Cleft lip with or without cleft palate(CP) is one of the most common congenital malformations. Ultrasonographers involved in the routine 20-wk ultrasound screening could encounter these malformations. The face and pal...Cleft lip with or without cleft palate(CP) is one of the most common congenital malformations. Ultrasonographers involved in the routine 20-wk ultrasound screening could encounter these malformations. The face and palate develop in a very characteristic way. For ultrasonographers involved in screening these patients it is crucial to have a thorough understanding of the embryology of the face. This could help them to make a more accurate diagnosis and save time during the ultrasound. Subsequently, the current postnatal classification will be discussed to facilitate the communication with the CP teams.展开更多
The perineal membrane (PM) is a thick, elastic fiber-rich, smooth muscle-poor membrane extending along the vestibule and lower vaginal wall and embedding the urethrovaginal sphincter and compressor urethrae muscles. T...The perineal membrane (PM) is a thick, elastic fiber-rich, smooth muscle-poor membrane extending along the vestibule and lower vaginal wall and embedding the urethrovaginal sphincter and compressor urethrae muscles. To provide a better understanding of the topographical relationship between the PM and the levator ani muscle, we examined histological sections from 15 female cadavers. The composite fibers of the PM were usually continuous with that of a fascia covering the inferior or lateral surface of the levator ani (fascia diaphragmatis pelvis inferior) rather than the endopelvic fascia covering the superior or medial surface of the latter muscle. However, this fascial connection was sometimes interrupted by a venous plexus. The deep transverse perineal muscle was consistently adjacent to the posterolateral aspect of the PM, but whether it extended superficially or deeply to the PM depended on size of the muscle. In contrast to the endopelvic fascia embedding abundant middle-sized nerves (cavernous and sphincter nerves;0.05 - 0.1 mm in thickness), the PM contained very thin nerves: many in 10 cadavers but few in 5 cadavers. Most of the nerves seemed to be sensory on the basis of immunohistochemistry. The levator ani muscle was considered likely to provide traction force to the PM, but active elevation appeared to be difficult because of the highly elastic nature of the PM and the interrupting venous plexus. Loss of nerves in the PM might be one of a number of factors that can accelerate pelvic organ prolapse.展开更多
We reported a case of an intravesical foreign body in a 16 years old teenager for abortion attempt. During laparotomy for suspected pelvic appendicitis, we incidentally discovered an intravesical foreign body. From th...We reported a case of an intravesical foreign body in a 16 years old teenager for abortion attempt. During laparotomy for suspected pelvic appendicitis, we incidentally discovered an intravesical foreign body. From this first observation in our urology division, we reviewed the literature on the nature and circumstance of self introduction in bladder of foreign body and their surgical ablation. We emphasized the importance of endoscopy as a support of diagnosis and therapeutic of intravesical foreign body. This observation also highlighted the lack of information in our teenagers about reproductive and sexual health.展开更多
BACKGROUND Hormones could play a role in the evolution of follicular thyroid cancer(FTC)for which we discuss an unusual presentation of FTC occurring during pregnancy.CASE SUMMARY A pregnant woman was admitted with FT...BACKGROUND Hormones could play a role in the evolution of follicular thyroid cancer(FTC)for which we discuss an unusual presentation of FTC occurring during pregnancy.CASE SUMMARY A pregnant woman was admitted with FTC metastasis resulting in a gluteal mass.Preoperative abdominal computed tomography revealed liver metastasis for which the patient underwent total thyroidectomy and liver resection,oral radioiodine therapy and radiotherapy,followed by embolization of the pelvic mass.The patient died of cerebral hemorrhage 16 mo after the initial diagnosis.CONCLUSION Human chorionic gonadotropin and estrogen stimulation might have a role in cancer growth,especially during pregnancy.FTC management aims to stop disease progression and overcome hormonal imbalances after thyroidectomy thus reducing fetal complications.It is still under debate whether it is possible to combine optimal timing for treatment to ensure the best possible outcome with reduction of fetal complications and risk of cancer growth.展开更多
Objective. The aim of this retrospective multicenter study was to assess whether the pre- chemotherapy hemoglobin levels have any impact on the clinical outcome of patients with advanced epithelial ovarian cancer who ...Objective. The aim of this retrospective multicenter study was to assess whether the pre- chemotherapy hemoglobin levels have any impact on the clinical outcome of patients with advanced epithelial ovarian cancer who received a first- line taxane/platinum- based regimen. Methods. The study was conducted on 315 patients who underwent initial surgery followed by taxane/- platinum- based chemotherapy for FIGO stage IIc- IV epithelial ovarian cancer. All the patients had ECOG performance status 0- 1 at presentation. The median follow- up of survivors was 36 months (range, 6- 120 months). Results. The 25% , 50% , and 75% quantiles of hemoglobin levels before starting first line chemotherapy were 10.2, 11.4, and 12.3 g/dl, respectively. Residual disease after initial surgery (>1cmversus ≤ 1cm, P = 0.0013) was the only independent prognostic variable for overall survival. Conversely, hemoglobin levels (< 10.2 g/dl versus 10.2- 11.4 g/dl versus 11.5- 12.3 g/dl versus >12.3 g/dl)were inversely related to overall survival at univariate (P = 0.03) but not at multivariate analysis. Conclusions. This investigation showed that hemoglobin levels before starting first- line taxane/platinum- based chemotherapy are not an independent prognostic factor for overall survival in patients with advanced epithelial ovarian cancer.展开更多
文摘Cleft lip with or without cleft palate(CP) is one of the most common congenital malformations. Ultrasonographers involved in the routine 20-wk ultrasound screening could encounter these malformations. The face and palate develop in a very characteristic way. For ultrasonographers involved in screening these patients it is crucial to have a thorough understanding of the embryology of the face. This could help them to make a more accurate diagnosis and save time during the ultrasound. Subsequently, the current postnatal classification will be discussed to facilitate the communication with the CP teams.
文摘The perineal membrane (PM) is a thick, elastic fiber-rich, smooth muscle-poor membrane extending along the vestibule and lower vaginal wall and embedding the urethrovaginal sphincter and compressor urethrae muscles. To provide a better understanding of the topographical relationship between the PM and the levator ani muscle, we examined histological sections from 15 female cadavers. The composite fibers of the PM were usually continuous with that of a fascia covering the inferior or lateral surface of the levator ani (fascia diaphragmatis pelvis inferior) rather than the endopelvic fascia covering the superior or medial surface of the latter muscle. However, this fascial connection was sometimes interrupted by a venous plexus. The deep transverse perineal muscle was consistently adjacent to the posterolateral aspect of the PM, but whether it extended superficially or deeply to the PM depended on size of the muscle. In contrast to the endopelvic fascia embedding abundant middle-sized nerves (cavernous and sphincter nerves;0.05 - 0.1 mm in thickness), the PM contained very thin nerves: many in 10 cadavers but few in 5 cadavers. Most of the nerves seemed to be sensory on the basis of immunohistochemistry. The levator ani muscle was considered likely to provide traction force to the PM, but active elevation appeared to be difficult because of the highly elastic nature of the PM and the interrupting venous plexus. Loss of nerves in the PM might be one of a number of factors that can accelerate pelvic organ prolapse.
文摘We reported a case of an intravesical foreign body in a 16 years old teenager for abortion attempt. During laparotomy for suspected pelvic appendicitis, we incidentally discovered an intravesical foreign body. From this first observation in our urology division, we reviewed the literature on the nature and circumstance of self introduction in bladder of foreign body and their surgical ablation. We emphasized the importance of endoscopy as a support of diagnosis and therapeutic of intravesical foreign body. This observation also highlighted the lack of information in our teenagers about reproductive and sexual health.
文摘BACKGROUND Hormones could play a role in the evolution of follicular thyroid cancer(FTC)for which we discuss an unusual presentation of FTC occurring during pregnancy.CASE SUMMARY A pregnant woman was admitted with FTC metastasis resulting in a gluteal mass.Preoperative abdominal computed tomography revealed liver metastasis for which the patient underwent total thyroidectomy and liver resection,oral radioiodine therapy and radiotherapy,followed by embolization of the pelvic mass.The patient died of cerebral hemorrhage 16 mo after the initial diagnosis.CONCLUSION Human chorionic gonadotropin and estrogen stimulation might have a role in cancer growth,especially during pregnancy.FTC management aims to stop disease progression and overcome hormonal imbalances after thyroidectomy thus reducing fetal complications.It is still under debate whether it is possible to combine optimal timing for treatment to ensure the best possible outcome with reduction of fetal complications and risk of cancer growth.
文摘Objective. The aim of this retrospective multicenter study was to assess whether the pre- chemotherapy hemoglobin levels have any impact on the clinical outcome of patients with advanced epithelial ovarian cancer who received a first- line taxane/platinum- based regimen. Methods. The study was conducted on 315 patients who underwent initial surgery followed by taxane/- platinum- based chemotherapy for FIGO stage IIc- IV epithelial ovarian cancer. All the patients had ECOG performance status 0- 1 at presentation. The median follow- up of survivors was 36 months (range, 6- 120 months). Results. The 25% , 50% , and 75% quantiles of hemoglobin levels before starting first line chemotherapy were 10.2, 11.4, and 12.3 g/dl, respectively. Residual disease after initial surgery (>1cmversus ≤ 1cm, P = 0.0013) was the only independent prognostic variable for overall survival. Conversely, hemoglobin levels (< 10.2 g/dl versus 10.2- 11.4 g/dl versus 11.5- 12.3 g/dl versus >12.3 g/dl)were inversely related to overall survival at univariate (P = 0.03) but not at multivariate analysis. Conclusions. This investigation showed that hemoglobin levels before starting first- line taxane/platinum- based chemotherapy are not an independent prognostic factor for overall survival in patients with advanced epithelial ovarian cancer.
