Giant myomas, defined as those > 9 cm, are uncommon. Due to the difficulties caused by its enormous size, the usual surgical treatment is a simple total hysterectomy. The surgery may be performed by either laparosc...Giant myomas, defined as those > 9 cm, are uncommon. Due to the difficulties caused by its enormous size, the usual surgical treatment is a simple total hysterectomy. The surgery may be performed by either laparoscopy or laparotomy. However, the case presents a 45-year-old woman who was diagnosed with a giant myoma of 23 cm. The patient is asymptomatic and does not accept the indication of a simple total hysterectomy because of her fear to lose her femininity and a feeling of mutilation and unfulfilled genesic desire. A personalized procedure was performed: myomectomy by laparotomy with subsequent uterine reconstruction. The case is described to focus the interest on giant uterine myomas, taking into account the limited availability of literature on the topic, and to highlight the reconstruction after myomectomy.展开更多
Asherman's syndrome(AS) is a common disease that presents endometrial regeneration disorder. However, little is known about its molecular features of this aregenerative endometrium in AS and how to reconstruct the...Asherman's syndrome(AS) is a common disease that presents endometrial regeneration disorder. However, little is known about its molecular features of this aregenerative endometrium in AS and how to reconstruct the functioning endometrium for the patients with AS. Here, we report that ΔNp63 is significantly upregulated in residual epithelial cells of the impaired endometrium in AS; the upregulated-ΔNp63 induces endometrial quiescence and alteration of stemness. Importantly, we demonstrate that engrafting high density of autologous bone marrow mononuclear cells(BMNCs) loaded in collagen scaffold onto the uterine lining of patients with AS downregulates ΔNp63 expression, reverses ΔNp63-induced pathological changes, normalizes the stemness alterations and restores endometrial regeneration. Finally, five patients achieved successful pregnancies and live births. Therefore, we conclude that ΔNp63 is a crucial therapeutic target for AS. This novel treatment significantly improves the outcome for the patients with severe AS.展开更多
文摘Giant myomas, defined as those > 9 cm, are uncommon. Due to the difficulties caused by its enormous size, the usual surgical treatment is a simple total hysterectomy. The surgery may be performed by either laparoscopy or laparotomy. However, the case presents a 45-year-old woman who was diagnosed with a giant myoma of 23 cm. The patient is asymptomatic and does not accept the indication of a simple total hysterectomy because of her fear to lose her femininity and a feeling of mutilation and unfulfilled genesic desire. A personalized procedure was performed: myomectomy by laparotomy with subsequent uterine reconstruction. The case is described to focus the interest on giant uterine myomas, taking into account the limited availability of literature on the topic, and to highlight the reconstruction after myomectomy.
基金supported by the Strategic Priority Research Program of the Chinese Academy of Sciences (XDA01030505)Key research and development program of Jiangsu province (BE2016612), Jiangsu Biobank of Clinical Resources (BM2015004)+1 种基金the Key Laboratory for Maternal-Fetal Medicine from the Health Department of Jiangsu Province, China (XK201102)Project of Nanjing clinical medicine center and the National Natural Science Foundation of China (81401223)
文摘Asherman's syndrome(AS) is a common disease that presents endometrial regeneration disorder. However, little is known about its molecular features of this aregenerative endometrium in AS and how to reconstruct the functioning endometrium for the patients with AS. Here, we report that ΔNp63 is significantly upregulated in residual epithelial cells of the impaired endometrium in AS; the upregulated-ΔNp63 induces endometrial quiescence and alteration of stemness. Importantly, we demonstrate that engrafting high density of autologous bone marrow mononuclear cells(BMNCs) loaded in collagen scaffold onto the uterine lining of patients with AS downregulates ΔNp63 expression, reverses ΔNp63-induced pathological changes, normalizes the stemness alterations and restores endometrial regeneration. Finally, five patients achieved successful pregnancies and live births. Therefore, we conclude that ΔNp63 is a crucial therapeutic target for AS. This novel treatment significantly improves the outcome for the patients with severe AS.
