OBJECTIVE To analyze the clinical characteristics,pathologic diagnosis,treatment and prognosis of amelanotic melanoma in the female genital tract(AMFGT).METHODS The medical records of 6 patients with AMFGT between 199...OBJECTIVE To analyze the clinical characteristics,pathologic diagnosis,treatment and prognosis of amelanotic melanoma in the female genital tract(AMFGT).METHODS The medical records of 6 patients with AMFGT between 1991 and 2006 in our hospital were reviewed.RESULTS Of these cases,4 were preliminarily misdiagnosed as chorioepithelioma,sarcoma,adenocarcinoma or lymphoma.Two patients were determined to have AMFGT preoperatively after positive immunohistochemical staining for both S-100 protein and HMB-45.Specimens removed from all 6 cases were tested for immunohistochemical staining,as well as H&E histochemical stains.S-100 and vimentin were both positive in all patients,and HMB-45 was positive in 3 out of 5 patients.Four patients recurred(at 6,6,12 and 19 months) a er primary treatments.Three patients died(at 13,18 and 19 months) a er the initial diagnosis.CONCLUSION Because of an absence of pigmentation AMFGT is extremely difficult to diagnose.Combined immunohistochemical staining,such as the S-100 protein,HMB-45 and vimentin etc,is important in the evaluation of AMFGT.Correct diagnosis plays a crucial role in the treatment of this disease.展开更多
Vulvodynia is a prevalent form of chronic pain, most com- monly affecting the vaginal vestibule （vestibulodynia） （Pukall et al., 2016）. Women with vulvodynia describe intense pain in response to light touch of the...Vulvodynia is a prevalent form of chronic pain, most com- monly affecting the vaginal vestibule （vestibulodynia） （Pukall et al., 2016）. Women with vulvodynia describe intense pain in response to light touch of the affected region, such that sexual function and other activities can be severely limited. Medical costs associated with vulvodynia are high, exceeding $21 billion annually in the United States （Xie et al., 2012）. The high level of direct medical costs has been linked to high treatment failure rates. Many women with the disorder consult multiple practitioners and undergo multiple courses of treatment with limited benefit.展开更多
This study was conducted with the aim to record pathological conditions of the female genital tract of Red Sokoto (RS) and West African Dwarf (WAD) does with the objective of comparing the prevalence of genital tract ...This study was conducted with the aim to record pathological conditions of the female genital tract of Red Sokoto (RS) and West African Dwarf (WAD) does with the objective of comparing the prevalence of genital tract pathology between the two breeds. Of the 211 (RS) and 221 (WAD) genital tract collected and examined, 104 (49.3%) of RS and 97 (43.3%) of WAD showed different types of pathological conditions. Highest occurrence of pathological conditions found in RS was in the uterus (38.4%), followed by those in the ovary (30.8%), cervix (6.6%), salpinx (6.2%) and vagina (1.4%) while in WAD, pathological conditions were highest in the uterus (28.1%), and followed by ovary (26.8%), salpinx (5.0%), cervix (2.2%) and vagina (0.5%). In RS and WAD does, respectively, endometritis (11.9% and 7.1%) was the most common pathology followed by ovaro-bursal adhesion (10.4% and 5.4%), inactive ovaries (4.3% and 4.9%), cystic Graffian follicles (4.2% and 2.2%), paraovarian cyst (3.3% and 3.1%), uterine haemorrhage (3.8% and 2.7%), and ovarian hypoplasia (2.4% and 4.5%). Other pathological conditions found in RS and WAD does include cervical lesions: cervicitis (2.8% and 1.8%), haemorrhage (3.2% and 0.5%);uterine lesions: hydrometra (1.9% and 1.3%), pyometra (2.8% and 1.8%), mucometra (2.8% and 3.6%), metritis (2.4% and 1.3%), post parturient metritis (2.8% and 1.8%), caruncular atrophy (1.4% and 0.5%), endometrial hyperplasia (1.0% and 1.8%), melanosis (1.9% and 1.8%), post parturient emphysematous metritis (1.4% and 2.2%), perimetritis (1.4% and 2.2%), uterine congestion (1.9% and 2.2%), oedema (1.0% and 0.5%) and Cysticercus tenuicolis cyst (0.5% and 0.5%);esophageal lesions: salpingitis (1.9% and 3.1%), hydrosalpinx (1.0% and 0.5%), tubo-bursal cyst (3.3% and 0.9%), ovarian lesions: cystic corpora lutea (2.8% and 1.8%), oophoritis (0.5% and 1.8%), and Cysticercus tenuicolis cyst (1.0% and 0.9%). Hyperaemia (0.5%) and calcification of cervical caudal rugae (0.5%) occurred in RS only. Genital lesions were not statistically different (P > 0.05) between RS and WAD does. In the two breeds, the 13 - 24 months age group had high prevalence of genital lesions. The current study has shown that endometritis and ovaro-bursal adhesions are the common female genital tract pathological conditions in Red Sokoto and West African Dwarf does. The high prevalence of female genital tract abnormalities may suggest that genital diseases are of serious limitation to goat production in Makurdi.展开更多
For assisted reproduction technologies （ART）, numerous techniques were developed to isolate spermatozoa capable of fertilizing oocytes. While early methodologies only focused on isolating viable, motile spermatozoa,...For assisted reproduction technologies （ART）, numerous techniques were developed to isolate spermatozoa capable of fertilizing oocytes. While early methodologies only focused on isolating viable, motile spermatozoa, with progress of ART, particularly intracytoplasmic sperm injection （ICSI）, it became clear that these parameters are insufficient for the identification of the most suitable spermatozoon for fertilization. Conventional sperm preparation techniques, namely, swim-up, density gradient centrifugation and glass wool filtration, are not efficient enough to produce sperm populations free of DNA damage, because these techniques are not physiological and not modeled on the stringent sperm selection processes taking place in the female genital tract. These processes only allow one male germ cell out of tens of millions to fuse with the oocyte. Sites of sperm selection in the female genital tract are the cervix, uterus, uterotubal junction, oviduct, cumulus oophorus and the zona pellucida. Newer strategies of sperm preparation are founded oni （i） morphological assessment by means of＇motile sperm organelle morphological examination （MSOM E）＇; （ii） electrical charge; and （ili） molecular binding characteristics of the sperm cell. Whereas separation methods based on electrical charge take advantage of the sperm＇s adherence to a test tube surface or separate in an electrophoresis, molecular binding techniques use Annexin V or hyaluronic acid （HA） as substrates. Techniques in this category are magnet-activated cell sorting, Annexin V-activated glass wool filtration, flow cytometry and picked spermatozoa for ICSI （PICSI） from HA-coated dishes and HA-containing media. Future developments may include Raman microspectrometry, confocal light absorption and scattering spectroscopic microscopy and polarization microscopy.展开更多
To study the clinicopathologic features and immunoprofile of angiomyofibroblastoma (AMF) with emphasis on differential diagnosis Methods Seven vulvar, two vaginal and one perineal angiomyofibroblastomas were evaluat...To study the clinicopathologic features and immunoprofile of angiomyofibroblastoma (AMF) with emphasis on differential diagnosis Methods Seven vulvar, two vaginal and one perineal angiomyofibroblastomas were evaluated by light microscopy and immunohistochemistry The immunohistochemical studies were performed on paraffin embedded sections using the standard ABC method with a panel of antibodies Results Angiomyofibroblastoma predominantly occurred in middle aged women in the genital region, especially in the superficial area of the vulva Clinically, most of the tumors presented as slowly growing painless masses and were often diagnosed as Bartholin's gland cysts Histologically, the tumors were all well circumscribed and characterized by alternating hypocellular and hypercellular areas with abundant thin walled blood vessels The tumor cells were bland and spindle shaped or epithelioid and tended to concentrate around the vessels or cluster in small nests Immunohistochemically, the tumor cells expressed vimentin and estrogen receptor protein in all 10 cases and desmin in 9 cases Three cases showed weak or focal immunoreactivity to alpha smooth muscle actin and muscle specific actin All ten patients were treated by local excision Follow up showed a benign course with no signs of recurrence Conclusions Angiomyofibroblastoma is a distinctive neoplasm that has a propensity to occur in the female genital tract Recognition of this entity is important to avoid misdiagnosis with other vulvar angiomyxoid neoplasms展开更多
PCR was used to detect (HPV) in condyloma accuminata (CA),pseudocondyloma whose cause is unclear,and the other benign lesions in female genital tract.The results showed that HPV prevalence rate in CA was 98.2%,type 6 ...PCR was used to detect (HPV) in condyloma accuminata (CA),pseudocondyloma whose cause is unclear,and the other benign lesions in female genital tract.The results showed that HPV prevalence rate in CA was 98.2%,type 6 was in 11 was 85.7%,展开更多
No consensus exists regarding the role of radiotherapy in the management of gynecologic cancer in nonagenarian patients.We retrospectively reviewed the outcomes of 19 consecutive nonagenarian patients with gynecologic...No consensus exists regarding the role of radiotherapy in the management of gynecologic cancer in nonagenarian patients.We retrospectively reviewed the outcomes of 19 consecutive nonagenarian patients with gynecologic cancer(6 endometrial cancers,6 cervical cancers,4 vulvar cancers,and 3 vaginal cancers) who were treated with radiotherapy.Radiotherapy was performed mainly in a palliative setting(n = 12;63.2%),with a median dose of 45 Gy(range,6-76 Gy).Infrequent major acute or late toxicities were reported.Among 19 patients,9(47.4%) experienced tumor progression,5(26.3%) experienced complete response,2(10.5%) experienced stable disease and/or partial response.At last follow-up,12 patients(63.2%) had died;most deaths(n = 9) occurred because of the cancer.These results suggest that radiotherapy is feasible in the treatment of nonagenarian patients with gynecologic cancer.展开更多
A 33-year-old woman, gravida 1, para 0, came to the hospital with the chief complaint of severe dysmenorrhea and infertility. Her menstrual cycle was regular, bleeding moderately for 3–5 days with an interval of 30 d...A 33-year-old woman, gravida 1, para 0, came to the hospital with the chief complaint of severe dysmenorrhea and infertility. Her menstrual cycle was regular, bleeding moderately for 3–5 days with an interval of 30 days. She was diagnosed with ectopic pregnancy and received the left salpingectomy in September 2014. Intraoperative exploration showed a slightly enlarged retroverted uterus with a wide fundus and a normal right fallopian tube. As a further examination of infertility, hysterosalpingography was done in January 2016, which showed a unicornuate uterus （left） with an obstructed unilateral fallopian tube. She was referred to the Department of Obstetrics and Gynecology at Peking Union Medical College Hospital in February 2016. Her basic body temperature showed biphasic pattern. The sperm test of her husband was normal. Physical examination indicated two vaginal orifices in the vestibule, with a vertical septate lying in between. The left lateral vaginal lumen could be easily expanded and speculated, and a normal cervix was seen at its top. In contrast, the cervix was unable to be seen through the right lateral vaginal lumen, which was narrow and difficult to be exposed or inspected. Pelvic ultrasound scan showed that the uterus was 4.7 cm ×6.0 cm × 3.6 cm in size, along with the Y-shaped endometrium of 0.8 cm in thickness, and a normal echo in the muscular layer. No abnormalities were found at the bilateral adnexa areas or pelvic cavity. Besides, the bilateral renal areas and ureters were found normal in the ultrasound scan as well.展开更多
Background：Female genital malformations represent miscellaneous deviations from normal anatomy.This study aimed to explore the clinical characteristics of patients who underwent surgery for genital tract malformation...Background：Female genital malformations represent miscellaneous deviations from normal anatomy.This study aimed to explore the clinical characteristics of patients who underwent surgery for genital tract malformations at Peking Union Medical College Hospital （PUMCH） during a 31-year period.Methods：We retrospectively reviewed surgical cases of congenital malformation of the female genital tract at PUMCH for a 31-year period,analyzed the clinical characteristics of 1634 hospitalized patients,and investigated their general condition,diagnosis,and treatment process.Results：The average patient age was 27.6 ± 9.9 years.The average ages of patients who underwent surgery for uterine malformation and vaginal malformation were 31.9 ± 8.8 years and 24.7 ± 9.0 years,respectively;these ages differed significantly （P 〈 0.01）.Among patients with genital tract malformation,the percentages of vaginal malformation,uterine malformation,vulva malformation,cervical malformation,and other malformations were 43.9%,43.5%,7.4%,2.3%,and 2.8%,respectively.Among patients with uterine malformation,34.5% underwent surgery for the genital tract malformation,whereas in patients with vaginal malformation,the proportion is 70.6%;the difference between the two groups was statistically significant （P 〈 0.01）.The percentage of complications of the urinary system in patients with vaginal malformations was 10.2%,which was statistically significantly higher than that （5.3%） in patients with uterine malformations （P 〈 0.01）.Conclusions：Compared to patients with uterine malformations,patients with vaginal malformations displayed more severe clinical symptoms,a younger surgical age,and a greater need for attention,early diagnosis,and treatment.Patients with genital tract malformations,particularly vaginal malformations,tend to have more complications of the urinary system and other malformations than patients with uterine malformations.展开更多
文摘OBJECTIVE To analyze the clinical characteristics,pathologic diagnosis,treatment and prognosis of amelanotic melanoma in the female genital tract(AMFGT).METHODS The medical records of 6 patients with AMFGT between 1991 and 2006 in our hospital were reviewed.RESULTS Of these cases,4 were preliminarily misdiagnosed as chorioepithelioma,sarcoma,adenocarcinoma or lymphoma.Two patients were determined to have AMFGT preoperatively after positive immunohistochemical staining for both S-100 protein and HMB-45.Specimens removed from all 6 cases were tested for immunohistochemical staining,as well as H&E histochemical stains.S-100 and vimentin were both positive in all patients,and HMB-45 was positive in 3 out of 5 patients.Four patients recurred(at 6,6,12 and 19 months) a er primary treatments.Three patients died(at 13,18 and 19 months) a er the initial diagnosis.CONCLUSION Because of an absence of pigmentation AMFGT is extremely difficult to diagnose.Combined immunohistochemical staining,such as the S-100 protein,HMB-45 and vimentin etc,is important in the evaluation of AMFGT.Correct diagnosis plays a crucial role in the treatment of this disease.
基金A project described in this work regarding innervation changes in the murine vagina in response to inflammation was supported by a grant from the Centre for Neuroscience,Flinders University,Australia
文摘Vulvodynia is a prevalent form of chronic pain, most com- monly affecting the vaginal vestibule （vestibulodynia） （Pukall et al., 2016）. Women with vulvodynia describe intense pain in response to light touch of the affected region, such that sexual function and other activities can be severely limited. Medical costs associated with vulvodynia are high, exceeding $21 billion annually in the United States （Xie et al., 2012）. The high level of direct medical costs has been linked to high treatment failure rates. Many women with the disorder consult multiple practitioners and undergo multiple courses of treatment with limited benefit.
文摘This study was conducted with the aim to record pathological conditions of the female genital tract of Red Sokoto (RS) and West African Dwarf (WAD) does with the objective of comparing the prevalence of genital tract pathology between the two breeds. Of the 211 (RS) and 221 (WAD) genital tract collected and examined, 104 (49.3%) of RS and 97 (43.3%) of WAD showed different types of pathological conditions. Highest occurrence of pathological conditions found in RS was in the uterus (38.4%), followed by those in the ovary (30.8%), cervix (6.6%), salpinx (6.2%) and vagina (1.4%) while in WAD, pathological conditions were highest in the uterus (28.1%), and followed by ovary (26.8%), salpinx (5.0%), cervix (2.2%) and vagina (0.5%). In RS and WAD does, respectively, endometritis (11.9% and 7.1%) was the most common pathology followed by ovaro-bursal adhesion (10.4% and 5.4%), inactive ovaries (4.3% and 4.9%), cystic Graffian follicles (4.2% and 2.2%), paraovarian cyst (3.3% and 3.1%), uterine haemorrhage (3.8% and 2.7%), and ovarian hypoplasia (2.4% and 4.5%). Other pathological conditions found in RS and WAD does include cervical lesions: cervicitis (2.8% and 1.8%), haemorrhage (3.2% and 0.5%);uterine lesions: hydrometra (1.9% and 1.3%), pyometra (2.8% and 1.8%), mucometra (2.8% and 3.6%), metritis (2.4% and 1.3%), post parturient metritis (2.8% and 1.8%), caruncular atrophy (1.4% and 0.5%), endometrial hyperplasia (1.0% and 1.8%), melanosis (1.9% and 1.8%), post parturient emphysematous metritis (1.4% and 2.2%), perimetritis (1.4% and 2.2%), uterine congestion (1.9% and 2.2%), oedema (1.0% and 0.5%) and Cysticercus tenuicolis cyst (0.5% and 0.5%);esophageal lesions: salpingitis (1.9% and 3.1%), hydrosalpinx (1.0% and 0.5%), tubo-bursal cyst (3.3% and 0.9%), ovarian lesions: cystic corpora lutea (2.8% and 1.8%), oophoritis (0.5% and 1.8%), and Cysticercus tenuicolis cyst (1.0% and 0.9%). Hyperaemia (0.5%) and calcification of cervical caudal rugae (0.5%) occurred in RS only. Genital lesions were not statistically different (P > 0.05) between RS and WAD does. In the two breeds, the 13 - 24 months age group had high prevalence of genital lesions. The current study has shown that endometritis and ovaro-bursal adhesions are the common female genital tract pathological conditions in Red Sokoto and West African Dwarf does. The high prevalence of female genital tract abnormalities may suggest that genital diseases are of serious limitation to goat production in Makurdi.
文摘For assisted reproduction technologies （ART）, numerous techniques were developed to isolate spermatozoa capable of fertilizing oocytes. While early methodologies only focused on isolating viable, motile spermatozoa, with progress of ART, particularly intracytoplasmic sperm injection （ICSI）, it became clear that these parameters are insufficient for the identification of the most suitable spermatozoon for fertilization. Conventional sperm preparation techniques, namely, swim-up, density gradient centrifugation and glass wool filtration, are not efficient enough to produce sperm populations free of DNA damage, because these techniques are not physiological and not modeled on the stringent sperm selection processes taking place in the female genital tract. These processes only allow one male germ cell out of tens of millions to fuse with the oocyte. Sites of sperm selection in the female genital tract are the cervix, uterus, uterotubal junction, oviduct, cumulus oophorus and the zona pellucida. Newer strategies of sperm preparation are founded oni （i） morphological assessment by means of＇motile sperm organelle morphological examination （MSOM E）＇; （ii） electrical charge; and （ili） molecular binding characteristics of the sperm cell. Whereas separation methods based on electrical charge take advantage of the sperm＇s adherence to a test tube surface or separate in an electrophoresis, molecular binding techniques use Annexin V or hyaluronic acid （HA） as substrates. Techniques in this category are magnet-activated cell sorting, Annexin V-activated glass wool filtration, flow cytometry and picked spermatozoa for ICSI （PICSI） from HA-coated dishes and HA-containing media. Future developments may include Raman microspectrometry, confocal light absorption and scattering spectroscopic microscopy and polarization microscopy.
基金This study was supparted in paut by the Shanghai Medi cal Leading Speciality(No 993025).
文摘To study the clinicopathologic features and immunoprofile of angiomyofibroblastoma (AMF) with emphasis on differential diagnosis Methods Seven vulvar, two vaginal and one perineal angiomyofibroblastomas were evaluated by light microscopy and immunohistochemistry The immunohistochemical studies were performed on paraffin embedded sections using the standard ABC method with a panel of antibodies Results Angiomyofibroblastoma predominantly occurred in middle aged women in the genital region, especially in the superficial area of the vulva Clinically, most of the tumors presented as slowly growing painless masses and were often diagnosed as Bartholin's gland cysts Histologically, the tumors were all well circumscribed and characterized by alternating hypocellular and hypercellular areas with abundant thin walled blood vessels The tumor cells were bland and spindle shaped or epithelioid and tended to concentrate around the vessels or cluster in small nests Immunohistochemically, the tumor cells expressed vimentin and estrogen receptor protein in all 10 cases and desmin in 9 cases Three cases showed weak or focal immunoreactivity to alpha smooth muscle actin and muscle specific actin All ten patients were treated by local excision Follow up showed a benign course with no signs of recurrence Conclusions Angiomyofibroblastoma is a distinctive neoplasm that has a propensity to occur in the female genital tract Recognition of this entity is important to avoid misdiagnosis with other vulvar angiomyxoid neoplasms
文摘PCR was used to detect (HPV) in condyloma accuminata (CA),pseudocondyloma whose cause is unclear,and the other benign lesions in female genital tract.The results showed that HPV prevalence rate in CA was 98.2%,type 6 was in 11 was 85.7%,
文摘No consensus exists regarding the role of radiotherapy in the management of gynecologic cancer in nonagenarian patients.We retrospectively reviewed the outcomes of 19 consecutive nonagenarian patients with gynecologic cancer(6 endometrial cancers,6 cervical cancers,4 vulvar cancers,and 3 vaginal cancers) who were treated with radiotherapy.Radiotherapy was performed mainly in a palliative setting(n = 12;63.2%),with a median dose of 45 Gy(range,6-76 Gy).Infrequent major acute or late toxicities were reported.Among 19 patients,9(47.4%) experienced tumor progression,5(26.3%) experienced complete response,2(10.5%) experienced stable disease and/or partial response.At last follow-up,12 patients(63.2%) had died;most deaths(n = 9) occurred because of the cancer.These results suggest that radiotherapy is feasible in the treatment of nonagenarian patients with gynecologic cancer.
文摘A 33-year-old woman, gravida 1, para 0, came to the hospital with the chief complaint of severe dysmenorrhea and infertility. Her menstrual cycle was regular, bleeding moderately for 3–5 days with an interval of 30 days. She was diagnosed with ectopic pregnancy and received the left salpingectomy in September 2014. Intraoperative exploration showed a slightly enlarged retroverted uterus with a wide fundus and a normal right fallopian tube. As a further examination of infertility, hysterosalpingography was done in January 2016, which showed a unicornuate uterus （left） with an obstructed unilateral fallopian tube. She was referred to the Department of Obstetrics and Gynecology at Peking Union Medical College Hospital in February 2016. Her basic body temperature showed biphasic pattern. The sperm test of her husband was normal. Physical examination indicated two vaginal orifices in the vestibule, with a vertical septate lying in between. The left lateral vaginal lumen could be easily expanded and speculated, and a normal cervix was seen at its top. In contrast, the cervix was unable to be seen through the right lateral vaginal lumen, which was narrow and difficult to be exposed or inspected. Pelvic ultrasound scan showed that the uterus was 4.7 cm ×6.0 cm × 3.6 cm in size, along with the Y-shaped endometrium of 0.8 cm in thickness, and a normal echo in the muscular layer. No abnormalities were found at the bilateral adnexa areas or pelvic cavity. Besides, the bilateral renal areas and ureters were found normal in the ultrasound scan as well.
文摘Background：Female genital malformations represent miscellaneous deviations from normal anatomy.This study aimed to explore the clinical characteristics of patients who underwent surgery for genital tract malformations at Peking Union Medical College Hospital （PUMCH） during a 31-year period.Methods：We retrospectively reviewed surgical cases of congenital malformation of the female genital tract at PUMCH for a 31-year period,analyzed the clinical characteristics of 1634 hospitalized patients,and investigated their general condition,diagnosis,and treatment process.Results：The average patient age was 27.6 ± 9.9 years.The average ages of patients who underwent surgery for uterine malformation and vaginal malformation were 31.9 ± 8.8 years and 24.7 ± 9.0 years,respectively;these ages differed significantly （P 〈 0.01）.Among patients with genital tract malformation,the percentages of vaginal malformation,uterine malformation,vulva malformation,cervical malformation,and other malformations were 43.9%,43.5%,7.4%,2.3%,and 2.8%,respectively.Among patients with uterine malformation,34.5% underwent surgery for the genital tract malformation,whereas in patients with vaginal malformation,the proportion is 70.6%;the difference between the two groups was statistically significant （P 〈 0.01）.The percentage of complications of the urinary system in patients with vaginal malformations was 10.2%,which was statistically significantly higher than that （5.3%） in patients with uterine malformations （P 〈 0.01）.Conclusions：Compared to patients with uterine malformations,patients with vaginal malformations displayed more severe clinical symptoms,a younger surgical age,and a greater need for attention,early diagnosis,and treatment.Patients with genital tract malformations,particularly vaginal malformations,tend to have more complications of the urinary system and other malformations than patients with uterine malformations.
