Objective： To investigate the clinical characteristics, diagnosis and surgical treatment of intravenous leiomyomatosis （IVL）, and outline the differences between Chinese and overseas cases. Methods： Clinical data ...Objective： To investigate the clinical characteristics, diagnosis and surgical treatment of intravenous leiomyomatosis （IVL）, and outline the differences between Chinese and overseas cases. Methods： Clinical data of two IVL cases, treated in our hospital, were analyzed retrospectively and the related literature was also reviewed. The data of preoperative diagnostic rate, surgical procedures, and postoperative recurrence between patients in China and other countries were compared. Results： The first stage operation was performed successfully in 2 patients. However, they refused subsequent therapies, including a second stage operation to excise the remnants Of the tumor, uterus, bilateral oviducts and ovaries, and anti-estrogen therapy. Both suffered from IVL recurrence, one at 6-month and the other at 9-month, and died at 16-month and 12-month respectively after the first stage surgery. Worldwide reports of 110 IVL cases were reviewed, which included 28 cases in China and 82 cases in other countries. In the majority of the Chinese patients, tumors only extended into the fight atrium rather than the right ventricle （RA 22 cases vs RV 4 cases）. However, among the overseas patients, the rate of extension into the right atrium was similar to that of extension into the right ventricle （RA 41 cases vs RV 38 cases）. The rate of hysterectomies was not significantly different between Chinese and overseas patients （ 67.86% vs 55.9%, P=0.278）. The rate of correct preoperative diagnosis in the Chinese patients was significantly lower than that in the overseas patients （32.14% vs 80%, P=0.000002.）, as well asthe rate of complete excision of the tumor （22.7@0 vs 75.5%, P=0.000001）. The proportion of patients who undergoing a single-stage or a two-stage operation was similar in Chinese and overseas patients. The recurrence rate was significantly higher in the Chinese patients than in the overseas patients （36.8% vs 9.1%, P=0.0055）, and the patients with tumor recurrence were partial tumor excision patients. Conclusion： The possibility of IVL should be considered if echocardiography in female patients demonstrates a tumor in the right heart and a mass in the inferior vena cava （IVC）. Further imaging should be performed to confirm the diagnosis. The correct diagnosis and accurate preoperative delineation of tumor extension are essential for an optimal surgical outcome. The key point in IVL treatment is the complete excision of tumors （single-stage or two-stage surgical procedure）.展开更多
Objectives: We present eight cases of vascular thrombosis of the pelvic vessels and deep venous thrombosis (DVT) of the lower limb, secondary to compression of the pelvic vessels by the uterine fibroid, managed over a...Objectives: We present eight cases of vascular thrombosis of the pelvic vessels and deep venous thrombosis (DVT) of the lower limb, secondary to compression of the pelvic vessels by the uterine fibroid, managed over a span of twelve years from 2001 to 2013. We discuss the mean size of the leiomyoma, the prediliction for DVT of the left lower limb, the role of oral contraceptives when used in women with large fibroids, to increase the risk of DVT and present a brief literature review.?Results:?Age,?the mean age of our patients was—41.12 yrs, range—18 yrs to 50 yrs.?Parity and Menopausal Status: Seven were parous women. One was unmarried, nulligravid.?Seven were premenopausal and one was postmenopausal.?Vascular Thrombosis:?In one it was arterial thrombosis and in seven it was venous thrombosis.?DVT was on the left side in -6/8?-?75%. Clinical Complaints:?The presenting complaints were heavy menstrual bleeding in three,?severe dysmenorrhoea and heavy bleeding in one,?mass per abdomen in one, heavy menses and abdominal mass in one, no complaints apart from DVT in one.?Uterine Enlargement:?The size of the uterus was between 12 to 26 weeks. The mean size was 20 weeks.?It was a single fibromyoma in six and multiple, two in two.?Use of Oral Contraceptives:?OC pills were used to control heavy menstrual bleeding in three cases—3/8, 37.5%.?Discussion:?The DVT was on the left side in six of our cases,?75% were on the left side in our series. Menstrual problems like heavy bleeding can be secondary to fibromyoma. Three of the eight—37.5%,?women used OC pills to control menorrhagia. One developed DVT after one cycle of use of OC pills;?the second developed arterial thrombosis of the pelvic vessels after four cycles of OC pill use;?the third used OC pills for a longer period, on and off. The woman who developed arterial thrombosis was using OC pills with 50 mcgs of oestrogen and 0.5 mg norgestrel. Conclusions: Uterine leiomyoma can cause vascular thrombosis secondary to compression of the pelvic vessels. The mean size of the uterine enlargement by the fibromyoma was 20 weeks and in 6/8, it was a solitary fibromyoma. DVT was on the left side in 75% of our cases. Use of OC pills in women with an enlarged uterus with leiomyoma can increase the risk of DVT.展开更多
Introduction: The prevalence of cervical cancer in Cameroon is 80.73/100,000 women, with an estimated incidence of 40/100,000 women-years. It is a real public health problem. There is no systematic and effective scree...Introduction: The prevalence of cervical cancer in Cameroon is 80.73/100,000 women, with an estimated incidence of 40/100,000 women-years. It is a real public health problem. There is no systematic and effective screening program for cervical cancer in our country, despite the advent of visual tests that are simple to use, low cost, and adapted to the modest income of our social groups. Objectives: We aimed at determining the usefulness and place of visual tests in screening for cervical dysplasia and cervical cancer for its implementation at the Laquintinie Hospital Douala, Cameroon. Methods: We conducted a prospective analytic cross-sectional study of cervical dysplasia and cervical cancer screening by visual testing at the Laquintinie Hospital Douala from December 1, 2016 to March 31, 2017. Data collection was by consecutive non-probabilistic method and consenting sexually active women older than 21 years were enrolled for study. Data analysis was with Epi InfoTM version 7. Associations were done with the Chi square, student t-test and Fischer’s exact test where appropriate. Bivariate and multivariate analysis was done and reported as odd ratios, adjusted odd ratios and 95% confidence intervals. Statistical significance was set at P 0.05. Results: We received 1590 women, of whom 1506 (94.7%) screened for dysplastic lesions and cervical cancer during the study period. The results obtained were: 1417 (94.1%) had a normal result;64 (4.2%) had a positive visual test (TV+);and 25 (1.7%) visual tests were inconclusive (TV-nC). Of the 64 women whose visual tests were positive, 15 (23.5%) were HIV+. We performed 80 colposcopies and biopsies, including 61 women with positive visual tests and 19 non-conclusive visual tests. Among women with TV+, we found 06 cancers (squamous cell carcinoma: 05, adenocarcinoma: 01) and 05 dysplasias (CIN1: 04, CIN3: 01). Histological examination in women with TV-nC revealed 02 dysplasias (CIN1: 02). Half of the women with cervical cancer were HIV+. In our series, the prevalence of cervical dysplasia and cervical cancer was respectively 05 per 1000 women and 04 per 1000 women. The early onsets of sexual intercourse and co-infection with HIV were the main factors associated. Visual tests were very sensitive (84.62%), but with a relatively low specificity (25.37%). Conclusion: Visual tests prove to be a useful tool for mass screening of precancerous and cancerous lesions of the cervix in view of its sensitivity, cost and performance.展开更多
日本化纤协会《行业新闻》最近报道,泰国的大宗聚酯制造厂家Indorama Ventures Public Company Limited（IVL）宣布,就收购英国大宗化工制造厂家BP Chemical Co.在阿拉巴马州Decatur拥有的石油化工厂,达成协议。预计2016年上半年完成收...日本化纤协会《行业新闻》最近报道,泰国的大宗聚酯制造厂家Indorama Ventures Public Company Limited（IVL）宣布,就收购英国大宗化工制造厂家BP Chemical Co.在阿拉巴马州Decatur拥有的石油化工厂,达成协议。预计2016年上半年完成收购。BP已经宣布,作为石油化工事业重组计划的一环,出售该工厂。展开更多
基金supported by a grant:the"QingLan"projectthe Department of Education of Jiangsu province,No.(JX10210540 /DG216G15020)
文摘Objective： To investigate the clinical characteristics, diagnosis and surgical treatment of intravenous leiomyomatosis （IVL）, and outline the differences between Chinese and overseas cases. Methods： Clinical data of two IVL cases, treated in our hospital, were analyzed retrospectively and the related literature was also reviewed. The data of preoperative diagnostic rate, surgical procedures, and postoperative recurrence between patients in China and other countries were compared. Results： The first stage operation was performed successfully in 2 patients. However, they refused subsequent therapies, including a second stage operation to excise the remnants Of the tumor, uterus, bilateral oviducts and ovaries, and anti-estrogen therapy. Both suffered from IVL recurrence, one at 6-month and the other at 9-month, and died at 16-month and 12-month respectively after the first stage surgery. Worldwide reports of 110 IVL cases were reviewed, which included 28 cases in China and 82 cases in other countries. In the majority of the Chinese patients, tumors only extended into the fight atrium rather than the right ventricle （RA 22 cases vs RV 4 cases）. However, among the overseas patients, the rate of extension into the right atrium was similar to that of extension into the right ventricle （RA 41 cases vs RV 38 cases）. The rate of hysterectomies was not significantly different between Chinese and overseas patients （ 67.86% vs 55.9%, P=0.278）. The rate of correct preoperative diagnosis in the Chinese patients was significantly lower than that in the overseas patients （32.14% vs 80%, P=0.000002.）, as well asthe rate of complete excision of the tumor （22.7@0 vs 75.5%, P=0.000001）. The proportion of patients who undergoing a single-stage or a two-stage operation was similar in Chinese and overseas patients. The recurrence rate was significantly higher in the Chinese patients than in the overseas patients （36.8% vs 9.1%, P=0.0055）, and the patients with tumor recurrence were partial tumor excision patients. Conclusion： The possibility of IVL should be considered if echocardiography in female patients demonstrates a tumor in the right heart and a mass in the inferior vena cava （IVC）. Further imaging should be performed to confirm the diagnosis. The correct diagnosis and accurate preoperative delineation of tumor extension are essential for an optimal surgical outcome. The key point in IVL treatment is the complete excision of tumors （single-stage or two-stage surgical procedure）.
文摘Objectives: We present eight cases of vascular thrombosis of the pelvic vessels and deep venous thrombosis (DVT) of the lower limb, secondary to compression of the pelvic vessels by the uterine fibroid, managed over a span of twelve years from 2001 to 2013. We discuss the mean size of the leiomyoma, the prediliction for DVT of the left lower limb, the role of oral contraceptives when used in women with large fibroids, to increase the risk of DVT and present a brief literature review.?Results:?Age,?the mean age of our patients was—41.12 yrs, range—18 yrs to 50 yrs.?Parity and Menopausal Status: Seven were parous women. One was unmarried, nulligravid.?Seven were premenopausal and one was postmenopausal.?Vascular Thrombosis:?In one it was arterial thrombosis and in seven it was venous thrombosis.?DVT was on the left side in -6/8?-?75%. Clinical Complaints:?The presenting complaints were heavy menstrual bleeding in three,?severe dysmenorrhoea and heavy bleeding in one,?mass per abdomen in one, heavy menses and abdominal mass in one, no complaints apart from DVT in one.?Uterine Enlargement:?The size of the uterus was between 12 to 26 weeks. The mean size was 20 weeks.?It was a single fibromyoma in six and multiple, two in two.?Use of Oral Contraceptives:?OC pills were used to control heavy menstrual bleeding in three cases—3/8, 37.5%.?Discussion:?The DVT was on the left side in six of our cases,?75% were on the left side in our series. Menstrual problems like heavy bleeding can be secondary to fibromyoma. Three of the eight—37.5%,?women used OC pills to control menorrhagia. One developed DVT after one cycle of use of OC pills;?the second developed arterial thrombosis of the pelvic vessels after four cycles of OC pill use;?the third used OC pills for a longer period, on and off. The woman who developed arterial thrombosis was using OC pills with 50 mcgs of oestrogen and 0.5 mg norgestrel. Conclusions: Uterine leiomyoma can cause vascular thrombosis secondary to compression of the pelvic vessels. The mean size of the uterine enlargement by the fibromyoma was 20 weeks and in 6/8, it was a solitary fibromyoma. DVT was on the left side in 75% of our cases. Use of OC pills in women with an enlarged uterus with leiomyoma can increase the risk of DVT.
文摘Introduction: The prevalence of cervical cancer in Cameroon is 80.73/100,000 women, with an estimated incidence of 40/100,000 women-years. It is a real public health problem. There is no systematic and effective screening program for cervical cancer in our country, despite the advent of visual tests that are simple to use, low cost, and adapted to the modest income of our social groups. Objectives: We aimed at determining the usefulness and place of visual tests in screening for cervical dysplasia and cervical cancer for its implementation at the Laquintinie Hospital Douala, Cameroon. Methods: We conducted a prospective analytic cross-sectional study of cervical dysplasia and cervical cancer screening by visual testing at the Laquintinie Hospital Douala from December 1, 2016 to March 31, 2017. Data collection was by consecutive non-probabilistic method and consenting sexually active women older than 21 years were enrolled for study. Data analysis was with Epi InfoTM version 7. Associations were done with the Chi square, student t-test and Fischer’s exact test where appropriate. Bivariate and multivariate analysis was done and reported as odd ratios, adjusted odd ratios and 95% confidence intervals. Statistical significance was set at P 0.05. Results: We received 1590 women, of whom 1506 (94.7%) screened for dysplastic lesions and cervical cancer during the study period. The results obtained were: 1417 (94.1%) had a normal result;64 (4.2%) had a positive visual test (TV+);and 25 (1.7%) visual tests were inconclusive (TV-nC). Of the 64 women whose visual tests were positive, 15 (23.5%) were HIV+. We performed 80 colposcopies and biopsies, including 61 women with positive visual tests and 19 non-conclusive visual tests. Among women with TV+, we found 06 cancers (squamous cell carcinoma: 05, adenocarcinoma: 01) and 05 dysplasias (CIN1: 04, CIN3: 01). Histological examination in women with TV-nC revealed 02 dysplasias (CIN1: 02). Half of the women with cervical cancer were HIV+. In our series, the prevalence of cervical dysplasia and cervical cancer was respectively 05 per 1000 women and 04 per 1000 women. The early onsets of sexual intercourse and co-infection with HIV were the main factors associated. Visual tests were very sensitive (84.62%), but with a relatively low specificity (25.37%). Conclusion: Visual tests prove to be a useful tool for mass screening of precancerous and cancerous lesions of the cervix in view of its sensitivity, cost and performance.
文摘日本化纤协会《行业新闻》最近报道,泰国的大宗聚酯制造厂家Indorama Ventures Public Company Limited（IVL）宣布,就收购英国大宗化工制造厂家BP Chemical Co.在阿拉巴马州Decatur拥有的石油化工厂,达成协议。预计2016年上半年完成收购。BP已经宣布,作为石油化工事业重组计划的一环,出售该工厂。
