Expression of CPEB,GAPDH and U6snRNA in cervical and ovarian tissue during cancer development

Persistent infection with high‐risk human papillomavirus (HPV) and expression of the proteins E6 and E7 is a prerequisite for development of cervical cancer. The distal non‐coding part of E6/E7 messengers from several HPV types is able to downregulate synthesis of a reporter gene through mechanisms with involvement of cytoplasmic polyadenylation elements (CPEs) in the messengers. We here show that the mRNA levels of one of the four known CPE‐binding proteins (CPEBs), the CPEB3, were downregulated in HPV‐positive cervical cancers, whereas in ovarian cancer the CPEB1 mRNA level was downregulated. In addition, we showed that the RNA levels of the widely used reference marker GAPDH were upregulated in both cancer forms, and the level of the reference marker U6snRNA was upregulated in cervical cancers. Moreover, a possible correlation between the degree of U6snRNA upregulation and cervical cancer propagation was shown. These changes observed in CPEB1 and CPEB3 might indicate regulatory functions of CPEBs in cancer development of HPV‐positive and HPV‐negative tumors, respectively, and the U6snRNA, GAPDH mRNA and CPEB1 mRNA levels may be useful as tumor markers for genital cancers although further investigations are needed.     

硫酸皮肤素在分娩前后子痫前期患者体内变化情况分析

目的探讨硫酸皮肤素(DS)在分娩前后子痫前期患者体内的变化情况。方法选择2010年3～12月在大连市妇产医院产科病房住院并拟行剖宫产的轻度子痫前期患者40例(轻度组)和重度子痫前期患者40例(重度组)及同期住院并拟行剖宫产的正常妊娠晚期妇女40例(对照组)为观察对象,采用发色底物法检测观察对象分娩前后体内DS抗凝活性。结果 (1)产前血浆DS含量:重度组为(0.272±0.075)μg/ml、轻度组为(0.223±0.038)μg/ml、对照组为(0.216±0.032)μg/ml,重度组较轻度组和对照组均明显增高(P<0.05),轻度组与对照组比较差异无统计学意义(P>0.05)。(2)产后血浆DS含量:重度组为(0.105±0.06)μg/ml、轻度组为(0.096±0.067)μg/ml、对照组为(0.083±0.064)μg/ml,3组产妇血浆DS含量较产前均明显降低(P均<0.05),且均恢复接近正常,而重度组较轻度组和对照组仍轻微增高,但无统计学差异(P>0.05)。结论子痫前期患者体内DS水平增高,分娩后降低;DS可作为监测子痫前期患者病情严重程度的指标。     

Cartilaginous symphysis pubis cysts: report of two cases, technique for removal, and review of the literature

Cartilaginous symphysis pubis cysts are rare. There are 7 cases previously reported in the literature. Patients are commonly asymptomatic or may present with a slow-growing, painless vulvar mass, voiding difficulty, and/or dyspareunia. Two cases were managed at our center over 5 years. We present these 2 cases, a surgical technique for removal, a summary of all reported cases, and some perspectives on the pathophysiologic mechanisms for the origin of this lesion.     

Hemorrhagic complication during placement of tension-free vaginal tape

A 66-year-old para III with a 20-year history of stress urinary incontinence underwent placement of tension-free vaginal tape. Intraoperative arterial bleeding occurred. An expanding hematoma was palpated postoperatively. Interventional radiology performed a pelvic arteriogram with selective bilateral internal iliac arteriograms, a supraselective anterior division and obturator arteriogram, a left external iliac arteriogram, coil embolization of a branch of the left obturator artery, and gel foam embolization of the anterior division of the left internal iliac artery.     

Life‐Space Assessment in Urogynecology and Gynecological Oncology Surgery Patients: A Measure of Perioperative Mobility and Function

OBJECTIVE: To assess the effect of gynecological surgery on mobility and functional status in women aged 60 and older using Life‐Space Assessment (LSA). DESIGN: Observational prospective cohort study. SETTING: Academic outpatient urogynecology and gynecological oncology clinics. PARTICIPANTS: Women presenting for urogynecology (n=51) and gynecological oncology (n=51) surgery. MEASUREMENTS: LSA scores 6 weeks, 6 months, and 1 year after surgery. Information on participant demographics, preoperative diagnoses, surgical approach, and medical comorbidities was collected. Analyses used repeated measures. RESULTS: Mean age was 71 ± 7. Urogynecology participants started and maintained a higher LSA (P=.03) than oncology participants at all study intervals. Six weeks after surgery, urogynecology and oncology participants' mean decline was 13 points (95% confidence interval (CI)=4–21; P=.004) and 23 points (95% CI=13–33; P<.001), respectively. At 6 months, the urogynecology and oncology participants' scores increased by a mean of 9 points (95% CI=1–17; P=.03) and 13 points (95% CI=5–20; P=.001), respectively. No significant difference was found 1 year from baseline within each group or between groups in LSA scores. Income, depression, body mass index, and having an operative complication predicted a larger decline in life‐space over time in both groups. CONCLUSION: Gynecological surgical interventions in older women limit physical and functional ability at 6 weeks after surgery. The urogynecology and gynecological oncology cohorts returned to baseline levels by 6 months, which was sustained to 1 year.     

An International Series on Abdominal Radical Trachelectomy: 101 Patients and 28 Pregnancies

OBJECTIVES: Abdominal radical trachelectomy (ART) is a type C resection (uterine vessels ligated at origin from the hypogastric vessels). Questions arise as to whether fertility is maintained after ART, particularly when uterine vessels are sacrificed. We report an international series on ART to describe fertility and oncologic outcomes. METHODS: Databases at 3 institutions were queried to identify patients planned for ART from 1999 to 2011. Clinical and demographic data were gathered. RESULTS: One hundred one patients underwent ART. Mean age was 31 years (range, 19-43 years). Histologic classifications were adenocarcinoma (n = 54), squamous cell carcinoma (n = 40), adenosquamous carcinoma (n = 6), and clear cell carcinoma (n = 1). Twenty patients (20%) required conversion to hysterectomy (10 margins and 10 nodes). Eight patients underwent completion hysterectomy owing to the following: positive margins on final pathology (n = 3), patient's choice (n = 4), or recurrence (n = 1). Postoperatively, 20 patients (20%) received adjuvant chemotherapy and/or radiation (4 final pathology margins and 16 nodes). Four patients (4%) had recurrence and lived 22 to 35 months after diagnosis. Of the 70 women who had neither hysterectomy nor adjuvant therapy, 38 (54%) attempted pregnancy and 28 (74%) achieved pregnancy. Thirty-one pregnancies resulted in 16 (52%) third trimester deliveries. Six patients are currently pregnant with outcomes pending. CONCLUSIONS: These data demonstrate that ART preserves fertility and maintains excellent oncologic outcomes. Most women (74%) attempting pregnancy after ART are able to achieve pregnancy and deliver in the third trimester (52%). Preservation of the uterine vasculature is not necessary for fertility; obstetrical outcomes are similar to those of the historical vaginal radical trachelectomy cohorts.