Identifcation of up-regulated genes in human uterine leiomyoma by sup-pression subtractive hybridization

In searching for differentially expressed genes in human uterine leiomyomas (ULs), suppression sub-tractive hybridization was used to construct an UL up-regulated library, which turned out to represent 88genes. After two rounds of screening by reverse Northern analysis, twenty genes were proved to be up-regulated, including seventeen known genes and three genes with unknown function. All these genes werefirstly associated with UL. Three genes with notable difference were selected for Northern confirmationOur results proved the authenticity of the twenty genes. One gene named Phospholipase A2 (PLA2) showedup-regulation in 4/6 of the patients and investigation of tissue distribution indicated that it had obviousexpression in prostate, testis, liver, heart and skeletal muscle.

Uterine Leiomyomas Surgery: Assessment of Five Years in the Gynecology Department of Hôpital du Mali

Uterine leiomyomas (myomas) are the most common benign tumors of the female genital tract. They affect 20% to 25% of women of childbearing age and are 3 to 9 times more common in black women. We initiated this study in order to report the socio-demographic aspects and the indications for leiomyomas surgery at Hôpital du Mali. This was a retro-prospective descriptive study, conducted in the gynecology department of Hôpital du Mali from January 1, 2015 to December 31, 2019. Any patients, regardless of their age, in whom a leiomyomas had been detected and surgically treated were included. We had collected 180 cases of surgery for leiomyomas out of 950 surgical procedures, with a frequency of 18.94%. The 36 - 45 age group represented 45% of our patients with an average age of 35 years. Nulligravida accounted for 48.9% and nulliparous (60%). The main reason for consultation was the desire to become pregnant (53.33%). A history of myomectomy was found out in 15.55% of patients. Pelvic ultrasound figured out 64.44% interstitial myomas. Myomectomy was performed in 88.88% of cases and hysterectomy in 11.12% of cases. Among our patients 39.37% had become pregnant. Operative complications were dominated by anemia 14.44%. Leiomyoma was the histological tissue found in all cases of myomectomy. The average duration of hospitalization was 3 days. Conclusion: Leiomyomas surgery is the first scheduled gynecological surgical activity. Laparotomy remains the primary route of entry. The indications are dominated by the desire for pregnancy.

Influence of assisted reproductive technology and uterine leiomyoma on pregnancy outcomes in women with adenomyosis

Aim To assess whether adverse pregnancy outcomes in women with adenomyosis are different according to the method of conception and the concurrent of uterine leiomyoma(UL).Methods We performed a retrospective study.Fifty-three singleton pregnancy cases complicated with adenomyosis were included in this study.In the study group,15 women became pregnant with assisted reproductive technology(ART)and 21 women combined with UL.Pregnancy outcomes were compared between ART and non-ART,UL and non-UL groups.Results The prevalence for such complications as hypertensive disorder complicating pregnancy(HDCP)and postpartum hemorrhage(PPH)were significantly higher in the women conceived by ART(33.3%vs.5.3%,P​=​0.023)and(53.3%vs.23.7%,P​=​0.037),respectively.And women concurrent with UL of which the diameter≥4​cm were more likely to have severe PPH(44.4%vs.0%,P​=​0.021).Conclusion ART may increase the risk of adverse pregnancy outcomes such as HDCP and PPH in women with adenomyosis and UL of which the diameter≥4​cm may further increase the risk of severe PPH.

Efficacy of patient-controlled hydromorphone analgesia in those undergoing uterine fibroid artery embolization via the right radial artery

Objective: To evaluate the efficacy and safety of patient-controlled analgesia(PCA) with hydromorphone as perioperative analgesia during uterine artery embolization(UAE) via the right radial artery.Patients and methods: A total of 33 patients with uterine fibroids, who underwent UAE at the authors’ hospital between June 2021 and March 2022, were selected. Hydromorphone(10 mg) was dispensed into a 100 ml PCA pump with normal saline. Pump administration was initiated 15 min before the start of the procedure, and the intraoperative dose was adjusted according to patient pain level. A numerical rating scale was used to evaluate pain immediately after embolization, 5 min after embolization, at the end of the procedure, and 6, 12, 24, 48, and 72 h after the procedure. Side effects were also observed.Results: Thirty-three patients underwent uterine artery embolization via the right radial artery. Patient pain was well controlled at all time points surveyed, and patients reported satisfaction with analgesia. The median length of hospital stay was 5 days. There were 7 cases of adverse reactions, but no serious side effects were observed.Conclusion: Patients reported positive experiences with arterial embolization of uterine fibroids via the right radial artery. Hydromorphone PCA effectively controlled pain. The PCA pump is easy to operate, has a low incidence of adverse reactions, and offers economic benefits at the patient and institutional levels.

Giant cellular leiomyoma in the broad ligament of the uterus:A case report

BACKGROUND The treatment of large pelvic masses in postmenopausal women is a challenge in clinical practice.Although ultrasound or magnetic resonance imaging can be used to determine the size and location of the mass,it is still difficult to achieve a preoperative diagnosis.The majority of cellular leiomyomas are diagnosed by histopathology after surgery.We report the differential diagnosis and surgical management of a rare case of cellular leiomyoma in the broad ligament of the uterus.CASE SUMMARY A 52-year-old Chinese woman without sexual history was admitted to the First Affiliated Hospital of Guangzhou University of Chinese Medicine for the first time.The patient had a 1-year history of progressive abdominal enlargement as well as a 2-year history of menopause,and complained of frequent abdominal pain and low-grade fever.Computed tomography of the abdomen showed a solid cystic mass(29.4 cm×18.8 cm×37.7 cm)in the pelvis and abdomen.Moreover,routine blood test results indicated a baseline cancer antigen 125(CA-125)level of 187.7 U/mL and C-reactive protein of 109.58 mg/L.Subsequently,retrograde hysterectomy and bilateral adnexectomy were performed in this patient.On histopathologic examination of the surgical specimen,a rare cellular leiomyoma in the broad ligament was diagnosed.CONCLUSION Clinicians need to constantly improve diagnosis and treatment for the challenges posed during clinical assessment,differential diagnosis,and surgical management.

Mice-lacking LMP2, immuno-proteasome subunit, as an animal model of spontaneous uterine leiomyosarcoma

Uterine tumors are the most common type of gynecologic neoplasm.Uterine leiomyosarcoma(LMS)is rare,accounting for 2%to 5%of tumors of the uterine body.Uterine LMS develops more often in the muscle tissue layer of the uterine body than in the uterine cervix.The development of gynecologic tumors is often correlated with female hormone secretion;however,the development of uterine LMS is not substantially correlated with hormonal conditions,and the risk factors are not yet known.Radiographic evaluation combined with PET/CT can be useless in the diagnosis and surveillance of uterine LMS.Importantly,a diagnostic biomarker,which distinguishes malignant LMS and benign tumor leiomyoma(LMA)is yet to be established.Accordingly,it is necessary to analyze risk factors associated with uterine LMS in order to establish a method of treatment.LMP2-deficient mice spontaneously develop uterine LMS,with a disease prevalence of~40%by 14 months of age.It is therefore of interest whether human uterine LMS shows a loss of LMP2 expression.We found LMP2 expression is absent in human LMS,but present in human LMA.Therefore,defective LMP2 expression may be one of the risk factors for LMS.LMP2 is potentially a diagnostic biomarker for uterine LMS,and gene therapy with LMP2-encording DNA may be a new therapeutic approach.