean and clear, and it can reduce the operating time and recurrence rate. It can also reduce electro-coagulation on the surgical surface and therefore cause less tissue necrosis and lower incidence of complications. PMID:24995096

  20. 21 CFR 884.2730 - Home uterine activity monitor.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... the clinic. The HUAM system comprises a tocotransducer, an at-home recorder, a modem, and a computer... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Home uterine activity monitor. 884.2730 Section... Devices § 884.2730 Home uterine activity monitor. (a) Identification. A home uterine activity...

  1. 21 CFR 884.2730 - Home uterine activity monitor.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... the clinic. The HUAM system comprises a tocotransducer, an at-home recorder, a modem, and a computer... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Home uterine activity monitor. 884.2730 Section... Devices § 884.2730 Home uterine activity monitor. (a) Identification. A home uterine activity...

  2. 21 CFR 884.2730 - Home uterine activity monitor.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... the clinic. The HUAM system comprises a tocotransducer, an at-home recorder, a modem, and a computer... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Home uterine activity monitor. 884.2730 Section... Devices § 884.2730 Home uterine activity monitor. (a) Identification. A home uterine activity...

  3. 21 CFR 884.2730 - Home uterine activity monitor.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... the clinic. The HUAM system comprises a tocotransducer, an at-home recorder, a modem, and a computer... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Home uterine activity monitor. 884.2730 Section... Devices § 884.2730 Home uterine activity monitor. (a) Identification. A home uterine activity...

  4. Uterine cirsoid aneurysm: MRI and MRA

    SciTech Connect

    Joja, Ikuo; Asakawa, Mari; Motoyama, Kazumi

    1996-03-01

    Uterine cirsoid aneurysm is uncommon. It is important to make a diagnosis of this disease preoperatively, because repeated curettages may induce life-threatening massive genital bleeding. We present a case of a 51-year-old woman with uterine cirsoid aneurysm in whom MRI and MRA were very useful for the preoperative diagnosis. The radiologic appearances on ultrasonography, CT, conventional SE MRI, MRA, dynamic MRI, and pelvic angiography are presented. Conventional SE T1-weighted and T2-weighted images demonstrated multiple flow voids in the uterus and bilateral adnexal regions. MRA demonstrated a cluster of distinct, tortuous, and coiled vascular channels in the pelvis. MRA could obtain images almost equal to angiography and was considered to be an excellent noninvasive imaging technique for the diagnosis of uterine cirsoid aneurysm. 28 refs., 7 figs

  5. Use of Cyclosporine in Uterine Transplantation

    PubMed Central

    Saso, Srdjan; Logan, Karl; Abdallah, Yazan; Louis, Louay S.; Ghaem-Maghami, Sadaf; Smith, J. Richard; Del Priore, Giuseppe

    2012-01-01

    Uterine transplantation has been proposed as a possible solution to absolute uterine factor infertility untreatable by any other option. Since the first human attempt in 2000, various teams have tried to clarify which immunosuppressant would be most suitable for protecting the allogeneic uterine graft while posing a minimal risk to the fetus. Cyclosporine A (CsA) is an immunosuppressant widely used by transplant recipients. It is currently being tested as a potential immunosuppressant to be used during UTn. Its effect on the mother and fetus and its influence upon the graft during pregnancy have been of major concern. We review the role of CsA in UTn and its effect on pregnant transplant recipients and their offspring. PMID:22132302

  6. [Ultrasonic diagnosis of congenital uterine abnormalities].

    PubMed

    Funk, A; Fendel, H

    1988-01-01

    1-2% of women has abnormal uterine development due to nonunification of the Müllerian ducts in the embryonal period. At the RWTH Aachen, in the department of gynaecology and obstetrics, between January and June 1987, we had searched systematically for maldevelopment of the uterus in 2299 echosonografies. In 13 cases we found maldevelopment of internal genital; 5 of these cases were diagnosed by an echosonografic routine-examination. The echografic criteria of the different grades of uterine malformations have been determined, systematized and discussed in relation to the symptoms. The most frequent malformations as uterus subseptus, uterus septus, uterus bicornis and uterus duplex are subject of a detailed discussion. This work demonstrates that echosonografic is a very efficient instrument to diagnose uterine malformations and gives us a very exact anatomic interpretation of malformations.

  7. The SCEC-USGS Dynamic Earthquake Rupture Code Verification Exercise - Recent Progress

    NASA Astrophysics Data System (ADS)

    Harris, R.

    2012-12-01

    We summarize recent progress by the SCEC-USGS Dynamic Rupture Code Verification Group, that examines if SCEC and USGS researchers' spontaneous-rupture computer codes agree when computing benchmark scenarios of dynamically propagating earthquake rupture. Our latest benchmarks have involved dynamic rupture propagating on planar vertical strike-slip faults with heterogeneous initial stress conditions and cases of dynamic rupture on branching vertical strike-slip faults. The heterogeneous initial stress cases produced good agreement among the codes and we are confident that this was a successful endeavor. The branching fault cases will be a focus of continued study because those results were not as successful as hoped. We are examining the reasons for this mismatch of the branching fault benchmark results, and have a number of ideas to explore. Our next benchmark exercises will continue with dynamic rupture on branching vertical strike-slip faults, until we obtain good matches among the code results. We will also investigate another fault geometry, the case of a stepover in a vertical strike-slip fault.

  8. Mesonephric adenocarcinoma of the uterine corpus

    PubMed Central

    Wu, Haixia; Zhang, Lin; Cao, Wenfeng; Hu, Yuanjing; Liu, Yixin

    2014-01-01

    Mesonephric carcinomas are rare in the female genital tract and usually are found in sites where embryonic remnants of wolffian ducts are usually detected, such as the uterine cervix, broad ligament, mesosalpinx and exceptionally rarely in the uterine corpus. To date, only four cases of mesonephric carcinomas arising in the uterine corpus have been described in literature. Here we report two cases of mesonephric carcinomas arising in a deep intramural location of the uterine corpus in a 55-year-old woman and a 62-year-old woman in Chinese populations. It is believed to be the first report in China. Both cases presented with a little postmenopausal bleeding. Before hospitalized, uterine curettages were programmed for both cases. The pathology reports were mesonephric adenocarcinoma. A total hysterectomy and bilateral salpingo-oophorectomy were performed. On gross examination, the tumors of both cases were confined to the myometrium. Microscopic examination found both tumors of these two cases were adenocarcinomas mixed with spindle cell component. The most primary histologic patterns of the mesonephric adenocarcinomas were tubular glands that varied in size and were lined by one to several layers of columnar cells. Immunohistochemically, the tumor cells expressed positive with CD10, calretinin, vimentin, cytokeratin (AE1/AE3) and epithelial membrane antigen (EMA); but expressions of ER and PR were completely negative. The peculiar location of mesonephric carcinoma of the uterine corpus may be misinterpreted as other histological type neoplasms. Awareness of this rare phenomenon and immunostaining for markers of mesonephric carcinoma can prevent from making a false diagnosis. PMID:25400789

  9. Spontaneous retroperitoneal hemorrhage secondary to subcapsular renal hematoma: MRI findings.

    PubMed

    Balci, N C; Sirvanci, M; Tüfek, I; Onat, L; Duran, C

    2001-10-01

    Spontaneous retroperitoneal hemorrhage is a rare intraabdominal bleeding. In this report we present a case of a nontraumatic retroperitoneal hemorrhage secondary to spontaneous subcapsular renal hematoma. A 54-year-old patient who was under warfarin therapy, developed subcapsular right renal hematoma. Subcapsular and retroperitoneal hemorrhage were low signal on T1- and T2-weighted images consistent with acute stage of blood. The source of subcapsular hematoma was shown to be the rupture of hemorrhagic renal cyst on MRI. Extension of hemorrhage into the retroperitoneal space anterior to right psoas muscle was also successfully shown on MRI. Patient underwent nephrectomy and retroperitoneal blood was evacuated.

  10. Uterine Prolapse: From Antiquity to Today

    PubMed Central

    Downing, Keith T.

    2012-01-01

    Uterine prolapse is a condition that has likely affected women for all of time as it is documented in the oldest medical literature. By looking at the watershed moments in its recorded history we are able to appreciate the evolution of urogynecology and to gain perspective on the challenges faced by today's female pelvic medicine and reconstructive surgeons in their attempts to treat uterine and vaginal vault prolapse. “He who cannot render an account to himself of at least three thousand years of time, will always grope in the darkness of inexperience” —Goethe, Translation of Panebaker PMID:22262975

  11. Laparoscopic uterine sling suspension: a new technique of uterine suspension in women desiring surgical management of uterine prolapse with uterine conservation.

    PubMed

    Cutner, A; Kearney, R; Vashisht, A

    2007-09-01

    The surgical management of uterine prolapse in women who wish to retain their uterus remains a challenge. Several techniques have been reported using open abdominal, laparoscopic and vaginal approaches. The laparoscopic approach offers both excellent intraoperative visualisation of supportive and adjacent structures and quick postoperative recovery. Currently, laparoscopic suspension of the uterus to the round ligaments, uterosacral ligaments, suture and synthetic mesh suspension to the sacral promontory have been reported. This report describes a new surgical technique of laparoscopic uterine suspension, which has been performed successfully in eight women. Mersilene tape is used to suspend the uterus to the sacral promontory bilaterally and to recreate new uterosacral ligaments.

  12. Uterine cancer presenting as obstructive jaundice

    PubMed Central

    Manuel, Valdano; Rocha, Eserval; Fortini, Giovana; Pascoal, Zeida; Netto, Renata; Rengel, Lenira; Birolini, Claudio; Utiyama, Edivaldo Massazo

    2016-01-01

    Obstructive jaundice as an initial manifestation of uterine cancer is extremely rare. We present a case of a 72-year-old female who presented with obstructive jaundice, supposedly for pancreatic cancer. After detailed diagnostic investigation, the cause of the jaundice was attributed to a metastatic compression of the common bile duct, from the primary neoplasm of the uterus. This case highlights the importance of including uterine cancer in the differential diagnosis of woman presenting with obstructive jaundice, even though it is very rare. PMID:27462179

  13. Endovascular repair of a spontaneous ilio-iliac fistula presenting as pulmonary embolism.

    PubMed

    Melas, N; Saratzis, A; Abbas, A; Sarris, K; Saratzis, N; Lazaridis, I; Kiskinis, D

    2011-05-01

    Spontaneous rupture of a common iliac artery aneurysm into the common iliac vein is a rare phenomenon. We report the case of a 68 year old man admitted with acute cardiac failure and massive pulmonary embolism as a complication of a spontaneous ilio-iliac fistula, secondary to aneurysmal rupture. The aneurysm was successfully excluded using an aorto-uni-iliac stent graft. No complications were noted at 9 months follow-up. Arteriovenous fistulae should be considered in patients with aortic or iliac aneurysms who develop a pulmonary embolism or symptoms of venous congestion. Endovascular repair of these pathologies is a feasible therapeutic option; however long term results remain unknown.

  14. [Quadriceps and patellar tendon ruptures].

    PubMed

    Grim, C; Lorbach, O; Engelhardt, M

    2010-12-01

    Ruptures of the quadriceps or patellar tendon are uncommon but extremely relevant injuries. Early diagnosis and surgical treatment with a stable suture construction are mandatory for a good postoperative clinical outcome. The standard methods of repair for quadriceps and patellar tendon injuries include the placement of suture loops through transpatellar tunnels. Reinforcement with either a wire cerclage or a PDS cord is used in patellar tendon repair. The PDS cord can also be applied as augmentation in quadriceps tendon repair. In secondary patellar tendon repair an autologous semitendinosus graft can be used. For chronic quadriceps tendon defects a V-shaped tendon flap with a distal footing is recommended. The different methods of repair should lead to early functional postoperative treatment. The clinical outcome after surgical treatment of patellar and quadriceps tendon ruptures is mainly good.

  15. [Two cases of testicular rupture].

    PubMed

    Tsujino, S; Hirata, T; Shimizu, H; Ito, T; Shiozawa, H; Koshiba, K

    1989-06-01

    Two cases of testicular rupture are presented and 119 cases in Japanese literature are reviewed. A 29-year-old man and a 32-year-old man were admitted to our hospital with the complaint of gradually increasing pains and swelling on the right testicle. Four days and three days before admission they experienced trauma during athletic activities. The diagnosis was established preoperatively by means of ultrasonography in the first one, but not in the other. The necrotic tissue of 1/3-1/2 of testis was removed and tunica albuginea was repaired in both cases. Of 119 cases of testicular rupture in Japanese literature a peak occurs in the 2nd decade and during contact sports. The ultrasonography is an effective diagnostic modality. The rate of orchiectomy has been decreasing. The function of the affected testis is hard to evaluate.

  16. Rupture of vertical soap films

    NASA Astrophysics Data System (ADS)

    Rio, Emmanuelle

    2014-11-01

    Soap films are ephemeral and fragile objects. They tend to thin under gravity, which gives rise to the fascinating variations of colors at their interfaces but leads systematically to rupture. Even a child can create, manipulate and admire soap films and bubbles. Nevertheless, the reason why it suddenly bursts remains a mystery although the soap chosen to stabilize the film as well as the humidity of the air seem very important. One difficulty to study the rupture of vertical soap films is to control the initial solution. To avoid this problem we choose to study the rupture during the generation of the film at a controlled velocity. We have built an experiment, in which we measure the maximum length of the film together with its lifetime. The generation of the film is due to the presence of a gradient of surface concentration of surfactants at the liquid/air interface. This leads to a Marangoni force directed toward the top of the film. The film is expected to burst only when its weight is not balanced anymore by this force. We will show that this leads to the surprising result that the thicker films have shorter lifetimes than the thinner ones. It is thus the ability of the interface to sustain a surface concentration gradient of surfactants which controls its stability.

  17. Molecular dynamics of interface rupture

    NASA Technical Reports Server (NTRS)

    Koplik, Joel; Banavar, Jayanth R.

    1993-01-01

    Several situations have been studied in which a fluid-vapor or fluid-fluid interface ruptures, using molecular dynamics simulations of 3000 to 20,000 Lennard-Jones molecules in three dimensions. The cases studied are the Rayleigh instability of a liquid thread, the burst of a liquid drop immersed in a second liquid undergoing shear, and the rupture of a liquid sheet in an extensional flow. The late stages of the rupture process involve the gradual withdrawal of molecules from a thinning neck, or the appearance and growth of holes in a sheet. In all cases, it is found that despite the small size of the systems studied, tens of angstroms, the dynamics is in at least qualitative accord with the behavior expected from continuum calculations, and in some cases the agreement is to within tens of percent. Remarkably, this agreement occurs even though the Eulerian velocity and stress fields are essentially unmeasurable - dominated by thermal noise. The limitations and prospects for such molecular simulation techniques are assessed.

  18. Splenic rupture following routine colonoscopy.

    PubMed

    Rasul, Tabraze; Leung, Edmund; McArdle, Kirsten; Pathak, Rajiv; Dalmia, Sanjay

    2010-10-01

    Splenic rupture is a life-threatening condition characterized by internal hemorrhage, often difficult to diagnose. Colonoscopy is a gold standard routine diagnostic test to investigate patients with gastrointestinal symptoms as well as to those on the screening program for colorectal cancer. Splenic injury is seldomly discussed during consent for colonoscopy, as opposed to colonic perforation, as its prevalence accounts for less than 0.1%. A 66-year-old Caucasian woman with no history of collagen disorder was electively admitted for routine colonoscopy for surveillance of adenoma. She was admitted following the procedure for re-dosing of warfarin, which was stopped prior to the colonoscopy. The patient was found collapsed on the ward the following day with clinical shock and anemia. Computed tomography demonstrated grade 4 splenic rupture. Immediate blood transfusion and splenectomy was required. Splenic rupture following routine colonoscopy is extremely rare. Awareness of it on this occasion saved the patient's life. Despite it being a rare association, the seriousness warrants inclusion in all information leaflets concerning colonoscopy and during its consent.

  19. Assessment and optimization of uterine activity during labor.

    PubMed

    Simpson, Kathleen R; Miller, Lisa

    2011-03-01

    Accurate assessment of uterine activity during labor is essential to promote optimal patient outcomes. This review provides clinicians with information to develop an evidence-based, standardized approach to the evaluation and management of uterine activity during labor including identification and treatment of excessive uterine activity. Common terminology is defined in an effort to enhance clear and direct communication and accurate assessment. The latest evidence regarding normal labor is presented along with physiology related to uterine activity and fetal oxygenation. Suggestions for managing excessive uterine activity are offered as well as a synopsis of risk reduction strategies for clinical practice.

  20. MRI Assessment of Uterine Artery Patency and Fibroid Infarction Rates 6 Months after Uterine Artery Embolization with Nonspherical Polyvinyl Alcohol

    SciTech Connect

    Das, Raj Gonsalves, Michael; Vlahos, Ioannis; Manyonda, Issac; Belli, Anna-Maria

    2013-10-15

    Purpose: We have observed significant rates of uterine artery patency after uterine artery embolization (UAE) with nonspherical polyvinyl alcohol (nsPVA) on 6 month follow-up MR scanning. The study aim was to quantitatively assess uterine artery patency after UAE with nsPVA and to assess the effect of continued uterine artery patency on outcomes. Methods: A single centre, retrospective study of 50 patients undergoing bilateral UAE for uterine leiomyomata was undertaken. Pelvic MRI was performed before and 6 months after UAE. All embolizations were performed with nsPVA. Outcome measures included uterine artery patency, uterine and dominant fibroid volume, dominant fibroid percentage infarction, presence of ovarian arterial collaterals, and symptom scores assessed by the Uterine Fibroid Symptom and Quality of Life questionnaire (UFS-QOL). Results: Magnetic resonance angiographic evidence of uterine artery recanalization was demonstrated in 90 % of the patients (64 % bilateral, 26 % unilateral) at 6 months. Eighty percent of all dominant fibroids demonstrated >90 % infarction. The mean percentage reduction in dominant fibroid volume was 35 %. No significant difference was identified between nonpatent, unilateral, and bilateral recanalization of the uterine arteries with regard to percentage dominant fibroid infarction or dominant fibroid volume reduction. The presence of bilaterally or unilaterally patent uterine arteries was not associated with inferior clinical outcomes (symptom score or UFS-QOL scores) at 6 months. Conclusion: The high rates of uterine artery patency challenge the current paradigm that nsPVA is a permanent embolic agent and that permanent uterine artery occlusion is necessary to optimally treat uterine fibroids. Despite high rates of uterine artery recanalization in this cohort, satisfactory fibroid infarction rates and UFS-QOL scores were achieved.

  1. Stomach rupture as a result of gastrointestinal barotrauma in a SCUBA diver.

    PubMed

    Cramer, F S; Heimbach, R D

    1982-03-01

    A single case of operatively proven spontaneous rupture of a normal stomach secondary to diving barotrauma is reported. The rupture was linear and located along the lesser curvature, as described most commonly in adults. Possible mechanisms to explain the closed loop obstruction required to produce this phenomenon are the swallowing of water and filling of the stomach with air, while trapped under water, at a depth of 27 meters. To the best of the authors' knowledge this case represents the first report of gastric rupture secondary to SCUBA (self-contained underwater breathing apparatus) diving. The presence of a normal abdominal examination by an experienced observed while compressed in the chamber does not preclude the diagnosis of a perforated viscus.

  2. Ground motion hazard from supershear rupture

    USGS Publications Warehouse

    Andrews, D.J.

    2010-01-01

    An idealized rupture, propagating smoothly near a terminal rupture velocity, radiates energy that is focused into a beam. For rupture velocity less than the S-wave speed, radiated energy is concentrated in a beam of intense fault-normal velocity near the projection of the rupture trace. Although confined to a narrow range of azimuths, this beam diverges and attenuates. For rupture velocity greater than the S-wave speed, radiated energy is concentrated in Mach waves forming a pair of beams propagating obliquely away from the fault. These beams do not attenuate until diffraction becomes effective at large distance. Events with supershear and sub-Rayleigh rupture velocity are compared in 2D plane-strain calculations with equal stress drop, fracture energy, and rupture length; only static friction is changed to determine the rupture velocity. Peak velocity in the sub-Rayleigh case near the termination of rupture is larger than peak velocity in the Mach wave in the supershear case. The occurrence of supershear rupture propagation reduces the most intense peak ground velocity near the fault, but it increases peak velocity within a beam at greater distances. ?? 2010.

  3. Influence of epoxyeicosatrienoic acids on uterine function.

    PubMed

    Gonzalez, E; Jawerbaum, A; Novaro, V; Gimeno, M A

    1997-01-01

    In spite of the large quantities of epoxyeicosatrienoic acids (EEts) released by reproductive tissues, their function has not yet been determined. In order to analyze the influence of epoxygenase products on isolated uterine function, Clotrimazole, a cytochrome P450 inhibitor was used. The drug decreased isolated rat uterine isometric developed tension (IDT) and frequency (FC). 14,15 EEt induced a contractile response when added at 10(11) M, 8,9 EEt and 11,12 EEt produced an increment of IDT when added to 10(-7) M and 5,6 EEt did not modify IDT values. A contractile stimulatory effect was observed when 14,15 EEt (10(-7) M) was added to a tissue bath preparation containing Clotrimazole (20 microM). On the other hand, uterine contractile response to 14,15 EEt addition was partially abolished by indomethacin (10(-6) M), a well known cyclooxygenase inhibitor. Uterine response to 5,6; 8,9 and 11,12 EEts was not modified by indomethacin. This is the first evidence of 14-15 EEt uterotonic properties, possibly exerted in part through the cyclooxygenase pathway.

  4. Incidence, aetiology and epidemiology of uterine fibroids.

    PubMed

    Okolo, Stanley

    2008-08-01

    Uterine fibroids are the most common benign tumour of the female genital tract. However, their true prevalence is probably under-estimated, as the incidence at histology is more than double the clinical incidence. Recent longitudinal studies have estimated that the lifetime risk of fibroids in a woman over the age of 45 years is more than 60%, with incidence higher in blacks than in whites. The cause of fibroids remains unclear and their biology poorly understood. No single candidate gene has been detected for commonly occurring uterine fibroids. However, the occurrence of rare uterine fibroid syndromes, such as multiple cutaneous and uterine leiomyomatosis, has been traced to the gene that codes for the mitochondrial enzyme, fumarate hydratase. Cytogenetic abnormalities, particularly deletions of chromosome 7, which are found in up to 50% of fibroid specimens, seem to be secondary rather than primary events, and investigations into the role of tumour suppressor genes have yielded conflicting results. The key regulators of fibroid growth are ovarian steroids, both oestrogen and progestogen, growth factors and angiogenesis, and the process of apoptosis. Black race, heredity, nulliparity, obesity, polycystic ovary syndrome, diabetes and hypertension are associated with increased risk of fibroids, and there is emerging evidence that familial predisposition to fibroids is associated with a distinct pattern of clinical and molecular features compared with fibroids in families without this prevalence.

  5. Alliance ruptures and rupture resolution in cognitive-behavior therapy: a preliminary task analysis.

    PubMed

    Aspland, Helen; Llewelyn, Susan; Hardy, Gillian E; Barkham, Michael; Stiles, William

    2008-11-01

    An initial ideal, rational model of alliance rupture and rupture resolution provided by cognitive-behavioral therapy (CBT) experts was assessed and compared with empirical observations of ruptures and their resolution in two cases of successful CBT. The initial rational model emphasized nondefensive acknowledgment and exploration of the rupture. Results indicated differences between what therapists think they should do to resolve ruptures and what they actually do and suggested that the rational model should be expanded to emphasize client validation and empowerment. Therapists' ability to attend to ruptures emerged as an important clinical skill.

  6. Anastomoses of the Ovarian and Uterine Arteries: A Potential Pitfall and Cause of Failure of Uterine Embolization

    SciTech Connect

    Matson, Matthew; Nicholson, Anthony; Belli, Anna-Maria

    2000-09-15

    Four women with symptomatic uterine fibroids were treated by uterine artery embolization (UAE). In all cases both uterine arteries were embolized via a single femoral puncture with polyvinyl alcohol using a selective catheter technique. In three cases, the ovarian artery was not visible on the initial angiogram before embolization, but appeared after the second uterine artery had been treated. In one case of clinical failure following UAE, a repeat angiogram demonstrated filling of the fibroids from the ovarian artery. Anastomoses between uterine and ovarian arteries may cause problems for radiologists performing UAE and are a potential cause of treatment failure.

  7. Magnetic Resonance–Guided High-Intensity Focused Ultrasound (MRgHIFU) Treatment of Symptomatic Uterine Fibroids: An Evidence-Based Analysis

    PubMed Central

    Pron, G

    2015-01-01

    Background Magnetic resonance–guided high-intensity focused ultrasound (MRgHIFU) is a noninvasive uterine-preserving treatment alternative to hysterectomy for women with symptomatic uterine leiomyomas (fibroids). Uterine fibroids commonly occur, have a broad impact on women's health and lifestyle, continue to be the main indication for hysterectomy, and represent a costly public health burden. Objectives The objectives of the analysis were to evaluate patients’ eligibility for MRgHIFU treatment of symptomatic uterine fibroids and the technical success, safety, effectiveness, and durability of this treatment. The review also compared the safety and effectiveness of MRgHIFU with other minimally invasive uterine-preserving treatments and surgeries for uterine fibroids. Methods A literature search was performed on March 27, 2014, using Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid EMBASE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), and EBM Reviews, for studies published from January 1, 2000, to March 27, 2014. Results The evidence review identified 2 systematic reviews, 2 RCTs, 45 cohort study reports, and 19 case reports involving HIFU treatment of symptomatic uterine fibroids. Eligibility for MRgHIFU treatment was variable, ranging from 14% to 74%. In clinical cohort studies involving 1,594 patients, 26 major complications (1.6%) were reported. MRgHIFU resulted in statistically and clinically significant reductions in fibroid-related symptoms in studies conducted in 10 countries, although few involved follow-up longer than 1 year. Retreatment rates following MRgHIFU were higher in early clinical studies involving regulated restrictions in the extent of fibroid ablation than in later reports involving near-complete ablation. Emergent interventions, however, were rare. Although a desire for fertility was an exclusion criteria for treatment, spontaneous term pregnancies did occur following HIFU. There were no

  8. Spontaneous formation of an "antidrop".

    PubMed

    Galvin, Kevin P; Pratten, Stephen J; Evans, Geoffrey M; Biggs, Simon

    2006-01-17

    We have observed, with great surprise, the spontaneous formation of a quite unusual drop. Because of its similarity to the antibubble [(a) Hughes, W.; Hughes, A. R. Nature 1932, 129 (3245), 59. (b) Skogen, N. Am. J. Phys. 1956, 24, 239. (c) Strong, C. L. Sci. Am. 1974, 230 (4), 116.], we describe our find as an "antidrop", a thin spherical shell of an aqueous salt solution, surrounded by an inner and outer organic liquid phase. Two of these antidrops, about 8 mm in diameter, are shown in the present paper resting on a bed of smaller conventional drops. Drops of this size do not normally appear so spherical, however the antidrop is a mere shell, and hence its geometry is dominated by the interfacial tension. We found these drops to be remarkably stable, given it was possible to reversibly deform the drops and even slice through a drop with a glass rod to produce two antidrops. Ultimately, after some finite time period, the antidrops simply disintegrated into clouds of tiny droplets of the aqueous salt solution because of the drainage and concomitant rupturing of the liquid comprising their thin spherical shells.

  9. Is a history of cesarean section a risk factor for abnormal uterine bleeding in patients with uterine leiomyoma?

    PubMed Central

    Kinay, Tugba; Basarir, Zehra O.; Tuncer, Serap F.; Akpinar, Funda; Kayikcioglu, Fulya; Koc, Sevgi; Karakaya, Jale

    2016-01-01

    Objectives: To determine whether a history of cesarean section was a risk factor for abnormal uterine bleeding in patients with uterine leiomyomas, and to identify other risk factors for this symptom. Methods: We analyzed retrospectively, the medical records of patients who underwent hysterectomies due to the presence of uterine leiomyomas during a 6-year period (2009 and 2014) at Etlik Zubeyde Hanim Women’s Health Training and Research Hospital, Ankara, Turkey. Uterine leiomyoma was diagnosed based on histopathological examination of hysterectomy specimens. Demographic characteristics, and laboratory and histopathological findings were compared between patients with uterine leiomyoma with and without abnormal uterine bleeding. Results: In total, 501 (57.9%) patients had abnormal uterine bleeding and 364 (42.1%) patients had other symptoms. A history of cesarean section was more common in patients with abnormal uterine bleeding than in those with other symptoms (17.6% versus 9.3%, p=0.001; odds ratio [OR]: 2.1; 95% confidence interval [CI]: 1.4-3.3). The presence of a submucosal leiomyoma (OR: 2.1; 95% CI: 1.5-3.1) and coexistent adenomyosis (OR: 1.6; 95% CI: 1.1-2.4) were also associated with abnormal uterine bleeding. Conclusion: A history of cesarean section was an independent risk factor for abnormal uterine bleeding in patients with uterine leiomyomas; submucosal leiomyoma and coexisting adenomyosis were also independent risk factors. PMID:27464864

  10. Multiple linear regression models to fit magnitude using rupture length, rupture width, rupture area, and surface displacement

    NASA Astrophysics Data System (ADS)

    Chu, A.; Zhuang, J.

    2015-12-01

    Wells and Coppersmith (1994) have used fault data to fit simple linear regression (SLR) models to explain linear relations between moment magnitude and logarithms of fault measurements such as rupture length, rupture width, rupture area and surface displacement. Our work extends their analyses to multiple linear regression (MLR) models by considering two or more predictors with updated data. Treating the quantitative variables (rupture length, rupture width, rupture area and surface displacement) as predictors to fit linear regression models on magnitude, we have discovered that the two-predictor model using rupture area and maximum displacement fits the best. The next best alternative predictors are surface length and rupture area. Neither slip type nor slip direction is a significant predictor by fitting of analysis of variance (ANOVA) and analysis of covariance (ANCOVA) models. Corrected Akaike information criterion (Burnham and Anderson, 2002) is used as a model assessment criterion. Comparisons between simple linear regression models of Wells and Coppersmith (1994) and our multiple linear regression models are presented. Our work is done using fault data from Wells and Coppersmith (1994) and new data from Ellswort (2000), Hanks and Bakun (2002, 2008), Shaw (2013), and Finite-Source Rupture Model Database (http://equake-rc.info/SRCMOD/, 2015).

  11. Histologic analysis of ruptured quadriceps tendons.

    PubMed

    Trobisch, Per David; Bauman, Matthias; Weise, Kuno; Stuby, Fabian; Hak, David J

    2010-01-01

    Quadriceps tendon ruptures are uncommon injuries. Degenerative changes in the tendon are felt to be an important precondition for rupture. We retrospectively reviewed 45 quadriceps tendon ruptures in 42 patients. Quadriceps tendon ruptures occurred most often in the sixth and seventh decade of life. Men were affected six times as often as women. A tissue sample from the rupture-zone was obtained in 22 cases and histologic analysis was performed. Degenerative changes were present in only 14 (64%) of the 22 samples. We observed an increasing ratio of degenerative to nondegenerative tendons with increasing patient age. Our data suggests that quadriceps tendon rupture, especially in younger patients, can occur in the absence of pathologic tendon degeneration.

  12. Investigation of cryogenic rupture disc design

    NASA Technical Reports Server (NTRS)

    Keough, J. B.; Oldland, A. H.

    1973-01-01

    Rupture disc designs of both the active (command actuated) and passive (pressure ruptured) types were evaluated for performance characteristics at cryogenic temperatures and for capability to operate in a variety of cryogens, including gaseous and liquid fluorine. The test results, coupled with information from literature and industry searches, were used to establish a statement of design criteria and recommended practices for application of rupture discs to cryogenic rocket propellant feed and vent systems.

  13. Spontaneous pneumothorax during pregnancy.

    PubMed

    Gorospe, Luis; Puente, Susana; Madrid, Carmen; Novo, Susana; Gil-Alonso, José L; Guntiñas, Alicia

    2002-05-01

    Spontaneous pneumothorax complicating pregnancy is rare. Only 41 cases have been previously published. We describe a case of spontaneous pneumothorax successfully treated with tube thoracostomy during the 38th week of pregnancy. Under epidural anesthesia, the patient had vaginal delivery of a healthy male infant 36 hours after tube thoracostomy.

  14. Acute Pectoralis Major Rupture Captured on Video.

    PubMed

    Ordas Bayon, Alejandro; Sandoval, Enrique; Valencia Mora, María

    2016-01-01

    Pectoralis major (PM) ruptures are uncommon injuries, although they are becoming more frequent. We report a case of a PM rupture in a young male who presented with axillar pain and absence of the anterior axillary fold after he perceived a snap while lifting 200 kg in the bench press. Diagnosis of PM rupture was suspected clinically and confirmed with imaging studies. The patient was treated surgically, reinserting the tendon to the humerus with suture anchors. One-year follow-up showed excellent results. The patient was recording his training on video, so we can observe in detail the most common mechanism of injury of PM rupture. PMID:27595030

  15. Rupture dynamics in model polymer systems.

    PubMed

    Borah, Rupam; Debnath, Pallavi

    2016-05-11

    In this paper we explore the rupture dynamics of a model polymer system to capture the microscopic mechanism during relative motion of surfaces at the single polymer level. Our model is similar to the model for friction introduced by Filippov, Klafter, and Urbakh [Filippov et al., Phys. Rev. Lett., 2004, 92, 135503]; but with an important generalization to a flexible transducer (modelled as a bead spring polymer) which is attached to a fixed rigid planar substrate by interconnecting bonds (modelled as harmonic springs), and pulled by a constant force FT. Bonds are allowed to rupture stochastically. The model is simulated, and the results for a certain set of parameters exhibit a sequential rupture mechanism resulting in rupture fronts. A mean field formalism is developed to study these rupture fronts and the possible propagating solutions for the coupled bead and bond dynamics, where the coupling excludes an exact analytical treatment. Numerical solutions to mean field equations are obtained by standard numerical techniques, and they agree well with the simulation results which show sequential rupture. Within a travelling wave formalism based on the Tanh method, we show that the velocity of the rupture front can be obtained in closed form. The derived expression for the rupture front velocity gives good agreement with the stochastic and mean field results, when the rupture is sequential, while propagating solutions for bead and bond dynamics are shown to agree under certain conditions. PMID:27087684

  16. Acute Pectoralis Major Rupture Captured on Video

    PubMed Central

    Valencia Mora, María

    2016-01-01

    Pectoralis major (PM) ruptures are uncommon injuries, although they are becoming more frequent. We report a case of a PM rupture in a young male who presented with axillar pain and absence of the anterior axillary fold after he perceived a snap while lifting 200 kg in the bench press. Diagnosis of PM rupture was suspected clinically and confirmed with imaging studies. The patient was treated surgically, reinserting the tendon to the humerus with suture anchors. One-year follow-up showed excellent results. The patient was recording his training on video, so we can observe in detail the most common mechanism of injury of PM rupture. PMID:27595030

  17. Quadriceps and patellar tendon ruptures.

    PubMed

    Lee, Dennis; Stinner, Daniel; Mir, Hassan

    2013-10-01

    The diagnosis of quadriceps and patellar tendon ruptures requires a high index of suspicion and thorough history-taking to assess for medical comorbidities that may predispose patients to tendon degeneration. Radiographic assessment with plain films supplemented by ultrasound and magnetic resonance imaging when the work-up is equivocal further aids diagnosis; however, advanced imaging is often unnecessary in patients with functional extensor mechanism deficits. Acute repair is preferred, and transpatellar bone tunnels serve as the primary form of fixation when the tendon rupture occurs at the patellar insertion, with or without augmentation depending on surgeon preference. Chronic tears and disruptions following total knee arthroplasty are special cases requiring reconstructions with allograft, synthetic mesh, or autograft. Rehabilitation protocols generally allow immediate weight-bearing with the knee locked in extension and crutch support. Limited arc motion is started early with active flexion and passive extension and then advanced progressively, followed by full active range of motion and strengthening. Complications are few but include quadriceps atrophy, knee stiffness, and rerupture. Outcomes are excellent if repair is done acutely, with poorer outcomes associated with delayed repair.

  18. Suppression of slip and rupture velocity increased by thermal pressurization: Effect of dilatancy

    NASA Astrophysics Data System (ADS)

    Urata, Yumi; Kuge, Keiko; Kase, Yuko

    2013-11-01

    investigated the effect of dilatancy on dynamic rupture propagation on a fault where thermal pressurization (TP) is in effect, taking into account permeability varying with porosity; the study is based on three-dimensional (3-D) numerical simulations of spontaneous ruptures obeying a slip-weakening friction law and Coulomb failure criterion. The effects of dilatancy on dynamic ruptures interacting with TP have been often investigated in one- or two-dimensional numerical simulations. The sole 3-D numerical simulation gave attention only to the behavior at a single point on a fault. Moreover, with the sole exception based on a single-degree-freedom spring-slider model, the previous simulations including dilatancy and TP have not considered changes in hydraulic diffusivity. However, the hydraulic diffusivity, which strongly affects TP, can vary as a power of porosity. In this study, we apply a power law relationship between permeability and porosity. We consider both reversible and irreversible changes in porosity, assuming that the irreversible change is proportional to the slip rate and dilatancy coefficient ɛ. Our numerical simulations suggest that the effects of dilatancy can suppress slip and rupture velocity increased by TP. The results reveal that the amount of slip on the fault decreases with increasing ɛ or exponent of the power law, and the rupture velocity is predominantly suppressed by ɛ. This was observed regardless of whether the applied stresses were high or low. The deficit of the final slip in relation to ɛ can be smaller as the fault size is larger.

  19. Neonatal outcome after prolonged rupture of the membranes starting in the second trimester.

    PubMed Central

    Blott, M; Greenough, A

    1988-01-01

    The neonatal outcomes of 30 pregnancies that were complicated by premature and prolonged rupture of the membranes that had started in the second trimester of pregnancy, were reviewed. The neonatal mortality was 11 (36%), the main cause of death being pulmonary hypoplasia. Two infants died of sepsis, but these were the only proved episodes of maternal or fetal infection. Of the survivors, 27% developed compressive limb abnormalities, all of which responded to passive physiotherapy. Pulmonary hypoplasia was significantly associated with earlier onset of rupture of the membranes, and the absence of fetal breathing movements. Compressive limb abnormalities were significantly associated with longer periods of oligohydramnios. We conclude that premature rupture of the membranes, even with onset in the second trimester, may be associated with a favourable outcome and this may be predicted by the persistence of fetal breathing movements. We therefore, recommend expectant management of such pregnancies, but suggest elective delivery at 34 weeks to limit fetal exposure to uterine compression and minimise the risks of prematurity. PMID:3196069

  20. Clinical Efficacy and Complications of Uterine Artery Embolization in Symptomatic Uterine Fibroids.

    PubMed

    Salehi, Mohammadgharib; Jalilian, Nasrin; Salehi, Ayoub; Ayazi, Mojgan

    2016-01-01

    We decided to evaluate the efficacy and complications of uterine artery embolization (UAE) in patients with symptomatic uterine fibroids. Sixty-five premenopausal patients, without considering the fibroids size and its location, were treated by bilateral UAE. At baseline and after 3, 6, and 12 months MRI was obtained to determine the uterine length and fibroid diameter. In addition, symptoms of the patients were documented at these follow-up schedules. UAE was successful in 62 (95.4%) cases. Complete infarction rate of the fibroid was 83.1%. After 12 months, the uterine length showed a decrease of 55.7% (mean of 9.4 cm) and the diameter of the dominant fibroid revealed a decrease of 52.1% (mean of 3.4 cm). Menorrhagia improved in 45 cases (91.8%), abdominal mass in 24 cases (82.28%), urinary symptoms in 17 cases (85%), pelvic pain in 21 cases (84%), and dysmenorrhea in 25 cases (80.6%). At final follow-up performed after one year, complete infarction of the fibroma was demonstrated in 49 patients (83.1%). Two cases achieved successful pregnancy in the one year follow-up period. Five patients developed post-embolization syndrome which necessitated admission to the hospital. Twenty-two patients presented and complained of pain for which outpatient pain management was done. UAE was a successful treatment for uterine fibroids that preserved the uterus, had minimal complications, and required short hospitalization and recovery. PMID:26925914

  1. Clinical Efficacy and Complications of Uterine Artery Embolization in Symptomatic Uterine Fibroids

    PubMed Central

    Salehi, Mohammadgharib; Jalilian, Nasrin; Salehi, Ayoub; Ayazi, Mojgan

    2016-01-01

    We decided to evaluate the efficacy and complications of uterine artery embolization (UAE) in patients with symptomatic uterine fibroids. Sixty-five premenopausal patients, without considering the fibroids size and its location, were treated by bilateral UAE. At baseline and after 3, 6, and 12 months MRI was obtained to determine the uterine length and fibroid diameter. In addition, symptoms of the patients were documented at these follow-up schedules. UAE was successful in 62 (95.4%) cases. Complete infarction rate of the fibroid was 83.1%. After 12 months, the uterine length showed a decrease of 55.7% (mean of 9.4 cm) and the diameter of the dominant fibroid revealed a decrease of 52.1% (mean of 3.4 cm). Menorrhagia improved in 45 cases (91.8%), abdominal mass in 24 cases (82.28%), urinary symptoms in 17 cases (85%), pelvic pain in 21 cases (84%), and dysmenorrhea in 25 cases (80.6%). At final follow-up performed after one year, complete infarction of the fibroma was demonstrated in 49 patients (83.1%). Two cases achieved successful pregnancy in the one year follow-up period. Five patients developed post-embolization syndrome which necessitated admission to the hospital. Twenty-two patients presented and complained of pain for which outpatient pain management was done. UAE was a successful treatment for uterine fibroids that preserved the uterus, had minimal complications, and required short hospitalization and recovery. PMID:26925914

  2. Uterine sarcoma Part II-Uterine endometrial stromal sarcoma: The TAG systematic review.

    PubMed

    Horng, Huann-Cheng; Wen, Kuo-Chang; Wang, Peng-Hui; Chen, Yi-Jen; Yen, Ming-Shyen; Ng, Heung-Tat

    2016-08-01

    Endometrial stromal tumors are rare uterine tumors (<1%). Four main categories include endometrial stromal nodule, low-grade endometrial stromal sarcoma (LG-ESS), high-grade endometrial stromal sarcoma (HG-ESS), and uterine undifferentiated sarcoma (UUS). This review is a series of articles discussing the uterine sarcomas. LG-ESS, a hormone-dependent tumor harboring chromosomal rearrangement, is an indolent tumor with a favorable prognosis, but characterized by late recurrences even in patients with Stage I disease, suggesting the requirement of a long-term follow-up. Patients with HG-ESS, based on the identification of YWHAE-NUTM2A/B (YWHAE-FAM22A/B) gene fusion, typically present with advanced stage diseases and frequently have recurrences, usually within a few years after initial surgery. UUS is, a high-grade sarcoma, extremely rare, lacking a specific line of differentiation, which is a diagnosis of exclusion (the wastebasket category, which fails to fulfill the morphological and immunohistochemical criteria of translocation-positive ESS). Surgery is the main strategy in the management of uterine sarcoma. Due to rarity, complex biological characteristics, and unknown etiology and risk factors of uterine sarcomas, the role of adjuvant therapy is not clear. Only LG-ESS might respond to progestins or aromatase inhibitors. PMID:27590366

  3. Clinical Efficacy and Complications of Uterine Artery Embolization in Symptomatic Uterine Fibroids.

    PubMed

    Salehi, Mohammadgharib; Jalilian, Nasrin; Salehi, Ayoub; Ayazi, Mojgan

    2016-01-01

    We decided to evaluate the efficacy and complications of uterine artery embolization (UAE) in patients with symptomatic uterine fibroids. Sixty-five premenopausal patients, without considering the fibroids size and its location, were treated by bilateral UAE. At baseline and after 3, 6, and 12 months MRI was obtained to determine the uterine length and fibroid diameter. In addition, symptoms of the patients were documented at these follow-up schedules. UAE was successful in 62 (95.4%) cases. Complete infarction rate of the fibroid was 83.1%. After 12 months, the uterine length showed a decrease of 55.7% (mean of 9.4 cm) and the diameter of the dominant fibroid revealed a decrease of 52.1% (mean of 3.4 cm). Menorrhagia improved in 45 cases (91.8%), abdominal mass in 24 cases (82.28%), urinary symptoms in 17 cases (85%), pelvic pain in 21 cases (84%), and dysmenorrhea in 25 cases (80.6%). At final follow-up performed after one year, complete infarction of the fibroma was demonstrated in 49 patients (83.1%). Two cases achieved successful pregnancy in the one year follow-up period. Five patients developed post-embolization syndrome which necessitated admission to the hospital. Twenty-two patients presented and complained of pain for which outpatient pain management was done. UAE was a successful treatment for uterine fibroids that preserved the uterus, had minimal complications, and required short hospitalization and recovery.

  4. Relation between energy radiation ratio and rupture speed in numerically simulated earthquakes

    NASA Astrophysics Data System (ADS)

    Noda, H.; Lapusta, N.; Kanamori, H.

    2011-12-01

    One of the prominent questions in seismology is energy partitioning during an earthquake. Venkataraman and Kanamori [2004] discussed radiation ratio η_R, the ratio of radiated energy E_R to partial strain energy change ΔW_0 which is the total released strain energy minus the energy that would have been dissipated if a fault had slipped at the final stress. They found positive correlation between η_R and rupture speed in large earthquakes, and compared these data with theoretical estimates from simplified models. The relation between η_R and rupture speed is of great interest since both quantities can be estimated independently although there are large uncertainties. We conduct numerical simulations of dynamic ruptures and study the obtained energy partitioning (and η_R) and averaged rupture speeds V_r. So far, we have considered problems based on TPV103 from the SCEC/USGS Spontaneous Rupture Code Verification Project [Harris et al., 2009, http://scecdata.usc.edu/cvws/], which is a 3-D problem with the possibility of remarkable rate weakening at coseismic slip rates caused by flash heating of microscopic asperities [Rice, 1999]. We study the effect of background shear stress level τ_b and the manner in which rupture is arrested, either in rate-strengthening or unbreakable areas of the fault. Note that rupture speed at each fault point is defined when the rupture is still in progress, while η_R is defined after all dynamic processes such as propagation of a rupture front, healing fronts, and seismic waves have been completed. Those complexities may cause a difference from the theoretical estimates based on simple models, an issue we explore in this study. Overall, our simulations produce the relation between η_R and V_r broadly consistent with the study of Venkataraman and Kanamori (2004) for natural earthquakes and the corresponding theoretical estimates. The model by Mott [1948] agrees best with the cases studied so far, although it is not rigorously

  5. Spontaneous retroperitoneal renal hemorrhage: imaging and angiographic findings in five patients.

    PubMed

    Baekelandt, M; Leyman, P; Wynant, H; Stockx, L; Van Steenberge, R; D'Haenens, P

    1991-01-01

    The authors describe one case and report four other of pathologically proven spontaneous retroperitoneal renal hemorrhage due to a ruptured hemorrhagic cyst (2 cases), a renal cell carcinoma, an angiomyolipoma, and a tubular adenoma. The contribution of US, CT, and angiography to the diagnosis is discussed and the recent literature is reviewed.

  6. Hormones and pathogenesis of uterine fibroids.

    PubMed

    Reis, Fernando M; Bloise, Enrrico; Ortiga-Carvalho, Tânia M

    2016-07-01

    The role of ovarian steroid hormones in the pathogenesis of uterine fibroids is supported by epidemiological, clinical, and experimental evidence. Estradiol and progesterone induce mature leiomyoma cells to release mitogenic stimuli to adjacent immature cells, thereby providing uterine leiomyoma with undifferentiated cells that are likely to support tumor growth. Progesterone action is required for the complete development and proliferation of leiomyoma cells, while estradiol predominantly increases tissue sensitivity to progesterone by increasing the availability of progesterone receptors (PRs). The selective estrogen receptor modulator (SERM) raloxifene and the selective PR modulators (SPRMs) mifepristone, asoprisnil, and ulipristal acetate have been shown in clinical trials to inhibit fibroid growth. The role of sex steroids is critical for leiomyoma development and maintenance, but a number of autocrine and paracrine messengers are involved in this process; hence, numerous pathways remain to be explored in therapeutic innovations for treating this common disease. PMID:26725037

  7. Uterine fibroids: clinical manifestations and contemporary management.

    PubMed

    Doherty, Leo; Mutlu, Levent; Sinclair, Donna; Taylor, Hugh

    2014-09-01

    Uterine fibroids (leiomyomata) are extremely common lesions that are associated with detrimental effects including infertility and abnormal uterine bleeding. Fibroids cause molecular changes at the level of endometrium. Abnormal regulation of growth factors and cytokines in fibroid cells may contribute to negative endometrial effects. Understanding of fibroid biology has greatly increased over the last decade. Although the current armamentarium of Food and Drug Administration-approved medical therapies is limited, there are medications approved for use in heavy menstrual bleeding that can be used for the medical management of fibroids. Emergence of the role of growth factors in pathophysiology of fibroids has led researchers to develop novel therapeutics. Despite advances in medical therapies, surgical management remains a mainstay of fibroid treatment. Destruction of fibroids by interventional radiological procedures provides other effective treatments. Further experimental studies and clinical trials are required to determine which therapies will provide the greatest benefits to patients with fibroids.

  8. Hemobilia from ruptured hepatic artery aneurysm in polyarteritis nodosa.

    PubMed

    Park, Sung Soon; Kim, Byeong Uk; Han, Hye Suk; Goo, Ja Chung; Han, Joung Ho; Bae, Il Hun; Park, Seon Mee

    2006-03-01

    Hemobilia, in patients with the diagnosis of polyarteritis nodosa, is rare at clinical presentation and has a grave prognosis. We describe a case of massive hemobilia, due to aneurysmal rupture, in a patient with polyarteritis nodosa. A 39-year-old man was admitted to the hospital with upper abdominal pain. The patient had a history of partial small bowel resection, for intestinal infarction, about 5 years prior to this presentation. Abdominal computed tomography demonstrated multiple high attenuation areas in the bile duct and gallbladder. Hemobilia with blood seepage was visualized on endoscopic retrograde cholangiopancreatography; this bleeding stopped spontaneously. The following day, the patient developed a massive gastrointestinal bleed with resultant hypovolemic shock. Emergent hepatic angiogram revealed multiple microaneurysms; a communication was identified between a branch of the left hepatic artery and the bile duct. Hepatic arterial embolization was successfully performed. The underlying disease, polyarteritis nodosa, was managed with prednisolone and cyclophosphamide.

  9. Rupture and recoil of bent-core liquid crystal filaments.

    PubMed

    Salili, S M; Ostapenko, T; Kress, O; Bailey, C; Weissflog, W; Harth, K; Eremin, A; Stannarius, R; Jákli, A

    2016-05-25

    The recoil process of free-standing liquid crystal filaments is investigated experimentally and theoretically. We focus on two aspects, the contraction speed of the filament and a spontaneously formed undulation instability. At the moment of rupture, the filaments buckle similarly to the classical Euler buckling of elastic rods. The tip velocity decays with decreasing filament length. The wavelength of buckling affinely decreases with the retracting filament tip. The energy gain related to the decrease of the total length and surface area of the filaments is mainly dissipated by layer rearrangements during thickening of the fibre. A flow back into the meniscus is relevant only in the final stage of the recoil process. We introduce a model for the quantitative description of the filament retraction speed. The dynamics of this recoil behaviour may find relevance as a model for biology-related filaments. PMID:27140824

  10. Thermal ablative treatment of uterine fibroids.

    PubMed

    Quinn, Stephen Derek; Gedroyc, Wladyslaw M

    2015-05-01

    In addition to surgical methods of treating uterine fibroids, numerous non-invasive treatments have been developed. Many of these involve the use of hyperthermia, the heating of tissue by a variety of methods. These include the use of lasers, radiofrequency, microwave energy and high intensity focused ultrasound, guided by both ultrasound and magnetic resonance imaging. In this review we examine the technology behind these treatment modalities and review the current evidence for their use. PMID:25815582

  11. Uterine tumors in ataxia-telangiectasia.

    PubMed

    Gatti, R A; Nieberg, R; Boder, E

    1989-02-01

    Roughly one-third of patients with ataxia-telangiectasia (AT) develop malignant tumors, usually of lymphoid origin. AT patients also exhibit progeric changes. We describe three patients, between the ages of 27 and 32 years, with uterine tumors: one with a frank leiomyosarcoma and chronic T-cell leukemia, one with a multilobulated leiomyoma of uncertain malignant potential, and one with an unremarkable leiomyoma. Thus, the spectrum of tumors in AT patients beyond adolescence includes nonlymphoid malignancies and precocious, benign leiomyomas.

  12. 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

  13. Fractal avalanche ruptures in biological membranes

    NASA Astrophysics Data System (ADS)

    Gözen, Irep; Dommersnes, Paul; Czolkos, Ilja; Jesorka, Aldo; Lobovkina, Tatsiana; Orwar, Owe

    2010-11-01

    Bilayer membranes envelope cells as well as organelles, and constitute the most ubiquitous biological material found in all branches of the phylogenetic tree. Cell membrane rupture is an important biological process, and substantial rupture rates are found in skeletal and cardiac muscle cells under a mechanical load. Rupture can also be induced by processes such as cell death, and active cell membrane repair mechanisms are essential to preserve cell integrity. Pore formation in cell membranes is also at the heart of many biomedical applications such as in drug, gene and short interfering RNA delivery. Membrane rupture dynamics has been studied in bilayer vesicles under tensile stress, which consistently produce circular pores. We observed very different rupture mechanics in bilayer membranes spreading on solid supports: in one instance fingering instabilities were seen resulting in floral-like pores and in another, the rupture proceeded in a series of rapid avalanches causing fractal membrane fragmentation. The intermittent character of rupture evolution and the broad distribution in avalanche sizes is consistent with crackling-noise dynamics. Such noisy dynamics appear in fracture of solid disordered materials, in dislocation avalanches in plastic deformations and domain wall magnetization avalanches. We also observed similar fractal rupture mechanics in spreading cell membranes.

  14. Fractal avalanche ruptures in biological membranes.

    PubMed

    Gözen, Irep; Dommersnes, Paul; Czolkos, Ilja; Jesorka, Aldo; Lobovkina, Tatsiana; Orwar, Owe

    2010-11-01

    Bilayer membranes envelope cells as well as organelles, and constitute the most ubiquitous biological material found in all branches of the phylogenetic tree. Cell membrane rupture is an important biological process, and substantial rupture rates are found in skeletal and cardiac muscle cells under a mechanical load. Rupture can also be induced by processes such as cell death, and active cell membrane repair mechanisms are essential to preserve cell integrity. Pore formation in cell membranes is also at the heart of many biomedical applications such as in drug, gene and short interfering RNA delivery. Membrane rupture dynamics has been studied in bilayer vesicles under tensile stress, which consistently produce circular pores. We observed very different rupture mechanics in bilayer membranes spreading on solid supports: in one instance fingering instabilities were seen resulting in floral-like pores and in another, the rupture proceeded in a series of rapid avalanches causing fractal membrane fragmentation. The intermittent character of rupture evolution and the broad distribution in avalanche sizes is consistent with crackling-noise dynamics. Such noisy dynamics appear in fracture of solid disordered materials, in dislocation avalanches in plastic deformations and domain wall magnetization avalanches. We also observed similar fractal rupture mechanics in spreading cell membranes.

  15. Flexor digitorum superficialis rupture: a case report.

    PubMed

    Culver, J E

    1976-04-01

    A rupture of the musculotendinous junction of the flexor digitorum superficialis to the index finger in a baseball pitcher is described. No underlying abnormality could be detected. Because of loss of strength and dexterity, repair of the rupture was accomplished with an improved result.

  16. Uterine cancer in the writings of ancient Greek physicians.

    PubMed

    Tsoucalas, Gregory; Karamanou, Marianna; Sgantzos, Markos; Deligeoroglou, Efthimios; Androutsos, George

    2015-01-01

    In this article, we present the views on uterine cancer of the ancient Greek physicians. We emphasize on uterine's cancer aetiology according to the dominant in antiquity humoural theory, on its surgical treatment suggested by Soranus of Ephesus, and in the vivid description provided by Aretaeus of Cappadocia. During that period, uterine cancer was considered as an incurable and painful malignancy and its approach was mainly palliative. PMID:26537093

  17. Uterine activty and plasma progesterone levels in pregnant goats.

    PubMed

    Jones, D E; Kinfton, A

    1977-01-01

    Uterine activity was recorded during the last few weeks of pregnacy in goats, and related to changes in plasma progesterone concentration. In six of the 14 pregnancies, there was little activity until immediately pre-partum, but the remainder showed a progressive increase in uterine motility, particularly during the last seven days of pregnancy. There was a significant correlation between increased uterine activity and decline of peripheral plasma progesterone levels. PMID:841203

  18. Uterine activty and plasma progesterone levels in pregnant goats.

    PubMed

    Jones, D E; Kinfton, A

    1977-01-01

    Uterine activity was recorded during the last few weeks of pregnacy in goats, and related to changes in plasma progesterone concentration. In six of the 14 pregnancies, there was little activity until immediately pre-partum, but the remainder showed a progressive increase in uterine motility, particularly during the last seven days of pregnancy. There was a significant correlation between increased uterine activity and decline of peripheral plasma progesterone levels.

  19. Uterine cancer in the writings of ancient Greek physicians.

    PubMed

    Tsoucalas, Gregory; Karamanou, Marianna; Sgantzos, Markos; Deligeoroglou, Efthimios; Androutsos, George

    2015-01-01

    In this article, we present the views on uterine cancer of the ancient Greek physicians. We emphasize on uterine's cancer aetiology according to the dominant in antiquity humoural theory, on its surgical treatment suggested by Soranus of Ephesus, and in the vivid description provided by Aretaeus of Cappadocia. During that period, uterine cancer was considered as an incurable and painful malignancy and its approach was mainly palliative.

  20. Uterine anomaly and recurrent pregnancy loss.

    PubMed

    Sugiura-Ogasawara, Mayumi; Ozaki, Yasuhiko; Katano, Kinue; Suzumori, Nobuhiro; Mizutani, Eita

    2011-11-01

    Women with recurrent pregnancy loss have a 3.2 to 6.9% likelihood of having a major uterine anomaly and a 1.0 to 16.9% chance of having an arcuate uterus. Bicornuate and septate uterine have a negative impact on reproductive outcomes and are associated with subsequent euploid miscarriage. The impact of an arcuate uterus on pregnancy outcome remains unclear. There are no definitive criteria to distinguish among the arcuate, septate, and bicornuate uteri. The American Fertility Society classification of Müllerian anomalies is the most common standardized classification of uterine anomalies. According to estimates, 65 to 85% of patients with bicornuate or septate uteri have a successful pregnancy outcome after metroplasty. However, 59.5% of the patients with such anomalies have a successful subsequent pregnancy without surgery, with a cumulative live birthrate of 78.0%. There is no case-control study to compare live birthrates in women who had surgery compared with those who did not. Strict criteria to distinguish between the bicornuate and septate uterus should be established. Further study is needed to confirm the benefits of metroplasty.

  1. Computational modeling of inhibition of voltage-gated Ca channels: identification of different effects on uterine and cardiac action potentials

    PubMed Central

    Tong, Wing-Chiu; Ghouri, Iffath; Taggart, Michael J.

    2014-01-01

    The uterus and heart share the important physiological feature whereby contractile activation of the muscle tissue is regulated by the generation of periodic, spontaneous electrical action potentials (APs). Preterm birth arising from premature uterine contractions is a major complication of pregnancy and there remains a need to pursue avenues of research that facilitate the use of drugs, tocolytics, to limit these inappropriate contractions without deleterious actions on cardiac electrical excitation. A novel approach is to make use of mathematical models of uterine and cardiac APs, which incorporate many ionic currents contributing to the AP forms, and test the cell-specific responses to interventions. We have used three such models—of uterine smooth muscle cells (USMC), cardiac sinoatrial node cells (SAN), and ventricular cells—to investigate the relative effects of reducing two important voltage-gated Ca currents—the L-type (ICaL) and T-type (ICaT) Ca currents. Reduction of ICaL (10%) alone, or ICaT (40%) alone, blunted USMC APs with little effect on ventricular APs and only mild effects on SAN activity. Larger reductions in either current further attenuated the USMC APs but with also greater effects on SAN APs. Encouragingly, a combination of ICaL and ICaT reduction did blunt USMC APs as intended with little detriment to APs of either cardiac cell type. Subsequent overlapping maps of ICaL and ICaT inhibition profiles from each model revealed a range of combined reductions of ICaL and ICaT over which an appreciable diminution of USMC APs could be achieved with no deleterious action on cardiac SAN or ventricular APs. This novel approach illustrates the potential for computational biology to inform us of possible uterine and cardiac cell-specific mechanisms. Incorporating such computational approaches in future studies directed at designing new, or repurposing existing, tocolytics will be beneficial for establishing a desired uterine specificity of action

  2. The effects of barriers on supershear rupture

    NASA Astrophysics Data System (ADS)

    Xu, Jiankuan; Zhang, Zhenguo; Chen, Xiaofei

    2016-07-01

    A barrier may induce a supershear rupture transition in some cases, whereas it may prevent the further propagation of a supershear rupture in other cases. We investigate the effects of a barrier on the supershear rupture propagation on a planar fault in a 3-D half-space. Our results show that the effect of a barrier on supershear is strongly dependent on its size, strength, and location. For larger sizes, shallower buried depths, and relatively higher strengths, the barrier tends to prevent supershear propagation more strongly. When the barrier is located on the free surface and near the critical distance, it prevents the further propagation of supershear rupture. If a barrier is located far from the critical distance, the first supershear daughter crack is slowed down and a new supershear daughter crack is generated after the rupture front passes through the barrier. This mechanism greatly lengthens the supershear transition distance.

  3. Uterine disorders and pregnancy complications: insights from mouse models

    PubMed Central

    Lim, Hyunjung Jade; Wang, Haibin

    2010-01-01

    Much of our knowledge of human uterine physiology and pathology has been extrapolated from the study of diverse animal models, as there is no ideal system for studying human uterine biology in vitro. Although it remains debatable whether mouse models are the most suitable system for investigating human uterine function(s), gene-manipulated mice are considered by many the most useful tool for mechanistic analysis, and numerous studies have identified many similarities in female reproduction between the two species. This Review brings together information from studies using animal models, in particular mouse models, that shed light on normal and pathologic aspects of uterine biology and pregnancy complications. PMID:20364098

  4. Do buried-rupture earthquakes trigger less landslides than surface-rupture earthquakes for reverse faults?

    NASA Astrophysics Data System (ADS)

    Xu, Chong

    2014-07-01

    Gorum et al. (2013, Geomorphology 184, 127-138) carried out a study on inventory compilation and statistical analyses of landslides triggered by the 2010 Mw 7.0 Haiti earthquake. They revealed that spatial distribution patterns of these landslides were mainly controlled by complex rupture mechanism and topography. They also suggested that blind-rupture earthquakes trigger fewer landslides than surface-rupture earthquakes on thrust reverse faults. Although a few lines of evidence indicate that buried-rupture earthquakes might trigger fewer landslides than surface-rupture earthquakes on reverse faults, more careful comparisons and analyses indicate that it is not always true. Instead, some cases show that a buried-rupture earthquake can trigger a larger quantity of landslides that are distributed in a larger area, whereas surface-rupture earthquakes can trigger larger but a fewer landslides distributed in a smaller area.

  5. Uterine artery embolisation for uterine fibroids: Our experience at a tertiary care service hospital

    PubMed Central

    Dsouza, John; Kumar, Sushil; Hande, P.C.; Singh, S.N.

    2015-01-01

    Background Uterine artery embolisation (UAE) has evolved as a minimally invasive and effective alternative, treatment modality for women with symptomatic fibroids. We discuss our initial experience of UAE in the management of symptomatic fibroids. Methods Twenty five symptomatic patients of uterine fibroids were treated with UAE by selectively cannulating and injecting poly vinyl alcohol particles into the uterine arteries. Post treatment follow up was done at 2 and 6 months respectively. Results Pre-treatment, the sizes of fibroids were between 3.9 and 10.9 cm (mean 7.4) on ultrasonography. Of the total 25 patients, 49 uterine arteries were embolised with a technical success rate of 98%. Menorrhagia persisted in 7 patients, dysmenorrhea in 4 patients and pressure symptoms in 2 patients respectively in follow up study of six months which corresponds to a reduction in symptoms by 68% for menorrhagia, 71% for dysmenorhoea and 75% for those with pressure symptoms respectively. At 2 months follow-up post embolisation, the mean diameter of the fibroid was 4.03 cm (range 2–5.2 cm) and at 6 months 3.2 cm (range 1.3–4.1 cm), corresponding to size reduction of 45.5% and 57%, respectively. Follow up with ultrasonography at 2 and 6 months period showed successful fibroid reduction in 24 patients with corresponding reduction in the symptomatology. One patient remained symptomatic with increase in fibroid size and had to undergo hysterectomy. Conclusion Uterine artery embolisation can be considered as an alternative to hysterectomy in appropriately selected symptomatic patients of uterine fibroids. PMID:26288491

  6. Outpatient versus inpatient uterine polyp treatment for abnormal uterine bleeding: randomised controlled non-inferiority study

    PubMed Central

    Cooper, Natalie A M; Middleton, Lee; Diwakar, Lavanya; Smith, Paul; Denny, Elaine; Roberts, Tracy; Stobert, Lynda; Jowett, Susan; Daniels, Jane

    2015-01-01

    Objective To compare the effectiveness and acceptability of outpatient polypectomy with inpatient polypectomy. Design Pragmatic multicentre randomised controlled non-inferiority study. Setting Outpatient hysteroscopy clinics in 31 UK National Health Service hospitals. Participants 507 women who attended as outpatients for diagnostic hysteroscopy because of abnormal uterine bleeding and were found to have uterine polyps. Interventions Participants were randomly assigned to either outpatient uterine polypectomy under local anaesthetic or inpatient uterine polypectomy under general anaesthesia. Data were collected on women’s self reported bleeding symptoms at baseline and at 6, 12, and 24 months. Data were also collected on pain and acceptability of the procedure at the time of polypectomy. Main outcome measures The primary outcome was successful treatment, determined by the women’s assessment of bleeding at six months, with a prespecified non-inferiority margin of 25%. Secondary outcomes included generic (EQ-5D) and disease specific (menorrhagia multi-attribute scale) quality of life, and feasibility and acceptability of the procedure. Results 73% (166/228) of women in the outpatient group and 80% (168/211) in the inpatient group reported successful treatment at six months (intention to treat relative risk 0.91, 95% confidence interval 0.82 to 1.02; per protocol relative risk 0.92, 0.82 to 1.02). Failure to remove polyps was higher (19% v 7%; relative risk 2.5, 1.5 to 4.1) and acceptability of the procedure was lower (83% v 92%; 0.90, 0.84 to 0.97) in the outpatient group Quality of life did not differ significantly between the groups. Four uterine perforations, one of which necessitated bowel resection, all occurred in the inpatient group. Conclusions Outpatient polypectomy was non-inferior to inpatient polypectomy. Failure to remove a uterine polyp was, however, more likely with outpatient polypectomy and acceptability of the procedure was slightly lower. Trial

  7. MR Reproducibility in the Assessment of Uterine Fibroids for Patients Scheduled for Uterine Artery Embolization

    SciTech Connect

    Volkers, Nicole A. Hehenkamp, Wouter J. K.; Spijkerboer, Anje M.; Moolhuijzen, Albert D.; Birnie, Erwin; Ankum, Willem M.; Reekers, Jim A.

    2008-03-15

    Magnetic resonance imaging (MRI) is increasingly applied in the evaluation of uterine fibroids. However, little is known about the reproducibility of MRI in the assessment of uterine fibroids. This study evaluates the inter- and intraobserver variation in the assessment of the uterine fibroids and concomitant adenomyosis in women scheduled for uterine artery embolization (UAE). Forty patients (mean age: 44.5 years) with symptomatic uterine fibroids who were scheduled for UAE underwent T{sub 1}- and T{sub 2}-weighted MRI. To study inter- and intraobserver agreement 40 MR images were evaluated independently by two observers and reevaluated by both observers 4 months later. Inter- and intraobserver agreement was calculated using Cohen's {kappa} statistic and intraclass correlation coefficient for categorical and continuous variables, respectively. Inter-observer agreement for uterine volumes ({kappa} = 0.99, p < 0.0001), dominant fibroid volumes ({kappa} = 0.98, p {<=} 0.0001), and number of fibroids ({kappa} = 0.88; CI, 0.77-0.93; p < 0.0001) was excellent. For the T{sub 1}- and T{sub 2}-weighted signal intensity of the dominant fibroid there was good agreement between the observers (87%; 95% CI, 71.9%-95.6%) and the intraobserver agreement was good for observer A (95%; 95% CI, 83.1%-99.4%) and moderate for observer B ({kappa} = 0.47). The interobserver agreement with respect to the presence of adenomyosis was good ({kappa} = 0.73, p < 0.0001), while both intraobserver agreements were fair to moderate (observer A, {kappa} = 0.55, p = 0.0003; and observer B, {kappa} = 0.66, p < 0.0001). In conclusion, MRI criteria used for the selection of suitable UAE patients show good inter- and intraobserver reproducibility.

  8. Current Role of Uterine Artery Embolization in the Management of Uterine Fibroids.

    PubMed

    Spies, James B

    2016-03-01

    Uterine artery embolization (UAE) is a well-established therapy for uterine fibroids, with safety and efficacy demonstrated in several comparative randomized trials. It is a minimally invasive procedure, which allows for rapid recovery and return to normal activities. Most studies demonstrate outcomes similar to those of myomectomy with a reintervention rate of 20% to 30% at 5 years after therapy. While pregnancy is often successful after UAE, limited comparative data suggest that myomectomy may be preferred in those patients who have not had prior fibroid interventions. UAE should be discussed as an option for most women presenting for treatment of fibroids. PMID:26630074

  9. Transcatheter arterial embolization of a uterine artery pseudoaneurysm with Onyx® following D&C for uterine bleeding.

    PubMed

    Wendel, Mark; Beheshti, Michael; Yousaf, Muhammad; Erdem, Eren

    2013-01-01

    Transcatheter uterine artery embolization is well described and performed for treatment of symptomatic uterine leiomyomas, for postpartum hemorrhage, and for hemorrhage following hysterectomy. Embolic agents have included polyvinyl alcohol, gelfoam, coils, and Embospheres®. We present a case of severe uterine hemorrhage after a missed abortion (after two instances of dilatation and curettage), which could not be managed with traditional embolic techniques but was successfully controlled with Onyx®.

  10. Spontaneous combustion of hydrogen

    NASA Technical Reports Server (NTRS)

    Nusselt, Wilhelm; Pothmann, PH

    1923-01-01

    It is shown by the author's experiments that hydrogen which escapes to the atmosphere through openings in the system may burn spontaneously if it contains dust. Purely thermal reasoning can not account for the combustion. It seems to be rather an electrical ignition. In order to determine whether the cause of the spontaneous ignition was thermo-chemical, thermo-mechanical, or thermo-electrical, the experiments in this paper were performed.

  11. Spontaneous cholecystocutaneous abscess.

    PubMed

    Metsemakers, W J; Quanten, I; Vanhoenacker, F; Spiessens, T

    2010-01-01

    Spontaneous cholecystocutaneous abscesses or fistulae are rare complications of neglected biliary calculous disease which have become extremely rare during the last decades. We report a case of spontaneous cholecystocutaneous abscess in a 69-year-old male who presented with a mass in the right subcostal region.The diagnosis was made by CT scan with multiplanar reformating. Treatment consisted of incision and drainage of the abdominal wall abscess followed by cholecystectomy in a one-stage protocol.

  12. Fan-head shear rupture mechanism as a source of off-fault tensile cracking

    NASA Astrophysics Data System (ADS)

    Tarasov, Boris

    2016-04-01

    This presentation discusses the role of a recently identified fan-head shear rupture mechanism [1] in the creation of off-fault tensile cracks observed in earthquake laboratory experiments conducted on brittle photoelastic specimens [2,3]. According to the fan-mechanism the shear rupture propagation is associated with consecutive creation of small slabs in the fracture tip which, due to rotation caused by shear displacement of the fracture interfaces, form a fan-structure representing the fracture head. The fan-head combines such unique features as: extremely low shear resistance (below the frictional strength) and self-sustaining tensile stress intensification along one side of the interface. The variation of tensile stress within the fan-head zone is like this: it increases with distance from the fracture tip up to a maximum value and then decreases. For the initial formation of the fan-head high local stresses corresponding to the fracture strength should be applied in a small area, however after completions of the fan-head it can propagate dynamically through the material at low shear stresses (even below the frictional strength). The fan-mechanism allows explaining all unique features associated with the off-fault cracking process observed in photoelastic experiments [2,3]. In these experiments spontaneous shear ruptures were nucleated in a bonded, precut, inclined and pre-stressed interface by producing a local pressure pulse in a small area. Isochromatic fringe patterns around a shear rupture propagating along bonded interface indicate the following features of the off-fault tensile crack development: tensile cracks nucleate and grow periodically along one side of the interface at a roughly constant angle (about 80 degrees) relative to the shear rupture interface; the tensile crack nucleation takes place some distance behind the rupture tip; with distance from the point of nucleation tensile cracks grow up to a certain length within the rupture head zone

  13. Dynamic Rupture Modeling in Three Dimensions on Unstructured Meshes Using a Discontinuous Galerkin Method

    NASA Astrophysics Data System (ADS)

    Pelties, C.; Käser, M.

    2010-12-01

    We will present recent developments concerning the extensions of the ADER-DG method to solve three dimensional dynamic rupture problems on unstructured tetrahedral meshes. The simulation of earthquake rupture dynamics and seismic wave propagation using a discontinuous Galerkin (DG) method in 2D was recently presented by J. de la Puente et al. (2009). A considerable feature of this study regarding spontaneous rupture problems was the combination of the DG scheme and a time integration method using Arbitrarily high-order DERivatives (ADER) to provide high accuracy in space and time with the discretization on unstructured meshes. In the resulting discrete velocity-stress formulation of the elastic wave equations variables are naturally discontinuous at the interfaces between elements. The so-called Riemann problem can then be solved to obtain well defined values of the variables at the discontinuity itself. This is in particular valid for the fault at which a certain friction law has to be evaluated. Hence, the fault’s geometry is honored by the computational mesh. This way, complex fault planes can be modeled adequately with small elements while fast mesh coarsening is possible with increasing distance from the fault. Due to the strict locality of the scheme using only direct neighbor communication, excellent parallel behavior can be observed. A further advantage of the scheme is that it avoids spurious high-frequency contributions in the slip rate spectra and therefore does not require artificial Kelvin-Voigt damping or filtering of synthetic seismograms. In order to test the accuracy of the ADER-DG method the Southern California Earthquake Center (SCEC) benchmark for spontaneous rupture simulations was employed. Reference: J. de la Puente, J.-P. Ampuero, and M. Käser (2009), Dynamic rupture modeling on unstructured meshes using a discontinuous Galerkin method, JOURNAL OF GEOPHYSICAL RESEARCH, VOL. 114, B10302, doi:10.1029/2008JB006271

  14. Patient, Physician, and Nurse Factors Associated With Entry Onto Clinical Trials and Finishing Treatment in Patients With Primary or Recurrent Uterine, Endometrial, or Cervical Cancer

    ClinicalTrials.gov

    2016-10-26

    Recurrent Cervical Carcinoma; Recurrent Uterine Corpus Carcinoma; Recurrent Uterine Corpus Sarcoma; Stage I Uterine Corpus Cancer; Stage I Uterine Sarcoma; Stage IA Cervical Cancer; Stage IB Cervical Cancer; Stage II Uterine Corpus Cancer; Stage II Uterine Sarcoma; Stage IIA Cervical Cancer; Stage IIB Cervical Cancer; Stage III Cervical Cancer; Stage III Uterine Corpus Cancer; Stage III Uterine Sarcoma; Stage IV Uterine Corpus Cancer; Stage IV Uterine Sarcoma; Stage IVA Cervical Cancer; Stage IVB Cervical Cancer

  15. In Vitro Assessment of the Expression and T Cell Immunogenicity of the Tumor-Associated Antigens BORIS, MUC1, hTERT, MAGE-A3 and Sp17 in Uterine Cancer

    PubMed Central

    Vanderstraeten, Anke; Tuyaerts, Sandra; Everaert, Tina; Van Bree, Rieta; Verbist, Godelieve; Luyten, Cathérine; Amant, Frederic

    2016-01-01

    Background: While immunotherapy moved to the forefront of treatment of various cancers, it remains underexplored for uterine cancer. This might be due to the small patient population with advanced endometrial carcinoma and uterine sarcoma. Data about immunotherapeutic targets are scarce in endometrial carcinoma and lacking in uterine sarcoma. Methods: Expression of five tumor-associated antigens (TAA) (BORIS, MUC1, hTERT, MAGE-A3 and Sp17) was validated in uterine tumor samples by immunohistochemistry (IHC) and/or quantitative reverse-transcriptase polymerase chain reaction (qRT-PCR). TAA immunogenicity was analyzed by determining spontaneous T cell responses towards overlapping peptide pools covering the whole TAA in patient blood. Results: At mRNA level, MAGE-A3 and Sp17 were overexpressed in a minority of patients and BORIS was moderately overexpressed (26% in endometrial carcinoma and 62% in uterine sarcoma). hTERT was overexpressed in the vast majority of tumors. On protein level, MUC1 was upregulated in primary, recurrent and metastatic EMCAR and in metastatic US tumors. hTERT protein was highly expressed in both normal and malignant tissue. Spontaneous TAA-specific T cell responses were detected in a minority of patients, except for hTERT to which T cell responses occurred more frequently. Conclusions: These data point to MUC1 and hTERT as most suitable targets based on expression levels and T cell immunogenicity for use in immunotherapeutic regimens. PMID:27618037

  16. Therapeutic strategies for complications secondary to hydatid cyst rupture

    PubMed Central

    Cobanoglu, Ufuk; Sayır, Fuat; Şehitoğlu, Abidin; Bilici, Salim; Melek, Mehmet

    2011-01-01

    Objective: Clinical approach and therapeutic methods are important in cases with complicated hydatid cysts of the lung. This study was designed to retrospectively investigate cases with hydatid cysts, thereby discussing diagnostic methods, treatment modalities, and rates of morbidity and mortality in line with the literature. Methods: 176 cases with perforated hydatid cysts, who presented to our clinic and underwent surgery between 2003 and 2011, were included in the study. There were 71 (40.34%) females and 105 males (59.66%) with a mean age of 27.80±14.07. The most common symptom was dyspnea (44.31%) and the most common radiological finding was the water lily sign (21.02%). 88.06% of the cases were surgically treated by Cystotomy+closure of bronchial opening+ capitonnage, 3.97% by wedge resection, 4.54% by segmentectomy and 3.40% by lobectomy. Results: The cysts exhibited multiple localization in 24 cases (13.63%), bilateral localization in 14 cases (7.95%), with the most common localization (43.75%) being the right lower lobe. While the hydatid cyst rupture occurred due to delivery in three (1.70%), trauma in 11 (6.25%), and iatrogenic causes in seven (3.97%) cases, it occurred spontaneously in the rest of the cases (88.08%). Fourteen of the cases with spontaneously occurring rupture (7.95%) were detected to have received anthelmintic treatment for hydatid cyst during the preoperative period (albendazole). The rate of morbidity was 27.27% and the rate of mortality was 1.13% in our study. Two cases recurred during a one-year follow-up (1.13%). Conclusion: Hydatid cyst rupture should be considered in the differential diagnosis of cases with pleural effusion, empyema, pneumothorax and pneumonia occurring in endemic regions. Symptoms occurring during and after perforation lead to errors in differential diagnosis. Performing the surgery without delay favorably affects postoperative morbidity and mortality. While parenchyma-preserving surgery is preferential, there

  17. The Role of Vitamin D in Uterine Fibroid Biology

    PubMed Central

    Brakta, Soumia; Diamond, Justin S.; Al-Hendy, Ayman; Diamond, Michael P.; Halder, Sunil K.

    2015-01-01

    Objective To provide a detailed summary of current scientific knowledge on uterine fibroids (leiomyomas) in vitro and in in vivo animal models, as well as to postulate the potential role of vitamin D3 as an effective, inexpensive, safe long-term treatment option for uterine fibroids. Design PubMed search articles were used to identify the most relevant studies on uterine fibroids as well as effects of vitamin D3 on uterine fibroid cells and fibroid tumor growth in in vivo animal models. Setting University research laboratory - affiliated infertility clinic. Patient(s) Not applicable. Intervention(s) None Main Outcome Measure(s) Not applicable. Results Despite numerous publications available on uterine fibroids, information about the role that vitamin D3 plays in the regulation of uterine fibroids are limited. Most of the recent vitamin D3-related studies on uterine fibroids were published from our group. Recent studies have demonstrated that vitamin D deficiency plays a significant role in the development of uterine fibroids. Our recent studies have demonstrated that vitamin D3 reduces leiomyoma cell proliferation in vitro, and leiomyoma tumor growth in in vivo animal models. These results postulate the potential role of vitamin D3 for an effective, safe non-surgical medical treatment option for uterine fibroids. Conclusions This article reviews human and animal studies and uncover new possibilities for understanding the vitamin D-based therapeutic option for an effective, safe long-term treatment of uterine fibroids. Based on these results, a clinical trial with vitamin D3 or a hypocalcemic analog, paricalcitol may be warranted for non-surgical medical treatment of uterine fibroids. PMID:26079694

  18. Reproductive failure due to spontaneous abortion and recurrent miscarriage.

    PubMed

    Bulletti, C; Flamigni, C; Giacomucci, E

    1996-01-01

    The epidemiology, aetiology, diagnosis and clinical management of spontaneous and recurrent abortion and of the failure of embryo implantation are discussed in a retrospective overview of the major studies conducted since 1975 identified through a Medline search. Infertile women who experienced spontaneous single (32%) and recurrent (0.5%) abortion as well as those who became pregnant after induction of ovulation with gonadotrophins (abortion rate 17-31%) and those who underwent assisted fertilization programmes (abortion rate 18-34%) are considered. Causes and treatments are here reported. Medical treatments for immunologically mediated abortion (IMA) are based on prednisolone, heparin, aspirin and intravenous immunoglobulin. Efficacy of the medical treatment of patients with a history of IMA has yet to be completely demonstrated. Genetic disorders are possible causes of both failure in implantation and early abortion; this cause is more prominent with advanced age and currently cannot be treated. Endocrine factors may also be responsible for miscarriage, and correction of hormone abnormalities is discussed. Infections, endometriosis and psychological factors are other possible important causes of embryo loss without specific widely accepted treatments. Prominent areas of research are the identification of genetic preimplantation abnormalities, and pharmacological intervention for abnormal spontaneous uterine contractility. The data here reported are encouraging, but the efficacy of different treatments is still not convincing. The information available is sufficient to develop new diagnostic and therapeutic tools to evaluate their efficacy in reducing spontaneous abortion at an early stage.

  19. Metrics for comparing dynamic earthquake rupture simulations

    USGS Publications Warehouse

    Barall, Michael; Harris, Ruth A.

    2014-01-01

    Earthquakes are complex events that involve a myriad of interactions among multiple geologic features and processes. One of the tools that is available to assist with their study is computer simulation, particularly dynamic rupture simulation. A dynamic rupture simulation is a numerical model of the physical processes that occur during an earthquake. Starting with the fault geometry, friction constitutive law, initial stress conditions, and assumptions about the condition and response of the near‐fault rocks, a dynamic earthquake rupture simulation calculates the evolution of fault slip and stress over time as part of the elastodynamic numerical solution (Ⓔ see the simulation description in the electronic supplement to this article). The complexity of the computations in a dynamic rupture simulation make it challenging to verify that the computer code is operating as intended, because there are no exact analytic solutions against which these codes’ results can be directly compared. One approach for checking if dynamic rupture computer codes are working satisfactorily is to compare each code’s results with the results of other dynamic rupture codes running the same earthquake simulation benchmark. To perform such a comparison consistently, it is necessary to have quantitative metrics. In this paper, we present a new method for quantitatively comparing the results of dynamic earthquake rupture computer simulation codes.

  20. Age at intracranial aneurysm rupture among generations

    PubMed Central

    Woo, D; Hornung, R; Sauerbeck, L; Brown, R; Meissner, I; Huston, J; Foroud, T; Broderick, J

    2009-01-01

    Background: Previous studies have reported intracranial aneurysm (IA) occurring at young ages in subsequent generations. These studies did not correct for duration of follow-up. Second-generation members who would have their ruptured IA late in life may not be detected due to shorter follow-up time than the first generation. We examined families in which ruptured IA occurred in two consecutive generations for the hypothesis that the second generation (F1) was more likely to have a rupture at a younger age than the older generation (F0). Methods: The Familial Intracranial Aneurysm (FIA) Study is a multicenter, international study recruiting families of ruptured and unruptured IA. All available family members are interviewed. Cox proportional hazards regression models and Kaplan-Meier curves were used to examine differences by generation. Results: Although we found that the F1 generation was more likely to have an aneurysm rupture at a younger age than the F0 generation, we found that this was largely because of a lack of follow-up time in the F1 generation. The F1 generation had 50% the rupture rate of the prior generation. When analyzed by Kaplan-Meier curves, we found a tendency to have a slightly later rupture rate in the F1 generation once time to follow-up was included in the analysis model. Conclusions: Families of ruptured intracranial aneurysm (IA) do not appear to demonstrate “anticipation.” Our finding suggests that genetic epidemiology of ruptured IA should examine all types of variations such as single base-pair changes, deletions, insertions, and other variations that do not demonstrate anticipation. GLOSSARY FIA = familial intracranial aneurysm; IA = intracranial aneurysm; SAH = subarachnoid hemorrhage. PMID:19237697