Cavernous hemangioma of the cervix with intractable bleeding. A case report

BACKGROUND: Cavernous hemangioma of the cervix is rare and may cause serious bleeding. CASE: A 33-year-old woman developed intractable cervical bleeding following pregnancy termination. Bleeding persisted despite curettage and suturing, and ultimately required hysterectomy. Cavernous hemangioma was confirmed histologically. CONCLUSION: This condition is a potential cause of uncontrollable cervical bleeding.     

Changes of serum pyruvate and lactate in open-heart surgery

In 20 patients under extracorporeal bypass, a study was undertaken of the changes in plasma of lactate and pyruvate, the lactate/pyruvate ratio and the lactate excess. A decrease has been found in the pyruvate and an increase in the other values lasting for the first days of the post-operative period. The causes may be many, such as changes in the oxidation potential, blood transfusions and liver function, and these may be manifested in an increase in the serum glutamic oxalacetic transaminase, glutamic pyruvic transaminase, lactic dehydrogenase, and gamma-glutamyl transpeptidase.     

Comparison of response to serotonin of radial artery grafts and internal mammary grafts to native coronary arteries and the effect of diltiazem

We studied the response of radial artery (RA) or left internal mammary artery grafts to the intraluminal infusion of serotonin in 22 consecutive patients 1 year after the operation, subsequently evaluating the effect of diltiazem in 9 patients. Serotonin causes a significant vasoconstriction of the RA grafts, but not of the left internal mammary artery grafts, whereas oral diltiazem treatment does not prevent the effect of the higher dose of serotonin on RA grafts.     

Long-term safety of growth hormone replacement therapy after childhood medulloblastoma and PNET: it is time to set aside old concerns

To assess the long-term safety of administering growth hormone (GH) in patients with GH deficiency due to treatment for childhood medulloblastoma and primitive neuroectodermal tumor (PNET). Data were retrospectively retrieved on children receiving GH supplementation, assessing their disease-free and overall survival outcomes and risk of secondary malignancies using Kaplan–Meier and Cox models. Overall 65 children were consecutively collected from May 1981 to April 2013. All patients had undergone craniospinal irradiation (total dose 18–39 Gy), and subsequently received GH for a median (interquartile range, IQR) of 81 (50.6–114.9) months. At a median (IQR) of 122.4 months (74.4–149.5) after the end of their adjuvant cancer treatment, two patients (3?%) experienced recurrent disease and 8 (12.3?%) developed secondary malignancies, all but one of them (an osteosarcoma) related to radiation exposure and occurring within the radiation fields. There was no apparent correlation between the administration of GH replacement therapy (or its duration) and primary tumor relapse or the onset of secondary malignancies [HR: 1.01 (95?% CI: 0.98, 1.03) for every additional 12 months of GH supplementation; p?=?0.36). At univariate analysis, the large cell or anaplastic medulloblastoma subtype, metastases and myeloablative chemotherapy correlated with a higher risk of secondary malignancies (p?<?0.1), but multivariate analysis failed to identify any factors independently associated with this risk. Our data supports once more the safety of long-term GH replacement therapy in children treated for medulloblastoma/PNET, previously reported in larger data sets. The neurooncology community now need to warrant large-scale meta-analyses or international prospective trials in order to consolidate our knowledge of factors other than GH, such as genetic predisposition, high-grade/metastatic disease, high-dose chemotherapy and era of treatment, in promoting the occurrence of secondary malignancies.     

Pulsatile normothermic cardiopulmonary bypass and plasma catecholamine levels

The aim of the study was to assess plasma catecholamine levels in patients undergoing myocardial revascularization and relate them to pulsatile (P) and nonpulsatile (NP) normothermic cardiopulmonary bypass (CPB). Twenty-eight patients were randomly assigned to different CPB management: 15 patients were assigned to group 'P', 13 patients to group 'NP'. During normothermic extracorporeal circulation, group 'P' received pulsatile perfusion, while group 'NP' received nonpulsatile perfusion. Levels of epinephrine and norepinephrine were evaluated during the operation and in the intensive care unit (ICU), at seven time points. Haemodynamic assessment was performed at four time points in the same period. Demographic and surgical data were collected, and the postoperative course was analysed. Epinephrine levels were markedly increased during CPB in both groups, while norepinephrine increased more in group NP in comparison with group P. No significant difference was found in fluid administration, transfusion, drugs usage, or postoperative complications. Normothermic pulsatile CPB seems to achieve reduced levels of norepinephrine. A clinical beneficial effect of this finding was not demonstrated during the study.