Comparative assessment of the methods of treatment of Condylomata acuminata

The treatment of Condylomata acuminata often causes disappointment to both the physician and the patient since most of the current medical approaches require multiple examines while on the other hand success rates are low and recurrence rates remain high. The treatment approaches include surgical as well as non-surgical methods. The non-surgical treatment includes the application of local agents such as imiquimod, podophyllotoxin, and 5-fluorouracil. Other local agents, used in outpatient treatment settings, include trichloroacetic acid (TCA), podophyllin, or the intralesional application of agents such as interferon and bleomycin. The surgical methods include cryotherapy, electrosurgery, excision and laser therapy. Their major goal is the removal of the visible lesions. The development of the laser systems and the new HPV vaccines are a significant progress in the treatment and prevention of the HPV infections.     

妊娠肝内胆汁淤积症患者的胎儿淋巴细胞研究

目的探讨胎儿淋巴细胞在妊娠肝内胆汁淤积症(ICP)发病中的作用。方法采用单向混合淋巴细胞反应法,检测20例ICP患者(ICP组)及20例正常孕妇(对照组)的脐血胎儿淋巴细胞与母体外周血已灭活的淋巴细胞、皮肤组织可溶性抗原、蜕膜组织可溶性抗原的增殖反应情况。结果(1)ICP组脐血胎儿淋巴细胞与母体已灭活的淋巴细胞混合反应中,胎儿淋巴细胞的增殖反应程度为2．75±0．36,显著高于对照组的1．45±0．19,两组比较,差异有统计学意义(P＜0．05);(2) ICP组脐血胎儿淋巴细胞与母体蜕膜组织可溶性抗原混合反应中,胎儿淋巴细胞的增殖反应程度为1．45±0．19,显著高于对照组的0．67±0．24,两组比较,差异有统计学意义(P＜0．05);(3)ICP组脐血胎儿淋巴细胞与母体皮肤组织可溶性抗原反应中,胎儿淋巴细胞的增殖反应程度为1．22±0．44,显著高于对照组的0．66±0．27,两组比较,差异有统计学意义(P＜0．05)。结论胎儿淋巴细胞可能是ICP发病过程中的主要效应细胞之一;母-胎间免疫失衡是ICP发病的重要机制之一。     

子宫颈腺癌136例分析

1956～1989年本院收治子宫颈腺癌136例,平均年龄48.9岁。其中11％无症状,均以手术治疗为主,广泛性全子宫切除术及盆腔淋巴清扫术76例,广泛性全子宫切除术加放疗45例,淋巴转移率为Ⅰ期12.3％,Ⅱ期40.5％。5、10年生存率分别为90.8±2.9％、86.0±4.4％;15、20、25年生存率分别为81.0±4.4％。预后与期别淋巴结转移有关。     

Evaluation of the diurnal rhythm of secretion of chorionic gonadotropins in the first trimester of normal pregnancy

The authors evaluated the diurnal rhythm of the secretion of hCG in patients in the first trimester of normal pregnancy. The examination was carried out in a group of 22 patients (chosen at random) who came to hospital to undergo abortion (for social indications). The patients stayed in normal hospital conditions and were not given any drugs. All of them were informed of the aim and method of the examination and agreed to it. The blood to be examined was taken every two hours during 24 hours. The determination of hCG was made by means of the radioimmunological method. The statistical analysis was made by means of the Halberg cosinor method. In 14 patients the authors found the existence of the diurnal rhythm (p less than 0.05), in 4 cases the rhythm was circadian (p less than 0.1), in 4 remaining patients no rhythm was found. For the values obtained from 14 patients with a clear diurnal rhythm the authors drew an ellipse of errors by the Halberg method. The ellipse does not cover the centre of the cosinor circle, which confirms the compatibility of the results obtained. The medium value of the amplitude in this group was 20.72% of mesor and acrophase appeared at 16(01).     

Prenatal diagnosis of a case of obstruction of the uretero-pelvic junction]

The Authors report a case of bilateral ureteropelvic junction obstruction in a pregnant woman at to 20th week of gestation. The pathology arose suddenly during the second trimester. An anhydramnios was picant and the enlarged kidneys filled the entire fetal abdomen. The woman decided for abortion. The Authors describe the etiopathology and management of this disease.     

松弛素对雌性大鼠生殖器官结缔组织重建的影响

本研究用高纯度猪松弛素免疫大鼠产生抗松弛素交叉抗体中和内源性松弛素作用后,观察大鼠卵巢和子宫结统组织中细胞外基质的几种重要成分—胶原蛋白、弹性蛋白和蛋白多糖的变化,探讨松弛素对雌性生殖器官结统组织重建的影响.结果显示:(1)免疫后产生抗体的大鼠,其卵巢和子宫结缔组织中胶原蛋白、弹性蛋白和酸/中性蛋白多糖的含量比未经免疫的大鼠均有不同程度的降低.(2)松弛素对不同部位胶原合成的影响有差异,尤其对印泡膜和子宫固有层结缔组织的作用较明显.本研究结果提示松弛素对卵巢和子宫的结缔组织重建具有重要的作用,可能是其参与局部生殖调节的主要机制之一.     

Review of ovarian cancer of the University of Athens

One hundred and eight patients with cancer of the ovaries were studied retrospectively for a period of seventeen years. All the patients were managed in the Second Department of Obstetrics and Gynecology of the University of Athens. The symptoms of the patients were: pelvic pain in 43, ascites in 27, metrorrhagia in 23 and weight loss in 12. Fifty six per cent of the patients were between 40 to 60 years old and 63% were menopause. The PAP-smear in 40% was class I or II, in 50% was class III and in 10% was class IV-V. The stage of the disease was: 3 patients stage I, stage II 38, stage III 42 and 25 stage IV. No patient had stage 0. Laparotomy was done in all the patients. Thirty eight patients had Co-treatment and 42 patients chemotherapy. The pathology report was: serous cystadeno-Ca in 40, mucinous cystadeno-Ca in 38 of the cases, adenocarcinoma 18 and 12 other types of malignant tumors. The follow up of the patients showed a five years survival rate in 10% for stage I, 25% for stage II, 5% for stage III and none for stage IV.     

BARD1剪切变异体的自身抗体在卵巢恶性肿瘤诊断中的临床价值

目的 评价1个新的卵巢恶性肿瘤抗原--乳腺癌易感基因1(BRCA1)相关的具有环状结构域的蛋白(BARD1)剪切变异体(OV-142)的自身抗体在卵巢恶性肿瘤诊断中的价值.方法 RT-PCR技术克隆OV-142基因的开放阅读框,构建OV-142的原核表达质粒,表达、纯化OV-142重组融合蛋白;用间接酶联免疫吸附试验检测126例卵巢恶性肿瘤患者、15例卵巢交界性肿瘤患者、42例卵巢良性肿瘤患者血清中OV-142的IgG、IgM型自身抗体的相对含量,并分析自身抗体在卵巢恶性肿瘤诊断中的临床价值.结果 成功构建了OV-142的原核表达质粒,并获得了OV-142重组融合蛋白.当联合分析OV-142 IgG型自身抗体与CA125时,在卵巢恶性肿瘤诊断中的敏感性为71.4%,高于单独分析IgG(41.3%)或CA125(61.1%);特异性为89.1%,高于单独分析IgG(84.2%)或CA125(88.0%);准确性为81.9%,高于单独分析IgG(66.8%)或CA125(77.1%).结论 OV-142是BARD1的1个剪切变异体,其有可能成为卵巢恶性肿瘤免疫治疗的新靶点.OV-142抗原的IgG型自身抗体在卵巢恶性肿瘤诊断中有可能成为CA125的1个重要的补充血清学标志物.     

子宫输卵管造影诊断符合率及诊断一致性分析

目的:研究不同医师对子宫输卵管造影的诊断符合率以及诊断一致性。方法:选取60例接受宫、腹腔镜手术患者的造影片,由4位临床医师读片诊断。诊断结果分成输卵管积水、输卵管近端阻塞、输卵管远端阻塞、盆腔粘连以及子宫内膜息肉,分别分析各医师的诊断结果与宫、腹腔镜诊断结果的符合率以及一致性(以κ值表示)。结果:造影诊断符合率分别为输卵管积水敏感度83.33%~100.00%,特异度97.22%~98.15%;输卵管近端阻塞敏感度75.00%~83.33%,特异度88.89%~92.60%;输卵管远端阻塞敏感度85.71%~92.86%,特异度77.78%~81.11%;子宫内膜息肉敏感度12.50%~25.00%,特异度94.23%~100.00%;盆腔粘连敏感度58.93%~64.26%,特异度45.31%~64.06%。各医师诊断一致性(κ值):输卵管积水为0.758,输卵管近端阻塞为0.815,输卵管远端阻塞为0.277,盆腔粘连为0.431,子宫内膜息肉为0.658。结论:造影诊断输卵管积水符合率较高;诊断近端阻塞及子宫内膜息肉不易误诊,但易漏诊;诊断远端阻塞不易漏诊,但易误诊;诊断盆腔粘连敏感度及特异度均较低,临床价值有限。不同医师诊断输卵管近端阻塞和输卵管积水一致性较高,输卵管远端阻塞和盆腔粘连诊断一致性较低。     

Quality of life of victims of intimate partner violence

OBJECTIVE: To investigate possible correlations of ZPT or ZPTV with clinical outcome following in vitro fertilization. METHODS: Two hundred forty-six embryos were selected for transfer on day 3 with clear image record from 81 IVF-ET cycles. The laser system measurement software was used to measure the ZTP value of each embryo and the ZPTV was computed. Statistical analysis was done using the ANOVA or Chi-square test. RESULTS: Both ZPT and ZPTV declined with women's age. The mean ZPTV of embryos from patients between 30 and 34 years old was significantly higher than that from patients older than 35 (P<0.001). The ZPTV in pregnancy group was significantly higher than that in nonpregnancy group (P<0.005). The clinical pregnancy rate in the group with ZPTV more than 20% was significantly higher than that in the group with ZPTV less than 20% (P<0.05). The ZPTV of high grade embryos was significantly higher than that of low grade embryos (P<0.001). CONCLUSIONS: ZPTV rather than ZPT is an effective parameter to evaluate the embryo quality. Increasing the ZPTV may enhance embryo implantation potential.     

卵巢子宫内膜异位症恶性变25例临床分析

目的 探讨卵巢子宫内膜异位症恶性变的临床表现、病理特征、治疗方法和预后。方法 回顾性分析２５例卵巢子宫内膜异位症恶性变患者和病量资料。结果 卵巢子宫内膜异位症恶性变患者的主要症状为盆腔包块、腹胀、腹痛、异常阴道流血和流液。病理类型为子宫内膜样癌１４例,透明细胞癌２例,腺棘癌２例,浆液性腺癌１例,混合性卵巢上皮性癌６例,镜下均可见良性的异位子宫内膜向恶性移行的证据。临床分期为Ⅰ１４例,Ⅱ期７例,Ⅲ期３例,Ⅳ期１例。治疗方法均采用肿瘤细胞减灭术＋化学治疗。患者５年生存率达７７．７％。结论 卵巢子宫内膜异位症恶性变的确切发生率难以估计,该病的治疗以肿瘤细胞减灭术＋化学治疗为主。     

35例宫颈腺鳞癌临床分析

目的:分析宫颈腺鳞癌患者的临床特点、治疗方式。比较不同期别、不同组织分级患者的生存情况。方法:回顾性分析35例宫颈腺鳞癌患者的临床资料。结果:35例患者中位年龄45岁,均以阴道异常出血为首发临床症状。14例ⅠB1期～ⅡA期患者中,有2例ⅡA期患者接受了单纯放疗,另外12例接受了手术治疗,其中2例术后接受了化疗,2例术后接受了单纯放疗,2例术后接受了同步放化疗,其余6例术后未接受辅助治疗。18例ⅡB期～ⅢB期患者中9例接受了单纯放疗,9例接受了同步放化疗。3例Ⅳ期患者均接受了化疗+姑息性放疗。共有10例患者肿瘤复发,复发率为28.6%。中位复发时间为4.5个月。所有患者的3年和5年生存率分别为85.7%和78.0%。Ⅰ、Ⅱ和Ⅲ期患者的5年生存率分别为100%,93.3%和56.3%,3例Ⅳ期患者的生存时间分别为2、10和15个月。高、中分化患者的5年生存率为93.3%,低分化患者的5年生存率为66.9%,但无显著差异(P=0.208)。结论:宫颈腺鳞癌早期患者可以手术治疗或同步放化疗,预后较好。晚期患者应予同步放化疗,预后相对较差,特别是Ⅳ期患者,预后极差。     

Analysis of treatment results of vulvar cancer

OBJECTIVES: To evaluate clinical prognostic factors and outcome for patients with vulvar cancer. MATERIALS AND METHODS: We conducted a retrospective review of the medical records of 32 patients treated at the Lower Silesian Cancer Center in Wroc?aw for vulvar cancer from 1996 to 1998. RESULTS: The stages of disease were as follows: 0--9%, Ia--22%, Ib--16%, II--22% and III--31%. The overall probability of survival was 46.2% at 5 years. The probability of disease-free survival was 40% at 5 years. Recurrence of disease was found in 10 patients (7 cases of local recurrences and 3 cases of dissemination). CONCLUSIONS: The most important prognostic factors were: patients' age, depth of invasion, lymph node status and tumor size. The clinical outcome was strongly influenced by general state of health of patients which makes impossible to perform optimal treatment in many cases. The prognosis in cases in which recurrence occurred is usually poor.     

Study of endometrial maturation under the influence of an oestrogen-progestin combination containing 30 mcg of EE and 150 mcg of desogestrel: the value of biopsy of the endometrium in assessing the efficacy of an oestrogen-progestin combination

Endometrial biopsies were performed on 21 female volunteers aged 18-40 years to evaluate the inhibitory effects of a new contraceptive formulation and the influence of the steroid on 1 of the major target organs. The formulation contained 30 mcg of ethinyl estradiol and 150 mcg of the new progestin desogestrel. The 21 women had taken the OC for at least 3 months. The aspiration biopsies were performed during 3 different cycle phases in 3 different centers in Nice, Bordeaux, and Paris. 5 biopsies done during days 1-9, 5 during days 10-17, and 7 during days 18-23 were retained. Results from the 17 biopsies were remarkably homogeneous for all cycle dates. The endometrium was constantly hypotrophic, the glandular tubes were of small size, and signs of glandular secretion were present in 16 of 17 cases with intracellular vacuoles and a visible secretion. Mitosis was observed in the glandular cellule in only 1 case. The stroma were edematous in 9 of 17 cases. The results demonstrated a low estrogenic stimulation and a dominant progestagenic action due to the strong antigonadotrophic and progestagenic properties of desogestrel. The advantages of the new generation of progestins such as desogestrel are obvious from the study. The study also demonstrates the need for endometrial biopsies to characterize the overall effects and climate of combined OCs, since some of the most common markers can provide misleading results.     

子宫恶性肿瘤骨转移八例临床分析

目的 探讨子宫恶性肿瘤骨转移的临床特征、危险因素和预后.方法 回顾性分析2001年3月至2005年6月北京大学人民医院收治的316例子宫恶性肿瘤中发生骨转移的8例患者的临床病理资料.其中,宫颈癌5例,子宫内膜癌3例.结果 （1）骨转移时间：子宫恶性肿瘤诊断后发生骨转移的时间一般在2年内.低分化患者中,平均发生骨转移时间为5.3个月;中～高分化患者,平均发生骨转移时间为21.0个月.（2）骨转移部位：骨盆转移6例,腰骶椎转移4例,肋骨转移1例;单一部位骨转移6例,两处及以上部位骨转移2例.（3）骨转移危险因素：子宫恶性肿瘤骨转移的发生率为2.5%（8/316）,其中特殊病理类型37例中3例（包括宫颈腺癌、子宫内膜奖液性乳头状腺癌、伴有透明细胞癌的子宫内膜样腺癌各1例）发生骨转移,占8.1%;低分化67例患者中3例发生骨转移,占4.5%.特殊病理类型、低分化为发生骨转移的危险因素.（4）治疗及预后：8例发生骨转移的患者中,3例未接受任何治疗或只接受了对症支持治疗,均在6个月内死亡;其他5例患者接受了手术治疗或放、化疗,目前存活4例（生存时间分别为5、5、8、12个月）.结论 子宫恶性肿瘤骨转移一般在诊断后2年内发生,以骨盆和椎骨为主要转移部位,特殊病理类型、低分化为发生骨转移的危险因素.子宫恶性肿瘤发生骨转移者预后不良,积极治疗骨转移可以在一定程度上延长患者的生存时间.     

Detection of cancer of the endometrium

The frequency and severity of endometrial cancer justify the effort of a screening. The screening methods most used currently are based on the microscopical study of the cellular material taken from the uterine cavity. More recently a non-invasive method, the progestative test, has been offered. The results of the screening and the problems raised by the various techniques are discussed.     

建立人子宫内膜异位症动物模型的方法学研究

目的:探讨采用人在位子宫内膜及异位子宫内膜建立子宫内膜异位症动物模型的可行性。方法:取32只NOD/SCID鼠,随机分为两组。将人分泌晚期在位子宫内膜及人异位子宫内膜分别种植于NOD/SCID鼠腹部皮下,为在位内膜组和异位内膜组。于第8周取出其皮下移植物行常规病理及免疫组织化学检查。结果:32只小鼠均存活。在位内膜组有15只小鼠皮下移植物经HE染色可见明显的子宫内膜腺体和间质,成功率为93.75%。腺上皮细胞角蛋白、ki-67染色均阳性,基质细胞波形蛋白染色阳性。而异位内膜移植物仅见到纤维结缔组织。结论:用人在位内膜建立NOD/SCID小鼠子宫内膜异位症模型成功率高,模型性状显著且稳定。     

阿司匹林对异位子宫内膜间质细胞核因子kB表达的影响

目的:研究不同浓度阿司匹林对异位子宫内膜间质细胞中核因子kB(NF- kB)表达的影响。方法:体外培养卵巢巧克力囊肿的异位内膜间质细胞,用免疫细胞化学法鉴定细胞,四甲基偶氮唑蓝(MTT)法检测阿司匹林对内膜间质细胞的抑制作用,应用蛋白印迹方法(Western blot)检测NF-kB的表达。结果:阿司匹林对内膜异位间质细胞生长的抑制呈时间剂量依赖性。对照组和阿司匹林组NF-kB蛋白表达无明显差异(P>0.05),TNF-α组NF-kB蛋白表达明显增高,阿司匹林+TNF-α组NF-kB蛋白表达明显下降,各组间差异有统计学意义(P<0.01)。结论:阿司匹林可以降低由TNF-α引起的NF- kB蛋白的高表达。     

Electrical activity of the smooth muscle of guinea-pig oviduct and effects of catecholamines

The membrane activity of the oviductal smooth muscle cell of the nonpregnant guinea pig was studied intracellularly. The membrane potential was about 50 mV. The cells used were spontaneously active in normal solution. Spontaneous action potentials were recorded from the regions of infundibulum, isthmus, and ampulla of the oviduct. Action potentials were composed of repetitive spikes and a plateau phase and the duration of the plateau phase ranged from 2 sec to 6 sec. The amplitude of the plateau phase was about 20 mV. The shape of the spontaneous action potential obtained from the mesosalpinx differed from that of the oviduct. Adrenaline, noradrenaline, and phenylephrine evoked the excitatory action. In general, small depolarization, increase in spikes on a plateau, and prolongation of the plateau duration occurred because of these drugs. After the treatment with phentolamine, adrenaline inhibited spike generation. Isoprenaline decreased the number of spikes on the plateau and the plateau duration. At higher concentration of isoprenaline, the membrane activity was abolished. The inhibitory effect of isoprenaline was blocked by propranolol. Prostaglandin F2-alpha excited membrane activity. These results indicate that the sympathetic innervation of the oviductal smooth muscle is alpha-excitatory and beta-inhibitory.     

Validation of an Italian version of the prolapse quality of life questionnaire

OBJECTIVE: To validate the italian translated version of the prolapse quality of life questionnaire (P-QOL). STUDY DESIGN: The P-QOL questionnaire was translated into Italian and administered to women recruited from a gynaecology outpatient clinic. All women completed a P-QOL questionnaire at the time of the visit, and were examined in left lateral position using the ICS prolapse score. A second P-QOL questionnaire was posted and completed by women 1 week later. The validity was assessed by measuring levels of missing data, comparing symptom scores with objective prolapse stages and between affected and asymptomatic women. The reliability was assessed by testing internal consistency and stability using 1-week test retest analysis. RESULTS: 132 symptomatic and 61 asymptomatic women were studied. The number of missing items was 2%. P-QOL domain scores were significantly different between symptomatic and asymptomatic women (P<0.001). Severity according to P-QOL strongly correlated with the prolapse size (P<0.01, rho>0.5). All items achieved a Cronbach alpha greater than 0.8. The test retest reliability confirmed a highly significant correlation between the total scores for each domain. CONCLUSION: The Italian version of the P-QOL questionnaire has been validated, providing a reliable, easily comprehensible and valid instrument for the symptomatic assessment of Italian-speaking women with uterovaginal prolapse.